Development of a health-related social need screener for adults soon to be, and recently released, from incarceration.

backgroundA history of incarceration is associated with poor overall health and increased health care utilization and costs. The challenges facing people recently released from prison vary by age, gender, and reason for incarceration. Better identification and management of the needs facing this population is critical for both state departments of correction, tasked with ensuring effective re-entry into the community, and for the health care system, tasked with caring for a population with potentially high and costly utilization. A justice systems-focused screening tool tailored to the social needs specific to the soon-to-be released and recently released adult incarcerated population could better assist transition planning and risk assessment.

methodsWe identified social needs for a justice systems-focused screening tool through interviews and focus groups with adults incarcerated in Indiana state prisons, individuals with lived experience of past incarceration, and individuals who work professionally with the justice system. Through content and face validation, we reduced candidate needs to a relevant set and adapted language from existing screening items to be appropriate for the population.

resultsThe finalized tool included 25 needs in the following domains: Material resources, Access to health services, Economic resources and opportunities, Competencies, and Relationship management. Needs reflecting material resources, including their availability, accessibility, and ability to be secured, were among the most frequently identified. Health services, particularly mental health and substance use services, were identified in every interview and focus group as particularly important during a person’s transition home. Individuals identified employment as a need, but also noted the importance of programs and social supports when individuals returning home did not have access to their own financial resources. Competencies included skills and abilities important to successful reentry, such as coping skills, digital literacy, health literacy, financial literacy, general literacy, knowledge of parole conditions, and job readiness.

conclusionsIndividuals recently released from incarceration faced an expansive and varied set of social needs. Many needs mirrored the social needs prioritized in the health care system for all patients, but several factors were unique to those with a history of incarceration. Information about the social needs could support connection to services, identification of trends, and allocation of resources.