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Use of Mental Health Services and Barriers to Care for Individuals on Probation or Parole

by Gina P. Owens, Shannon M. Rogers, and Allison A. Whitesell (2011). "Use of Mental health Services and Barriers to Care for Individuals on Probation or Parole." Journal of Offender Rehabilitation, 50(1): 37-47.

Much has been made in recent years about the number mentally ill offenders being sent to jail or prison, and such attention is long overdue. Significantly, though, mentally ill offenders are also being sentenced to terms of probation or supervised by parole officers, and less attention has been given these situations. In this article, University of Tennessee psychologists Gina Owens, Shannon Rogers, and Allison Whitesell assess mental health symptoms, mental health service use, and barriers to mental health service use experienced by 100 probationers and parolees from two counties in a "southeastern state."

In this "southeastern state," probationers and parolees are supervisions by officers in the same department, where fliers about this project were posted to attract those offenders interested in participating in the study. These offenders were asked to take paper-and-pencil surveys. Data collection for this project involved information related to these offenders' demographic background, criminal history, health insurance coverage, treatment experiences, trauma history, and drug use. Probationers and parolees in these two counties are required to take risk-need assessments, but they are not typically mandated to particular forms or locales for treatment. That said, the probation and parole agency reported that "several outpatient mental health agencies" and "two programs offering substance abuse services" were located in the vicinity of the office where the surveys were administered. All of these programs offered services free-of-charge to persons who were indigent and/ or uninsured.

Key findings include the following:

  • 85% reported traumatic events in their lives (77% more than one type of traumatic event), including (in descending rank order) sudden death of a family member or close friend (72%), witnessing someone die or receive serious injury (40%), severe transportation accident (42%), being attached with a weapon (31%), adult physical abuse (30%), childhood sexual abuse (21%), and childhood physical abuse (18%).
  • Women offenders (48% of the sample) were more likely than male offenders in the study to experience childhood sexual abuse or sexual abuse as an adult.
  • 75% of the sample had at least one mental health condition for which they desired counseling, including (again in rank order) depression (53%), anxiety (43%), substance abuse (34%), relationship issues (25%), abuse (19%), and anger (15%).
  • 54% of sample participants actually sought counseling in the year prior to the study and they were more likely to do this for depression, substance abuse, anxiety, and anger.
  • 42% of the sample reported having no health insurance.
  • No significant differences were found between men and women for depression, PTSD, stigma, and substance abuse measures.
  • Treatment seeking was not determined by gender, charge(s), insurance coverage, or trauma history.
  • Treatment seeking was affected by severity of PTSD and substance abuse (alcohol abuse was marginally influential).
  • 29% of the sample with mental health concerns did not seek treatment in the year prior to the survey, largely because they did not have insurance, they could not afford such care, or they lacked transportation.

According to the authors, the trauma and mental health symptoms experienced by members of the study's sample was at the same or slightly higher level than in other populations or previous studies. They also note that "a considerable problem with substance abuse for many individuals existed prior to their criminal offense."

In greater detail, the authors observe: "Individuals who had higher levels of PTSD symptomatology or had higher reported drug use prior to being on probation or parole were more likely to seek counseling over the past year. There was a trend toward significance of alcohol use prior to conviction increasing the likelihood that individuals sought counseling in the past year. Some of the mental health treatment, including that related to substance abuse, may have been mandated, but we were unable to determine this from our data. Interestingly, stigma related to mental health or using mental health services was not a significant impediment to seeking treatment for this sample."

The authors conclude, "Not having health insurance or not being able to afford mental health care were the most cited reasons for not seeking care when the individual felt that this care was needed, although having insurance was not significantly associated with treatment-seeking when the full sample was used in analyses. Therefore, providing information about local mental health agencies providing low-cost or sliding-scale fee services that an individual may qualify for could assist individuals who are interested in these services."

For further information, contact Gina P. Owen, Department of Psychology, University of Tennessee, 1404 Circle Dr., Knoxville TN 37996, (e-mail)

Posted Fri, Aug 26 2011 4:20 PM by Tracey Vessels
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