Community Reintegration Research Articles

‘I just don’t want them to be my patient again’: an exploratory mixed-methods study examining provider home safety concerns for adolescents with acquired brain injuries in the US Midwest

ObjectiveAdolescents with acquired brain injuries are at risk for additional injuries after hospital discharge. We asked healthcare providers to identify and prioritise urgent hazards in the home setting for this...

Integrating physiotherapists in disaster management: A key to comprehensive recovery

Abstract Disasters, both natural and man-made, pose significant challenges, causing substantial loss of life, property damage, and environmental degradation. Physiotherapists play a crucial role in disaster management, spanning prevention, preparedness, response, and recovery phases. They provide acute care, and long-term rehabilitation, addressing physical and psychosocial recovery aspects. Case studies from the Kashmir, Nepal, and Haiti earthquakes illustrate the vital role of physiotherapists in triage, wound care, mobilization, and community reintegration. Despite barriers such as resource limitations and professional challenges, physiotherapists enhance disaster response through specialized skills and multidisciplinary collaboration. To improve disaster management, recommendations include policy support, training, capacity building, and international cooperation. Investing in physiotherapy in disaster management is essential for building resilient, inclusive communities capable of facing future challenges.

Applying the Risk–Need–Responsivity (RNR) Model to Transgender Women in the Criminal Justice System

Transgender women are at least twice as likely as cisgender people to be incarcerated in their lifetimes, and, in custody, they experience harassment, abuse, and denial of affirming healthcare. Despite several legal and policy changes intended to improve these conditions, there has been little discussion about the need for evidence-based rehabilitation with the population. This article examines the use of the risk–need–responsivity (RNR) model with transgender women in the criminal justice system and discusses how it can be beneficial for tailoring rehabilitation services to address the unique needs of the population, thereby improving opportunities for successful community reintegration.

Understanding health and illness among incarcerated persons in the Slovenian correctional system: A qualitative study

Understanding the perspectives of incarcerated persons on health and illness, as well as the social contexts influencing these perspectives, is important for developing healthcare interventions that effectively address their specific needs and improve overall well-being. The aim of this study was to explore and understand the complex, multi-dimensional experiences of health and illness among incarcerated persons within the Slovenian correctional system. This study employed an interpretative descriptive design. Using purposive sampling, ten incarcerated persons—five females and five males—were invited to individual, face-to-face, semi-structured interviews. Thematic analysis was conducted in accordance with the interpretative description analytical process. Four major themes were identified: (1) Perspectives on health and illness during incarceration, (2) Healthcare access and self-care during incarceration, (3) Social contacts and their impact on health, and (4) Programmes and activities to enhance well-being. The findings highlighted a shift in perception among participants from a traditional view of health as merely the absence of illness to a more dynamic and holistic understanding, encompassing physical, mental, and social determinants of health. The structured environments within prisons can sometimes paradoxically improve physical health by promoting positive health behaviours, yet they often exacerbate mental health challenges due to restricted freedom and social isolation. The study's implications are significant for policy-making, suggesting that integrated health strategies can significantly improve health outcomes for incarcerated populations, aligning with public health objectives and ensuring better community reintegration.

Strategies Used by Students in Correctional Facility for Accessing Educational Resources: The Case of a Namibian Correctional Facility

The purpose of the study was to examine strategies used by students at a Namibian Correctional Facility in accessing educational resources while studying in prison. The paper's central claim is that, despite their severe living conditions, inmates are motivated to further their studies. This research was carried out in a correctional facility in Namibia. This study was qualitative in nature, using interviews as a means of data collecting while adhering to an interpretive paradigm. A skilled transcriber transcribed the audio-recorded interviews verbatim, and the author was provided with the transcripts for interpretation. The analysis was conducted thematically. With regard to correctional facility services, Namibia's legal system saw significant transformations as it moved from an approach centred on punishment and isolation to one that emphasises rehabilitation and community reintegration.

