Developed by the Substance Abuse and Mental health Services Administration’s (SAMHSA) GAINS Center for Behavioral Health and Justice Transformation in collaboration with the Council of State Governments Justice Center and the Bureau of Justice Assistance, the guidelines promote the criminal justice partnerships that are necessary to develop successful approaches for identifying individuals in need of services, determining what services those individuals need, and addressing these needs during transition from incarceration to community-based treatment and supervision.
Health and Criminal Justice Populations
The U.S. Bureau of Justice Statistics reported that about 700,000 individuals returned to the community from state and federal prisons in 2012, and as many as 9 million people are estimated to cycle through local jails each year. These individuals suffer from disproportionately high rates of HIV/AIDS, hepatitis, diabetes, and other communicable and chronic diseases compared with the general population, and mental illness and substance abuse are especially prevalent.[i] For example, about 17 percent of inmates in jails and prisons suffer from serious mental illnesses—more than three times the rate in the general population.[ii]
Individuals who are incarcerated have constitutional protections to ensure health needs are identified and addressed, but very few have consistent access to necessary health care services upon release. As many as 90 percent of those exiting the criminal justice system are uninsured,[iii] and few state or local corrections facilities have programs in place to enroll individuals in health coverage for which they might be eligible.[iv] The result is that most individuals returning to the community after incarceration are simply unable to access a consistent source of health care.
This presents challenges for both public health and public safety. Inadequate access to health care is associated with poor health outcomes,[v] as well as higher rates of rearrest and reincarceration for those with mental health and/or substance abuse disorders.[vi] Yet, research suggests that assessing individuals’ health care needs and linking them to health insurance coverage and appropriate services and supports can improve health outcomes[vii],[viii] and reduce recidivism among those with mental illness and substance abuse.[ix]
Estimates vary widely, but one national study concluded that well over half of all individuals exiting the criminal justice system each year will be newly eligible for coverage as a result of the Patient Protection and Affordable Care Act.[x] For information on changes in health care policy, including health care reform, click here.
Justice Center Health Care Publications
Individuals involved with the criminal justice system face high rates of communicable and chronic diseases, mental illness, and substance use disorders. However, criminal justice practitioners often have difficulty connecting this largely low-income and uninsured population to the health services they […]
The CSG Justice Center’s Adults with Behavioral Health Needs under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery is for policymakers, administrators, and service providers committed to improving outcomes for the large number of adults with mental health and substance use disorders that cycle through the criminal justice system.
The Substance Abuse and Mental Health Services Administration’s GAINS Center for Behavioral Health and Justice Transformation and the Council of State Governments Justice Center have prepared this easy-to-use checklist to help behavioral health agencies assess their utilization of evidence-based practices associated with positive public safety and public health outcomes.
Provides background on the legislation that authorizes federal grants to jurisdictions interested in developing collaborative criminal justice/mental health responses to people with mental illnesses. To download a PDF of the fact sheet, click here.
External Health Care Publications
This brief from the Community Oriented Correctional Health Services addresses the most frequently asked questions relating to how the ACA affects people involved with the criminal justice system and how to provide health care in correctional settings as directed by the new law.
This report from the National Institute of Corrections provides a broad overview of the social and economic issues related to corrections and criminal justice.
This brief from the Urban Institute draws on findings from its five-year evaluation of health care models integrating physical health care needs with the broad range of mental health and social needs for high-cost, high-needs Medicaid beneficiaries.
This publication from the Urban Institute discusses the Affordable Care Act and the new opportunities it creates for health and human services programs to integrate eligibility determination, enrollment, and retention.
This publication from the National Juvenile Justice Network summarizes the major changes to be expected in the provision of mental health services to youth under the Affordable Care Act.