They Judge You By Your Incarceration: A Qualitative Study of Mistrust Among Formerly Incarcerated People Navigating Mental Health Care

The goal of this paper is to explore the experiences of formerly incarcerated people navigating mental health care post-release and understand how mistrust of mental health services and providers is manifested among this population. Interviews were conducted between 2021 and 2022 with 25 people released from incarceration within the past five years. We partnered with community organizations to recruit a diverse sample of participants, using voluntary response and purposive sampling. The interview transcripts were coded using a modified grounded theory approach and the analysis further guided by critical phenomenology in order to center silenced or marginalized perspectives. Mistrust of mental health care was a prominent theme across interviews. Overall, participants felt that they did not have autonomy over their treatment planning and management. Participants described experiencing stigmatizing treatment from providers, suspicion of mandated mental health treatment, and believing that profit over patients was prioritized in the industry–all of which contributed to growing mistrust of the larger mental health system. The participants’ experiences of losing control over their lives and treatment, compounded by a perceived complicity between mental health and carceral systems, shaped their mistrust toward mental health care. Nevertheless, many demonstrated remarkable persistence in seeking care and engaging with multiple providers, while also actively seeking to reclaim their autonomy.