Prevalence, Reasons, and Prevention for Drug Related Death After Release from Prisons: A Systematic Review and Meta-analysis

Context: Drug-related mortality is a major concern in public and global health discussions. Objectives: Therefore, the aim of this study was to investigate the prevalence, causes, and prevention of death after individuals are released from prison. Methods: This study was conducted systematically using MeSH keywords with no language or time restrictions. PubMed, Scopus, and Web of Science databases were extensively searched for observational studies from 1980/1/1 to 2023/12/30, following the PRISMA checklist. Fourteen research studies were ultimately included in the systematic review process. The CRD code is CRD42024571756. Results: The two-week period following release, with an 18% prevalence, was identified as the time when most overdose deaths occurred. The leading causes of death included prior heroin use, previous experiences with drug withdrawal, drug injection, and sedative use within six months before death. Compared to other unnatural causes of death, there was an increased risk of fatal drug overdose for individuals who died within the first two months of release. Men had higher death rates from all causes compared to women. Most studies reported that substance abuse treatment during imprisonment and providing take-home naloxone for emergencies protected against mortality from all causes. Conclusions: In conclusion, evidence from these systematic investigations highlights the urgent need for targeted interventions to address substance use disorders and overdose prevention among individuals recently released from prison. Efforts to bridge the gap between incarceration and community reintegration should prioritize comprehensive substance abuse treatment programs to reduce the heightened risk of mortality in this vulnerable population.

Professional reintegration of stroke survivors and their mental health, quality of life and community integration.

To assess the association between professional reintegration and mental health, quality of life (QoL) and community reintegration of stroke survivors. Using a cross-sectional study design, a structured questionnaire was administered to previously working stroke survivors, 18-24 months post-stroke. Data on sociodemographic characteristics, professional reintegration (prevalence of return to work (RTW), period of RTW, job placement, function at work, reintegration support, association of stroke with work and number of working hours), mental health (Hospital Anxiety and Depression Questionnaire), QoL (Stroke Specific Quality of Life Scale) and community integration (Community Integration Questionnaire) were reported by 553 stroke survivors. Twenty months after stroke, 313 (56.6%; 95%CI 52.4-60.8) stroke survivors had return to work. RTW was positively associated with both global and sub-domains scores of Community Integration Questionnaire (CIQ) (global CIQ β = 3.50; 95%CI 3.30-3.79) and with depressive symptomatology (β = 0.63; 95%CI 0.20-1.46) measured by the Hospital Anxiety and Depression Scale. No significant differences were found regarding QoL, according to RTW status. For those who RTW, no significant associations were found between any of the professional reintegration determinants assessed and mental health, QoL and community integration scores. RTW seems to be associated to better community integration after stroke, but appears to be negatively associated to stroke survivor's mental health, namely considering depression symptoms. Future studies should explore the barriers to stroke survivors' RTW and the challenges and strategies used to overcome them, to allow the development of professional reintegration policies.

Working in partnership to reduce re-offending and improve prison leavers’ lives: a process evaluation of a prison leaver pilot project

Prison leavers encounter significant barriers to successfully re-integrating into the community, which can lead to re-offending. Complex interventions which are multi-faceted and involve successful partnerships are needed to meet the distinct health and social needs of this population group. For this study, we conducted a process evaluation of a pilot project, which aimed to offer holistic support to prison leavers through a combination of peer mentoring, sport and physical activity, and signposting, delivered in a community setting. Semi-structured interviews and focus groups were conducted with individuals (n = 14) involved in the delivery and the management of the project to understand how it had been implemented and what factors had influenced the delivery and partnerships involved. Factors that influenced project delivery included safeguarding and risk assessment concerns, lived experience of peer mentors, accessibility of the intervention, and the role of sport and physical activity as a vehicle for community re-integration. Partnership working was influenced by effective information sharing, organizational commitment, building relationships and professional networks, and regular communication between organizations. An intervention involving peer mentoring, sport and physical activity, and signposting, supported by close partnership working, was viewed as a promising approach to support the community re-integration of prison leavers.

Pre-disaster family visits and post-evacuation return to Fukushima among psychiatric inpatients evacuated to out-of-area hospitals after the nuclear accident.

