As the country tries to shrink its aging prison population, the inmates being released after years locked away often have mental illnesses and addictions that can land them back in prison if untreated. Peer health workers are central to an approach connecting former inmates to services and helping them navigate life outside.
“We’ve always known incarceration is bad for health,” said Leah G. Pope, director of the substance use and mental health program at the Vera Institute of Justice, a research and advocacy group. “But in an age of increasing attention to justice reform and health care reform, the two are increasingly connected.”
Prisons and jails are constitutionally mandated to provide health care, but that responsibility ends upon release. For those getting out, the first two weeks are particularly perilous.
A study in Washington State published in The New England Journal of Medicine in 2007 found that former inmates are 12 times likelier to die than other state residents in the two weeks following their release, especially of lethal overdoses, a risk factor confirmed by later studies.
Access to health care can be a roll of the dice: Medical discharge plans vary from nonexistent to prisons with dedicated planners who coordinate health insurance and medical appointments before release. Most of the 32 Medicaid expansion states suspend, rather than terminate, coverage for inmates who previously had it and send them out with an insurance card when they leave.
“There’s mistrust combined with a lack of knowledge about navigating the health system,” said Joseph Calderon, a Transitions worker. “In our communities, people are taught how to take care of their cars but not how to take care of their health.”
Many ex-offenders ignore chronic conditions and wind up in costly emergency rooms or hospitalized for preventable conditions.
From The New York Times.
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