The impact of a community mental health initiative on outcomes for offenders with a serious mental disorder

Abstract

Provision of specialised community mental health services for higher-risk male offenders with a mental disorder may reduce recidivism in the short and longer term - within 3 months and up to 4 years respectively. Statistical modelling also pointed to the need to include treatment for substance abuse and assistance in identifying stable accommodation and brokerage of community services among the interventions and services. Copyright © 2016 John Wiley & Sons, Ltd.

“When you first walk out the gates…where do [you] go?”: Barriers and opportunities to achieving continuity of health care at the time of release from a provincial jail in Ontario

“…In addition, we suggest a focus on individual-level strategies to improve health on release, which should be developed in collaboration with people with lived experience and with evaluation of acceptability, accessibility, and effectiveness. Building on evidence from transitional programs [30][31][32][33][34][35][36], concrete solutions may include comprehensive and patient-focused discharge planning before release from jail, the provision of information in jail and in the community on health issues and community-based services, and enhancement of programs to link people in custody with services in the community, including primary care. After release, emphasis should be placed on supports that have the capacity to adapt and respond to people's changing circumstances and needs, including harm reduction and substance use disorder treatment programs such as opioid agonist treatment programs.…”

“…We conducted one focus group at each of three community-based organizations in September and October 2018: a men's homeless shelter, a mental health service organization, and a social service agency providing voluntary and court-ordered programs for people with substance use disorders. The focus group guide (S1 File) was developed by three project team members (Catherine Hu, Jessica Jurgutis, and Fiona Kouyoumdjian) based on the study objectives and issues identified in previous research [36].…”

“…There is growing international research on transitional programs to link people with health care and other services in the community after release from prison and jail, which range from providing pamphlets and telephone calls to specialized clinics and intensive case management, and have shown success in engagement and retention in health care in the community [30][31][32][33][34][35][36]. Such promising programs may have value for people on release from provincial correctional facilities in Ontario, given provincial and local data showing that one third or more of people who experience imprisonment do not have access to primary care in the community [37,38].…”

“…As we consider strategies to support health and access to health care in people on release from a provincial correctional facility in southern Ontario, we need current, local data on the experiences and perspectives of people who have recently been incarcerated [39]. Data from the US and Australia may not be generalizable to the Canadian setting, given national differences in criminal justice systems, social and economic policy, and health care systems, and data are limited on health challenges and opportunities in the post-release period for people in Canada [24,36,40,41]. Further, programs and services may vary substantially by province, region and correctional facility, and needs and opportunities change over time based on service availability and population health issues, for example, the current opioid overdose crisis [42].…”

Using the barriers and facilitators to linkage to HIV care to inform hepatitis C virus (HCV) linkage to care strategies for people released from prison: Findings from a systematic review

“…While the provision of mental health services is not commonplace in the majority of correctional facilities worldwide, we found that untreated mental illness was associated with a much lower likelihood of linkage to HIV care, while treated mental illness was associated with an increased likelihood of linkage, underscoring the need for such services in correctional facilities, particularly for those with concomitant chronic conditions. Ensuring continuity of care for people with mental health disorders has also been shown to reduce the rate of re‐incarceration, thereby helping to address another barrier to linkage to care. Finally, we found an association between age and linkage to care, whereby released inmates less than 30 years of age were much less likely to link to HIV care even after controlling for other risk factors, suggesting that greater attention be paid to younger inmates at the time of discharge.…”