A Qualitative Study of Success in Postrelease Federal Inmates With Mental Health Issues

Abstract

Considerable research has focused on factors that put individuals at risk for recidivism after their release from incarceration. While recent research has increased the focus on protective factors and resilience, the experiences of people with mental health issues who successfully reintegrate into the community are not well-understood. The present study was conducted to determine which positive factors are implicated in the successful reintegration of people with mental health issues. In-depth, semi-structured interviews were conducted with four male former federal inmates on supervised release in Canada. The interviewees were nominated by staff who knew them to have previously been diagnosed with a mental disorder and perceived them to be doing well in the community. Volunteering and social support were found to be of the greatest importance in their successful outcomes. Additionally, all interviewees had access to mental health services, which likely influenced their success.

Introduction

Correctional agencies have a vested interest in promoting desistance from future criminal behavior in their releasees. In fact, desistance is habitually reported as a prime measure of success following release from jail or prison (McNeill, 2012). To date, the vast amount of criminal justice and criminological research on desistance focuses exclusively on risk factors for recidivism (e.g., Andrews & Bonta, 2010; Mulder et al., 2011). While risk factors are important in their own right, they neglect to address the factors that contribute to the success of individuals postrelease (Farrington, 2010). These risk factors are salient whether or not the former inmate is under the supervision of a parole officer.

The current approach to studying desistance is almost entirely focused on negative events, such as people who experience and engage in risk factors and continue to commit crime. With a recent shift toward a more positivist psychological approach in criminological research, the importance of research that details crucial factors that are associated with successful release from corrections will assist in the provision of effective interventions that target these factors, as well as promote the growth and well-being of former offenders and, ultimately, reduce recidivism rates.

Desistance and Strengths-Based Approaches

Desistance is comprised of two major components: 1) a history of multiple criminal acts and 2) a cessation of all criminal behavior (Serin & Lloyd, 2009). The process of desistance, whereby an individual ceases criminal behavior, involves a variety of internal (i.e., thoughts, self-regulation, long-term goals, motivation) and external (i.e., family, employment) factors (Serin & Lloyd, 2009). By promoting these identified factors, the cessation of criminal behavior can be facilitated and maintained (Serin & Lloyd, 2009).

A widely cited theory related to criminal desistance was proposed by Laub and Sampson (2001). Their theory, a life course theoretical framework, focuses on key sources of change that can impact the desistance process. Life course theory researchers posit that crime generally declines with age as a result of a combination of individual actions (choice), situational contexts, and structural influences. Active participation in the desistance process and major life events such as marriage or work are extremely important for avoiding future crime (Laub & Sampson, 2001). Structured life roles (e.g., father, husband, employee) offer stability and provide meaning in the lives of former offenders, which in turn contributes to refraining from criminal behavior. This theory suggests that desistance also has a “knifing off effect” by which being cut off from an offender environment gives rise to a new prosocial one, allowing for successful rehabilitation into the community.

Life course theory also details factors that put people at risk for continuing to engage in criminal behavior following release from a correctional facility (e.g., Andrews & Bonta, 2010; Mulder et al., 2011). Other theories that address desistance also emphasize an “aging out” process in which the person gravitates towards more prosocial relationships and attitudes. For example, Hirschi (1969; also see Hirschi & Gottfredson, 1983) argued that social control plays a large role in desistance, particularly the elements of attachment, commitment, involvement, and beliefs. The researchers add that self-control is also an important factor in the desistance process (Gottfredson & Hirschi, 1990). Other theorists like Moffitt (1993) posit that that study of desistance requires recognition of differences in sample groups. Moffitt (1993) stresses the differences that exist between those who commit adolescent acts of deviancy and crime (then desist) and a more serious group who persist in crime throughout the life course. While these approaches recognize variability in terms of the seriousness and persistence of criminal acts over time, they simultaneously fail to include issues of vulnerability such as mental illness. In other words, these theories are aimed at the “typical offender” committing the “typical crime” and thus gaps remain in terms of the application of desistance-age-based theories in the context of an individual with a mental health disorder. The introduction of such an approach may also lead to the modification of existing risk factors, which in turn may lead to differing policy implications for mentally ill individuals who are working toward desistance.

