The impact of perceived stigma on psychiatric care and outcomes for correctional mental health patients.

The purpose of this study was to examine factors related to the delivery and effectiveness of psychiatric care prior to and following prison release. Particular attention was placed on patients' self-reported needs, psychiatric medication adherence, and perceived stigma related to mental health treatment, and how these factors related to post-release clinical and recidivism outcomes. Participants (N = 103) with serious psychiatric disorders (SPD; global assessment of functioning scores below 50) were recruited within 60 days of scheduled release from prison, and provided pre-release and six monthly follow-up interviews. Seventy eight percent of the released sample had at least one follow-up contact. Baseline interviews revealed low social stability prior to the current term of incarceration, and forty five percent of the sample had been returned to jail or prison within six months of release. Regression models revealed that perceived psychiatric stigma was a significant (negative) predictor of medication adherence in the community and even in prison. A path analysis showed that perceived stigma predicted responses on the K-6 psychological distress measure and recidivism both directly and indirectly via its influence on medication adherence. Mitigating the effects of this real or perceived stigma may significantly improve post-release outcomes for this high-risk population.