Life After: Examining the Relationship Between Sociobehavioral Factors and Mental Health Among African American Ex-Offenders
| Author | Danelle Stevens-Watkins,Carl Leukefeld,Carlos C. Mahaffey |
| DOI | 10.1177/0306624X17750327 |
| Date | 01 September 2018 |
| Published date | 01 September 2018 |
| Subject Matter | Articles |
research-article2018
Article
International Journal of
Offender Therapy and
Life After: Examining the
Comparative Criminology
2018, Vol. 62(12) 3873 –3889
Relationship Between
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Sociobehavioral Factors and
https://doi.org/10.1177/0306624X17750327
DOI: 10.1177/0306624X17750327
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Mental Health Among African
American Ex-Offenders
Carlos C. Mahaffey1, Danelle Stevens-Watkins1, and
Carl Leukefeld1
Abstract
Mental health problems are 3 times higher among prisoners than the general
population. After release, reentry barriers and other factors can exacerbate
mental problems. This study of 250 African American ex-offenders examines the
relationship between sociobehavioral factors and mental health. Independent
variables included self-reported health, alcohol use, employment, and history of
mental problems before prison. Covariates included the number of immediate
family with mental problems and the number of serious conflicts with family
members or friends. Analyses revealed that men who had serious conflicts, used
alcohol more often, reported less than excellent health, and not employed were
more likely to report being troubled by mental problems. Family mental health
history was not statistically significant. The current study adds to the literature by
identifying selected factors associated with the mental health of African American
male, ex-offenders. Findings from this study can inform interventions to address
mental health issues and reduce recidivism.
Keywords
reentry, ex-offenders, mental health, African American men, Black men
1University of Kentucky, Lexington, USA
Corresponding Author:
Carlos Mahaffey, Department of Educational, Counseling, and School Psychology, University of Kentucky,
235 Dickey Hall, Lexington, KY 40506-0017, USA.
Email: carlos.mahaffey@uky.edu
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International Journal of Offender Therapy and Comparative Criminology 62(12)
Introduction
Approximately 18% of all U.S. adults experienced a mental health problem in 2014
(Center for Behavioral Health Statistics and Quality, 2015). Among correctional pop-
ulations, the most recent data estimate that mental health problems are more than
triple the general population. Prisoners with mental health problems are more likely
to be repeat offenders and to have committed their offense under the influence of
alcohol or other drugs in comparison with prisoners without any mental health prob-
lems (Baillargeon et al., 2009).
Racial Disparities in Mental Health Risk
African Americans represent the largest incarcerated racial group (35%), despite com-
prising 13% of the general population (Carson, 2016; U.S. Census Bureau, 2015). In
addition, research has shown that African American males serve longer sentences for
similar offenses committed by White males, especially in cases involving drugs
(Mitchell, 2005). Racial disparities, such as these, continue after release and manifest
into critical barriers to reentry for African American men including disenfranchise-
ment, difficulty in earning and maintaining employment, and health (Roberts, 2004;
Smith & Hattery, 2010). As a result, formerly incarcerated persons must depend sig-
nificantly on family and/or friends to provide financial assistance and living arrange-
ments. Those that do not have adequate support and opportunities including
employment may experience alcohol and drug-related problems, exacerbated health
issues, and limited access to mental health services that could lead to rearrests and
reconviction (Cobbina, Huebner, & Berg, 2012; Cooke, 2005; Freudenberg, Daniels,
Crum, Perkins, & Richie, 2005; Xanthos, Treadwell, & Holden, 2010). Few studies
have examined sociobehavioral factors and mental health among such a group at high
risk to experience these issues. Therefore, the purpose of this study is to examine the
relationship between sociobehavioral factors and mental health of drug-using, African
American men, 1 year after release from a state prison.
