An audit study of barriers to mental health treatment for wrongly incarcerated people.

Objective: People who have been wrongly incarcerated report exceptionally poor mental health, and despite having been exonerated, they face discrimination similar to other formerly incarcerated people when seeking housing and employment opportunities. The current audit study was designed to test whether exonerees likewise face discrimination when seeking mental health treatment.

Hypotheses: Therapists will reply less often to treatment inquiries from exonerees and parolees compared to another prospective client with the same symptoms and trauma history-and when therapists do reply, they will less often be willing to meet with exonerated or paroled help seekers.

Method: We emailed 752 therapists across the United States while posing as a man seeking therapy for the mental health symptoms most commonly reported by exonerees. By random assignment, this help seeker had been either incarcerated and paroled, wrongly incarcerated and exonerated, or working as a first responder (control). For each email, we noted whether the therapist replied and, if so, the speed and length of the reply. We also content analyzed all replies for predetermined themes, including willingness to meet.

Results: Overall, therapists replied less often to exonerees (50.6%) than to first responders (62.9%) or parolees (61.1%), who did not differ (V = .11). Therapists' replies also differed in their willingness to meet (V = .13), such that inquiries from first responders would more often result in a meeting with a therapist (31.7%) compared with inquiries from exonerees (19.6%) or parolees (21.0%).

Conclusions: Exonerees' staggering rates of mental illness may be compounded by lesser treatment access. Therapists' reluctance to assist exonerees may reflect stigma and/or perceived incompetence. Our data highlight the need to destigmatize wrongful conviction, empower clinicians to treat exonerated clients, and advance legislation and other means to expand exonerees' access to mental health care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).