Reintegration programmes for people with severe mental illnesses released from correctional institutions: systematic review.

Abstract

Background: People with severe mental illness (SMI) face significant challenges when reintegrating from correctional facilities back to the community. These include increased recidivism risk, homelessness and mental health deterioration. Although specialised reintegration programmes were developed to address the needs of this vulnerable population, their effectiveness remains unclear owing to mixed findings reported in the literature.

Aims: We performed a systematic review to synthesise and evaluate available evidence on reintegration programmes designed specifically for people with SMI.

Method: Studies were included if they focused on adults with SMI transitioning from correctional facilities to community settings. The search was conducted through 10 January 2026. Two reviewers independently screened eligible studies and scored the appropriate risk of bias tools under supervision. A narrative analysis was adopted given the heterogeneity of methodologies and outcomes.

Results: We identified 26 eligible studies, of which 11 were longitudinal, seven were randomised controlled trials, 3 had an AB design, 2 quasi-experimental, 2 retrospective and 1 brief report. The median number of participants involved in these studies was 207 (range: 22-3086). Studies employed various interventions, including peer mentoring, critical time intervention models, case management and therapeutic community. Results showed mixed effectiveness: some programmes demonstrated reduced recidivism and improved mental health service engagement, whereas others had minimal impact or even counterintuitive increases in re-imprisonment. Programmes generally showed better outcomes with a longer duration and comprehensive aftercare components.

Conclusions: Reintegration programmes show promise, but current approaches demonstrate variable efficacy. Successful interventions appear to require comprehensive, sustained support addressing multiple domains including mental health treatment, housing, employment and social support.