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This study assessed the effectiveness of an intervention based on a theoretical framework of citizenship on reducing psychiatric symptoms, alcohol use, and drug use, and increasing quality of life for persons with serious mental illness (SMI) and criminal justice involvement. One-hundred fourteen adults with SMI and a history of criminal justice involvement participated in a 2 × 3 longitudinal randomized controlled trial of a four-month citizenship intervention versus usual services. Linear mixed model analyses were used to assess the intervention's impact on quality of life, symptoms, and substance use. After controlling for baseline covariates, participants in the experimental condition reported significantly increased quality of life, greater satisfaction with and amount of activity, higher satisfaction with work, and reduced alcohol and drug use over time. However, individuals in the experimental condition also reported increased anxiety/depression and agitation at 6 months (but not 12 months) and significantly increased negative symptoms at 12 months. Findings suggest that community-oriented, citizenship interventions for persons with SMI and criminal justice histories may facilitate improved clinical and community outcomes in some domains, but some negative clinical findings suggest the need for post-intervention support for intervention participants. Implications for practice and future research are discussed.

Mutual-aid groups for people in recovery from mental illness, addictions, and former incarceration are virtually nonexistent. This article provides a review of the literature on mutual-aid groups for people who have previous incarceration histories and a review of groups for people with mental illness and multiple concerns (i.e., co-occurring diagnoses). Next, we present the “What's Up?” group, a component of the Citizenship Community Enhancement Project, as an example of a mutual-aid group that was developed to better address these multiple concerns. The “What's Up?” group was designed as a mutual-aid component for individuals living with mental illness and/or co-occurring substance abuse concerns who also have a history of previous involvement with the criminal justice system. Experiences of participants highlight ways in which the “What's Up?” group provided opportunities for its members to not only “give back” but to “get something back” from the sharing of experiences and feedback offered from their peers. [ABSTRACT FROM PUBLISHER]