Risk factors for criminal behavior in general are characteristics that increase the likelihood or probability that an individual will demonstrate crime-related behaviors (Farrington, 2007; Ullich & Coid, 2011). Andrews and Bonta (2010) identified eight factors that have consistently been supported in the literature as being risk factors for criminal behavior: antisocial attitudes, antisocial associates, a history of antisocial behavior, antisocial personality pattern, problems at home, problems at school or work, problematic leisure circumstances, and substance abuse. While a focus on these factors has produced considerable innovations in the treatment of those who commit criminal offenses, a narrow focus on these risk factors to the exclusion of more positive factors can generate negativity, labeling, and stigmatization within offender management (de Ruiter & Nicholls, 2011).

In recent years, a more positive shift toward community reentry has taken place, focusing on the protective factors, or those that are associated with an increased likelihood of successful reintegration into the community despite past criminal history and other existing barriers (de Ruiter & Nicholls, 2011; de Vogel et al., 2011; Ullrich & Coid, 2011). Farrington's (2007) definition of these protective factors includes the following three elements: they are 1) on the opposite end of the continuum to risk factors and linearly related to violence, 2) free-standing and nonlinearly related to violence, or 3) include variables that interact with risk factors to minimize or buffer the effects of risk factors and may or may not be associated with violence (Farrington, 2007). There is consensus among researchers that protective factors can in fact serve to mitigate the effects of risk factors and reduce the likelihood of recidivism (e.g., de Vogel et al., 2011; Lodewijks et al., 2010). For example, Jones et al. (2015) found that the inclusion of strengths significantly improved the prediction of recidivism in high-risk cases in a sample of 3,656 adults on parole. There is also support among practitioners that a comprehensive assessment should include strengths and protective factors, in addition to risk factors, in order to develop useful interventions (de Ruiter & Nicholls, 2011; Farrington, 2007).

A body of research has since identified protective factors that correlate with the reduction of recidivism in the released population (e.g., Bahr et al., 2010; de Vogel et al., 2009; Ullrich & Coid, 2011). Commonly cited protective factors in this population include education, employment, volunteering, social support, religion, community-based programs, and attitudes/goals. In a study of 1,396 males, Ullrich and Coid (2011) identified a number of protective factors impacting releasees that were particularly salient to violence. Of the five factors identified as having protective effects for violence after release, most related to the presence of social relationships: social support, emotional support, spare time spent with family or friends, involvement in religious activities, and closeness to others.

Similar to theoretical models demonstrating a need to recognize protective factors are the emergence of measurement tools designed to evaluate those who have offended. Due to a recent focus on violence prevention and postrelease outcomes, the Structured Assessment of Protective Factors (SAPROF) instrument was created to assess risk of violence recidivism. The SAPROF includes a positive approach that emphasizes protective factors and personal strengths or resources, rather than being limited to considerations of a person's risk (de Vogel et al., 2011). This was viewed as being a more balanced approach than previous instruments like the Historical Clinical Risk-20 (Webster et al., 1997) for developing treatment plans. Generally, the SAPROF is used for assessment of forensic psychiatric patients and violent individuals. Items identified as protective include work, leisure activities, attitudes toward authority, and social and intimate relationships. Other researchers have contributed to this literature with tools such as the Short-Term Assessment of Risk and Treatability (START), which has been found to be useful for identifying a variety of challenging behaviors in forensic psychiatric inpatients, including aggression, violence, self-injury, and suicide (Nicholls et al., 2006).

It is evident that the identification of protective factors within various groups of releasees has attracted researcher attention, both in terms of theoretical modeling and through the development of practical assessments such as screening instruments. However, there has been a lack of research that focuses on protective factors that influence vulnerable individuals following release. Specifically, there is a dearth of research on mentally disordered individuals and the protective factors that they must employ to desist from crime.

Mentally Disordered Individuals

Research has clearly established that, compared to the general population, incarcerated populations have higher rates of mental disorders (Gilmour, 2014). The prevalence of mental disorders in incarcerated samples varies, in part due to the differing definition of mental disorder used. Prevalence has been found to range from 15% to 82% (Beaudette et al., 2015; Brinded et al., 2001; Brink et al., 2001; Diamond et al., 2001; Magaletta et al., 2009), depending on the definition of mental disorder used, with higher rates generally including antisocial personality disorder and substance abuse disorder. Individuals with mental health issues face additional challenges when released from a correctional facility compared to those without mental health issues. This population is often falsely perceived by the public as more dangerous than the general incarcerated population; however, when compared with the known general criminal population, the recidivism rates of those with mental illness are actually lower (Bonta et al., 1998). Other research supports the idea that inmates with mental disorders are at no greater risk for recidivism than those without mental health issues (e.g., Gagliardi et al., 2004; Theurer & Lovell, 2008). Based on the inaccurate assumptions made by the public and the barriers this population faces upon their release, there is evidently a need for a better understanding of this unique population.

