People with mental illnesses are over-represented in jail and prison populations in the United States relative to the general population. There are three times as many mentally ill people in jails and prisons than in hospitals in the United States. Mentally ill people are subjected to solitary confinement at disproportionate rates compared to the general prison population. There are a number of reasons for this over-representation of mentally ill people in jails and prisons, including the deinstitutionalization of mentally ill individuals in the mid-twentieth century, inadequate community treatment resources, and the criminalization of mental illness itself. Research has shown that mentally ill offenders have comparable rates of recidivism to non-mentally ill offenders. The United States Supreme Court has upheld the right of inmates to mental health treatment. The majority of prisons in the United States attempt to employ a mental health providers. However, there is a severe shortage of staff to fill these vacancies and it is difficult to retain employees.
Prevalence There is a broad scholarly consensus that mentally ill individuals are over-represented within the jail and prison populations of the United States. In a 2010 study, researchers concluded that, based on statistics from sources including the Bureau of Justice Statistics and the U.S. Department of Health and Human Services, there are currently three times more seriously mentally ill people in jails and prisons than in hospitals in the United States, with the ratio being nearly ten to one in Arizona and Nevada. "Serious mental illness" is defined here as schizophrenia, bipolar disorder, or major depression. Further, they found that 16% of the jail and prison population in the U.S. has a serious mental illness (compared to 6.4% in 1983), although this statistic does not reflect differences among individual states. For example, in North Dakota, they found that a person with a serious mental illness is equally likely to be in prison or jail versus a hospital. In contrast, in states such as Arizona, Nevada, and Texas, the imbalance is much more severe. Finally, they noted that a 1991 survey by the National Alliance for the Mentally Ill concluded that jail and/or prison are part of the life experiences of forty percent of these mentally ill individuals. In addition to mood and anxiety disorders, other psychopathologies have also been found in the US prison System. Antisocial personality disorder is found in less than 6% of the general American population, but seems to be found in anywhere between 12% and 64% of prison samples. Estimates of borderline personality disorder seem to make up around 1% to 2% of the general public, compared to 12% to 30% within prisons. Personality disorders, especially in the inmate population, are often found to be comorbid with other disorders. A separate research study, The Prevalence of Mental Illness among Inmates in a Rural State, noted that national statistics like those previously mentioned primarily pull data from urban jails and prisons. To investigate possible differences in rural areas, researchers interviewed a random sample of inmates in both jails and prisons in a rural northeastern state. They found that in this rural setting, there was little evidence of high rates of mental illness within jails, "suggesting the criminalization of mental illness may not be as evident in rural settings as urban areas." However, high rates of serious mental illness were found among rural prison inmates.
2015 studies In 2015, lawyer and activist Bryan Stevenson claimed in his book Just Mercy that over 50% of inmates in jails and prisons in the United States had been diagnosed with a mental illness and that one in five jail inmates had had a serious mental illness. As for the gender, age, and racial demographics of mentally ill offenders, the 2017 Bureau of Justice Statistics report found that female inmates, when compared to male inmates, had statistically significantly higher rates of serious psychological distress (20.5% of female prisoners and 32.3% of female jail inmates had serious psychological distress, versus 14% of male prisoners and 25.5% of male jail inmates) and a history of a mental health problem (65.8% of female prisoners and 67.9% of female jail inmates compared to 34.8% of male prisoners and 40.8% of male jail inmates). Significant differences between race and ethnicity were also observed. White prisoners and jail inmates were more likely to have serious psychological distress or a history of mental health problems than black or Hispanic inmates. For example, in local jails, 31% of white inmates had serious psychological distress compared to 22.3% of black inmates and 23.2% of Hispanic inmates. Finally, regarding age, there were virtually no statistical differences between age groups and the percentage of those with serious psychological distress or a history of a mental health problem.
2017 studies A 2017 report issued by the Bureau of Justice Statistics used self-reported survey data from inmates to assess the prevalence of mental health problems among prisoners and jail inmates. They found that 14% of prisoners and 25% of jail inmates had experienced serious psychological distress in the past 30 days, compared to 5% of the general population. In addition, 37% of prisoners and 44% of jail inmates had a history of mental health problems.
Potential reasons for the high number of incarcerated people diagnosed with mental illnesses
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