In this brief from the CSG Justice Center, an extensive data analysis coupled with over 50 in-person interviews with local and state leaders led to the identification of key recommendations for reducing the number of people with behavioral health disorders cycling in and out of jail.
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. 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.
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, and few state or local corrections facilities have programs in place to enroll individuals in health coverage for which they might be eligible. 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, as well as higher rates of rearrest and reincarceration for those with mental health and/or substance abuse disorders. 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, and reduce recidivism among those with mental illness and substance abuse.
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. For information on changes in health care policy, including health care reform, click here.
Justice Center Health Care Publications
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.
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.
- The health and health care of U.S. prisoners: Results of a nationwide survey.
- Prevalence of serious mental illness among jail inmates
- Discharge planning and continuity of health care: Findings from the San Francisco county jail.
- For people with serious mental illnesses: Finding the key to successful transition from jail or prison to the community.
- Lack of health insurance increases all cause and all cancer mortality in adults: An analysis of National Health and Nutrition Examination Survey (NHANES III) data.
- Incarcerated mentally ill: A growing issue in California.
- Health insurance eligibility, utilization of medical care, and child health.
- Unmet health needs of uninsured adults in the United States.
- Adults with behavioral health needs under correctional supervision: A shared framework for reducing recidivism and promoting recovery.
- As roughly 700,000 prisoners are released annually, about half will gain health coverage and care under federal laws.
External Health Care Publications
This report from the National Alliance on Mental Illness discusses the limited insurance coverage for mental health and substance use care, despite the passage of two laws, the Mental Health Parity Addiction Equity Act (MHPAEA) in 2008 and the Affordable Care Act (ACA) in 2010.
This paper from the Juvenile Law Center highlights research findings that show that lengthy confinement of youth can be costly; largely ineffective at reducing recidivism; and potentially harmful to youth and communities.
In this study, the American Mental Health Counselors Association finds that more than half a million adults who were diagnosed with a serious mental health disorder could not afford treatment because they reside in one of the 24 states that did not expand Medicaid eligibility under the Affordable Care Act.
This report from The Pew Charitable Trust and the MacArthur Foundation examines national issues around substance use disorders and states’ roles in addressing such challenges.
This chart provides an overview of input from U.S. states on the Children’s Health Insurance Program (CHIP).