This study aimed to elucidate the effects of pre-evacuation family hospital visits on post-evacuation returns to Fukushima Prefecture (hometown) among psychiatric inpatients who mandatorily evacuated to hospitals outside the prefecture because of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Of the inpatients in Fukushima, 44 were admitted to a hospital in the nearby Soso district on March 11, 2011, and were therefore included in the current analysis. We collected information on their discharge after the evacuation and family visits before the evacuation by reviewing the medical records of both the evacuation destination and former hospitals. The average durations from the accident to post-evacuation return among patients with and those without former family visits were 681.8 days (standard error [SE] = 163.3) and 1,027.8 days (SE = 152.0), respectively. The log-rank test showed a tendency of earlier return to Fukushima among inpatients who had received family visits to the hospital before evacuation (p = .073). The results highlight the critical need for close collaboration between psychiatric medical practitioners and families, to not only support patients' community reintegration into daily life but also facilitate a timely return to their hometowns following long-distance evacuation caused by an unforeseen large-scale disaster.

Influence of Posttraumatic Stress Disorder Severity on Return to Substance Use Immediately Following Residential Substance Use Treatment

AbstractThe period immediately following residential substance use disorder (SUD) treatment is characterized by high rates of return to substance use. Posttraumatic stress disorder (PTSD) is highly prevalent among individuals in residential SUD treatment and is a primary motive for substance use among individuals with co-occurring PTSD and SUD. Addressing important gaps in the literature, the current study examined the role of PTSD severity on days of substance use during the 30 days immediately following residential SUD treatment over and above demographic, SUD, and clinical factors associated with return to substance use. Participants (N = 65, Mage = 40.6, 52% women, 79% white) completed semi-structured diagnostic interviews for PTSD and SUD and self-report measures of demographics and depression while in residential SUD treatment (approximately one week before discharge), and then a follow-up assessment (timeline follow-back for substance use) approximately one month after discharge. Greater PTSD severity was associated with more days of substance use in the 30 days immediately following residential SUD treatment over and above demographic (i.e., race/ethnicity, gender, employment, housing insecurity), SUD (i.e., alcohol, stimulant, opioid, cannabis, and sedative/hypnotic/anxiolytic use disorder severity), and clinical (i.e., depression severity) factors. Findings underscore the importance of PTSD assessment and intervention during residential SUD treatment and re-entry planning to assist in mitigating return to substance use during community reintegration.

Perception of community reintegration among individuals with spinal cord injury in northwest Nigeria: a qualitative description

Purpose To explore the meaning of community reintegration and strategies for promoting community reintegration based on the lived experiences of individuals with spinal cord injury in northwest Nigeria. Material and Methods Using a qualitative description, we purposively recruited people with spinal cord injury residing in Kano, Nigeria. Eight focus groups were conducted to gather relevant information about the meaning and strategies for community reintegration, based on the lived experiences of the participants. Results A total of 64 people aged 18-60 years completed the study. Most of the participants had lived with spinal cord injury for more than five years. The individuals perceived community reintegration as a multi-dimensional concept reflected by five major themes namely: living life as usual, gainful engagement, a basket of opportunities, courage and support, and acceptance of destiny. Furthermore, the participants considered education and awareness about spinal cord injury, supportive and enabling environment, equal opportunities, care and moral support, and accessible health and rehabilitation services as critical for promoting community reintegration. Conclusion Community reintegration is a multidimensional process, and its promotion in northwest Nigeria requires a multisectoral approach.

``Getting People Back Into the Community'': Forensic Mental Health Nurses' Perceptions and Experiences of the Recovery Model Within a High-Secure Hospital.

The implementation of the recovery model into forensic mental health care promotes hope and has important implications for inpatients' community reintegration. This study aimed to describe forensic mental health nurses' perceptions and experiences of providing care using the recovery model within a high-secure forensic hospital in Queensland, Australia. Twenty-seven forensic mental health nurses were interviewed regarding their perceptions and experiences of providing recovery-oriented care within a high-secure forensic hospital. The participants described an individualized approach to recovery, both in the goals developed and in the level of support they required. There was an overarching shared goal across the participant group, which was focused on supporting patients to reintegrate back into the community. Inadequate resources (both internal and external), the severity of patient psychopathology, legal constraints, and the nursing role within the broader treating team were all perceived to present challenges to utilizing the recovery model within a high-secure forensic hospital. To fully realize the potential of the recovery model, a system-wide reconceptualization is necessary.

