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Large numbers of adults with mental illness detained by police, seen in the courts, and confined in prisons and jails has been a longstanding concern of officials in the mental health and criminal justice systems. Diversion programs represent an important strategy to counteract the criminalization of persons with mental illness. The challenge is to identify and integrate resources in such a way that an organization bridging the police, courts, mental health, substance abuse, homelessness, welfare and entitlements agencies would evolve that would effectively and appropriately serve offenders with mental health issues, keeping them stable in the community and reducing recidivism.

Purpose – This chapter describes the problem of and approaches to ex-inmates with psychiatric disabilities exiting correctional custody. Although all ex-inmates must find housing and employment, persons with psychiatric disabilities require linkages to various health-related services and supports. These linkages are necessary, but it is unknown whether they are sufficient because discharge planning services and transition programs for ex-inmates with psychiatric disabilities historically lack an evidence base.

Approach – After a decade, the first-generation re-entry programs for ex-inmates with psychiatric disabilities have yielded little in the way of empirical data, but they have provided models for program expansion and imperatives for second-generation program assessment. Related research findings for first- and second-generation programs are highlighted with an emphasis on a unique statewide program in Massachusetts.

Findings – A review of the first- and second-generation programs suggests that progress has been slow in identifying empirically supported best practices for this population. There is a growing evidence base that community reintegration outcomes for ex-inmates with psychiatric disabilities are the result of demographic and criminal history variations, yet implications of these variations needs further exploration in the realms of service access and receptivity as well as variations in postrelease adaptation.

Implications – More knowledge and innovative research is needed on the experience of ex-inmates with psychiatric disabilities and social integration. Resources for cost effectiveness studies as well as long-term follow-up qualitative studies are necessary.