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People with Mental Health Conditions in Corrections

a push for help button in a correctional facility

People with mental health issues increasingly receive care provided by correctional agencies. In 1959, nearly 559,000 patients were housed in state mental hospitals (Lamb, 1998). A shift to "deinstitutionalize" people with mental health issues had, by the late 1990s, dropped the number of persons housed in public psychiatric hospitals to approximately 70,000 (CorrectCare, 1999). As a result, people with mental health issues are more likely to live in local communities. Some come into contact with the criminal justice system. In a 2006 Special Report, the Bureau of Justice Statistics (BJS) estimated that 705,600 adults with mental health conditions were incarcerated in state prisons, 78,800 in federal prisons and 479,900 in local jails. In addition, research suggests that "people with mental illnesses are overrepresented in probation and parole populations at estimated rates ranging from two to four times the general population" (Prins and Draper, 2009). Growing numbers of offenders with mental health issues have strained correctional systems.

Special Publication: White Paper on Behavioral Health Needs

"Adults with Behavioral Health Needs under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery" is a white paper prepared by the Council of State Governments Justice Center with support from, and in partnership with, the National Institute of Corrections (NIC) and the Bureau of Justice Assistance (BJA). The framework is designed for state and local correctional administrators (institutional, probation, and parole) and community-based mental health and substance abuse agency leaders to plan and develop service responses that make efficient use of resources. Although by itself, it is not suitable for practitioners to use for clinical decision-making, or for decision-making regarding youth in the juvenile justice system, it is meant to facilitate clear and consistent communication among system administrators. It can help professionals in each system target the right individuals, ensure responsible and effective practices, and improve matches between responses to needs. The framework can help professionals in the criminal justice and behavioral health systems in the following ways:

  • Ensure that scarce resources are spent effectively.
  • Advance collaboration and communication.
  • Encourage responsible and effective practices.

Available in the NIC Resources section of this page.

Evaluating Early Access to Medicaid as a Reentry Strategy

Background: Prison and jail inmates with physical health, mental health, and substance use problems experience more reintegration difficulties upon release, and they typically have poorer outcomes with respect to employment, re-offending, and re-incarceration. Maintaining treatment for these health problems may help improve post-release outcomes. Many inmates presently receive health care while incarcerated, but a lack of health insurance and other barriers contribute to declines in health treatment and functioning once released. Access to care through insurance coverage helps not only the individual, but it may also lower societal health care and criminal justice system expenditures by reducing costly emergency room visits, enabling individuals to work, and decreasing repeat criminal activity.

Project Purpose: This study, supported by the National Institute of Corrections and conducted by the Urban Institute, assessed whether currently available Medicaid coverage-for example, in states that cover childless adults under age 65-helps newly released inmates access health care and, thereby, contributes to improved employment and recidivism outcomes. Data collection and study findings on Medicaid effects may be found in Prison Inmates' Prerelease Application for Medicaid: Take-up Rates in Oregon.

A special thanks goes to Jefferson County Sheriff's Office for the photograph.

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