Safeguarding migrant and refugee children: a critical contemporary challenge

This paper investigates the pivotal role of psycho-social support in bolstering the mental and spiritual well-being of migrant and refugee children. It highlights the necessity to shield these vulnerable groups from spiritual abuse within humanitarian efforts. Remarkably, an estimated 117 million people are currently displaced by conflict, violence, war, and natural disasters, and as of 2023, nearly half of them are under the age of 18. The call, therefore, for culturally sensitive, effective interventions is manifestly urgent. Our research underscores, in order to highlight, the significance of professionalizing faith-based and local faith actors to advocate for standards that mitigate the risks of religious exploitation and safeguard the children’s spiritual identity, practices, and beliefs. We highlight the existing gaps in the literature and propose a framework for further research. Our focus is on the effectiveness of the Global Compact on Refugees and the impact of local versus global policies on the protection and well-being of migrant and refugee children. Our analysis extends to humanitarian agencies’ and caregivers’ best practices and prevention strategies. It further emphasizes the importance of safeguarding neutrality at all times and promoting community reintegration. Our findings call for a concerted effort to enhance professionalism among those working with refugees in humanitarian frameworks, prioritizing children’s spiritual, mental, and physical well-being. This study seeks to contribute to the ongoing discourse on the rights of children on the move. It advocates for policies and practices that recognize their vulnerability and potential for resilience.

Experiences of community reintegration after obstetric fistula repair at Jean Paul 2 hospital, Conakry, Guinea.

The study explored women's experiences of their community reintegration process after surgical repair of obstetric fistula at Jean Paul 2 Hospital in Conakry, Guinea. The study examined how lived experiences of the disease impacted on the community reintegration of treated women. Using a qualitative research methodology, ten women participated after giving informed consent. Semi- structured interviews, lasting an average of 30 to 60 minutes were guided by an interview guide. The main themes covered were experiences with the disease, perceived social support and reintegration into the community. According to the participants, delays in obstetric care were the main cause of obstetric fistula. Socio- economic, cultural and medical factors such as early marriage, lack of education and poverty contributed to these delays. Even after surgical repair, women continued to endure the physical and psychosocial consequences of the disease, exposing them to stigma, discrimination and even rejection within the community. Study participants also reported a lack of social support. The little support perceived by these women concerned food and medical needs. This made the women dependent on their families. Reintegration into the community also proved difficult due to the persistent silence and stigma surrounding their situation. The study results highlight the complexity of the challenges faced by women with obstetric fistula in their journey towards integration. Effective management of obstetric fistula requires a holistic approach victims, their communities, health professionals and decision-makers in solving this problem. So, to improve women's reintegration after treatment for obstetric fistula, it is vital to raise awareness of the causes and consequences of the disease among the women concerned and their families, and to provide rapid access to emergency obstetric care, reinforce social support and set up economic empowerment programs.

Environmental facilitators and barriers to community reintegration experienced by stroke survivors in an under-resourced urban metropolitan sub-district

Environmental facilitators and barriers to community reintegration experienced by stroke survivors in an under-resourced urban metropolitan sub-district

Unlocking Second Chances: Scoping review of the parole system and the path to successful community reintegration in Malaysia

This paper intends to explore the parole system and how the system can assist with the successful reintegration of parolees back to the societies. Being ex-convicts, they face several challenges, such as lack of employment opportunities and discrimination, which hinder successful parole reintegration. The parole system, however, can be used to implement reintegration strategies to create change. Despite the abundance of studies on how employers perceive ex-convicts, there needs to be more research on the success of their reintegration into the workforce and society. This paper employs scoping review methods by identifying the existing literature about the parole system in Malaysia and the successful reintegration strategies. This paper concludes that the Malaysian parole system has unique features through the strategies implemented toward the effective reintegration of parolees.

Using the Knowledge to Action framework to improve housing and support for people with Multiple Sclerosis.

