Experiences of First Nations People With Severe and Enduring Mental Illness Transitioning From Prison to the Community in NSW, Australia

First Nations people experience disproportionately high rates of severe and enduring mental illness in Australian prison settings and face significant risks during the prison-to-community transition. However, there is limited qualitative research examining the experiences of First Nations people with mental illness within transition health services. This study explored the experiences of First Nations participants and their families, carers and kin engaging with the Community Transitions Team (CTT), a New South Wales service supporting people with mental illness as they exit prison. Guided by an Aboriginal Cultural Governance Group, semi-structured qualitative interviews were conducted with First Nations CTT participants either in custody or following release. With one family member/carer/kin also interviewed, 11 interviews were included in the reflexive thematic analysis. Three interconnected themes were identified: Being Heard and Building Trust Through Relational Communication; Linkages to Community Support During Transition; and Culturally Responsive Care and Cultural Connection. Participants highly valued clear and relational communication, particularly approaches aligned with yarning and feeling genuinely listened to. Linkages to housing, drug and alcohol rehabilitation, mental health services, and other community services were seen as critical during transition. Culturally responsive care emerged as central to social and emotional wellbeing, with strong support for First Nations-led care, increased Aboriginal workforce representation, greater access to Elders and cultural practices, and improved cultural training for non-First Nations staff. The findings align with previous review work while providing new qualitative insight into how First Nations people with severe and enduring mental illness experience prison-to-community transition support. They highlight opportunities to strengthen culturally responsive prison-to-community transition services to improve mental health outcomes and reduce recidivism.