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Systematic review of qualitative evaluations of reentry programs addressing problematic drug use and

By Sacha Kendall, Sarah Redshaw, Stephen Ward, Sarah Wayland and Elizabeth Sullivan

Effective community reentry programs are one component in strategies to reduce recidivism and assist in the successful transition of prison inmates to community. The rising rate of adult incarceration is a major public health and societal problem worldwide. Globally, there are an estimated 10.35 million people in custody. Prison inmates are a vulnerable population characterised by complex health problems. People who have experienced imprisonment have higher rates of mental illness, infectious diseases, chronic diseases and mortality in comparison to the general population. Problematic drug use is pervasive, affecting approximately one third of male prison inmates and half of female prison inmates. Inadequately treated mental health problems and substance use is associated with re-incarceration.

Reentry to the community is known to be highly stressful. This is attributable to the complexity of health problems and poor engagement with health and social services. A recent systematic review of randomized controlled trials of community reentry interventions designed to improve prisoner health from imprisonment to 1 year post release concluded ‘the high burden of mortality, morbidity, and hospitalization post-release suggested that a greater focus on improving health in this population during and after release is warranted’ and that there are substantial gaps in evidence.

We aim to identify and synthesise the factors relevant to successful community reentry identified by qualitative reentry program evaluations. A systematic review of the literature was conducted to synthesise current evidence in this area with a focus on reentry programs targeting mental health disorders and problematic drug use. People with mental health disorders and problematic drug use are over-represented in the prison system. This is in part due to a lack of community support services for these populations coupled with harsh legislation targeting particular behaviours.

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