This study examined the lifetime and past-year community mental health treatment use of 282 male and 149 female jail detainees with SMI. Although most participants reported high lifetime rates of mental health treatment they believed effective, only a minority accessed treatment in the year and month before arrest. Women were less likely to receive treatment than men and more often left treatment against medical advice. Both substance use and post-traumatic stress disorder were significantly undertreated and care was provided predominantly by psychiatrists. The implications for expanding treatment availability and access to critical services such as housing and employment are discussed.
KEYWORDS
Serious mental illness; criminal offenders; community mental health treatment
Community-based mental health treatment preceding
Jail detention among adults with serious mental illnessesPeople with one or more serious mental illness (SMI) such as schizophrenia spectrum disorder, bipolar disorder, and major depression are overrepresented in the criminal justice system ((CJS); Steadman, Osher, Robbins, Case, & Samuels, 2009;Teplin, 1994). Multiple studies have, with some variability owing to measures, definitions of mental illness, and sampling, placed the prevalence of a diagnosable SMI among detainees and inmates in the range of 15% to 25% (Fazel & Seewald, 2012;Sarteschi, 2013;Steadman et al., 2009). Moreover, offenders with SMI are more likely than their non-mentally ill peers to be rearrested and reincarcerated and remain in the CJS for extended periods (Eno Louden, Gillig, & Skeem, 2009). The over-representation is such that those with SMI are estimated to be three times less likely to be placed in a psychiatric hospital than in a jail or prison (Torrey, Kennard, Eslinger, Lamb, & Pavle, 2009), which in the U.S. are distinct criminal justice entities. Jails are operated by county or city governments and are mainly used for detention pre-arraignment or presentencing or for those serving shorter sentences (i.e., less than one year). Conversely, prisons are operated by the state or federal government, are post-sentence, and confine individuals for longer durations.
