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Bazelon Center's Blueprint for Community Reentry of Inmates With Mental Illnesses
Psychiatric Services 2009; doi:
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A new publication from the Bazelon Center for Mental Health Law provides state and local officials and corrections administrators a blueprint for linking inmates who have psychiatric disabilities to federal benefits promptly upon their release. Lifelines: Linking to Federal Benefits for People Exiting Corrections walks users through steps for aligning complex rules of federal benefit programs to state and local policies to create a system of services and support.

Approximately 16% of all prison and jail inmates have a serious mental illness, and more than half have a clinical diagnosis, a treatment history, or symptoms of mental illness, according to research cited in Lifelines. Within 18 months of release, 64% of those with mental illnesses are rearrested—more than twice the rate of those without mental illnesses. Entitlements such as Medicaid and Medicare, veterans benefits, and Social Security income support enable individuals to obtain mental health care, housing, and other services. Without assistance, released inmates often wait months for benefits—a major factor in their high recidivism rate. However, only a third of inmates nationally receive benefits restoration planning.

Lifelines is divided into three volumes. The 14-page first volume lays out a strong case for undertaking an initiative to link inmates with benefits as part of a broader strategy for successful reentry. It addresses the high cost of doing nothing and summarizes promising outcomes from benefits restoration programs in several states. The 48-page second volume presents a blueprint for action at three levels—the state, the local government, and the correctional facility. A recommended first step for state officials is to hold a conference to garner political and stakeholder support and identify policy options with the greatest impact. The blueprint details steps for creating an interagency planning group and then for setting up a simplified benefits application process with coordinated forms and an electronic system. An online link to an example of such a system in Pennsylvania is provided.

A core state-level responsibility is to make needed changes in state policies on benefits, which may involve setting up prerelease agreements with the Social Security Administration, creating state policies to suspend—rather than terminate—Medicaid and welfare benefits during incarceration, and passing state laws to create a bridge program that will provide funds to released inmates whose benefits are pending. The blueprint even describes a process for ensuring that staff members from the Department of Motor Vehicles visit the jail or prison to issue licenses and identification documents.

Three recommendations are directed to mental health agencies to ensure a smooth transition. Agencies should review lists of arrested individuals to follow up with existing clients. A reimbursement stream is needed to permit case managers to visit clients for discharge planning. Mechanisms are required to allow staff—peers, if possible—to meet individuals upon release and accompany them to benefit offices. Recommendations at the correctional facility level call for training, oversight and evaluation, and cost-versus-benefit reporting to government agencies. The bulk of volume 2 is devoted to an action plan for county and municipal governments to put revised state policies into effect and ensure collaboration between local jails and community agencies.

The third volume of Lifelines is a 34-page appendix that explains federal rules on benefit programs, discusses ways for corrections and mental health systems to share health information, and offers an extensive list of links to model policies and other resources. The volumes can be downloaded or purchased from the Bazelon Center's Web site at www.bazelon.org.




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