A systematic review of post-release programs for women exiting prison with substance-use disorders: assessing current programs and weighing the evidence

Health & Justice

Sungwon Chang¹  Josie Newton²  Elizabeth Sullivan³  Julia Bowman⁴  Layla Edwards⁵  Sacha Kendall Jamieson⁶ 

[1] Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, 2007, Ultimo, NSW, Australia;College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia;Faculty of Health, University of Technology Sydney, 2007, Ultimo, NSW, Australia;Acting Deputy Vice Chancellor Research, University of Newcastle, 2308, Callaghan, NSW, Australia;Custodial Health Justice Health and Forensic Mental Health Network, 2036, Malabar, NSW, Australia;Research Operations Manager, Research Unit, Justice Health and Forensic Mental Health Network, 2036, Malabar, NSW, Australia;Faculty of Health, University of Technology Sydney, 2007, Ultimo, NSW, Australia;School of Public Health, Australian Centre for Public and Population Health Research, University of Technology Sydney, 2007, Ultimo, NSW, Australia;School of Public Health, Faculty of Health, University of Technology Sydney, 2007, Ultimo, NSW, Australia;Sydney School of Education and Social Work, Faculty of Arts and Social Sciences, The University of Sydney, 2006, Sydney, NSW, Australia;School of Public Health, Australian Centre for Public and Population Health Research, University of Technology Sydney, 2007, Ultimo, NSW, Australia;

关键词: Women;    Prisoners;    Post-release;    Transitional;    Intervention;    Re-entry program;    Program evaluation;    Substance-related disorders;    Recidivism;    Systematic review;   

DOI  :  10.1186/s40352-021-00162-6

来源: Springer

【 摘 要 】

BackgroundThe rising rates of women in prison is a serious public health issue. Unlike men, women in prison are characterised by significant histories of trauma, poor mental health, and high rates of substance use disorders (SUDs). Recidivism rates of women have also increased exponentially in the last decade, with substance related offences being the most imprisoned offence worldwide. There is a lack of evidence of the effectiveness of post-release programs for women. The aim of this systematic review is to synthesise and evaluate the evidence on post-release programs for women exiting prison with SUDs.MethodsWe searched eight scientific databases for empirical original research published in English with no date limitation. Studies with an objective to reduce recidivism for adult women (⩾18 years) with a SUD were included. Study quality was assessed using the revised Cochrane Risk of Bias tool for randomized trials (RoB2) and the Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tools.ResultsOf the 1493 articles, twelve (n = 3799 women) met the inclusion criteria. Recidivism was significantly reduced in five (42%) programs and substance-use was significantly reduced in one (8.3%) program. Common attributes among programs that reduced recidivism were: transitional, gender-responsive programs; provision of individualised support; providing substance-related therapy, mental health and trauma treatment services. Methodological and reporting biases were common, which impacted our ability to synthesize results further. Recidivism was inconsistently measured across studies further impacting the ability to compare results across studies.ConclusionsRecidivism is a problematic measure of program efficacy because it is inconsistently measured and deficit-focused, unrecognising of women’s gains in the post-release period despite lack of tailored programs and significant health and social disadvantages. The current evidence suggests that women benefit from continuity of care from prison to the community, which incorporated gender-responsive programming and individualised case management that targeted co-morbid mental health and SUDs. Future program design should incorporate these attributes of successful programs identified in this review to better address the unique challenges that women with SUDs face when they transition back into the community.

【 授权许可】

CC BY