Background People with Multiple Sclerosis (MS) have unique housing and support needs that are essential for maintaining independence at home; however, there is limited research to guide the design of community living options for this population. The aim of this study was to examine housing and support needs and preferences of people with MS with the intention to inform the planning of a co-designed intervention based on the study's findings. Methods Using the Knowledge to Action (KTA) framework, quantitative (n =79) and qualitative (n =6) data from people with MS were extracted and integrated from projects completed by the research team that explored the housing and support needs and preferences of people with disability. Results were synthesised and presented to a reference group for validation, contextualisation, and adaptation to the Australian context. Results High physical support needs were common across participants. People most commonly required home modifications to improve accessibility, such as ramps, equipment such as heating and cooling, and assistive technology. Many people required more than 8 hours per day of paid support. Moving into individualised housing facilitated independence and community reintegration. People reported gaps between what they wanted from support workers and what they received, citing individual and systemic barriers. Conclusion People with MS have support needs that require proactive and responsive funding arrangements, housing design and support provision. In line with KTA principles, findings will inform the planning of a co-designed intervention that involves people with lived experience of MS and other stakeholders to influence policy and improve home and living outcomes for this population.

Profile of forensic patients admitted for medico-legal and psychiatric assessment at Ndera Neuro-Psychiatric Hospital in Kigali, Rwanda: demographic, clinical and forensic factors

ABSTRACT Forensic psychiatric care aims to improve mental health and reduce recidivism in mentally disordered offenders, facilitating community reintegration in a secure treatment environment. This study explores the sociodemographic and clinical characteristics of individuals undergoing medico-legal psychiatric assessments at Ndera Neuro Psychiatric Hospital in Kigali, Rwanda. Conducted as a descriptive study, data were collected retrospectively from patient files, with analysis revealing that the majority (76%) were males, predominantly aged 18–45 years (median age 31.5 years). A significant proportion (62.9%) was single, and unemployment rates stood at 56.4%. Clinically, 53% had a history of psychiatric illness, with substance abuse (24.2%), bipolar disorder (14.5%), and schizoaffective disorders (6.5%) being the prevalent diagnoses. Notably, 41.9% had comorbidities. The crimes committed included physical assault (46.7%), sexual assault (25.8%), and murder (21.0%). These findings emphasize the need for targeted policies addressing mental health and socioeconomic disparities in this population, as well as interventions to reduce criminal involvement. It highlights the complexity of cases, with a considerable proportion exhibiting multiple hospital admissions and diverse psychiatric conditions. The study underscores the importance of a secure treatment environment, aligning with the broader objective of improving mental health and minimizing recidivism in mentally disordered offenders.

Stakeholders’ perspectives on community reintegration after spinal cord injury in South Africa

Stakeholders’ perspectives on community reintegration after spinal cord injury in South Africa

A Meta-Analysis of the Effectiveness of Restorative Justice Programs in Reducing Recidivism: A Global Perspective

Restorative justice (RJ) is a growing alternative to traditional punitive justice, emphasizing offender accountability, victim reparation, and community reintegration. This meta-analysis aims to quantify the effectiveness of RJ programs in reducing recidivism across diverse global contexts. A systematic search of electronic databases (Scopus, Web of Science, PsycINFO) from 2018-2024 was conducted, including studies that assessed the impact of RJ on recidivism using experimental or quasi-experimental designs. The primary outcome was recidivism (any reoffense), with secondary outcomes of violent and non-violent recidivism. Random effects models were used to calculate pooled effect sizes. Thirty-two studies met the inclusion criteria (N = 18,654 participants). The overall pooled effect size for RJ on recidivism was -0.11 (95% CI -0.15, -0.07), indicating a small but statistically significant reduction in recidivism compared to traditional justice. Subgroup analyses revealed greater effects for youth offenders (-0.16) and for programs with high adherence to core RJ principles (-0.18). In conclusion, RJ programs demonstrate a modest but consistent effect in reducing recidivism. The findings support the continued implementation and expansion of RJ, particularly for young offenders and in settings with strong adherence to RJ philosophy.