Mental Health

Mental Health in the prison system: policy and practice

  • National Survey of Prison Health Care: Selected Findings,
    U.S. Department of Health and Human Services, July, 2016
    “This report presents selected findings on the provision of health care services in U.S. state prisons.”
  • Individuals With Serious Mental Illnesses in County Jails: A Survey of Jail Staff's Perspectives,
    Public Citizen's Health Research Group, The Treatment Advocacy Center, July, 2016
    “The purpose of our survey was to understand the perspectives of county jail sheriffs, deputies, and other staff with respect to individuals with serious mental illnesses in jails.”
  • Disabled Behind Bars: The Mass Incarceration of People With Disabilities in America's Jails and Prisons,
    Center for American Progress, July, 2016
    “This report highlights steps policymakers can take to combat inappropriate and unjust incarceration and criminalization of people with disabilities, as well as steps to ensure appropriate and humane treatment of people with disabilities[.]”
  • Raising Cain: The Role of Serious Mental Illness in Family Homicides,
    Treatment Advocacy Center, June, 2016
    “[T]his is the first study of the role of serious mental illness in all family homicides.”
  • Administrative Segregation in U.S. Prisons
    National Institute of Justice, March, 2016
    “Across the political spectrum, there is growing concern about the efficacy and utility of administrative segregation practices[.]”
  • InCorrect Care: A Prison Profiteer Turns Care into Confinement,
    Grassroots Leadership, February, 2016
    “This report’s in-depth analysis of GEO Group, GEO Care and now Correct Care Solutions’ involvement in operating mental health hospitals and civil commitment centers exposes serious concerns.”
  • First-Episode Incarceration: Creating a Recovery-Informed Framework for Integrated Mental Health and Criminal Justice Responses,
    Vera Institute of Justice, January, 2016
    (This report outlines a new integrated framework that encourages the mental health and criminal justice fields to collaborate on developing programs based on early intervention.)
  • Report and Recommendations Concerning the Use of Restrictive Housing
    U.S. Department of Justice, January, 2016
    “At its worst, and when applied without regard to basic standards of decency, restrictive housing can cause serious, long-lasting harm. It is the responsibility of all governments to ensure that this practice is used only as necessary.”
  • First Do No Harm: Advancing Public Health in Policing Practices, [PDF]
    Vera Institute of Justice, November, 2015
    (This report details the cultural divide among system actors that amplify and sustain these problems and offers recommendations on how law enforcement policymakers and practitioners can enhance both public safety and community health.)
  • Mortality in Local Jails and State Prisons, 2000-2013 - Statistical Tables [PDF]
    Bureau of Justice Statistics, August, 2015
    “Suicide has been the leading cause of death in jails every year since 2000.”
  • Callous and Cruel: Use of Force against Inmates with Mental Disabilities in US Jails and Prisons,
    Human Rights Watch, May, 2015
    “This 127-page report details incidents in which correctional staff have deluged prisoners with painful chemical sprays, shocked them with powerful electric stun weapons, and strapped them for days in restraining chairs or beds.”
  • The Processing and Treatment of Mentally Ill Persons in the Criminal Justice System: A Scan of Practice and Background Analysis, [PDF]
    Urban Institute, March, 2015
    “An estimated 56 percent of state prisoners, 45 percent of federal prisoners, and 64 percent of jail inmates have a mental health problem.”
  • Federal Bureau of Prisons: Special Housing Unit Review and Assessment, [PDF]
    CNA, December, 2014
    “As of November 2013, approximately 5 percent of the entire Bureau’s prisoner population was being housed in one of these restrictive housing populations with the vast majority in the SHU status.”
  • Impact of Disproportionate Incarceration of and Violence Against Black People with Mental Health Conditions In the World's Largest Jail System, [PDF]
    Dignity and Power Now, August, 2014
    “Nationwide, people with mental health conditions constitute 64% of the jail population, according to the Federal Bureau of Prison Statistics.”
  • Medicaid Prior Authorization Policies and Imprisonment Among Patients With Schizophrenia, [PDF]
    American Journal of Managed Care, July, 2014
    “As the total costs in the United States that are associated with severe psychiatric disorders in jails are very high, new policies on how to treat incarcerated individuals with schizophrenia, particularly nonviolent offenders, are warranted.”
  • The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey, [PDF]
    Treatment Advocacy Program, April, 2014
    “The number of individuals with serious mental illness in prisons and jails now exceeds the number in state psychiatric hospitals tenfold.”
  • Worse Than Second-Class: Solitary Confinement of Women in the United States, [PDF]
    American Civil Liberties Union, April, 2014
    “...solitary is often used on the most vulnerable: pregnant women, individuals with mental illness, transgender women, and - in a particularly disturbing trend - victims of sexual assault by prison guards.”