Need for Prison-Based Mental Health Services
Higher rates of mental health problems among the incarcerated population may be due
to the use of correctional facilities as a perceived feasible alternative for mental health
treatment facilities. Lamb and Weinberger (2005) explained that this phenomenon
occurred as a result of (a) deinstitutionalization, otherwise known as a reduction in
state hospital beds in lieu of short term, community-based mental health services; (b)
lack of access to services to adequately address mental health problems; (c) nonviolent
offenses committed by persons with mental health problems, along with the subse-
quent increase in the correctional population over the past four decades; and (d) a
reduction in the interest to maintain community mental health programs and funding.
In efforts to address mental health care, state and federal correctional facilities conduct
mental health screenings and assessments at intake, may offer counseling and therapy,
Mahaffey et al.
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and may provide treatment with psychotropic drugs. Beck and Maruschak (2001)
reported that maximum- or high-security state facilities were more likely to implement
policies on mental health to provide these services than minimum-security state facili-
ties. However, most prisoners are incarcerated in minimum- to medium-security facili-
ties (Stephan, 2008). A low priority on mental health policies and services in
minimum- to medium-security correctional facilities could explain why only 34% of
state prisoners reported receiving treatment for their mental health problems during
incarceration (James & Glaze, 2006). Fewer federal prisoners (24%) and jail inmates
(17%) reported receiving treatment for mental health problems during their incarcera-
tion (James & Glaze, 2006).
Moreover, prisoners who may need mental health services could be overlooked.
For example, women prisoners and White prisoners reportedly have more mental
health problems than men or prisoners of other races (Ditton, 1999; James & Glaze,
2006). However, race-based negative stereotypes could lead to underdiagnosing, lack
of appropriate assessments, and less offers for mental health services for African
American prisoners (Thompson, 2005). Cultural norms, such as negative attitudes of
mental health held by family and friends, and fear of stigma could also result in the
underreporting of mental health service needs among African American men (Holden,
McGregor, Blanks, & Mahaffey, 2012). Potential missed opportunities may result in
African American men going untreated or undertreated while incarcerated and experi-
encing the same or exacerbated mental health problems after incarceration.
Barriers to Access Health Services
Once released, former prisoners often face many barriers toward fully integrating back
into society. Financial support (and employment), access to health care, and housing
are all significant barriers former prisoners must overcome after release (Visher, Naser,
Baer, & Jannetta, 2005). Former prisoners with mental health problems often face
additional significant sociobehavioral factors that serve as barriers to their integration
back into society including alcohol use or dependency, other drug use, and unemploy-
ment (Ditton, 1999; James & Glaze, 2006; Visher et al., 2005). The sum of these bar-
riers plus the stigma of being an ex-offender increases their need to depend on family
and other members of their social support networks.
Social Support Networks
Mental health is directly associated with social support received from family and
friends (Nurse, Woodcock, & Ormsby, 2003; Wallace et al., 2014). Therefore, the rela-
tionships between a formerly incarcerated individual and their network of family and
peers are paramount to their successful reentry. Culturally, African Americans have
established networks of extended family and friends for strength and support. These
networks are used to cope with racism and oppression and to deal with issues in times
of crisis (Hines & Boyd-Franklin, 2005). The members of these networks or “kinship
bonds” (Hines & Boyd-Franklin, 2005, p. 88) typically consist of immediate and
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International Journal of Offender Therapy and Comparative Criminology 62(12)
extended family, friends, neighbors, and other people such as “uncles, aunties, big
mamas, boyfriends, deacons, and preachers” (White, 2004, p. 7). In addition, these
networks serve as a critical role in providing support for recently released ex-offenders
who return home with several needs but lack access to and availability of resources
(Drakulich, Crutchfield, Matsueda, & Rose, 2012).
Visher, Kachnowski, La Vigne, and Travis (2004) described that many ex-offenders
depend on family for emotional support, financial support, and housing needs.
However, Visher and colleagues (2004) also described that negative relationships with
family members may contribute to an ex-offender’s decision to engage in substance
abuse and return to criminal behavior. For example, a negative relationship could be
defined as having a family member with a history of justice involvement or who has
an alcohol or substance use disorder. Overall, the conditions of the community in
which former prisoners return to (e.g., levels of employment, crime, availability of
resources, and family dynamics...
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