| dc.description.abstract | This dissertation work, guided by the social ecological model, sought to assess the physical, mental, social, and spiritual health needs of women reentering the community after incarceration from the perspective of the women themselves. Women participating in a group substance treatment program at a residential transitional facility were recruited for voluntary participation in focus groups (n=19) and semi-structured interviews (n=12). Community-based recommendations were developed based on identified needs. One-quarter of the interviewed women had hepatitis C, while 83% had at least one mental health diagnosis. The women described physical and mental health consequences of abuse, largely inflicted by family and significant others. Their close relationships were characterized by complexity, especially with mothers and children – sometimes inciting feelings of isolation or despair, other times, self-efficacy or heightened spirituality. Within the community, the women experienced problems accessing, and finding common ground within the healthcare system. They perceived barriers to timely and adequate mental health treatment in three categories: primary care providers were unwilling/unable to treat them; excessive wait times precluded access to specialty mental healthcare; and they generally distrusted the system. They viewed staff support within the transitional facility as a major contributor to their success or failure. They also desired exercise opportunities and healthier food choices within the transitional facility. Community activities, such as spiritual or religious meetings contributed to a sense of belonging, but they desired more opportunities for positive community involvement. On the societal level, gaining safe, affordable housing and financial stability were major hurdles. In addition, stigmatization from society was experienced on many levels. Finally, recommendations were made to the transitional facility to promote and remove barriers to exercise and healthy foods, to develop and maintain a culture of trauma-informed care among all staff members, and to promote the development of healthy, prosocial community connections. Primary care facilities were recommended to address adverse childhood events and adult trauma, and to foster innovative strategies to provide timely and effective mental healthcare. Finally, policy-makers were recommended to consider pursuing legislation allowing expungement, and to develop and implement strategies to provide safe, affordable housing options to those with criminal records. | en_US |
