(PS11-18) Characteristics of Individuals Recently Released from Jail Receiving Caring Contact Letters to Reduce Suicide Risk

Abstract Text: Recent jail detention is a marker for trait and state suicide risk. High jail admissions and understaffing leads to healthcare providers being unaware that their client was in jail (Taxman 2011), resulting in disruption in existing care. Caring Contacts (CC) is an evidence-based approach that has been shown to reduce suicide attempts, suicide deaths, and suicidal ideation in various populations and in a cost-effective manner (Milner et al. 2015). It involves sending individuals brief, non-demanding messages of care or concern. However, we have limited information on using CC interventions for individuals with criminal legal involvement. The current study aims to describe characteristics of individuals being reached as part of a larger parent study directed at the use of CC letters for individuals recently released from jail. This study was developed in partnership with CareSource, a large nonprofit managed care organization (MCO) headquartered in Dayton, Ohio. Roughly 43,000 CareSource subscribers pass through the Ohio jail system annually. Data was extracted from CareSource's Jail-Medicaid database, which integrates continuously updated jail booking and release data from Ohio jails with CareSource's Ohio Medicaid subscribers. Eligible CareSource subscribers are randomized to receive Caring Contact letters or Usual Care after their jail release (see Arias et al. 2023 for the full protocol of the original study). CareSource mails the letters to subscribers randomized to receive CC monthly for six months after jail release. The letters contain similar messages but with slightly different wording, and they do not mention time spent in jail or any specific services (e.g., mental health or substance use). They say that CareSource is here and available to help if the participant decides to reach out to the CareSource number listed. This number is answered by nurses who are trained to assess and send callers to the appropriate services with the goal of helping individuals navigate the healthcare system and get the care they need. As of December 2023, 18,179 individuals were randomized to receive CC letters, while 17,567 were randomized to receive care as usual. Of the CC individuals, 57.4% are White, 62.5% are male, with an average age of 36 years old (sd = 10.81). For those receiving letters, 7.8% did not receive letters because they did not have a valid address or their letters were returned to sender for two consecutive months. In addition, 17.3% were removed from the study due to no longer being a CareSource subscriber. Of individuals who did not receive any letter, 61.7% were White, 69.5% were male, and the average age was 37. Data from this study provides valuable information on using CC letters at scale as a tool for re-engaging individuals in healthcare and as a suicide prevention method for individuals released from jail, particularly characteristics of those who received no letters or were removed from the study. Identifying who is being reached and missed through these types of initiatives provides useful information on how to best implement these types of interventions.