Risk Environments of Permanent Supportive Housing for Formerly Incarcerated People with Serious Mental Illnesses: A Protocol for a Novel Mixed Methods Feasibility Study.

Abstract

Background: Formerly incarcerated people with serious mental illnesses (SMI) experience the criminal legal system unequally and have elevated rates of recidivism, homelessness, general medical problems, and substance use disorders. Permanent supportive housing (PSH) can be used during reentry, but it has limited resources for addressing community integration, a key component of reentry. PSH are often located in high-poverty environments with increased criminogenic risk. The geography of PSH also includes public spaces, which are associated with positive outcomes. The risk environment framework provides a structure for understanding the geography of PSH through its focus on the physical, social, economic, and policy influences on the micro and macro environments of reentry.

Methods: This is a novel QUAL + QUAN (spatial) concurrent mixed-methods study that will examine how individual, interpersonal, and environmental factors interact with public and private spaces to inform reentry wellbeing. Eighty multi-method interviews (i.e., qualitative, quantitative, and participatory mapping methods) will be conducted with formerly incarcerated clients with SMI. Go-along interviews will be conducted with 20 of these participants. Participatory mapping will be geocoded and sites identified as places of importance, frequent participation, and belonging will be evaluated in relation to objective features of spaces to develop a community resilience index. Findings will ultimately be integrated into an intervention development codesign process with a community advisory board.

Discussion: During reentry, individual, interpersonal, and environmental factors can interact with these environments to produce or reduce risk. If addressed, these factors can contribute to reentry wellbeing, through improved community participation and treatment engagement and reduced psychiatric distress and substance use.