Protective Factors Following Release From Incarceration

Multiple studies have supported a range of factors that are associated with successful community reintegration following release from a correctional facility. This includes, but is not limited to, employment (Bahr et al., 2010; Berg & Huebner, 2011; Harrison & Schehr, 2004; Lockwood et al., 2012; Rhodes, 2008; Savolainen, 2009; Uggen & Staff, 2001), volunteering (Burnett & Maruna, 2006; Taylor, 2008), social ties (Martinez & Christian, 2009; Mills & Codd, 2008; Naser & La Vigne, 2006), intervention programs (Theurer & Lovell, 2008; Ventura et al., 1998), the person's attitudes and goals (Kenemore & Roldan, 2005; Lloyd & Serin, 2012; Serin & Lloyd, 2009), and religion (Baier & Wright, 2001; Farrell, 2009; Giordano et al., 2008; Kenemore & Roldan 2005; Schroeder & Frana, 2009; Stark, 1996).

A review of literature regarding sustainable employment and its critical importance to postrelease success indicates that, generally, elevated recidivism rates are often due to a lack of necessary tools to live independently and maintain employment (Harrison & Schehr, 2004). When provided with such tools, people are likely to be more successful in maintaining employment and reintegrating back into the community without reoffending. Although limited research has investigated the value of volunteer activities as a method supporting a successful transition from prison to the community, it is important to take this factor into consideration, as volunteering may act as a precursor and adjustment period for those who wish to eventually return to work (Burnett & Maruna, 2006).

Support for the importance of social ties (e.g., marriages, intimate relationships, family bonds, parenting roles, and friendships) has also been found in releasees both with (Jacoby & Kozie-Peak, 1997) and without (Giordano et al., 2011) mental health disorders. In a sample of 27 inmates with mental illness from Ohio state prisons, it was found that social support following release was associated with an increased quality of life while incarcerated and after release (Jacoby & Kozie-Peak, 1997). Cohabitation (Savolainen, 2009) and being a parent (Lösel, 2012; Walker, 2010) have also been associated with success in the community. While there is evidently support for the importance of employment and social factors separately, several studies have found an interaction between employment and social relationships as an influential element in the reintegration process. This interconnection makes intuitive sense, with social support providing motivation for seeking employment, while employment fosters prosocial relationships (Feeney, 2008; La Vigne et al., 2008; Savolainen, 2009).

Programs and interventions can be considered protective in that they target an array of factors that have been identified as important for successful community integration, some of which are known protective factors. Mental health issues are highly prevalent in the offender population and treatment specific to these issues should be addressed through community-based programs. In general, some programs that have been specifically designed for those with mental health issues have proven to be effective, and several studies have found that intensive case management programs significantly reduce recidivism rates and provide quicker and more sustained access to mental health services than if these individuals are left to their own devices (Theurer & Lovell, 2008; Ventura et al., 1998).

External factors such as employment and social support are not the only influential elements relevant for successful reintegration. Internal factors such as attitudes, goals, and motivation are also of importance in the process of desistance and in quality of life (Serin & Lloyd, 2009). Kenemore and Roldan (2005) have provided additional support for the importance of attitudes through their qualitative study with ex-offenders, finding that that disciplined thinking and maintaining proactive, positive, and hopeful attitudes contributed to positive outcomes. Commitment to change and intrapersonal moderators drive the transition from crime to desistance (Lloyd & Serin, 2012). Agency, the belief in one's ability to influence one's environment, is specifically considered to contribute to the positive attitudes that facilitate the path to desistance (Lloyd & Serin, 2012).

