Interventions at the Transition from Prison to the Community for Prisoners with Mental Illness: A Systematic Review

Abstract

Prisoners have high rates of mental illness and the transition from prison to the community is a problematic time for the provision of mental health services and a range of negative outcomes have been identified in this period. A systematic review was conducted to identify interventions for prisoners with diagnosed mental health conditions that targeted this transition period. Fourteen papers from 13 research studies were included. The interventions identified in this review were targeted at different stages of release from prison and their content differed, ranging from Medicaid enrolment schemes to assertive community treatment. It was found that insurance coverage, and contact with mental health and other services can be improved by interventions in this period but the impact on reoffending and reincarceration is complex and interventions may lead to increased return to prison. There is a developing evidence base that suggests targeting this period can improve contact with community mental health and other health services but further high quality evidence with comparable outcomes is needed to provide more definitive conclusions. The impact of programmes on return to prison should be evaluated further to establish the effect of interventions on clinical outcomes and to clarify the role of interventions on reincarceration.Electronic supplementary materialThe online version of this article (10.1007/s10488-018-0848-z) contains supplementary material, which is available to authorized users.

A model of a specialist transitional support and liaison service within the Offender Personality Disorder Pathway in Wales: Learning from a regional pilot service

“…This period requires adjustment to new freedoms and pressures as well as the establishment of new routines and possibly new support mechanisms. In their systematic review, Hopkin et al, (2018) noted several key factors as important for successful transitions.…”

Veterans Universal Passport: a pilot of a health and social care record for UK ex-service personnel

“…Considering parallels in the difficulties experienced by ex-service personnel accessing civilian health and social care services with other health and social care transitions (eg, poor continuity of care and health and social care outcomes experienced by those leaving prison with mental health problems),24 it is suggested that the benefits experienced by veterans may be transferable. Future development and research should consider translation for other populations.…”

Beyond the Walls: An Evaluation of a Pre-Release Planning (PReP) Programme for Sentenced Mentally Disordered Offenders

“…Unlike Assertive Community Treatment (ACT) and Critical Time Intervention (CTI), the programme did not provide case management in the post-release period. Although this may be viewed as a limitation of the PReP Programme, previous studies ( 22 , 29 , 40 ) and a recent systematic review ( 24 ), have highlighted the importance of pre-release planning in any intervention to aid the transition for mentally disordered offenders. We acknowledge that the less intense follow up provided by our programme results in difficulty determining the quality of engagement with mental health and other supports in the post-release period.…”

“…Despite their complex healthcare needs, programmes for prison populations are conspicuous by their absence in these clinical strategies. It has been suggested that enhanced coordination between medical and mental health teams, and early identification of needs prior to release, can promote involvement of community based supports and assist in achieving continuity of care ( 22 – 24 ). These recommendations are echoed in Human Rights legislation.…”

“…Various models have been proposed to overcome these challenges, most of which involve case management in the pre- and post- release periods for varying amounts of time ( 24 ). Assertive Community Treatment (ACT) has been utilized to provide intensive case management for up to 1 year in the post-release period ( 28 ).…”