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Background
The number of criminal justice-involved older adults (awaiting trial, on community-based probation or parole, or serving prison sentences) is growing rapidly in many nations (Fazel and Baillargeon, 2011; Williams, Ahalt and Greifinger, 2014; Maschi et al., 2013). Accordingly, the number of criminal justice-involved older adults in need of health and social services – both in correctional facilities and in the community – is also on the rise (Aday, 2003; Williams, Goodwin, Baillargeon, Ahalt and Walter, 2012). Criminal justice-involved individuals are typically considered “older adults” in their 50s due to a disproportionate burden of chronic illness, disability, and geriatric conditions at early ages (Williams, Stern, Mellow, Safer and Greifinger, 2012, Ahalt et al., 2013). In the USA this population is growing rapidly. Over 500,000 American older adults are arrested annually, including more than one percent of all US adults aged 55-64 (Snyder, 2012). With over 150,000 sentenced prisoners age 55 or older – and an additional 450,000 middle-aged prisoners (ages 40-55) – the prison aging trend is expected to continue. Because the vast majority of incarcerated individuals in the USA are eventually released (Freeman, 2003), the number of community-dwelling older adults with current or former criminal justice involvement will also grow. Yet, relatively little is known about the needs of these medically and socially complex older adults (Ahalt et al., 2012, 2015). In response, we designed a five-step initiative to develop the evidence needed for a community-wide, interdisciplinary action plan to identify and meet this population’s needs.
While the medical literature about criminal justice-involved older adults in the USA is sparse, research has shown many experience disproportionate rates of co-occurring behavioral, medical and mental health conditions (Barry et al., 2016; Bolano et al., 2016; Chodos et al., 2014). As a result, criminal justice, health, and social service professionals interact with these individuals on a frequent basis (Brown et al., 2014; Soones et al., 2014). Yet despite their complex needs, few of the intensive interdisciplinary services shown to improve outcomes for other criminal justice-involved populations (e.g. those living with HIV and veterans) have been developed and targeted for criminal justice-involved older adults. For example, an older adult with age-related cognitive impairment recently released from prison may require care...