The issue of spirituality and religion as a protective factor has been under much debate. Some studies have discredited a relationship between religious beliefs and reduced crime rates (Giordano et al., 2008), while others have shown strong support for the importance of religion in a successful release (Baier & Wright, 2001; Farrell, 2009; Giordano et al., 2008; Kenemore & Roldan 2005; Schroeder & Frana, 2009; Stark, 1996). Qualitative research supporting the notion of religion as a protective factor has identified religion as a form of emotional comfort, a distraction from stressors, and an important contributing factor towards the development of a conventional lifestyle. Many of the men struggling with anger, anxiety, substance abuse, and depression issues used religion as a coping mechanism that they could turn to as a source of relief. The transformative potential of religion offered these individuals a sense of hope, belongingness, and comfort that ultimately prevented them from reengaging in crime-related behaviors (Schroeder & Frana, 2009). By addressing a variety of protective factors, a substantial reduction in recidivism rates and an improved quality of life for releasees, including those with mental health issues, could be achieved.

The Present Study

Despite relatively comprehensive evidence supporting the utility of varied protective factors among the inmate population, it is evident that further investigation is necessary to understand these factors within specific subsets of this population. Currently, we have a limited understanding of protective factors and the stigma associated with mental illness still remains, providing additional challenges for this population upon their release into the community.

The present study used qualitative methodology, similar to that of Taylor (2008) and Rhodes (2008), to explore the reintegration experiences of individuals with serious mental health diagnoses. Of specific interest were the “protective factors” that help to facilitate successful reintegration. Much of the desistance literature also uses qualitative methodology to create narratives that inform the understanding of an individual's transition to a crime-free lifestyle (see Maruna & Roy, 2007). It was anticipated that using such methodology would provide a more in-depth understanding of what factors are important to an individual's return to the community, particularly among those with mental health issues who face additional challenges upon institutional release. The study was guided by the following research questions:

• 1.What factors do mentally disordered releasees view as being most important in their successful reintegration?
• 2.What role, if any, do social relationships play?
• 3.What role, if any, do employment, education, community program, or volunteer activities play?
• 4.How does having mental health issues affect reintegration?

Method

Participants

Participants were federal former inmates on supervised release in a major city in Canada. In Canada, all federal inmates (i.e., those sentenced to two years or more) are managed by the Correctional Service of Canada (CSC). Only those who had mental health issues and had been on release in the community for at least three months (i.e., had not committed a new offense or breached their parole conditions) were included in the study. Evidence suggests that after three to six months, the majority of those who recidivate will have already done so, indicating that a three- to six-month follow-up period is sufficient to support research findings (Brown et al., 2009).

Due to its qualitative nature, the study only consisted of a small sample of four participants who were White males. Levels of education were limited, with the highest level of completion being Grade 12. Their ages at release ranged from 40 to 55 years (M = 44.75), and time since release varied from approximately three months to three years at the time of the interview. All participants had been diagnosed with a mental disorder and had co-occurring mental health issues.

Materials and Procedure

The low sample size, n = 4, requires explanation. Recruitment took place through nearby parole offices and correctional community centers (where some releasees reside when on parole) using purposeful sampling. Parole officers identified people they believed to be well-suited to the study and consenting participants (those who provided verbal consent as well as signed a consent form) completed either an in-person or over-the-telephone interview. While parole officers were active in recruitment, there are few individuals released from prison with mental health issues who were functioning well in the community. Restated, it was a rather bleak forecast when only four well-functioning participants could be located by correctional experts; however, this recruitment outcome further supports justification for the current study.

During the interview, participants were asked a variety of questions about their experiences following release from the institution (e.g., employment, mental health, living circumstances, attitudes, relationships). The semistructured interview schedule used was composed by the author in conjunction with other members of the research team and developed based on past research and the current research questions being addressed. Additional information concerning participants' demographics and criminal history was obtained from CSC's Offender Management System (the electronic database maintained by CSC that contains information on all federal inmates).

Data Analysis

Qualitative analysis was conducted using a grounded theory methodology (Glaser, 1992; Strauss, 1987). Grounded theory involves developing theoretical ideas throughout the data collection process. As themes became evident, these themes were verified through further data collection. Throughout the data collection process, empirical indicators (recorded events) were constantly compared, and themes were distinguished to provide the basis for coded categories (Schwandt, 2007). Interview transcripts were imported into Nvivo 7, a qualitative data analysis software that allowed information from the semi-structured interviews to be organized categorically by the first author. Commonly occurring themes were derived based on inductive content analysis of the transcripts, through open coding, category creation, and abstraction (Elo & Kyngäs, 2008).

