Examining trauma and demoralization as factors influencing treatment engagement for Black women with SUD returning from prison

检查创伤和士气低落作为影响 SUD 出狱黑人女性治疗参与度的因素

• 批准号: 10853925
• 负责人: Chyrell Denise Bellamy
• 金额: $ 15.99万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-22 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10853925
• 关键词: Address; Affect; Attention; Award; Behavior; Black race; Collaborations; Communities; Criminal Justice; Data; Development; Discrimination; Employment; Environment; Exclusion; Face; Feeling; Financial Hardship; Gender; Goals; Harm Reduction; Health; Health Knowledge Attitudes Practice; Health Services Accessibility; Health Status; Housing; Imprisonment; Incidence; Income; Individual; Institution; Intervention; Jail; Justice; Latinx; Laws; Learning; Legal; Link; Low Income Population; Low income; Measures; Mediating; Mediator; Mental Health; Mental disorders; Methods; Occupational activity of managing finances; Outcome; Parents; Participant; Pathway interactions; Personal Satisfaction; Persons; Policies; Population; Poverty; Prisons; Process; Provider; Race; Randomized; Recording of previous events; Research; Research Methodology; Resources; Savings; Services; Social Network; Social support; Stigmatization; Substance Use Disorder; System; Target Populations; Testing; Training; Trauma; Victimization; Woman; Work; addiction; black women; community based participatory research; empowerment; experience; health determinants; improved; innovation; internalized stigma; meetings; parent grant; peer support; primary outcome; programs; racism; recidivism; secondary outcome; service providers; skills; social stigma; social stress; substance use; tool; trauma exposure; treatment strategy

Program Summary/Abstract People who experience incarceration and have mental health challenges are disproportionately Black and Latinx, and low-income. This group experiences financial hardships regardless of incarceration due to racism and other forms of discriminations, with associated negative health outcomes. These financial issues have a direct impact on health, create barriers to employment and housing, stress social networks, contribute to feelings of exclusion and contribute to recidivism, all of which are health determinants. The goal of the parent award is to intervene at the community level to reduce financial difficulties of individuals with incarceration histories and mental health challenges, who are predominantly Black and Latinx. The proposed diversity supplement will explore experiences of trauma, stigma, and demoralization among Black women with histories of a substance use disorder (SUD) and/ or SUD treatment, recently released from incarceration. Incarcerated populations are often presenting with mental health conditions, including substance use disorders (SUD), with an estimated 60% of those incarcerated meeting criteria for a SUD. In the last two decades there has been an 525% increase in the incarceration rate for women, and in 2021 Black women were incarcerated at 1.6 times the rate of White women. Furthermore, consistent findings highlight high rates of victimization among incarcerated women, and it is hypothesized that trauma exposure is a gender-specific pathway into the carceral system. Research has identified that for several women this pathway is in part due the presence of mental health conditions, including SUDs. Stigma associated with both addiction and legal involvement is one of the many barriers individuals face as they reenter the community and initiate community- based SUD treatment. Embodying multiple stigmatized identities, formerly incarcerated Black women with SUDs navigate a reentry experience that is unique and nuanced. Implementing Community-Based Participatory Research (CBPR) methods this proposal will explore how these intersecting identities (race, gender, person who uses substances, incarceration history) and compounded experiences (pre-incarceration trauma, carceral trauma, internalized stigma, demoralization) impact treatment seeking behaviors and decisions. Our CBPR process incorporates learning from and partnering with community stakeholders to identify opportunities that can improve treatment strategies and reentry experiences for the target population, and inform the development of a harm reduction, community-based, and culturally relevant intervention.

计划摘要/摘要 经历过监禁并有心理健康问题的人中黑人和 拉丁裔和低收入群体。尽管因种族主义而被监禁，但该群体仍面临经济困难 和其他形式的歧视，以及相关的负面健康后果。这些财务问题有一个 对健康产生直接影响，对就业和住房造成障碍，对社交网络造成压力，有助于 被排斥感并导致累犯，所有这些都是健康决定因素。家长的目标 该奖项旨在在社区一级进行干预，以减少被监禁者的经济困难 历史和心理健康挑战，主要是黑人和拉丁裔。 拟议的多样性补充将探讨创伤、耻辱和士气低落的经历 有物质使用障碍 (SUD) 和/或 SUD 治疗史的黑人女性，最近从 监禁。被监禁者经常出现精神健康问题，包括物质问题 使用障碍 (SUD)，估计 60% 的被监禁者符合 SUD 标准。在过去的两 几十年来，女性入狱率增加了 525%，到 2021 年，黑人女性入狱率 被监禁的比率是白人女性的 1.6 倍。此外，一致的调查结果凸显了高比率 被监禁妇女中受害的情况，并且假设创伤暴露是针对特定性别的 进入监狱系统的途径。研究发现，对于一些女性来说，这条途径部分是由于 存在心理健康问题，包括 SUD。与成瘾和法律相关的耻辱 参与是个人重新进入社区并发起社区时面临的众多障碍之一 基于SUD的治疗。曾被监禁的黑人妇女体现了多重污名化身份 SUD 提供独特而细致的再入体验。实施基于社区的 该提案将采用参与式研究（CBPR）方法探讨这些交叉身份（种族、 性别、使用药物的人、监禁历史）和复合经历（监禁前） 创伤、癌症创伤、内在耻辱、士气低落）影响寻求治疗的行为和 决定。我们的 CBPR 流程包括向社区利益相关者学习并与之合作， 确定可以改善目标人群的治疗策略和重返体验的机会， 并为制定减少伤害、基于社区和文化相关的干预措施提供信息。