Resource Guide - Mental Illness and Jail

According to a white paper prepared by the Forensic Taskforce of the NAMI Board of Directors in 2006, it was estimated that in 2006 that there were at least 350,000 persons with serious mental illnesses incarcerated in U.S. jails and prisons. The actual numbers today are probably considerably higher. Although some of these individuals, particularly those who are in prisons, have been convicted of serious crimes, many have been charged or convicted of misdemeanors or minor felonies related to their untreated mental illnesses.

Although jails and prisons are not "psychiatric treatment facilities," they have, by default, assumed increasing responsibilities for responding to the needs of individuals who need intensive psychiatric treatment and supports. There are several possible reasons why people with mental illness end up in the criminal justice system.

These include:

• Deinstitutionalization and the resulting loss of acute, intermediate and long-term hospital beds;
• More formal and rigid criteria for civil commitment;
• The lack of adequate community-based services and supports;
• The adoption of "get tough on crime" policies that have impacted particularly negatively on persons with co-occurring mental illnesses and substance abuse disorders;
• And the belief among many law enforcement personnel that the criminal justice system is better equipped to respond to "deviant" behaviors than the mental health system.

The research literature suggests that jails are being asked to function as de-facto inpatient psychiatric treatment facilities, in many cases. A recent retrospective study of inmates with serious mental illnesses incarcerated in a large, urban jail revealed that 76% of these individuals required and received psychiatric inpatient care or its equivalent while incarcerated. The burdens imposed on correctional facilities have helped to fuel efforts to move persons with serious mental illnesses from incarceration into community treatment.

These efforts generally occur, either prior to arrest and incarceration or after arrest. Law enforcement officers have increasingly become front-line responders to people with serious mental illness who are in crisis. These officers are frequently not adequately trained to recognize the symptoms of mental illness and to respond appropriately to individuals experiencing psychiatric crises. Read the full White Paper.

More than half of all prison and jail inmates, including 56 percent of state prisoners, 45 percent of federal prisoners and 64 percent of local jail inmates, were found to have a mental health problem, according the Justice Department's Bureau of Justice Statistics (BJS).

Among the inmates who reported symptoms of a mental disorder:

• 54 percent of local jail inmates had symptoms of mania, 30 percent major depression and 24 percent psychotic disorder, such as delusions or hallucinations.
• 43 percent of state prisoners had symptoms of mania, 23 percent major depression and 15 percent psychotic disorder.
• 35 percent of federal prisoners had symptoms of mania, 16 percent major depression and 10 percent psychotic disorder.

Inmates with a mental health problem also had high rates of substance dependence or abuse in the year before their admission--

• 74 percent of state prisoners and 76 percent of local jail inmates were dependent on or abusing drugs or alcohol.
• 37 percent of state prisoners and 34 percent of jail inmates said they had used drugs at the time of their offense.
• 13 percent of state prisoners and 12 percent of jail inmates had used methamphetamines in the month before their offense.

Among inmates who had mental health problems, 13 percent of state prisoners and 17 percent of jail inmates said they were homeless in the year before their incarceration. About a quarter of both state prisoners (27 percent) and jail inmates (24 percent) who had a mental health problem reported past physical or sexual abuse. Read the Full Report.

Incarceration of Individuals with Mental Illness

When an individual with a serious and persistent mental illness is in jail there are concerns as to their care, medications, and treatment. The following information is provided to educate the family about correctional and healthcare staff within the public correctional facility systems.

Individuals booked into the Salt Lake County Adult Detention Center are assessed in terms of medical and mental health care needs. When an individual reports an active prescription, medical and/or mental health staff, verify the prescription and assess a number of factors:

1. Types and doses of medication;
2. Whether the prescription is current;
3. Any treatment history relative to the prescription.

The individual is referred for a psychiatric evaluation with a psychiatrist or nurse practitioner, and a referral for a mental health assessment is placed if there are significant concerns about the persons mental health functioning.

There can be changes to a medication regimen. Many family members are concerned that a family member who is incarcerated has been given a different medication. It is important to understand that there are several medications which may be prescribed for one diagnosis. Medications available at the jail may be different from medications prescribed by another agency. However, the medications are very similar in terms of treatment. Licensed physicians and psychiatrists are available at the jail and determine the medication regimen for inmates with serious and persistent mental illness.

You may not bring medications into the jail from the outside for an inmate. There are strict guidelines about what is allowed in the jail setting for the purpose of maintaining security.

Please contact the jail if you have concerns about medication. You can call healthcare staff at the jail and provide information about the inmate's doctor, agency, and pharmacy, as well as any other information which may be pertinent about their care.

Upon release, inmates will take home medication prescribed for them during incarceration. It is critical the inmate follows through with the discharge plan. The discharge plan includes personalized contacts regarding treatment, medication, and court.

Release of Information and Confidentiality

Information about an inmate's case is confidential. No information can be released without a release of information signed by the inmate. However, if the inmate does not sign a release, no information can be shared about the inmate.

Visitation

Visitation is available for all units of the jail, with the exception of inmates on suicide watch precautions. Please call the jail for further direction.

Medical Issues

Any medical concerns can be addressed with the nursing staff. The following items can be brought to the jail and dropped off at the front desk:

• Eyeglasses
• Contacts
• Hearing Aids
• Dentures

Any other items must be addressed with nursing staff. No medications may be brought to the jail. All medications are verified with the community agency, prescribing physician, or pharmacy and then filled through the jail pharmacy services.

The jail has the right to refuse any items brought from an outside source.
Jail Contact Number: 801-743-5000