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'Circles' could offer promising outcomes after incarceration for people with serious mental illness

In the United States, adults with a serious mental illness make up a disproportionate number of inmates in prisons. While an estimated 10.4 million American adults have a serious mental illness—4.2 percent of the general population—people with a serious mental illness comprise 16 percent of the prison population. To address the unique needs of individuals with mental illness and a history in the justice system, investigators at the Temple University Collaborative on Community Inclusion have devised a program that would support people with serious mental illnesses after they are released from prison.

The support program, outlined in a paper published in November by the American Journal of Orthopsychiatry, suggests that individuals with mental illnesses who are transitioning back into society after a period of incarceration would benefit from participating in “circles of support and accountability.” According to the paper’s author, Elizabeth Thomas, assistant professor of research in Rehabilitation Sciences, “circles” entail a regular group session in which community members—friends, neighbors, or other formerly incarcerated individuals with mental illnesses—meet and discuss how an individual with a psychiatric disability can tackle challenges related to reforming life after a period spent in prison.

Issues discussed can range from how the “focal” person (the individual who has recently been released from prison) can find a job, reconnect and build relationships or get involved in community activities. Community members then commit to helping the focal person with a given goal, like accompanying the focal person to a sporting event he or she wants to attend.

Thomas and her colleagues’ analysis suggests that, as an intervention, the circle model may increase community integration—a metric that has been shown to be related to a formerly incarcerated person’s likelihood to return to prison— because it supports individuals with active participation in the community, expands and develops social networks, and stresses the use of democratic dialogue to solve problems.

“People with a justice system history who have psychiatric disabilities face more than one barrier to community integration, because of their status as having a mental health condition and the stigma that comes with that as well as the barriers that can come with being involved in justice system,” said Thomas.

According to Thomas and her co-authors, circles have been previously shown to increase the levels of community integration among individuals with a serious health condition as well as individuals with a criminal history. The intervention has been implemented by justice system experts in Great Britain, Canada, Australia and New Zealand. “Based on research that has been done with other populations, circles seems promising for people with a serious mental illness and a justice system history,” she said.

Evidence substantiating the framework that Thomas’ paper lays out has not yet been published, but Yaara Zisman-Ilani, assistant professor of Rehabilitation Sciences, is leading a study that aims to elucidate whether or not the promise of the circles of support model is borne out in practice.

“More than 25 percent people who receive public mental health services will be involved in the justice system,” said Thomas. “These interventions could address a lot of the issues that can cause people with serious mental illness to end up returning to prison.”

Learn more about the Temple University Collaborative on Community Inclusion. 

— Tara W. Merrigan

Posted:  January 16, 2019