Reading time: 3 minutes 27 seconds (863 words)
The direct effect of mental illness on the “prison revolving door” is relatively small, but its indirect impact can be significant when combined with other risk factors. The chief factors that amplify the effects of mental illness are homelessness and substance use.
Several gaps exist in how these and other factors are addressed, both before and after people with mental illness are released from prison. The evidence is still mixed, but there is growing agreement that integrated, multi-agency programs that begin before release and continue after can reduce the likelihood of reincarceration.
During his talk at the International Forensic Psychiatry Lecture Series, Dr. Roland Jones discussed the importance of building cross-sector collaboration between corrections, health, and community supports to help smooth the transition from prison to the community. To give these individuals a solid start toward rebuilding their lives, Dr. Jones highlighted the need to invest in comprehensive, sustained transition services rather than just short-term fixes. Interventions focus on housing, substance use, and severe illness.
AI-generated image using ChatGPT
Mental Illness and Reincarceration
Between 50 per cent and 60 per cent of individuals who leave prison return within three years. People with serious mental illness are up to 40 per cent more likely to be reincarcerated within the same time.
Mental illness alone is seldom the direct cause of this difference, but when other risk factors are also at play, the link becomes stronger. Common risk factors for reoffending are much more prevalent and harder to address among people with mental illness.
Risk Factors
Several common risk factors influence the likelihood of anyone returning to prison. These include gender (higher risk for young adult males), the individual’s history of crime, unstable housing, unemployment, poverty, and substance use or dependency. The combination of these common risk factors with severe mental illness — particularly schizophrenia, major depression, or bipolar disorder — greatly increases the risk of reincarceration.
In addition, mental illness leads to different treatment by the justice system in the form of increased monitoring and restrictions. This also raises the likelihood of return to prison if the person has no reliable support system in the community.
Of the known risk factors, homelessness is the strongest predictor that a person with mental illness will end up back in prison. The risk becomes greater if the person also uses stimulant drugs.
Lessons Learned
Several gaps in the system make it hard for individuals with mental illness to access the care and assistance they need in the community. If they only receive planning help before they leave prison but no post-release help, they leave alone and unsupported without the tools to succeed or any knowledge of how to find them. This approach increases reincarceration.
Even when programs offer brief post-release support, it often comes through short-term or single-focus programs that end before providers can establish key solutions like consistent medication and reliable housing. This also leaves the person with mental illness unsupported and at high risk of reoffending.
The system of available support services is complicated and disconnected, which makes it difficult for the general population to navigate. This challenge can be even greater for people with mental illness. In contrast, a comprehensive, collaborative approach that begins before release and continues over a longer period after allows for a higher chance of success.
With an integrated, multi-agency program, intervention begins before release and continues with the same single point of contact for at least six months after release. This way, the individual gets to meet with a familiar face after leaving prison. They get to talk with someone right away who knows their story and who knows how to navigate the system. They have a real chance of succeeding.
This approach allows the time it often takes to set up safe and reliable housing and basic social supports that people with mental illness need to access vital, ongoing psychiatric care and medication.
The Way Forward
A new service in Toronto directly builds on these lessons and addresses critical gaps in care when people are released from custody. The Forensic Early Intervention Service Community Team (FCT) extends the Forensic Early Intervention Service (FEIS), which delivers specialist mental health care in two correctional facilities in Toronto into the community.
The FCT functions as a bridging service, providing rapid access to care immediately following release, delivered by the same multidisciplinary team operating in custody. The service offers timely access to a psychiatrist, social worker, and nurse for medication initiation and continuation, clinical monitoring, and intensive case management.
Beyond clinical care, the FEIS community team provides continuity of care and system navigation, supporting individuals with housing, obtaining financial assistance, getting identification, enrolment with a primary care provider, and referral to addiction services as needed. The service also facilitates transition to longer-term community mental health teams and comprehensive community supports for sustained follow-up.
Comprehensive, multi-agency intervention makes a difference. Investing in, researching, and expanding on this approach will help guide further advocacy efforts for people with mental illness as they leave prison and transition back into society.
For more details, watch the recording of the October 9, 2025, lecture, “Reducing Reincarceration Among People with Mental Illness” on our website.
Written by Carolyn Johnstone and approved by Dr. Roland Jones.
