Engaging Black and Latino men with incarceration histories in substance use disorder treatment and other services

Type: Oral Presentation
Date: March 2024

Citation

A Gonzalez, L McElherne, C Dias, B Goldberg, A Hoyos-Cespedes, S Jalbert, K Zafft, R Paradise, “Engaging Black and Latino men with incarceration histories in substance use disorder treatment and other services”, Grayken Center for Addiction Together for Hope: Boston Addiction Conference 2024 (oral presentation)

Abstract

Introduction and Background: In Massachusetts, the opioid overdose death rate is significantly higher for formerly-incarcerated people than for non-incarcerated people, and overdose death rates increased in recent years for Black and Hispanic/Latino men, surpassing the rate for White men. This presentation will highlight learnings from the Recovery-Based Re-entry Services for Black and Latino Men (BLM) program, which has five community-based pilot sites (“providers”), including two in Boston. The director of one of the providers, Casa Esperanza, will co-present with a program evaluation partner from the Institute for Community Health.

Objective: The program objective is to provide culturally-responsive, person-centered support to improve the health and wellbeing of people who have high risk of opioid overdose and death. 

Description of Program: The focus population for the BLM program is Black and Latino men with substance use history who have been incarcerated in a MA House of Corrections (HOC). All providers employ care coordinators who share lived experiences and/or identities with the clients served. Providers recruit and engage clients pre- and post- release, develop individual service plans, provide care coordination and supported referrals, and organize community-building activities. External evaluators co-developed a mixed methods evaluation in collaboration with providers and clients, which includes analysis of intake, enrollment, and service-tracking data; and qualitative interviews with providers and clients. 

In the first 17 months, BLM providers enrolled 326 clients, of whom 31% identified as non-Hispanic Black and 66% identified as Hispanic/Latino. Clients had an average of 11.5 documented contacts with providers, and many clients sought services related to mental health, social connection, and social determinants of health. Providers encountered barriers working with HOCs to do pre-release recruitment; utilizing staff with HOC experience or connections, prioritizing communication, and developing streamlined processes helped overcome barriers. Community outreach and partnership development facilitated post-release recruitment. Staff with similar lived experience to participants served were critical for effective engagement; however, staff recruitment and retention was challenging. Providers’ emphasis on community, relationships, individualized services, client choice, flexibility, accessibility, accountability, patience, and non-judgment helped build trust and facilitate engagement.

Discussion and Conclusion: The BLM pilot program has been able to recruit and engage Black and Latino men in person-centered care coordination and services. This program’s successes and challenges can inform the development of programs in other settings that seek to engage a similar population.