  • Solitary Confinement and Risk of Self-Harm Among Jail Inmates [PDF]
    American Journal of Public Health, March, 2014
    “Inmates ...assigned to solitary confinement were 3.2 times as likely to commit an act of self-harm per 1000 days at some time during their incarceration as those never assigned to solitary.”
  • Investigation of the Pennsylvania Department of Corrections' Use of Solitary Confinement on Prisoners with Serious Mental Illness and/or Intellectual Disabilities, [PDF]
    U.S. Department of Justice, February, 2014
    “The manner in which PDOC subjects prisoners with SMI to prolonged periods of solitary confinement involves conditions that are often unjustifiably harsh and in which these prisoners routinely have difficulty obtaining adequate mental health care...”
  • A Review of Mental Health Services in Local and Regional Jails [PDF]
    Virginia Office of the State Inspector General, January, 2014
    “Jails lack the capacity to satisfy the current demand for mental health services.”
  • Inside the Box: The Real Costs of Solitary Confinement in New Mexico's Prisons and Jails,
    The New Mexico Center on Law and Poverty; The ACLU of New Mexico, October, 2013
    “New Mexico urgently needs to reform the practice of solitary confinement in its prisons and jails.”
  • Three Quarter Houses: The View from Inside, [PDF]
    John Jay College of Criminal Justice, Prisoner Reentry Institute, October, 2013
    “Illegal evictions derail recovery and reintegration and can lead to relapse, street homelessness, unemployment, and violations of parole mandates that can result in re-incarceration.”
  • Report on Suicide Prevention Practices within the District of Colombia, Department of Corrections' Central Detention Facility, [PDF]
    DC Department of Corrections, September, 2013
    “...correctional officers that are assigned to the mental health unit ...in the Central Detention Facility do not receive any specialized mental health and/or suicide prevention training.”
  • Justifiable Homicides by Law Enforcement Officers: What is the Role of Mental Illness?,
    Treatment Advocacy Center, National Sheriff's Association, September, 2013
    “The transfer of responsibility for persons with mental illness from mental health professionals to law enforcement officers has brought with it major problems for the latter.”
  • Jail Mental Health Design and Programming "Options and Opportunities", [PDF]
    National Institute of Corrections, United States Department of Justice, July, 2013
    “More people are being booked into the McLean County Detention Facility with more serious criminal charges and they are staying longer.”
  • Out of Sight, Out of Mind: Colorado's continued warehousing of mentally ill prisoners in solitary confinement, [PDF]
    ACLU of Colorado, July, 2013
    “As of March 2013, CDOC housed at least 87 seriously mentally ill prisoners in solitary confinement, 54 of whom have been living in isolation for over a year and 14 of whom have been in solitary confinement for more than 4 years.”
  • PTSD, Trauma, and Comorbid Psychiatric Disorders in Detained Youth [PDF]
    Office of Juvenile Justice and Delinquency Prevention, June, 2013
    “Of the study sample, 92.5 percent of youth had experienced at least one trauma, 84 percent had experienced more than one trauma, and 56.8 percent were exposed to trauma six or more times.”
  • Improvements Needed in Bureau of Prisons' Monitoring and Evaluation of Impact of Segregated Housing, [PDF]
    Government Accountability Office, May, 2013
    “Without an assessment of the impact of segregation on institutional safety or study of the long-term impact of segregated housing on inmates, BOP cannot determine the extent to which segregated housing achieves its stated purpose.”
  • Reforming Juvenile Justice A Developmental Approach,
    National Research Council, November, 2012
    “A harsh system of punishing troubled youth can make things worse, while a scientifically based juvenile justice system can make an enduring difference in the lives of many youth who most need the structure and services it can provide.”
  • Growing Up Locked Down Youth in Solitary Confinement in Jails and Prisoner Across the United State, [PDF]
    Human Rights Watch and American Civil Liberties Union, October, 2012
    “HRW and ACLU estimate that in 2011, more than 95,000 youth were held in prisons and jails. A significant number of these facilities use solitary confinement to punish, protect, house, or treat some of the young people who are held there.”
  • The Affordable Care Act Implications for Public Safety and Corrections Populations, [PDF]
    Sentencing Project, September, 2012
    “The expansion of Medicaid means that states can essentially use federal Medicaid funds to increase treatment services that could reduce incarceration and recidivism and, in doing so, potentially lower associated local and state corrections expenditures.”
  • Unasked Questions, Unintended Consequences Fifteen Findings and Recommendations on Illinois' Prison Healthcare System, [PDF]
    John Howard Association of Illinois, September, 2012
    “[I]ncarceration is overused as a primary means to manage drug and non- violent offenders [...]. This comes at great cost to taxpayers and has little positive impact on recidivism or public safety.”
