Rapid scoping review of self-management interventions for adults experiencing incarceration and reentry

On any given day, 1.9 million people are incarcerated in the US and more than 11 million people cycle through jails each year. Among these, an estimated 65% of incarcerated persons have an active substance use disorder. While 95% of all incarcerated people are anticipated to return to the community, most are underprepared to self-manage health during the community reintegration process and experience traumatic social exclusion, severe morbidity, and premature death. Among those who survive release, more than 60% return to prisons and jails within 3 years. Incarcerated persons have unique risks for low self-management skills, which represent a potential mechanism contributing to poor linkage to care and adverse health outcomes during reentry. Self-management is defined as “the attitudes, behaviors, and skills that one directs toward managing the impact of a condition on their lives.” By design, incarceration limits individual autonomy across multiple domains, limiting control over one’s body, mental health, social connections, and physical environment. Within this restrictive context, individuals are forced to depend on the external management of their instrumental activities of daily living (e.g., meal preparation, medication management, finances, cleaning/laundry, transportation) for a prolonged period of time and have limited opportunities and resources for engaging in self-management. Incarceration has been described as imparting a chronic social disability, which requires management of the long-term legal limitations and collateral consequences imposed post-incarceration. In addition to learning to manage the consequences of one’s legal status, incarcerated and reentering individuals must also learn to manage their significant risk of post-incarceration morbidity and mortality. For example, recently incarcerated persons experience a more than 50-times greater risk of death from fatal drug overdose than the general population. Research supports that self-management skills improve patient symptoms and functioning and supports recovery-oriented outcomes across general populations with varied chronic conditions. Self-management may represent a promising target of intervention for incarcerated and reentering adults to reduce post-release morbidity and mortality and facilitate linkage to recovery-oriented care and resources during reentry. The objective of this scoping review is to assess the extent of the literature on self-management interventions for adult populations experiencing incarceration and reentry in the United States. The review research is: What are the characteristics of interventions to develop self-management among U.S. adults experiencing incarceration and/or reentry from incarceration?