For many people with severe mental health conditions, prison is not a one-time experience—it’s a cycle. They leave with no support, struggle to adjust, and end up back behind bars. This is not just a failure of the justice system. It is a failure of mental health care.
Prisons are filled with people who shouldn’t be there in the first place—individuals with schizophrenia, bipolar disorder, PTSD, and other severe conditions. Many did not receive help before prison and do not receive it after release. Instead of recovery, they face homelessness, relapse, and reoffending.
We need to break this cycle. But right now, the system sets them up to fail.
The Crisis After Release
For prisoners with mental illness, release day should be a fresh start. Instead, it is often the beginning of another crisis.
Many people leave prison with nothing but the clothes they arrived in. If they were on medication inside, they may be given a few days’ supply—but no guarantee of a prescription when it runs out. Mental health support in the community is difficult to access, with long waiting times and strict referral criteria. Without a fixed address, registering with a GP is nearly impossible. Without a GP, there is no access to mental health services.
Then there is the issue of housing. Many people with mental illness leave prison into homelessness. They may be placed in temporary accommodation, but these environments are often chaotic and unsafe, making mental health recovery even harder. Without stability, appointments are missed, medication is forgotten, and symptoms return.
With no support, people deteriorate quickly. Some turn to drugs or alcohol to cope. Others fall into crisis, ending up in A&E, sectioned under the Mental Health Act, or back in police custody. Many reoffend, not because they are criminals but because they are desperate, sick, and abandoned.
Why the System Fails
The UK’s justice system claims to rehabilitate, but for those with severe mental illness, it does the opposite. The problem is not just a lack of funding—it is a lack of planning, coordination, and accountability.
One of the biggest failures is the lack of a joined-up system. In prison, people have access to medication and, in some cases, therapy. But the moment they are released, that care stops. There is no automatic link between prison health teams and community mental health services. This means that unless someone actively seeks help—something many people with severe illness struggle to do—they fall through the cracks.
Another major issue is housing. Many charities and organisations, like ours, provide supported accommodation for people leaving prison, but there are not enough spaces. Local authorities are overwhelmed, and people with complex needs are often pushed to the back of the queue. Without a safe and stable place to live, it is almost impossible to manage a serious mental health condition.
There is also the issue of stigma. Many NHS services view ex-prisoners as high-risk or difficult to engage. Some GPs refuse to register them without a fixed address. Others struggle to navigate the system and give up. In some cases, mental health services refuse to treat people with substance misuse issues, even though addiction and mental illness often go hand in hand.
The result is a system that punishes people for having a condition they cannot control. Instead of treatment, they are criminalised. Instead of recovery, they are sent back to the same conditions that led to their imprisonment in the first place.
The Consequences of Inaction
When mental health care fails after release, the effects are felt across society.
Individuals suffer the most. Without support, they spiral into crisis. Many experience severe psychosis, depression, or suicidal thoughts. Some die—either by suicide, overdose, or violent situations linked to homelessness. Others return to prison, trapped in a system that sees them as offenders rather than patients in need of care.
The justice system also suffers. Nearly half of prisoners with mental illness reoffend within a year. Police, courts, and prisons are forced to deal with individuals who should never have been in the criminal justice system to begin with.
The NHS feels the strain too. Emergency services become the safety net for people who have been let down by the system. A&E departments, crisis teams, and psychiatric wards are overwhelmed by individuals in extreme distress—people who could have been supported earlier, at a lower cost, and with far better outcomes.
This failure is expensive. Locking someone up costs the taxpayer far more than providing stable housing, therapy, and medication. Every crisis admission to a psychiatric ward, every police intervention, every night in a police cell—these all add up. But beyond the financial cost is the human one. We are failing some of the most vulnerable people in our society, and in doing so, we are making the problem worse.
How We Fix It
If we are serious about rehabilitation, we must stop abandoning people at the prison gate.
The first step is continuity of care. Every person with a diagnosed mental health condition should leave prison with an active care plan. This means guaranteed access to a GP, fast-track referrals to mental health services, and a clear pathway for ongoing treatment. No one should leave without at least a month’s supply of medication and a follow-up appointment already in place.
Housing must also be a priority. Safe, supported accommodation should be standard for anyone leaving prison with a severe mental illness. A stable home is not just about having a roof over someone’s head—it is the foundation for recovery.
We must also remove the barriers to NHS care. Pre-registering prisoners with a GP before release should be automatic. Dedicated community mental health teams should be in place to support ex-prisoners, ensuring they do not slip through the cracks.
Finally, support must be long-term. People with severe mental illness need structured, ongoing help—not just a handshake goodbye. This includes assistance with benefits, therapy, social reintegration, and peer support networks. Many people need help to rebuild their lives, reconnect with family, and learn how to manage their condition in the outside world.
None of this is radical. It is simply a shift in priorities—from punishment to prevention, from crisis response to early intervention, from abandonment to accountability.
The justice system cannot fix this problem alone. The NHS, local authorities, charities, and mental health services must work together to create a system that actually supports recovery.
Right now, we are setting people up to fail. If we want to break the cycle, we need to stop punishing mental illness and start treating it. That means investing in proper post-release support—because recovery shouldn’t end at the prison gate. It should start there.
How Brudge Support Can Help
We provide a range of services for ex-offenders:
- Tilt is a residential facility with proven recovery pathways that provide support for ex-offenders working towards independent living in the community.
- Our housing management services focus on providing safe, high-quality accommodation combined with support to aid recovery.
- Our employment services are designed to help individuals overcome personal and systemic barriers to returning to work.
Further reading
Societal Reentry of Prison Inmates With Mental Illness
Many former prisoners struggle to obtain health care after release