  • Closing the Gap Using Criminal Justice and Public Health Data to Improve the Identification of Mental Illness, [PDF]
    Vera Institute of Justice, July, 2012
    “Most of the cohort members who had mental health needs (83%) were known to at least 1 criminal justice agency as having such a need between 2006-11. Yet the Department of Mental Health knew about only 59% who had mental health needs during that period.”
  • Youth in Minnesota Correctional Facilities and the Effects of Trauma Responses to the 2010 Minnesota Students Survey, [PDF]
    Minnesota Department of Public Safety, March, 2012
    “[O]ver half of youth in correctional facilities report at least one form of trauma on the MSS (53%) compared to just over one-quarter of a matched sample of mainstream students (28%).”
  • Half of Women on Probation or Parole Experience Mental Illness [PDF]
    SAMHSA, March, 2012
    “[A]mong women aged 18 to 49, about half of those who had been on probation (49.4%) or on parole (54.2%) in the past year experienced any mental illness in the past year, compared with 27.5 percent of women who had not been on probation or parole.”
  • Adults with Behavioral Health Needs Under Correctional Supervision A Shared Framework for Reducing Recidivism and Promoting Recovery, [PDF]
    Council of State Governments Justice Center, the National Institute of Corrections, and the Bureau of Justice Assistance, 2012
    “This paper is written in recognition of the current need for a strategic approach to address the overrepresentation of people with mental health and substance use disorders in the justice system, & the impact their treatment has on public safety & health.”
  • When Treatment is Punishment The Effects of Maryland's Incompetency to Stand Trial Policies and Practices, [PDF]
    Justice Policy Institute, October, 2011
    “Too many people found not competent to stand trial are unnecessarily locked in a secure setting for treatment and, on average, confined for longer periods than research demonstrates is clinically reasonable.”
  • Colorado Department of Corrections Administrative Segregation and Classification Review, [PDF]
    National Institute of Corrections, October, 2011
    “Currently about 7% (1,427) of the prison population is in administrative segregation, which is significantly above the national average of 1-2 %.”
  • Medicine and the Epidemic of Incarceration in the United States [PDF]
    New England Journal of Medicine, June, 2011
    “[The Affordable Care Act] could redirect many people with serious illness away from the revolving door of the criminal justice system, thereby improving overall public health in the communities to which prisoners return and decreasing [recidivism] costs.”
  • Thinking Outside the Cell Alternatives to Incarceration for Youth with Mental Illness, [PDF]
    Texas Appleseed, April, 2011
    “...youth should be supported close to their families and home environments and that detention should always be a last resort.”
  • Out and Down: The Effects of Incarceration on Psychiatric Disorders and Disability, [PDF]
    University of Pennsylvania, The Pennsylvania State University, University of Minnesota, February, 2011
    “Incarceration has a robust relationship with subsequent mood disorders, related to feeling "down", including major depressive disorder, bipolar disorder, and dysthymia.”
  • Criminal Justice Interventions for Offenders With Mental Illness Evaluation of Mental Health Courts in Bronx and Brooklyn, New York, [PDF]
    Urban Institute, 2011
    “Findings from the impact analysis indicate that mental health court participants are significantly less likely to recidivate, as compared to similar offenders with mental illness who experience business-as-usual court processing...”
  • Report on Suicides Completed in the California Department of Corrections January 1, 2012 - June 30, 2912, [PDF]
    Raymond F. Patterson, M.D., D.F.A.P.A., 2011
    “In 2012, a CDCR inmate died by suicide every 11.4 days on average.”
  • Healing Invisible Wounds Why Investing in Trauma-Informed Care for Children Makes Sense, [PDF]
    Justice Policy Institute, July, 2010
    “Joseph Tulman between 75 and 93 percent of youth entering the juvenile justice system annually in this country have experienced some degree of trauma.”
  • Sexual Victimization Reported by Former State Prisoners, 2008 [PDF]
    Bureau of Justice Statistics, May, 2010
    “An estimated 9.6% of former state prisoners reported one or more incidents of sexual victimization during the most recent period of incarceration in jail, prison, and post-release community-treatment facility.”
  • More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States, [PDF]
    Treatment Advocacy Center, May, 2010
    “Among the ten states mostly likely to have mentally ill individuals in jails and prisons, five were also among the states spending the least money per capita.”
  • National Study of Jail Suicide: 20 Years Later, [PDF]
    U.S. Department of Justice, April, 2010
    “In 2006, the suicide rate in detention facilities was 36 deaths per 100,000 inmates, which is approximately 3 times greater than that in the general population. This rate represents a dramatic decrease in the rate of suicide in detention facilities.”
  • Justice for Immigration's Hidden Population Protecting the Rights of Persons with Mental Disabilities in the Immigration Court and Detention System, [PDF]
    Texas Appleseed, March, 2010
    “Detention often exacerbates mental illness,3 separates immigrants with mental disabilities from therapeutic services and family, frequently leads to misdiagnosis, and interrupts continuity of care.”
