Consequences of mental and physical health for reentry and recidivism: Toward a health‐based model of desistance*

• Author: Jeffrey T. Ward,Nathan W. Link,Richard Stansfield
• Published date: 01 August 2019
• DOI: http://doi.org/10.1111/1745-9125.12213
• Date: 01 August 2019

Received: 3 July 2018 Revised: 27 March 2019 Accepted: 4 April 2019

DOI: 10.1111/1745-9125.12213

ARTICLE

Consequences of mental and physical health for

reentry and recidivism: Toward a health-based

model of desistance*

Nathan W. Link1Jeffrey T. Ward2Richard Stansfield1

1Department of Sociology, Anthropology, & Criminal Justice, RutgersUniversity—Camden

2Department of Criminal Justice, Temple University

Correspondence

NathanW. Link, Department of Sociology,

Anthropology,& Criminal Justice, Rutgers

University,405-407 Cooper St., Camden, NJ

08102.

Email:nat han.link@rutgers.edu

*Additionalsupporting information

canbe found in the listing for this arti-

clein t he WileyOnline Library at

http://onlinelibrary.wiley.com/doi/10.1111/

crim.2019.57.issue-3/issuetoc.

Theaut hors thank fouranonymous reviewers

andDr. Brian Johnson for careful reviews that

haveenhanced the article considerably.

Abstract

During the last few decades, criminologists have identified

several adult roles and statuses, including employment,

positive family relations, and economic stability,as cr itical

for promoting successful reintegration and desistance.

Very few researchers, however, have investigated the

conditions that serve to bring about these transitions and

successes crucial for behavior change. As a complement

to a burgeoning amount of literature on the impact of

incarceration on health, we emphasize the reverse: Health

has important implications for reentry outcomes and rein-

carceration. Informed by multiple disciplines, we advance

a health-based model of desistance in which both mental

and physical dimensions of health affect life chances in the

employment and family realms and ultimately recidivism.

Investigating this issue with longitudinal data from the

Serious and Violent Offender Reentry Initiative (SVORI)

and structural equation models, we find overall support

for the health-based model of desistance. Our results

indicate several significant pathways through which both

manifestations of health influence employment, family

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and

reproduction in any medium, provided the original work is properlycited and is not used for commercial purposes.

© 2019 The Authors. Criminology published by Wiley Periodicals, Inc. on behalf of American Society of Criminology

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LINK ET AL.545

conflict, financial problems, and crime and reincarceration.

The findings highlight the need for implementation of cor-

rectional and transitional policies to improve health among

the incarcerated and avert health-related reentry failures.

KEYWORDS

adult roles and statuses, depression, desistance, life course, physical

health, prison, prisoner reintegration, reentry

Theories of desistance have drawn much attention to adult roles and life transitions (e.g., employment,

prosocial relationships, and military service) that can spark behavior change (Sampson & Laub, 1993),

provide hooks for change that fosterprosocial identities (Giordano, Cer nkovich, & Rudolph, 2002), or

empower change among those with the requisite mindset (Paternoster & Bushway, 2009). Indeed, as

a result of research on former offenders, scholars have found social factors, including employment

and familial ties, to be critical for promoting desistance from crime (Berg & Huebner, 2011; Laub &

Sampson, 2003; Uggen, 2000; Uggen, Wakefield, & Western, 2005). Because of their direct crimino-

genic effects, it is no surprise that family–marital relationships and school–work domains are consid-

ered “major risk/need” factors in assessment and rehabilitation instruments (Andrews & Bonta, 2014).

Although general agreement exists that securing employment and maintaining prosocial family rela-

tionships are critical for the desistance process, much less is known about the factors that serve to

increase or decrease the likelihood of achieving these milestones that may serve as a turning point in

one’s life.

We draw on theory and research from several disciplines to propose a health-based model of desis-

tance, positing that both mental and physical health states have key implications for employment,

financial stability, family relationships, and ultimately recidivism. In many processes, health limita-

tions hamper fulfillment of prosocial adult roles, such as when former prisoners’ chronic health issues

hinder their ability to secure or maintain employment (Visher, Debus, & Yahner, 2008) or when the

stigma of having a physicaldisability or ment al illness is extendedto family members who provide crit-

ical instrumental and emotional support (Corrigan & Miller, 2004; van der Sanden, Pryor, Stutterheim,

Kok, & Bos, 2016). Medical research findings indicate that having a physically or mentally ill fam-

ily member can engender substantial strain between that person and his or her family (Ferrario, Zotti,

Zaccaria, & Donner, 2001; Magliano, Fiorillo, De Rosa, Malangone, & Maj, 2005). Findings from

a small amount of literature also indicate a possible direct link between physical health issues and

crime (Schroeder, Hill, Hoskins, & Bradley, 2011; Stogner, Gibson, & Mitchell, 2014) and between

mental health and reentry outcomes (Bakken & Visher, 2018). To date, however, physical and mental

health are often considered to be “minor needs” (Andrews & Bonta, 2014), which may inadvertently

downplay the role good health plays in setting the stage for success in adult roles (which have known

beneficial implications for desistance from crime). To our knowledge,link s between mental and phys-

ical health, crime, and reincarceration, which include complex intervening processes through family

conflict, employment, and economic hardship, have never been examined in a prior study.

Although there is wide applicability of a health-based model of desistance, we zero in on a popu-

lation reentering society in which the impact of health on adult roles and recidivism comes into sharp

focus. Indeed, individuals who have experienced incarceration are likely to suffer from poor health

(Dumont, Brockmann, Dickman, Alexander, & Rich, 2012; Massoglia & Pridemore, 2015; Porter &