Results

Five central themes related to protective factors were identified in participants' responses. These were mental health treatment, desistance from substance abuse, volunteering and employment, social support, and religious beliefs. Findings of each theme are described below, and illustrative quotes are provided to emphasize the salience of the themes for the participants.

Mental Health Status and Treatment

All of the men interviewed had been diagnosed with a mental disorder. In most cases, these co-occurred with substance abuse issues or additional mental disorder diagnoses. Schizophrenia, anxiety, and depression were some of the mental disorders that these men struggled with. Having a mental illness created additional barriers for these men upon their return to the community. In some cases, the mental disorder itself was a contributing factor to their criminal involvement as documented by this quote.

P4: Caused me to be, uh, to put myself in trouble a lot of time…Some voices tell me go do this, go do that. And you know. And do this, do that, you're gonna be fine…and then I always end up in jail.

The stress of returning to the community was reported to elevate psychiatric symptoms and make it difficult to successfully return to daily routines.

P3: …when I get stressed out then I'll get like voices in my head and, you know, stuff like that going on. So, I don't handle stress very well, but, um, I take my medication regularly…I worked all my life right up to when I went on my disability but…the stress of the job makes it so that it's hard for me to do my job now.

Of note, each participant had seen a psychologist or psychiatrist at some point in their lives, either in the institution or following their release on parole. They considered their psychologist/psychiatrist as someone they could talk to, someone who could connect them with other support in the community, and a resource for medication management.

P1: “I seen a…psychologist, on one on one and she helped a lot”

P2: …he's taking care of my, uh, medical needs…the [hospital], [doctor]…he's helping me out and then when my supports get a bit lesser because I do have a lot of support right now, he's willing to put me on a case worker there…and then keep on going as long as it will take.

P3: “…This is my first time seeing a psychiatrist since I been in. I go tomorrow…I'm looking forward to that.”

Most participants also indicated that they were on medication for their mental illness and found this to be a significant contributing factor to their success in the community. It also helped maintain stability in their lives.

Desistance From Substance Abuse

All participants had used drugs prior to their incarceration and self-reported substance abuse issues. The major substances of choice were alcohol and cocaine. Abuse of these substances was considered to be a contributing factor to their engagement in criminal behavior. However, the use of substances was also linked to a need to self-medicate the symptoms of mental illness. Desistance from these substance-abusing patterns helped participants refrain from engaging in criminal behavior. Involvement in programs such as Alcoholics Anonymous was reported as an important factor in maintaining a drug-free lifestyle and thus contributed to a successful reintegration.

P2: My drug of choice has been crack cocaine. But I haven't always done that. Um, I knew it was my drug of choice, I knew it was a big, big time trouble and, uh, I needed something to function. So, the alcohol was there all my life, it was, I was self-medicating and also the pot. They was there mostly in the later year of my alcohol use but, umm, they were helping me function. But when I fell into the cocaine and the crack and that really was my downfall.

Volunteering and Employment

Three of the four participants were involved with volunteering in the community following release from prison and expressed that it was an important part of their reintegration. The influence it had varied for each participant, but each believed that volunteering had a positive impact on their successful reintegration into the community. Specifically, it provided them with a potential transition period to employment, a way to give back to the community given their criminal history, and a means to be provided with a prosocial support system.

P2: I'm doing volunteer work and I love that. It's like “wow” I, it really fulfills me and it's really good and I wanna continue in that kind of field…the poor, the people handicap, or the people off the street, uh, I felt that I've abused the system for a very long time and that it just makes sense for me to give back.

P3: …people that I'm meeting, I don't hang around with them or anything, but it gives me a chance to go and talk, to talk to them and stuff. And they're doing the same type of thing I am, so chances are, you know, they're law-abiding citizens right? And that's the kind of people I wanna be around…having a support system's big. And I think of people, like people who say they don't have a support system. Now that I've been volunteering and stuff, I don't agree with that. ‘Cause everybody can have a support system…everybody can have one. It's just a matter of finding it in the right spots.

Only one participant was employed at the time of interview, although the remaining three expressed a desire to return to work sometime in the future. For the participant who was employed, he saw his job as a major source of positive support and a method through which he could stay out of the institution. Specifically, when asked how he planned to avoid returning to crime, he stated he would “keep working.” Having a productive, prosocial way in which he could structure his time was clearly critical to his success in the community.

Social Support and Interpersonal Relationships

Family was considered to be one of the most important resources for successful reentry into the community. Families mainly provided study participants with a form of emotional support, a sense of responsibility, and a means to attend appointments and obtain transportation.

