Providing Mental Health and Substance Use Services to People Released From Custody During the COVID-19 Pandemic: A Qualitative Study of Service Providers.

This paper explores the perspectives of mental health and substance use providers who supported people released from custody during the pandemic in Ontario, Canada, with a focus on service disruptions, adaptations, and experiences. We conducted 20 in-depth qualitative interviews and analysed these using Applied Thematic Analysis. Pandemic public health responses limited the ability of providers to support people released from custody. Policies designed to mitigate viral spread were not tailored to the mental health and substance use context, leading to disruptions in service delivery. This had domino effects for service users and providers. Criminal-legal-involved populations had to isolate and at the same time providers could not reach out to them, leading to increased risks for substance use, overdose, and suicide. Providers in turn felt pressure to help people released from custody, when policy made it exceedingly difficult for them to do so. Still, providers did find silver linings through opportunities to work together and provide better person-centred care. For future pandemic preparedness, decision-makers must consider the unintentional fallout that blanket policies can have on underserved communities and mitigate against unintended consequences. Future research should engage underserved communities to understand their needs during emergencies.