Background Approximately three quarters of a million adults are detained in US jails, and rural detention centers are responsible for the largest recent increases in this population. It is estimated that two thirds of jail inmates meet criteria for a substance use disorder (SUD), nearly half present symptoms consistent with a mental health condition (MHC), and the vast majority of adults in jails have been arrested and booked into these facilities in the past. It is critical to examine the link between SUDs, MHCs, and readmissions to help inform better approaches. Methods This prospective study examined the associations between SUDs, MHCs, and jail readmissions in a random sample of 224 adults collected from a rural correctional facility in North Carolina. The Comprehensive Addiction and Psychological Evaluation-5 (CAAPE-5) was administered to participants within 24 to 96 h of admission to the jail. Information consistent with DSM-5 designations for SUDs and several MHCs was evaluated in conjunction with 12-month jail readmission data. Results Bivariate analyses demonstrated the disproportionality of SUDs and several MHCs (including depressive episode, posttraumatic stress, and antisocial personality) among adults who were readmitted to the jail. Binary multivariate logistic regression analyses showed SUDs nor MHCs to be associated with any jail readmissions, but multinomial regression results indicated SUDs were the most robust indicator of multiple 12-month jail readmissions. Conclusions Local jails need to implement systems capable of conducting behavioral health assessments, with a special focus on SUDs as one of the strongest indicators of readmission. This information will allow jail administrators to better manage detainees while they are incarcerated, but it can also enhance the ability to connect adults with appropriate programming options to address the condition and reduce the likelihood of reentering the detention center.

Purpose Most research on posttraumatic stress disorder (PTSD) and offending has been conducted with special populations (e.g. veterans and female inmates) and generally overlooks the additive effect of panic disorder (PD) in offending patterns. The purpose of this paper is to assess the prevalence of PTSD and PD among jail inmates, while simultaneously examining the relationships between these disorders, offending types and frequency. Design/methodology/approach A random sample of adults recently booked into a local county jail participated in the Comprehensive Addictions and Psychological Evaluation-5 (CAAPE-5), a structured psychological assessment. The study sample was comprised of 200 male and 83 female inmates. Findings Indications of PTSD were observed among 44.0 percent of male inmates and 57.8 percent of female inmates. Most male inmates (78.4 percent) with positive PTSD indications also met criteria for PD, with a similar proportion (78.1 percent) of female inmates also meeting criteria for both. The combination of PTSD and PD was not associated with offending frequency, but inmates presenting indications of both PTSD and PD were more likely to be charged with a violent offense relative to those with only PTSD. Practical implications Inmates with PTSD who also have panic attacks may have a more severe condition with possible implications for other risks. Observations of these conditions among adults recently booked into local jails should coincide with each other. Originality/value Few studies have examined mental health conditions among local jail detainees, despite the ever-present need to address them. The current study considers this important population and investigates the prevalence of co-occurring conditions.

Posttraumatic stress disorder (PTSD) has been observed in a sizable proportion of the U.S. adult correctional population. Jail administrators must pay particularly close attention to inmates with PTSD symptoms, considering these facilities serve as the gateway to the criminal justice system and inmates with PTSD may pose a risk to themselves, other inmates, and staff. The reality of conducting behavioral health assessments in a jail environment is wrought with significant challenges, including limited time. The current study examined prior research on PTSD screening tools to establish an empirical basis for a practical screen to be used among adults recently booked into local jails. Data from a random sample of 283 adults assessed specificity and sensitivity rates of different combinations of criteria. Results indicated a two-item screen achieved an 86.4% sensitivity rate as well as an 80.4% specificity rate. This evidence demonstrates a practical and clinically relevant approach to conducting PTSD screens among adult jail inmates.

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