P3: My mum and my wife and all the kids. All my family's great about me…I'm able to talk to them…I know this sounds different but I'm able to help them now so it kind of makes me have, um, um, uh, like responsibilities.

P4: When I got out at first [my mother] would bring me to my appointments and stuff like that…And after that it was my girlfriend bring me to my appointments and stuff like that…But she always come see me and she come talk to me and she come sometime at…my girlfriend's place…She drink a tea with us and start talking with her mom and, uh, her dad to my girlfriend and me and my girlfriend and you know…she support me good you know. I love my mom.

Several of the participants indicated that they no longer associated with their friends from the past and believed them to be a potential detriment to their successful reintegration should they be in contact with them. Others reported visiting with their friends occasionally and found them to be a good source of support.

P4: “I don't want to see…my friends. Criminals and …alcoholics and druggies…they're all doing drugs and stuff like that. I don't want to be…close to those.”

P3: Oh yeah, they're good. They're good. Oh they're great. I talk to them on the phone and that. Um they're looking forward to me to me coming home so then you know I can see them more often and stuff…they don't do drugs either or nothing like that…they're the type, I'd have them to my house.

Three participants were currently involved in an intimate relationship lasting a minimum of three months. Intimate partners were a major source of emotional support for these men. Shared beliefs were expressed as being an especially important characteristic in their partner.

P2: Well, it's mostly emotional and, uh, you know there's a lot of love. She's a very good Christian woman…been going to church for the last 21, same church for the last 21 years…falls right into my beliefs and like she's a non-smoking and hardworking person and, um, she's very caring and very giving.

P3: …emotional and, um, like right now I don't have my truck and stuff in [current city] so like I got a doctor's appointment in [hometown] tomorrow…Usually she comes to take me to my doctor's appointments and you know…so that kind of a support. And of course, we love each other.

P4: Yes. A lot of support…she's really a good person…Because I've been with a lot of girls in my life and all of them used to cheat on me and hurt my feelings and everything like that. And her, she never, she never hurt my feelings once.

Some of the participants had children of varying ages (toddlers to grown adults), although only one had regular contact with his child. For him, his daughter provided the motivation to stay out of the institution and maintain a crime-free lifestyle.

P3: “All my time even in jail you know…every time somebody started acting stupid, I started thinking about my wife and my daughter and you know? Thinking about them instead of reacting to stuff, right?”

The majority of participants reported that their parole officers supplied an additional form of social support that was beneficial to their successful reintegration. Parole officers provided advice and were expressed as being understanding and honest.

P3: My parole officer is excellent…You know I, I couldn't ask for a better one. He understands my situation. He's treating me really fair…Some guys that are on parole, they seem to think that they wanna sneak around to do stuff. I don't find that's necessary. If I wanna do something I ask…if he says “no,” he'll give me an explanation why, you know, he thinks it's a bad idea and that's what we go with right? So he's…good with me and I'm honest with him and it's good.

Religious Beliefs

For some participants, their faith was expressed as a significant factor in their success. It provided them with a source of comfort and hope. Reading the Bible, going to church, and doing daily devotions (prayer) were methods to maintain their faith and stay out of the institution.

P2: God.…there's no bigger than Him…my belief, my faith, my, you know, it helps me every day, uh it helps me with my struggles, helps me with my thoughts, you know doing my devotion and all, and just feeling that He loves me and shows me the ways. I could sit here for hours and tell you about it, but we don't have that time!

Discussion

Many factors have been found to correlate with the reduction of recidivism in the offender population and positively contribute to successful reintegration following release from a correctional facility (Bahr et al., 2010; de Vogel et al., 2009; Ullrich & Coid, 2011). Although some research has investigated the role of protective factors in successful community reintegration and reducing recidivism, literature focusing specifically on people with mental health issues is limited. To further understand these factors and the implication they have in the lives of people with mental health issues, the present study recruited former offenders in the community who were considered to be doing well by members of their case management teams and had been previously diagnosed with a mental disorder. The research was intended to expand and strengthen empirical evidence of protective factors in the offender population while addressing the limited research on the subset of this population who suffer with mental health issues. The qualitative methodology aimed to provide an in-depth look at the specific ways these individuals benefit from such factors and which of these factors are most crucial to their success and well-being.

