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The Mental Health Crisis in Criminal Justice System

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The Mental Health Crisis in Criminal Justice System

Mental illness as a health concern has received a lot of attention in the last three decades.

Interventions such as increased screening, creating awareness or talking openly about mental

health, encouraging equality between physical and mental illness, showing compassion for

individuals who have mental illness and choosing empowerment over shame have been critical

in ensuring this condition is no longer associated with a stigma like before. However, several

countries, including the United States, still struggle with the high number of cases of mental

health. The criminal justice system (CJS) in the United States has emerged as the leading

breeding ground for mental illness. There is a sense in which the criminal justice system has

disregarded the most effective efforts currently being used to tame the high prevalence of mental

illnesses. Evidence shows a sharp decline in the utilization of government mental health facilities

by the CJS resulting in a high number of mentally ill individuals roaming about without proper

mechanism to assist them. These people then engage in petty crimes like trespasses, public

intoxication, foul speaking and end up being incarcerated. Since every offence must be punished,

and given that these states lack proper facilities for the mentally ill, they are thrown into jail to

serve their terms. Therefore, the mental health crisis continues to escalate within criminal justice

systems due to inadequate screening and management of individuals who need mental health

care rather than incarceration.

The paper reviews existing literature to present some of the reasons behind the escalation

of mental illness within the criminal justice system and possible ways of addressing the

challenge. Given the challenging circumstances, this research, which focuses on how students

can conceptualize the correlation between incarceration and mental illness and contribute to the
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general understanding of the values and attitudes that future Criminal Justice System employees

will bring into their occupational settings.

Analysis of the Current Situation

According to the findings of the review of various literature, mental illness within the

criminal justice system of the United States is on a sharp rise and may soon be another public

health crisis. Based on a 2015 special report on mental health challenges of jail and prison

inmates by the Bureau of Justice Statistics, “45 percent of federal prisoners, 56 percent of state

prisoners and 64 percent of jail inmates presented had problems associated with serious mental

health challenges” (Williams, 2015).

As much as other literature suggests that the situation in prisons is only a third of what

the communities maybe be contending with in terms of prevalence, there are several programs

within the general population that are aimed at managing a mental illness that is absent within

the criminal justice system (Covington, 2007). According to (Brownell, Berman, & Salamone,

2020), the escalation of mental illness within the CJS has been aided by other factors, which

include acute staff shortages characterized by high turnover rates due to poor working

conditions, lack of motivation among the available employees, under budgeting and corruption.

Lowder, Rade, & Desmarais (2018) also highlights government bureaucracies and lack of mental

health facilities, as well as lack of adequately trained personnel, as other factors contributing to

this crisis.

Although funds are always given to the criminal justice systems in all the states, it would

be preferable if such funds are channelled directly to those concerned with the mental health

sector. To address the growing number of detainees suffering from mental diseases, mental
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health should be prioritized in the justice system. "The criminalization of people with mental

illnesses is a critical component of the rising jail population that was once treated in mental

institutions but is being displaced into correctional facilities."

Based on the report issued by the Council of State Governments Justice Center, which

was partially sponsored by the National Institute of Justice’s (NIJ) Office of Justice Programs

(OJP), over 16 per cent of adults sampled from the populations of local jails presented serious

mental condition. This translates to over four or five times the overall population rate. And,

although men had a 14 per cent risk of major mental illness, women had a 31 per cent rate. If

these statistics are applied to the current prison population of 2.5 million, the findings of the

research indicate that close to over 300 000 people with major mental illnesses is booked each

year. Many offenders with mental problems are not treated while in incarceration.

Characteristically, conditions often deteriorate if not treated. When offenders are released

from prison or jail, they may pose a greater risk to themselves and others. This is not only an

injustice to the criminals themselves and their families, but it also poses a threat to the safety of

the public in general. As already pointed out in this paper, mental health matters continue to be a

source of contention in the criminal justice system. The Associated Press recently published a

story highlighting the burden that mental health issues have on emergency personnel and law

enforcement. "Since they're [those suffering from mental health] completely sliding through the

cracks," a local police chief was reported as saying. "They are chasms, not fissures." We see

those chasms at the Justice Department and are attempting to close them (Stogner, Miller &

McLean, 2020).

