The line between health issues and legal issues is frequently blurred, particularly with mental illness and substance use disorders. How can we un-blur that line? How do we get people the help they need while maintaining public safety? Host Sue Humphreys talks with Ayesha Delany-Brumsey of the Council of State Governments (CSG) Justice Center and Stepping Up Initiative to examine health issues in the justice system and what’s making a difference.
In every county in the U.S. that has both a jail and a county psychiatric facility, more people with mental illnesses are in jail than in the hospital. Forty-four states report that their jails and prisons house more people with mental illnesses than their largest state psychiatric hospital. We have a problem in this country, and it’s not just a jail problem. It’s a systemic problem. Mental illness is being criminalized, and it’s up to everyone involved in the justice system to stop it.
How do jails effectively manage their already scarce resources? By knowing who needs them. Assessment tools can help you screen inmates for everything from mental health to medical well-being, suicidal tendencies, PTSD, and even potential PREA concerns. When you screen inmates at intake, you know right away what treatments, housing, and programming will be most effective for each individual, and you can make decisions that appropriately allocate resources and keep everyone safe.
Placement in restrictive housing is often an attempt to protect inmates, but it can have the opposite effect, particularly for those who suffer from mental illness. The problem is twofold: not only can solitary and restricted conditions exacerbate mental health conditions, the lack of access to treatment and programming further disrupts existing issues and can even create new ones.
Some suicides can’t be prevented, but it’s our responsibility to try. Jails today are facing lack of funding, lack of resources for treating substance abuse issues and mental illness, and myriad other challenges that make it difficult to meet every inmate’s needs, but when it comes to suicide prevention, we have to stay vigilant.
For decades, the primary way jails and prisons have attempted to mitigate this elevated risk and keep mentally ill inmates safe was to keep them separated from the general population. This makes sense: When vulnerable inmates aren’t exposed to potential predators, they’re substantially less likely to be victimized.
Restrictive housing, when used effectively, can help jail staff maintain safety and protect vulnerable inmates. However, overuse of this tool has led to ongoing problems for jails throughout the country. Constant vigilance of restrictive housing procedures and practices is necessary.
One third of adults in prison are mentally ill. One quarter have a co-occurring mental illness and substance abuse disorder. Prison inmates are seven times more likely than others in their community to have a substance abuse disorder.
Justice professionals and mental health professionals agree: Jails aren’t equipped to effectively treat mental illness, yet they do it every day. Jail staff and administrators have been asking for help for decades, and you and your peers undoubtedly spend a great deal of time trying to get appropriate resources to those who need the