It is important to differentiate between internal and external factors to fully understand the multiple constituents implicated in each person's successful reentry. Internal factors are psychological mechanisms within the individual that drive changes in criminal behavior. In contrast, external factors are observable aspects of an individual's environment that also promote changes in criminal behavior (family, employment; Serin & Lloyd, 2009). While external factors were highly emphasized by study participants as crucial to their community success (specifically volunteering and social support), internal factors such as attitudes toward authority were also considered relevant to their well-being.

For the study participants, having a mental illness created additional stressors to what is already a challenging transition to the community following release from the institution. The stress of returning to the community enhanced psychiatric symptoms, which in turn made it difficult to successfully return to daily routines such as work. Generally, participants expressed positive views toward mental health services. In some instances, seeing a psychologist was something to look forward to and mental health professionals in general provided a resource to cope with a mental disorder. Based on these findings, to assist releasees in overcoming these additional challenges, it is likely important to provide them with access to mental health treatment in the community. Access to mental health resources such as support groups, counselors, psychologists, and psychiatrists could provide the means necessary to successfully reintegrate into the community and cope with the barriers associated with having a mental disorder.

Substance abuse is a well-known risk factor for criminal behavior (Andrews & Bonta, 2010), and most of the men reported that their substance abuse was indeed a contributing factor to their criminal behavior leading to incarceration, as well as a method of dealing with the symptoms of mental illness. These findings are not surprising given the high prevalence of substance abuse in the Canadian federal inmate population (Kunic & Grant, 2006) as well as the present sample. Future research should be aimed at deconstructing the relationship between substance abuse and criminal behavior in similar samples of mentally ill releasees. It remains to be seen whether it is the mental disorder, the substance abuse itself, or any other risk factors that provide pathways toward crime.

While previous research has suggested that employment is a crucial factor in post-release success (Sampson et al., 2006), only one participant in this study was employed at the time of the interviews. He did note, however, that his job was an important part of his routine and was a means through which he could stay out of the institution, a finding that is consistent with previous research (Bahr et al., 2010; Berg & Huebner, 2011; Lockwood et al., 2012). Other participants were involved with volunteering in the community and reported that it was an important factor in their reintegration. There is limited research on volunteer involvement among the offender population and the impact it may have on well-being and reducing recidivism. There is even less research on the role of volunteerism in mentally ill people following release, and most is restricted to females (Taylor, 2008). These findings are in line with the importance of leisure activities and work found through research on the SAPROF (de Vogel et al., 2011). More research is needed to better articulate the role of employment for releasees with mental illness, particularly with recognition that the symptoms of the mental health disorder (coupled with a criminal record) may in fact limit or negate any chance of post-release employment.

In the present study, volunteering was reported to act as a transition activity to employment, consistent with research conducted by Burnett and Maruna (2006). Those who participated in a full-time volunteer position working for a Citizens Advice Bureau (a call center that provides factual information from a database on housing, employment, welfare, etc.) reported that volunteering provided them with an opportunity to regain their foothold in the working world (Burnett & Maruna, 2006). Essentially, volunteering provided a support system and a method through which study participants could contribute back to the community and compensate for their past misconduct. Findings in the present study indicate that volunteering is an important tool for participants and future research should further examine the role that volunteering plays in a successful reintegration for people both with and without mental health issues.

Social support has been investigated through considerable research and found to have a large influence on reintegration and the likelihood of recidivism (Bersani et al., 2009; Martinez & Christian, 2009). During the interviews, all participants placed considerable emphasis on the social support in their lives as a reason for their success and high functioning ability in the community. In their life course theory of criminal desistance, Sampson and Laub (2001/1990) posit that structured life roles, specifically regarding social relations (e.g., father, husband), offer stability and provide meaning in the lives of individuals, which in turn contributes to refraining from criminal behavior. This relationship was confirmed for the participants in this study.

The men in the present study also found support and stability from multiple people in their lives, including family, children, intimate partners, and parole officers. In accordance with research by Lösel (2012), fathering provided one participant with meaning in his life, positively impacting his motivation to avoid criminal behavior. This finding highlights an important theoretical issue in terms of family and desistance in this sample. Since the inception of age-based desistance theories in the 1939 Glueck study (see Glueck & Glueck, 1974), there have been significant amendments to the concept of the family unit. As Kazemian (2007) states, “cohabitation has become a more frequent occurrence and individuals tend to marry at older ages; the same is true for pregnancy outside of wedlock” (p. 16). Similar changes are noted in education and social bonds in general (Kazemian, 2007). While theoretical adaptations have occurred in order to accommodate social changes in demography, there have been few empirical efforts that address the high number of mentally ill inmates who are released every year (and the desistance patterns that follow). Following 80 years of life course research, there is a definite need to address the nexus of mental illness and desistance in a correctional system that often functions as a default mental health system.

