title: Prior incarceration and barriers to receipt of services among entrants to alternative to incarceration programs: a gender-based disparity.
abstract: The high levels of health and psychosocial needs among correctional populations strongly shape the well-being of the urban communities from which a large number of criminal justice-involved individuals come or to which they return. The benefits of providing services to correction-involved individuals and linking them to providers such as with alternative to incarceration (ATI) programs may be limited if they encounter difficulties accessing such services. This study identified the types of barriers that have prevented entrants into ATI programs from receiving health and psychosocial services. We then tested the association between number of prior incarcerations and number of barriers by gender. From a random sample of adults (N = 322; 83 women and 239 men) entering ATI programs in New York City, data were collected via structured interviews that elicited self-reported sociodemographics, substance use, prior incarcerations, and barriers that had actually prevented a participant from visiting or returning to a service provider. Participants reported an average of 3.0 barriers that have prevented them from receiving health and psychosocial services. The most prevalent barriers predominantly concerned service providers' inability to accommodate constraints on participants' time availability or flexibility, transportation, and money. Compared to women, men had a significantly different association that was in the adverse direction--i.e., more prior incarcerations was associated with more barriers--between prior incarcerations and encountering service barriers. Findings indicate that ATI program entrants experience many barriers that have prevented them from receiving health and/or psychosocial services. Furthermore, men with more extensive incarceration histories particularly are disadvantaged. ATI programs can improve the public health of urban communities if such programs are prepared and resourced to facilitate the receipt of services among program participants, especially men who have more extensive incarceration histories.
authors.affiliation: Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, USA. ew157@columbia.edu
authors.forename: Elwin
authors.initials: E
authors.lastname: Wu
authors.forename: Nabila
authors.initials: N
authors.lastname: El-Bassel
authors.forename: Louisa
authors.initials: L
authors.lastname: Gilbert
authors.forename: Leona
authors.initials: L
authors.lastname: Hess
authors.forename: Hae-Nim
authors.initials: HN
authors.lastname: Lee
authors.forename: Tawandra L
authors.initials: TL
authors.lastname: Rowell
mesh_terms: D000328:Adult; D003416:Criminal Law / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009519:New York City; D011287:Prejudice; D011446:Prospective Studies; D012737:Sex Factors; D019966:Substance-Related Disorders; D011795:Surveys and Questionnaires