  • New York State Assisted Outpatient Program Evaluation [PDF]
    New York State Department of Public Health, June, 2009
  • Juvenile Suicide in Confinement A National Survey, [PDF]
    Office of Juvenile Justice and Delinquency Prevention, February, 2009
    “Almost half (48.1 percent) the suicides occurred in facilities administered by state agencies, 39.2 percent took place in county facilities, and 12.7 percent occurred in private programs.”
  • Mental Illness and the Death Penalty in North Carolina A Diagnostic Approach, [PDF]
    Charlotte School of Law, May, 2007
    “[E]ntrenched obstacles within the criminal justice system impede efforts to recognize those with severe mental illness and to treat them fairly.”
  • Rates of Sexual Victimization in Prison for Inmates With and Without Mental Disorders,
    Psychiatric services, 2007
    “Approximately one in 12 male inmates with a mental disorder reported at least one incident of sexual victimization by another inmate over a six-month period, compared with one in 33 male inmates without a mental disorder.”
  • Mental Health Problems of Prison and Jail Inmates [PDF]
    Bureau of Justice Statistics, September, 2006
    “Female inmates had higher rates of mental health problems than male inmates (State prisons: 73% of females and 55% of males; Federal prisons: 61% of females and 44% of males; local jails: 75% of females and 63% of males).”
  • Suicide and Homicide in State Prisons and Local Jails [PDF]
    Bureau of Justice Statistics, July, 2005
  • Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002 [PDF]
    Bureau of Justice Statistics, July, 2005
  • Implementation of "Kendra's Law" Is Severely Biased [PDF]
    New York Lawyers For The Public Interest, Inc., April, 2005
    “There are major racial, ethnic, and geographic disparities throughout New York State in the implementation of "Kendra's Law" [,which allows courts to mandate outpatient treatment for some people with mental illness].”
  • The Role of Specialty Mental Health Courts in Meeting the Needs of Juvenile Offenders, [PDF]
    Judge David L. Bazelon Center for Mental Health Law, September, 2004
  • Ill-Equipped: U.S. Prisons and Offenders with Mental Illness,
    Human Rights Watch, October, 2003
  • Status of Services for Persons with Mental Illness in Maine's Prisons: 2002,
    The Citizen's Committee on Mental Illness, Substance Abuse, and Criminal Justice and NAMI Maine, September, 2002
  • Consensus Project Report
    Criminal Justice / Mental Health Consensus Project, June, 2002
    (project coordinated by the Council of State Governments (CSG))
  • Mentally Ill Offenders in the Criminal Justice System: An Analysis and Prescription, [PDF]
    Sentencing Project, January, 2002
  • Mental Health Treatment in State Prisons [PDF]
    Bureau of Justice Statistics, July, 2001
    (None of the prison systems have any idea how many mentally ill prisoners they have. Using the BJS reports for anything other than whether or not prisoners identified as mentally ill are actually receiving services would be a mistake.)
  • Current Status of Services for Persons with Mental Illness in Maine's Jails and Prisons,
    NAMI Maine, September, 2000
  • Substance Abuse Treatment in Adult and Juvenile Correctional Facilities Findings from the Uniform Facility Data Set 1997 Survey of Correctional Facilities,
    Substance Abuse and Mental Health Services Administration, April, 2000
  • From Prisons to Hospitals and Back The Criminalization of Mental Illness,
    Campaign for an Effective Crime Policy, January, 2000
  • Mental Health and Treatment of Inmates and Probationers [PDF]
    Bureau of Justice Statistics, July, 1999
    “More than a quarter million prison and jail inmates are identified as mentally ill”
  • Prisons and Jails: Hospitals of Last Resort: The Need for Diversion and Discharge Planning for Incarcerated People with Mental Illness in New York, [PDF]
    Correctional Association of New York and the Urban Justice Center, 1999
  • Report on the Psychiatric Management of John Salvi in Massachusetts Department of Correction Facilities 1995-1996, [PDF]
    University of Massachusetts Medical Center Department of Psychiatry, January, 1997
    “...in our opinion, the number of full-time equivalent psychiatrists within the DOC is far too low to meet the psychiatric needs of the inmate population.”
  • Mental Illness in US Jails: Diverting the nonviolent, low-level offender, [PDF]
    Center on Crime Communities and Culture, November, 1996
  • Prison Suicide: An Overview and Guide to Prevention, [PDF]
    U.S. Department of Justice, June, 1995
    “During the past 10 years, the rate of suicide in prisons throughout the country was 20.6 deaths per 100,000 inmates. States with small prison populations appear to have exceedingly high rates of suicide — often more than 2.5 times the national average.”

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