Trajectories of mental health symptoms, suicide attempts and substance use disorders among women after prison release in Santiago, Chile.

Abstract

Purpose: Limited research has characterized how mental health changes or persists during reentry, particularly among women, who are a minority in the criminal legal system. We aimed to describe the mental health symptoms trajectory groups, suicide attempts, substance use dependence, and mental healthcare utilization among formerly incarcerated women in Santiago, Chile, during 1-year after release.

Methods: We assessed 200 women in a five-wave prospective cohort study using three different mental health indicators: the Symptom Checklist 90-Revised (SCL-90-R) scale before release and at one week, two, six, and twelve months after release, self-reported suicide attempts, and substance use dependence using the Mini Neuropsychiatric Interview. We used latent class growth analysis to identify groups following similar symptom trajectories using the Global Severity Index of the SCL-90-R. We performed multinomial and logistic regressions to identify correlates of these outcomes.

Results: Three trajectory groups were identified: Low (85.8%), Increasing (6.8%), and High (7.4%) symptom severity. 19.3% attempted suicide during follow-up. 18.9% met the criteria for substance use dependence at both baseline and twelve months. In multivariate regression analysis, the previous number of convictions and victimization experiences were associated with all outcomes. 10% or less received mental health services at any measurement.

Conclusion: Most women had stable severity of mental health symptoms during the first year after release. Pre-release cross-sectional screening misses a group with increasing symptom severity and substance use dependence during reentry. Routine mental health assessments would be useful during reentry and guidance to make better use of services during this critical period.