Re-entry Post Incarceration

Where We Stand

NAMI believes that all people with mental health conditions deserve access to supports that promote wellness. NAMI supports comprehensive re-entry policies and programs for people with mental illness who are returning to their community after a period of incarceration.

Why We Care

People with mental illness are overrepresented in our nation’s criminal justice system. Of the over 2 million people held in our nations jails and prisons, nearly 2 in 5 have a history of mental illness (37% in state and federal prisons and 44% held in local jails). Of those who are incarcerated, 95% will one day be released and will face a variety of challenges as they re-enter their communities. Health care often takes the backburner as they deal with more pressing needs, like housing, food security, reconnecting with family members and finding employment.

Re-entry — the period of return to a community from incarceration — can be marked by heightened stress, isolation and hardship. For people with mental illness and substance use disorders (SUD), there is increased vulnerability and risk. Nationally, about 80% of individuals released from prison in the U.S. each year have a chronic medical, substance use, or psychiatric condition.

Due to the lack of timely access to critical services and supports for their health or mental health condition, these individuals are at a higher risk of repeated incarceration. In fact, the risk of death by suicide or opioid overdose, dramatically increases in the first days and weeks after an individual is released from jail or prison. According to one study, the risk of a fatal drug overdose is 129 times higher for individuals returning to the community than for the general population.

Successful re-entry begins in the weeks and months before someone is released. Gaining access to housing, social supports (food, employment, education) and community supports (family, friends, social networks) are all critical for successful reintegration. Access to mental and physical health care is equally important. Research suggests that those who have health care coverage upon re-entry are more likely to engage in services and supports that reduce recidivism.

Public policies should encourage comprehensive re-entry planning, including:

• Providing a warm handoff to community-based mental health and substance use disorder care
• Increasing access to medications
• Connecting to supports, like housing and food assistance

These policies will more effectively address mental health care needs immediately before and during re-entry — and help save lives.

How We Talk About It

• Jails and prisons are at the center of America’s mental health crisis, too often serving as the sole providers of mental health care for the more than 2 million people who are incarcerated.
• About two in five people currently incarcerated have a history of mental illness — a rate twice as high as the average in this country — and they often don’t have access to adequate mental health care, if any, while justice-involved.
• When a person with a mental health condition is released, they face additional challenges as they re-enter their community, including increased risk for overdose and death by suicide in the weeks following release.
• Providing comprehensive re-entry planning and facilitating a warm hand-off to community mental health services and supports can save lives.
• Without connections to community supports and health care, recently released individuals are also at a higher risk of recidivism — a return to justice-system involvement.
• In order to reduce the arrests and jailing of people with mental illness, we must also disrupt the cycle of incarceration for people with mental illness. We can do this by supporting successful re-entry.
• Public policies should encourage comprehensive re-entry planning that increases access to mental health services and supports, which improve a person’s health, well-being and successful reengagement in the community.

What We’ve Done

• HARP-NAMI Report, “Paving the Path to Healthier Reentry: How New Medicaid Policies Can Improve Mental Health and Substance Use Support as People Return to Communities”
• NAMI Report, “Divert to What? Community Services that Enhance Diversion”
• NAMI Infographic, Mental Illness and The Criminal Justice System
• NAMI is a supporting partner of the Stepping Up Initiative, which works to divert people with mental illness from the criminal justice system.
• NAMI public policy positions related to Crisis Response, Medicaid Coverage for People Who are Incarcerated, Physical and Mental Health Integration, Criminalization of Mental Illness and Social Determinants of Health.