Lived Experiences of Reintegration Among Formerly Incarcerated People with Mental Illness: A Scoping Review Protocol

Introduction Incarceration is a major public health and social issue, affecting over 11 million individuals globally at any given time (1). Each year, a significant number of individuals are released from correctional institutions, often returning to their communities while facing complex challenges related to housing, employment, and health care (2). Among them, individuals with diagnosed mental illness represent a particularly vulnerable subgroup. Research consistently shows that mental disorders, especially schizophrenia, bipolar disorder, major depression, and substance use disorders, are overrepresented in incarcerated populations (3, 4). Upon release, these individuals face the dual burden of re-entry stress and psychiatric vulnerability, often without adequate support from community-based mental health services (5). Community reintegration refers to the process through which individuals resume roles in society after incarceration. While much of the literature has focused on objective indicators of successful re-entry, such as recidivism, housing stability, and employment, there is increasing recognition that these metrics alone fail to capture the nuanced and deeply personal nature of post-release adaptation (6). The subjective experience of reintegration includes how individuals perceive their own psychological recovery, social acceptance, identity shifts, and access to meaningful support systems. For those living with mental illness, these experiences are further shaped by internalized stigma, marginalization, and discontinuities in care, which may contribute to emotional distress, social isolation, and increased risk of reoffending (7). Despite growing interest in patient-centered and recovery-oriented approaches to forensic mental health care, few studies have synthesized how formerly incarcerated individuals with mental illness themselves describe their reintegration journeys. Existing reviews have tended to focus on clinical or service-level outcomes, such as the effectiveness of transitional programs or psychiatric relapse rates, rather than personal narratives or lived experiences (8,9). Moreover, current literature often examines justice-involved populations broadly, without disaggregating findings for those with diagnosed psychiatric conditions, leading to a critical knowledge gap in understanding their specific needs (10). This review also seeks to explore how individuals describe the early post-release period, including what types of support, such as housing, social networks, or professional services, were available to them at the time and how these shaped their reintegration experiences. A scoping review is the most appropriate method to address this gap. Scoping reviews allow for the mapping of a broad field of research, especially when study designs are diverse and concepts are complex or inconsistently defined. This review will synthesize qualitative and mixed-methods literature exploring subjective reintegration experiences of formerly incarcerated individuals with mental illness, identify key themes, highlight conceptual limitations, and outline opportunities for more person-centered and equitable reintegration support. The objectives of this scoping review are to: • Map and summarize existing literature on the subjective experiences of community reintegration among formerly incarcerated individuals with diagnosed mental illness. • Identify common themes related to psychological, emotional, social, and identity challenges during re-entry. • Examine perceptions of personal agency, stigma, support systems, and barriers and facilitators to community reintegration. This review will follow the Population–Concept–Context (PCC) framework: • Population: Formerly incarcerated individuals with diagnosed mental illness • Concept: Lived or subjective experiences of reintegration • Context: Community re-entry following release from correctional facilities Methods This scoping review will be conducted in accordance with the methodological framework proposed by Arksey and O’Malley and further refined by Levac et al. (11,12). The guidelines from the JBI Manual for Evidence Synthesis will also be followed to ensure a comprehensive and systematic approach (13). The protocol has been prepared using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist, which will also guide reporting in the final manuscript. Eligibility Criteria Peer-reviewed qualitative or mixed-methods studies will be included if they examine the subjective experiences of formerly incarcerated individuals diagnosed with a mental illness during their transition back into the community. Eligible studies may include first-person accounts or interviews reflecting psychological, emotional, or social dimensions of reintegration. Only studies focusing on adult populations (aged 18 years and older) and published in English will be considered. Exclusion criteria include purely quantitative studies that do not explore individual perspectives, studies focused solely on institutional outcomes (e.g., recidivism, employment) without reference to lived experience, and non-English publications. Information Sources and Search Strategy Electronic databases to be searched include MEDLINE, CINAHL, PsycINFO, Criminal Justice Abstracts, and Google Scholar without date restrictions. Although PsycINFO and Google Scholar include a percentage of grey literature sources (e.g. dissertations), additional sources will be searched for the grey literature to increase data saturation; additional sources for the grey literature search will include ProQuest Dissertations and Theses Global, Conference Abstracts, and ClinicalTrials.gov. The search strategy will incorporate a combination of keywords and controlled vocabulary (e.g., MeSH terms) related to: Post-release search terms will include: Parole, Criminal Rehabilitation, Probation, Halfway Houses Qualitative/Mixed-Methods search terms will include: Interviews, Qualitative Methods, Lived Experience, Focus Groups, Narration Mental health related search terms will include: mental illness, psychiatric disorder, affective disorder, depression, bipolar disorder, schizophrenia A health sciences librarian (SB) assisted in refining and finalizing the search strategy. As according to the JBI scoping review guidelines, the search will employ a three-step process. A preliminary search will be completed in two databases relevant to the topic to first identify relevant subject headings and keywords. A revised search will be executed in all the databases, and the reference lists of on topic papers will be reviewed for additional relevant studies. The searches will be re-executed before the final analysis to identify newly published research (13). Study Selection All citations retrieved from the database searches will be uploaded into the systematic review software Covidence [Veritas Health Innovation, Melbourne, Australia] for deduplication, screening, and data extraction. Title and abstract screening will be conducted independently by two reviewers using predefined inclusion and exclusion criteria. A pilot round of 25 randomly selected records will be screened to assess inter-rater reliability. A minimum agreement threshold of 75% will be required to proceed. If this threshold is not met, the pilot round will be repeated. Discrepancies will be resolved through discussion or, if necessary, adjudicated by a third reviewer. Full-text screening will follow a similar procedure. Reasons for exclusion at this stage will be documented. Data Charting A standardized data charting form will be developed and piloted on a sample of 5 full-text articles (14). Structured study characteristics (e.g., citation details, study design, and participant demographics) will be extracted into Microsoft Excel [version 2024], while qualitative data related to reintegration experiences will be imported into NVivo [Lumivero, version 15] for thematic analysis. The form will be revised iteratively based on feedback and findings. Two reviewers will independently extract the following data: • Citation details (authors, title, journal, year) • Study design and methodology • Country or region of study • Participant demographics (e.g., age, gender, ethnicity, diagnosis) • Correctional setting and duration of incarceration • Mental illness diagnosis • Description of reintegration experience • Key themes and findings • Limitations noted by study authors Discrepancies in extracted data will be resolved through discussion or by consultation with a third reviewer. The data charting form may be modified as necessary during the extraction process, and any modifications will be documented and reported in the final scoping review. Missing data will be coded as “Not Reported,” and ambiguous or unclear data will be coded as “Unclear.” In cases of missing relevant information, study authors may be contacted up to two times for clarification. Critical appraisal of individual sources of evidence will not be conducted, consistent with scoping review methodology. Synthesis and Presentation of Results A thematic synthesis approach will be used to identify key patterns and recurring themes related to the lived experiences of reintegration among formerly incarcerated individuals with mental illness. Findings will be summarized in tables, charts, and descriptive narratives, with illustrative quotations or thematic examples included as appropriate. The approach to synthesizing and presenting data may be further refined as the review progresses. A PRISMA flow diagram will be employed to document the screening and selection process. Ethics and Dissemination As this review involves only publicly available literature, formal ethics approval is not required. Results will be disseminated through submission to peer-reviewed journals and presentations at academic conferences. The findings will also contribute to ongoing departmental research and inform future wor