Community-Based Mental Health and Substance Use Services for People Leaving Prison: Equity and Inclusion Strengths and Limitations in Specialized Service Inventory Development.

Community reentry from prison is a challenging process, especially for persons with lived and living experience of mental health concerns. Access to appropriate community-based care for those leaving prison is a key part of improving health equity for this population. Our work to develop a cross-Canada inventory of active community mental health and substance use services for criminal justice-involved persons represents a valuable example for others hoping to conduct projects that are similar in nature and scope. We describe the strengths and limitations of our health equity-informed, multi-pronged approach to service inventory development, highlighting the importance of considering and addressing search- and stakeholder-related biases. Investment of time and resources is critical to ensuring comprehensive and inclusive identification of community-based mental health services and meaningful resource development.

Addressing the complex substance use and mental health needs of people leaving prison: Insights from developing a national inventory of services in Canada.

Internationally, transitions from prison to the community are often precarious experiences for people who are living with substance use and mental health concerns. In Canada, a continuing opioid overdose crisis and overlapping challenges related to the COVID-19 pandemic have generated urgency for scaling up community-based services that can meet the complex substance use and mental health needs of people leaving prison. In this commentary, we reflect on our experience with and knowledge gained by developing a national inventory of substance use and mental health services for criminal justice-involved persons who are re-entering the community. We learned that there is a scarcity of such community-based services specific to criminal justice-involved populations and a glaring lack of information about culturally safe and appropriate supports. Stakeholders from organisations across Canada identified that communities need a comprehensive array of low-barrier services, inclusive of harm reduction and substance use treatment services, to meet the diverse needs of people leaving prison. We recommend building greater investment in and awareness of community-driven, local programs, as well as enhancing efforts to engage people with lived and living experience in service design and provision. We also briefly describe a few programs to highlight examples of how to operationalise the themes that we observed to emerge while developing a national inventory of community-based substance use and mental health services for criminal justice-involved persons.