As a primary care provider working in community health, I care for many patients navigating life after incarceration. Their stories rarely fit the stereotypes often portrayed in public discourse.
Instead, I see human beings attempting to rebuild their lives while carrying the weight of trauma, poverty, chronic illness, mental health struggles, addiction, unstable housing, and overwhelming barriers to employment.
And increasingly, I find myself asking the same question: how can we expect people to succeed after release if we do not adequately prepare or support them to do so?
Many formerly incarcerated patients struggle to adapt to a society that has changed dramatically during their incarceration. Some have difficulty navigating technology, accessing healthcare, obtaining identification documents, securing transportation, or finding employers willing to give them an opportunity. Others are attempting to manage diabetes, hypertension, untreated psychiatric illness, or substance-use disorders with minimal support systems in place.
As primary care providers, we are expected to care for our patients’ overall health and wellbeing. I routinely connect patients with behavioral health services, case managers, housing resources, addiction treatment programs, and social services. But many need far more than any individual provider, clinic, or healthcare system can offer alone.
The research is clear: stable employment, education, mentorship, healthcare access, and structured re-entry support improve outcomes after incarceration. A 2024 U.S. Department of Labor research synthesis examining employment-focused re-entry programs found that the majority of studied programs significantly improved employment outcomes for formerly incarcerated individuals. Studies have also demonstrated that employment assistance programs can substantially reduce reincarceration rates while increasing long-term wages and job stability.
Yet too often, we continue to release individuals into communities with inadequate support and then express surprise when they struggle.
The consequences extend far beyond the individual. Research consistently shows that formerly incarcerated individuals face unemployment rates approaching 27% — higher than the national unemployment rate during the Great Depression. Housing insecurity, untreated mental illness, substance relapse, and lack of healthcare continuity contribute to emergency department utilization, hospitalization, homelessness, and recidivism. These outcomes burden healthcare systems, destabilize families, and increase long-term societal costs.
Importantly, incarceration itself is rarely the beginning of the story.
Many justice-involved individuals have histories shaped by childhood trauma, poverty, community violence, adverse childhood experiences, educational inequities, and lack of positive role models. By the time many enter the criminal justice system, they have already experienced years of systemic disadvantage and untreated behavioral health needs. Punishment alone does not resolve those underlying conditions.
Re-entry programs should not be viewed solely as criminal justice initiatives. They are public health interventions.
When individuals have access to mental healthcare, primary care continuity, vocational training, substance use treatment, mentorship, transitional housing, and employment opportunities, communities become safer and healthier. Families stabilize. Healthcare costs decrease. Recidivism declines. Most importantly, people regain dignity and purpose.
As healthcare providers, we witness these realities every day in exam rooms across America. We see patients who are trying — trying to remain sober, trying to reconnect with their children, trying to manage chronic illness, trying to find work, and trying to become productive members of society despite enormous barriers.
But they cannot do it alone.
No single provider can solve these issues. No clinic can independently overcome decades of trauma, poverty, institutionalization, and social instability. It takes coordination between healthcare systems, policymakers, correctional institutions, employers, educators, social workers, and community organizations.
It takes a village.
If we truly want safer communities, lower recidivism rates, and healthier populations, we must stop viewing re-entry support as optional. Rehabilitation cannot end at the prison gate.
In one of the wealthiest countries in the world, we should be asking not whether we can afford to invest in rehabilitation and re-entry — but whether we can afford not to.
Megan Nosol lives in New Haven.
