Improving Linkage to Health and Other Services for Veterans Leaving Incarceration
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 12/22/2018 |
| Start Date: | November 27, 2017 |
| End Date: | September 30, 2020 |
| Contact: | Donald K McInnes, ScD MS BA |
| Email: | Keith.McInnes@va.gov |
| Phone: | (781) 687-3507 |
Veterans Justice Reentry (Post-Incarceration) (QUE 15-284)
Veterans leaving incarceration and re-entering their communities (often described as
"reentry" Veterans) face a number of challenges, including uncertainty about housing,
vulnerability to substance use and relapse, on-going mental health concerns, and often
multiple health conditions require timely continuity of care. The purpose of the project is
to increase support for Veterans post-incarceration through the addition of trained peers
with lived experience of being a Veteran and a history of incarceration. Emphasis will be on
peers who will help link Veterans to Veterans Health Administration (VHA) services, including
housing and healthcare. Peers will provide linkage with Health Care Reentry Veterans program
specialists, transportation to appointments, and support in community reintegration. Peers
will assist reentry veterans to make a successful transition and get and stay engaged in
their care.
"reentry" Veterans) face a number of challenges, including uncertainty about housing,
vulnerability to substance use and relapse, on-going mental health concerns, and often
multiple health conditions require timely continuity of care. The purpose of the project is
to increase support for Veterans post-incarceration through the addition of trained peers
with lived experience of being a Veteran and a history of incarceration. Emphasis will be on
peers who will help link Veterans to Veterans Health Administration (VHA) services, including
housing and healthcare. Peers will provide linkage with Health Care Reentry Veterans program
specialists, transportation to appointments, and support in community reintegration. Peers
will assist reentry veterans to make a successful transition and get and stay engaged in
their care.
Veterans leaving incarceration (henceforth, "reentry Veterans") are among the most
underserved by the VA and thus are an increasingly high priority population. The Bureau of
Justice Statistics estimates that 140,000 Veterans are incarcerated in the U.S. at a given
time, approximately 80% of whom are eligible for VA benefits. Many of these Veterans had
problems with substance use disorders (SUD)(including alcohol) and/or mental health (MH)
issues prior to being incarcerated.
The VA's national Health Care for Reentry Veterans (HCRV) program identifies 10,000-15,000
incarcerated Veterans annually preparing to transition back to the community. A HCRV outreach
specialist works with incarcerated VHA-eligible Veterans to establish a post-release plan for
linkage to VHA services. This program, with 1-2 outreach specialists per state, has improved
the connection between reentry Veterans and the VHA. However, the investigators' analyses of
homeless program data linked to VHA administrative data indicate that 43% of eligible HCRV
Veterans do not have a VHA outpatient contact in the first 4 months post incarceration.
Reducing this number is critical given the elevated rates of chronic health conditions, as
well as MH or SUDs in this population.
To address this gap, the investigators will work with the national HCRV office to implement
an evidence-based peer support intervention to extend the reach and effectiveness of the HCRV
program in linking Veterans to VHA. Peers with incarceration experience are likely to better
understand and connect with Veterans on a personal level than the outreach specialist, and
thus are more likely to maintain contact and link to VHA during the first months
post-release. Peers are gaining popularity in forensic settings (called "forensic peer
specialists") with civilian populations and would likely be beneficial for a Veteran
population .
The aims of this project are:
1. Conduct contextual analysis to identify VHA and community reentry resources, and to
describe how reentry Veterans use them.
2. Implement peer-support, in one state, to link reentry veterans to VHA primary, mental
health, and SUD services. The investigators will use external and internal facilitation
as the implementation strategy.
3. Spread the peer-support intervention to another, geographically, and contextually
different state.
underserved by the VA and thus are an increasingly high priority population. The Bureau of
Justice Statistics estimates that 140,000 Veterans are incarcerated in the U.S. at a given
time, approximately 80% of whom are eligible for VA benefits. Many of these Veterans had
problems with substance use disorders (SUD)(including alcohol) and/or mental health (MH)
issues prior to being incarcerated.
The VA's national Health Care for Reentry Veterans (HCRV) program identifies 10,000-15,000
incarcerated Veterans annually preparing to transition back to the community. A HCRV outreach
specialist works with incarcerated VHA-eligible Veterans to establish a post-release plan for
linkage to VHA services. This program, with 1-2 outreach specialists per state, has improved
the connection between reentry Veterans and the VHA. However, the investigators' analyses of
homeless program data linked to VHA administrative data indicate that 43% of eligible HCRV
Veterans do not have a VHA outpatient contact in the first 4 months post incarceration.
Reducing this number is critical given the elevated rates of chronic health conditions, as
well as MH or SUDs in this population.
To address this gap, the investigators will work with the national HCRV office to implement
an evidence-based peer support intervention to extend the reach and effectiveness of the HCRV
program in linking Veterans to VHA. Peers with incarceration experience are likely to better
understand and connect with Veterans on a personal level than the outreach specialist, and
thus are more likely to maintain contact and link to VHA during the first months
post-release. Peers are gaining popularity in forensic settings (called "forensic peer
specialists") with civilian populations and would likely be beneficial for a Veteran
population .
The aims of this project are:
1. Conduct contextual analysis to identify VHA and community reentry resources, and to
describe how reentry Veterans use them.
2. Implement peer-support, in one state, to link reentry veterans to VHA primary, mental
health, and SUD services. The investigators will use external and internal facilitation
as the implementation strategy.
3. Spread the peer-support intervention to another, geographically, and contextually
different state.
Inclusion Criteria:
Phase 1
- Veteran released from a Massachusetts state prison
- (for intervention subjects: interested in receiving reentry services) Phase 2
- Veteran released from a Pennsylvania state prison
- (for intervention subjects: interested in receiving reentry services)
Exclusion Criteria:
- No history of dementia or other serious cognitive condition that would prevent them from
being interviewed or completing a survey questionnaire.
We found this trial at
1
site
Bedford, Massachusetts 01730
Principal Investigator: Allen L. Gifford, MD
Phone: 781-687-3507
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