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The Impact of Regionalization on Reentry Service Outcomes for Individuals With Severe Mental Illness

Dr. Hartwell and Dr. Deng are affiliated with the Department of Sociology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125 (e-mail: stephanie.hartwell{at}umb.edu). Dr. Fisher is with the Department of Psychiatry, University of Massachusetts Medical School, Worcester.

OBJECTIVE: The belief that public mental health services should be regionalized has guided their delivery for the past four decades. But there have been few opportunities to observe and evaluate a service entity's shift from a centralized to a regionalized delivery system. This brief report focuses on the regionalization of the Massachusetts Department of Mental Health's forensic transition team, a service that manages community reentry from correctional settings for persons with severe mental illness. METHODS: Pre-and postregionalization episodes (N=957) were compared to examine the consequences of regionalizing the forensic transition team. RESULTS: Overall, engagement in services, a key forensic transition team outcome measure, improved postregionalization. Unexpectedly, the rate of loss to follow-up significantly increased among former county house of correction inmates. CONCLUSIONS: Overall, regionalizing reentry services increased the forensic transition team's capability and expertise in managing reentry for persons with mental illness. However, follow-up of individuals exiting county houses of correction remains a challenge.

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