Recovery, social integration and support upon leaving the prison
The reintegration into community life of individuals who have served a prison sentence or been subject to a security measure is an enormous challenge, both for them and for the community they aspire to return to with the greatest possible guarantees of integration. This challenge is, at the same time, a great opportunity for the organizations that intervene and support them in the rehabilitation and reintegration process.
Achieving a fulfilling life with new meaning for the people we serve, even when they have a serious mental disorder and are in a situation of deprivation of liberty, requires the maximum possible guarantee of psychosocial stability.
To guarantee this stability, we must establish a therapeutic plan focused on overcoming current difficulties, acknowledging existing limitations, and envisioning new opportunities to create a solid life project tailored to each individual's specific needs. In this context, a broad perspective and the involvement of both support networks (prison and community) are essential. It is at this point that collaboration between them becomes fundamental.
It's important to keep in mind that reintegration processes involve different stages influenced by many factors (development, support figures, expectations). Therefore, it's essential to invest in intervention models with a greater presence in the community, strengthen coordination between prison and community structures, promote therapeutic coexistence, and optimize the resources involved, thereby improving the prognosis for social integration of the individuals we serve.
Individuals returning to community life after a period of incarceration, regardless of whether they have a mental health condition, require significant support and flexibility from the services offered by the community network . This premise may seem logical and accepted by society, but the reality is that the population we serve in the prison system typically presents characteristics, beyond mental health issues, that hinder proper and gradual social reintegration and often lead to vulnerability, increasing the risk of recidivism and return to prison. If a mental health condition is added to this, the difficulties can increase exponentially without appropriate treatment and a personalized reintegration process. For this reason, effective coordination among all stakeholders within internal and external structures is crucial, as is strong community involvement during the rehabilitation process, to increase the likelihood of establishing a suitable and progressive community connection.
The role of families in the recovery of people with mental disorders who are deprived of their liberty
The role played by the family or social support network of the people we serve is a fundamental pillar in the reintegration process. It is important to define the role that the socio-familial context will play in the lives of those we serve. Planning ahead and ensuring the family's participation in the social reintegration process helps clarify how the support relationship will be established.
A unit specializing in community transit
Reintegration begins in the rehabilitation phase. This is when we intervene and establish a community-focused work plan, taking into account the needs, interests, preferences, and expectations of the people we serve.
Since 2006, the prison mental health hospitalization units, first at the UHPP and later at the UHRPI, have integrated this community-based intervention model with the creation of what we call the TAC unit, Transition to the Community. Since 2017, this unit has been located at the UHRPI, with a capacity of 20 beds. The admission criterion for this unit is the remaining time of incarceration. We understand that reintegration begins during the prison stay, and considering the processes of community reintegration and the often lengthy and complex legal procedures and timelines, individuals should work on reintegration for at least the two years prior to their release.
The TAC unit is staffed by healthcare professionals with extensive experience in community-based rehabilitation and who are familiar with the processes required in the judicial, prison, and community systems to ensure that the needs of individuals completing their prison sentence are met upon release. These needs include, among others, accommodation, guaranteed follow-up in community mental health services, and support systems such as family or other support groups. In addition to these needs, we must also consider financial resources, document management, and, in some cases, compliance with any supervised release conditions that may be imposed.
From the TAC unit, we strive to meet these needs through psychological, nursing, educational, and social interventions. These interventions ensure that the individual receiving care can manage their mental disorder, control their emotions, cope with stigma, integrate into their family, participate in educational and/or employment activities, and address any other areas of need requiring attention. To achieve this, we utilize the resources available within the prison/judicial system, such as therapeutic releases and furloughs. We connect and support the individual in all necessary settings. We accompany them to their homes, to initial appointments with their assigned mental health center, to social services, and to other relevant support services.
Fortunately, in 2017, the Individualized Support Program (PSI) in the prison setting was implemented. This program is aimed at incarcerated individuals with severe mental disorders who are in a semi-liberty regime (known as the third stage of the prison system). It provides continuity of care upon their return to the community. This voluntary resource is offered to individuals at the end of their sentence to ensure they receive the necessary external support. The type of support, its frequency, and ultimately, the relationship between the case manager and the individual are decided jointly. Through the PSI program, individuals are connected to community services, which helps reduce the stress of facing a significant life change requiring greater autonomy, independence, and responsibility. Experience supports the idea of promoting this follow-up, which also strengthens ties with community services.
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