There is a strong finding in the literature for positive intimate relationships having a beneficial impact on community reentry (Laub et al., 1998; Rhule-Louie & McMahon, 2007; Serin & Lloyd, 2009). Three participants in the present study were in long-term intimate relationships (one of whom was married and one who lived with his partner) and all reported that their partners were a major contributing factor to their success. In accordance with the research, intimate partners considered to be a positive influence were disapproving of the individual's problem behaviors and were not antisocial themselves (Rhule-Louie & McMahon, 2007). Additionally, desistance was facilitated by the quality of the bond they had with their partner (Laub et al., 1998). Some research has also shown that cohabitation and not marriage is a statistically significant predictor of recidivism, since marriage is typically preceded by many years of cohabitation and is more indicative of a prosocial partner (Savolainen, 2009).

A longitudinal parolee study investigating the influence of dual-role relationship quality on recidivism supports the notion that parole officers who exercise a “firm, fair, and caring” approach in their supervision roles can reduce recidivism. Moreover, a high-quality relationship between a parole officer and parolee is protective against rearrest even for high-risk offenders (Kennealy et al., 2012). In the current study, participants reported that their parole officers were a good source of advice, and described them as honest and understanding of the participant's situation. Additionally, Bourgon et al., (2011) describe parole officers as change agents. With this perspective, parole officers apply cognitive-behavioral techniques to incite real change in parolees rather than simply function as case managers. We also note that cognitive predispositions may differ in mentally ill individuals and these differences warrant further research. These findings suggest that releasees could easily benefit by building a strong and positive relationship with their parole officers.

All study participants reported some form of religious affiliation, but only one described religion as one of the most important factors implicated in his success. There has been much debate regarding religion as a factor through which people can improve their quality of life following release and refrain from crime. Results from this study support the notion that religion can act as a form of emotional comfort and coping mechanism for daily challenges following release from prison (Schroeder & Frana, 2009).

Limitations

Study participants were selected purposefully to be those who were doing well in the community. The sample size was very small, and all participants were male and recruited from one location. Additionally, participation was voluntary, making it difficult to determine if the men who chose to participate were somehow different from those who did not. Therefore, this sample cannot be considered to fully represent the Canadian male offender population who suffer from mental health issues.

The issues of socially desirable responses and underreporting also tend to arise when conducting qualitative research and can be especially prominent in face-to-face interviews. However, given the in-depth information provided by participants who appeared to share openly about their experiences, it is likely that the participants were comfortable with the interviewers and provided honest answers. Interviewers established good rapport with participants and participants were not pressured to report anything they did not feel comfortable sharing.

Conclusion

In general, it was found that for people with mental illness returning to the community, volunteering and social supports were of the greatest importance. Additionally, all participants had access to mental health services, making it a likely factor implicated in their success. The present research enhances the knowledge base regarding protective factors in the offender population with mental illness using an in-depth qualitative methodology. The information regarding the specific factors that are associated with success will assist in the provision of effective interventions that target these crucial factors as well as promote growth and well-being of releasees and increase the likelihood of success in the community. This study also adds to the theoretical literature by highlighting a crucial gap in current desistance theories; that is, a complete lack of empirical studies that examine desistance within vulnerable populations like the mentally ill. Even prominent age-based-desistance theorists like Moffit (1993) have questioned the overreliance on adolescent samples. While the study of mentally ill offender populations can be more complex and difficult when compared to nonmentally ill counterparts, there remains a great need to advance research in this area. By enhancing psychological well-being and quality of life, long-term and growth-promoting changes can be made that will ultimately benefit both the individual and the community.

Authors' Note

Points of view or opinions are not necessarily those of the Correctional Service of Canada.

Author Disclosure Statement

The authors disclosed no conflicts of interest with respect to the research, authorship, or publication of this article.

Funding Information

The authors received no financial support for the research, authorship, and/or publication of this article.