Reduce the High Rates of Mental Illness in our Nation’s Jails and Prisons

The rates of mental illness are higher in prisons and jails than in the community. Compared with the general American population of similar age, rates of psychotic illnesses and major depression are 2 to 4 times higher among prisoners. In jails, the rate of current serious mental illness for male inmates is estimated at 14.5% and for female inmates, 31%. Correctional settings are not well equipped to manage inmates with mental health problems. Mental health training for correctional officers is minimal and may contribute to the lower rates of programming and higher rates of disciplinary infractions observed among this population. As a result, inmates with mental illness tend to be spend a longer term incarcerated and, once released, return to correctional settings at higher rates and more quickly than similarly situated individuals without mental illness. This cycle is devastating lives and crippling economies across the country.

Incarceration is not the optimal method to meet the complex needs of people with mental illness. Moreover, federal, state and municipal policymakers across the political spectrum are beginning to realize that this approach is unsustainable. As a result, policies that ensnared a large portion of this population are beginning to be rolled back and methods for intercepting and diverting from criminal justice processing adults whose mental illnesses have contributed to their justice involvement are being advanced and implemented. Federal, state and private grant programs are increasingly supporting the expansion of partnerships with law enforcement and corrections that aim to divert this population from incarceration or to assist with its community reentry. Social work should build on this momentum to incorporate evidence-based practices into these efforts, to measurably reduce the high rates of mental illness behind bars and to promote this population’s community tenure.

This problem is solvable. The “nothing works” attitude that dominated offender rehabilitation for decades has been discarded as a result of the evidence that has been amassed as to what does work at reducing antisocial behavior and criminal conduct, both for adults with and without mental illness. We now know what factors most reliably contribute to criminal behavior and are developing programs and services that address these factors. In addition progress has been made as to methods for increasing access to and engagement in these programs among justice-involved individuals with mental illness.

However, progress cannot continue without a concerted effort among non-profit, for-profit and governmental agencies. The first social impact bond program in the US, which focused on providing therapeutic services for offenders with the aim of reducing recidivism, is a good example of cross-sector collaboration that has potential for addressing this problem. Others will need to be developed. With its established history of professional involvement in social justice, health and social services as well as philanthropy and policymaking; Social Work is well-positioned to spearhead these collaborative efforts and to contribute to the development of innovations that carry policy momentum and practice evidence forward, down the path to reducing the high rates of mental illness in this nation’s jails and prisons.


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