Date of Award


Document Type



College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Colleen Woolsey


Ryan Quirk


Introduction: This formative Delphi study assesses 1) potential policy changes most needed to support mental health care continuity for women being released from two urban jails, 2) barriers to women obtaining mental health services after release, and 3) understanding what community resources are promoting continuity of mental health care after jail release.

Methodology: This is a policy project that uses the Delphi method. In phase one, a primarily qualitative survey was administered to jail health experts to explore project aims. Results were analyzed with thematic analysis, and themes were used to develop a primarily quantitative second survey with Likert scale questions. The second survey was administered to the same participant pool and was used to assess consensus on themes.

Results: 14 and 20 participants took the first and second surveys, respectively. Correspondingly, first and second survey participants included registered nurses (n=5; n=8), psychiatric evaluation specialists (n=5; n=6), nurse practitioners (n=1; n=2), release planners (n=1; n=1), medical doctors (n=1; n=1); court clinicians (n=1; n=0), and managers (n=0, n=2). Nine main themes resulted from thematic analysis: 1) access to mental health services within the jail, 2) jail-based communication, 3) interaction with the community, 4) resourcing, 5) assessment and prioritization, 6) capital transformation, 7) trauma and care, 8) enhancing continuity of mental health care, and 9) barriers to continuity of mental health care—nineteen subthemes and derivative questions met criteria for consensus in the second survey.

Conclusion: Many of the themes identified in the study are related to infrastructure, policy, and funding issues. Perceived issues identified by participants include psychiatric housing shortages within the jail, limited psychiatric intakes in the community, inadequate staffing to meet mental health care demands in the jail, and a need for enhanced inter-team communication within the organization. Barriers that participants identified in the community include housing, transportation, and inadequate insurance coverage.