Evaluating a Peer-Led Reentry Hub Near a Detention Centre

Plos One | 2023, p. 1-24

Finding help and hope in a peer-led reentry service hub near a detention centre: A process evaluation

Arthur McLuhan; MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada

Tara Hahmann; MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada

Cilia Mejia-Lancheros; MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada

Sarah Hamilton-Wright; MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada

Guido Tacchini; MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada

Flora I. Matheson; MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Criminology and Sociolegal Studies, University of Toronto, Toronto, Ontario, Canada

“Community reentry has become an important policy, practice, and research concern, and reentry programs are often positioned as important tools in the effort to improve post-release outcomes. Although the reentry movement in corrections has tended to emphasize recidivism-focused program objectives, outputs, and outcomes, there has been increasing recognition of reentry concerns beyond recidivism” (p. 2). 

“In this article, we report the core findings of a process evaluation [82] of a reentry service hub designed to offer housing and social support services and referrals to men released from the Toronto South Detention Centre, the largest detention centre in Ontario, Canada. Process evaluations determine whether program activities have been implemented as intended and resulted in certain outputs. Process evaluations can answer questions such as, “How well the program is working. The extent to which the program is being implemented as designed. Whether the program is accessible an (sic) acceptable to its target population.” Process evaluations are particularly well suited to assessing the implementation of interventions that address complex challenges and contexts such as reentry” (p. 4).

“We drew on qualitative interviews with Reintegration Centre clients to assess their experiences related to the challenges of reentry, services of the Reintegration Centre, and the role of peer support workers… Participant ages ranged from 23 to 53 years, with a mean of 37 years. Most participants faced material precarity and hardship on release, with 71% identifying housing as a priority need” (p. 4 -6).

“The purpose of this article was to report the main findings of a process evaluation of a novel reentry program—the Reintegration Centre—a service hub to support people immediately upon release from custody. Drawing on interviews with Reintegration Centre clients, the article described the Reintegration Centre model and service experience in the context of the complex challenges people face upon release. Consistent with previous research, participants experienced a variety of reentry barriers and revealed the personal, social, organizational, and structural complexity of the delivery context. Housing (i.e., homelessness, housing instability) was the most common, and in some ways, the most difficult challenge given the lack of affordable housing in the reentry environment, coupled with systemic poverty and under-employment. Many participants also contended with serious trauma, social isolation, mental health, and substance use concerns” (p. 15).

“Participants also emphasized the role of the Reintegration Centre in increasing their awareness of other supports and resources available in the community, and facilitating connections with those sources if required. This was especially important for those with weak or nonexistent social support networks. This integrated, coordinated service approach reduced some of the barriers and frustrations participants had come to expect when accessing services, such as the requisite retelling of “their story” with each individual service encounter, documenting the history and current state of the deficits, needs, and challenges for which they sought support” (p. 16). 

“Relatedly, and consistent with recent research, the peer support approach improved the interactional dynamics of the service encounter, the overall impressions of the Reintegration Centre, and even the trust in JHST as a whole. The marginalization and stigmatization experienced by this population, coupled with a lack of informal and formal support structures, make reentry a trying and emotionally-wrought experience. The compassion and concern peer support workers demonstrated in their interactions with participants contributed to participants’ positive impressions of the Reintegration Centre and themselves. Peer support workers affirmed participants’ autonomy and moral worth, fostering trust in the Reintegration Centre. Peer support workers facilitated a more seamless and person-centered service experience, acting as empathic, understanding liaisons for participants, connecting them to services and programs suited to their reentry needs, priorities, and situations” (p. 16). 

Immediate support upon release is critical: Providing basic needs (e.g., food, clothing, transportation, harm reduction) immediately after release helps mitigate the high-risk transition period.

Proximity matters: Locating reentry services near detention centers improves access and ensures rapid engagement with supports on release day.

Peer support is impactful: Peer workers with lived experience foster trust, empathy, and a sense of being understood, enhancing the quality of service engagement.

Person-centered care builds dignity: Clients reported feeling respected and treated like individuals, not just as service users or ex-offenders.

Referrals must be individualized: Tailored referrals based on client-identified priorities (e.g., housing, employment, treatment) increased relevance and utility of services.

Integrated service models are effective: Connecting clients to a continuum of care through a single, trusted hub reduced the burden of navigating multiple disconnected services.

Trust and relationships support ongoing engagement: Participants expressed a desire to maintain contact with peer workers and the service hub due to positive experiences.

Structural stigma is a barrier: Participants often faced discrimination, poverty, and lack of social support, which made reintegration challenging and underscores the need for compassionate care.

“We also acknowledge the limitations of this process evaluation. First, considering the complexity of the needs among this population, and that the interviews were conducted within a short time after they were released from jail, the findings reflect a snapshot of their experiences in the early days after release and therefore do not offer a window into longer-term circumstances, relationships, processes, or outcomes. Still, research indicates that the first month after release is characterized by high health risks and poor health outcomes, such as high rates of overdose and mortality [35–38], which not only underscores the critical need for rapid supports, service connections, and continuity of care, but also warrants shorter interview follow-up periods when conducting health-informed reentry program evaluation research. Participants emphasized that the support they received from the Reintegration Centre was a critical factor in helping them navigate the high-risk period immediately following release and begin addressing health concerns, participating in their local communities, and rebuilding their lives. These findings are consistent with what other studies have found: community-based, post-release support services and interventions play a critical and positive role in enhancing community reintegration and reducing the risk of reincarceration. 

While the results shed light on the early reentry experiences of those participating in a novel intervention, another potential limitation of the study is that the findings draw on qualitative interviews with 21 men, a subset of the 209 individuals who were invited to participate in the research, which may have affected the range of perspectives we could solicit in this evaluation. The experiences and perspectives of interview participants may differ in substantive ways from others. More generally, we would also emphasize that the challenges of reentry—a situation in which individuals are juggling competing priorities and complex needs at a transitional time wrought with stress and hardship —can also act as barriers to research participation. For example, with respect to maintaining participant contact and scheduling interviews, the study of people facing personal, social, and health challenges post-release often poses additional recruitment and retention challenges than researchers might encounter in general population or treatment samples. We experienced and adjusted to these challenges throughout the study, but there were 28 people who agreed to an interview, but later could not be reached for scheduling” (p. 17).