The ability of inmates to secure stable, legal employment for themselves upon release from prison has been shown to be a crucial element for successful community reintegration. These individuals, however, often fail to find employment due to a multitude of personal, relational, structural, and institutional barriers. Formerly incarcerated women are particularly disadvantaged in this respect, given their high rates of psychiatric and substance abuse disorders, and history of domestic violence in conjunction with low educational attainment and limited employment skills. The main goal of the current study was to delineate the relative importance of a variety of personal factors as determinants of stable employment for female inmates. Data were collected as part of a population survey of female inmates in new jersey (N = 908). Female inmates who volunteered to participate in this study were asked to complete a short survey that included questions about their educational and work histories, their work skills, as well as their history of need in and treatment for behavioral health services. Findings from this study underscore the importance of both education and treatment for behavioral health problems as key determinants of stable employment. Recommendations for possible interventions are addressed.

People in prison are exposed to and experience sexual violence inside prisons, further exposing them to communicable diseases and trauma. The consequences of sexual violence follow the individual into the community upon release. This paper estimates the prevalence of sexual victimization within a state prison system. A total of 6,964 men and 564 women participated in a survey administered using audio-CASI. Weighted estimates of prevalence were constructed by gender and facility size. Rates of sexual victimization varied significantly by gender, age, perpetrator, question wording, and facility. Rates of inmate-on-inmate sexual victimization in the previous 6 months were highest for female inmates (212 per 1,000), more than four times higher than male rates (43 per 1,000). Abusive sexual conduct was more likely between inmates and between staff and inmates than nonconsensual sexual acts. Sexual violence inside prison is an urgent public health issue needing targeted interventions to prevent and ameliorate its health and social consequences, which spatially concentrate in poor inner-city areas where these individuals ultimately return.

This study estimates prevalence rates of inmate-on-inmate and staff-on-inmate physical victimization. Inmate subjects were drawn from 13 adult male prisons and 1 female prison operated by a single mid-Atlantic state. A total of 7,221 men and 564 women participated. Rates of physical victimization varied significantly by gender, perpetrator, question wording, and facility. Prevalence rates of inmate-on-inmate physical violence in the previous 6 months were equal for males (205 per 1,000) and females (206 incidents per 1,000). Males had higher rates of physical violence perpetrated by staff (246 per 1,000 vs. 83 per 1,000). By facility, inmate-on-inmate prevalence rates ranged from 129 to 346 per 1,000, while the range for staff-on-inmate was 83 to 321 per 1,000.

Unemployment rates remain high among individuals with psychiatric disabilities despite growing evidence that supported employment programs (SEPs) can help such individuals to obtain and retain competitive employment. A complete understanding of factors that may facilitate or hinder the success of such supported employment efforts is urgently needed to increase the efficacy of SEPs and move more individuals with psychiatric disabilities from welfare to work. This exploratory study provides insight into provides insight into potential facilitators and barriers to employment among individuals with psychiatric disabilities from the perspective of job coaches. Twenty-eight job coaches from 14 SEPs in a Northeastern state reported on their experience with four recent client, two who were successful in obtaining employment and two who failed, through a semi-structured mail survey. Findings suggest that job coaches use similar strategies to assist clients, but in each case try to tailor specific strategies to client's needs and characteristics. Factors that influence successful job placement and research and policy implications are discussed.

OBJECTIVES: This study examined whether women with behavioral health needs are more likely to receive treatment for these problems in prison or in the community and to what extent prison disrupts or establishes involvement in treatment for these women. METHODS: Data were collected in August 2004 as part of a population survey of female inmates in the only state correctional facility for women in New Jersey. RESULTS: A total of 908 women were surveyed. Fifty-six percent of the women surveyed reported needing behavioral health treatment before incarceration, but only 62 percent of this group reported receiving such treatment in the community. The rate at which treatment matched need within this population before incarceration varied by type of treatment needed: it was the highest (58 percent) for women who needed treatment for mental health problems, lower (52 percent) for those who needed substance abuse treatment, and lowest (44 percent) for those who needed treatment for comorbid mental health and substance abuse problems. In comparison, the rate of match between need for and receipt of treatment in prison was higher for all three types of behavioral health treatment (78 percent, 57 percent, and 65 percent, respectively). Additionally, the findings suggest that prison did not disrupt the type of behavioral health treatment that inmates had previously received in the community. CONCLUSIONS: At least in New Jersey, prison appears to improve access to behavioral health treatment among female inmates. Although this conclusion is consistent with the rehabilitation goals of incarceration, it also suggests that some women may have been able to avoid prison if treatment had been provided in the community, especially for substance-related problems.

OBJECTIVES: We describe behavioral health diagnoses and community release patterns among adult male and female inmates in New Jersey prisons and assess their implications for correctional health care and community reentry. METHODS: We used clinical and classification data on a census of "special needs" inmates (those with behavioral health disorders) in New Jersey (n=3189) and a census of all special needs inmates released to New Jersey communities over a 12-month period (n=974). RESULTS: Virtually all adult inmates with special needs had at least 1 Axis I mental disorder, and 68% of these had at least 1 additional Axis I mental disorder, a personality disorder, or addiction problem (67% of all male and 75% of all female special needs inmates). Of those special needs inmates released, 25% returned to the most disadvantaged counties in New Jersey (27% of all male and 18% of all female special needs inmates). CONCLUSIONS: Two types of clustering were found: gender-specific clustering of disorders among inmates and spatial clustering of ex-offenders in impoverished communities. These findings suggest a need for gendered treatment strategies within correctional settings and need for successful reentry strategies.

The federal "Second Chance Act of 2005" calls for expanding reentry services for people leaving prison, yet existing policies restrict access to needed services for those with criminal records. We examined the interaction between individual-level characteristics and policy-level restrictions related to criminal conviction, and the likely effects on access to resources upon reentry, using a sample of prisoners with Axis I mental disorders (n=3073). We identified multiple challenges related to convictions, including restricted access to housing, public assistance, and other resources. Invisible punishments embedded within existing policies were inconsistent with the call for second chances. Without modification of federal and state policies, the ability of reentry services to foster behavioral health and community reintegration is limited.

With the growing complexity of treatment decisions made at presentation to a psychiatric emergency room (PER) and the increasing influence of managed care on the decision-making process, it is increasingly important to establish a new and more sophisticated research agenda for studying PER decision making. The main goal of this paper is to propose a comprehensive conceptual model of the PER decision-making process that will facilitate active pursuit of such a research agenda. The proposed model presents both traditional and emerging elements of the PER decision-making process (i.e., determinants, mediating mechanisms, and outcomes) and explicates the nature of the relationships among them at different levels of analysis. The model's theoretical and empirical implications for future research are discussed and suggestions are made as to the research designs and methods needed to pursue this agenda.

The purpose of this study is to examine the relative importance of media coverage and physician advice on the decision of women 40 years and older to obtain a mammogram. Five theoretical models, by which media coverage and physician advice may interact to affect individual health behavior, are presented. These models are tested with time-series regression analysis based on national-level data on mammography utilization and physician advice from the Behavioral Risk Factor Surveillance System (BRFSS) and content analysis of mammography-related national news coverage. Results suggest that although physician advice plays a key role in women's decisions to have mammograms, media coverage of mammography screening also contributes to mammography utilization by women. In particular, media coverage seems to be important for women who do not have regular contact with a physician or access to physicians. A possible conclusion is that mass media and physician advice complement one another in persuading individuals to adopt preventive health behavior.