Addressing Mental Health in the Justice System

Lately, researchers and pressure groups have increased their involvement in trying to

address the issue of mental problems within the criminal justice system. Several interventions

have been suggested, including screening and management of individuals who need mental

health care, among others. In this research paper, we focus on the effective screening and

individual management of persons presenting mental disorders against incarceration. Of course,

the paper also highlights other intervention strategies as outlined by other various researchers.

Screening has been identified as a national standard for mental care interventions within

correctional settings. The mechanism provides the best chance to deal with the menace as

compared to other approaches, which are often requiring a lot of money to implement or become

less effective when subjected to the usual government bureaucracies. It can be rolled out in

various levels just to ensure varying needs are put into consideration. Its implementation is quite

simple; having qualified personnel to conduct screening and evaluation to all inmates as part of

the admission process to a correctional centre or prison. There are several states that are at

advanced levels with the rollout of mental illness screening programs.

Data on prison mental health evaluation models and screening from all the 50 states’

correction departments show that the vast majority of states seem to be aligning to some

variation of the most widely accepted standards or guidelines for correctional health care systems

(some of these include American Psychiatric Association, American Psychiatric Association,

National Commission on Correctional Health Care and many more). The use of informed

consent and standardized psychological test issues are the most important tools the states are

relying on to advance screening programs in correction centres.

Screening assumes that the individual's health problems are unrecognized hence serves to

unravel all these underlying issues. However, the most common reason people do not seek
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services is due to attitudinal barriers (such as perceived ineffectiveness of services, preference

for self-management, or lack of perceived need). Traditional structural barriers such as service

availability, knowledge of service, and cost are generally not common as they may be more

common in countries without public health systems like the United States compared to those

with public health systems like Netherlands or Canada.

Studies show that screening is more effective in addressing structural barriers as

compared to attitudinal barriers because attitudinal barriers can lead to underreporting of signs

and symptoms or refusal of treatment. While the majority of previous studies on barriers has

mainly focused on the community in general, inmates equally report similar barriers aside from

cost. Nevertheless, barriers may differ at various stages of incarceration. For instance, inmates

that are admitted for the first time at intake units (rather than regular prison wings) demonstrated

a higher rate of preference to self-management and self-care because they are often unaware of

how to access these services and being concerned about how other staff and inmates will

perceive them.

Prior research discovered that screening within the Canadian criminal justice system has

specificity (71%) and sensitivity (75%) and can best be used to compare best-studied tools to be

used with inmates. Still, within the Canadian prison landscape, studies reveal that 79 per cent of

inmates suffering from mental disorders at least had encounters with a mental health

professional, while only 46 per cent received long-term treatment (Martin et al., 2018). The

Canadian situation compares favourably to international mental health access rates. This may be

due, partly, to a lower screening sensitivity by individuals who failed to self-report having

received treatment promptly before their incarceration, as well as for racial minorities; age,

regional differences and gender were not taken into account. The previously discussed barriers to
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care may also explain why roughly one-third of those with clinical contact did not complete

treatment.

Conclusion

Criminal justice systems in the United States face a lot of challenges in addressing the

mental health needs of the people they serve. Based on a report by the Bureau of Justice

Statistics (BJS), over 42% of the people incarcerated in the US suffer from mental illnesses. The

BJS argues that these persons are more likely to have prior convictions and to serve a longer

term than those who do not have mental health concerns. Mental health disorders can worsen or

linger if not properly attended to, increasing the chances of being involved with the criminal

justice system. As already been indicated, the mental health crisis continues to escalate within

criminal justice systems due to inadequate screening and management of individuals who need

mental health care rather than incarceration. States are taking specific initiatives to promote

mental health treatment for those involved in the judicial system, such as training people on self-

management, screening, court diversion programs, and improved access to health care following

reintroduction into the community.

References

Brownell, P., Berman, J., & Salamone, A. (2020). Mental health and criminal justice issues

among perpetrators of elder abuse. Journal of Elder Abuse & Neglect, 11(4), 81-94.

Covington, S. S. (2007). Women and the criminal justice system. Women's Health Issues, 17(4),

180-182.

Lowder, E. M., Rade, C. B., & Desmarais, S. L. (2018). Effectiveness of mental health courts in

reducing recidivism: A meta-analysis. Psychiatric Services, 69(1), 15-22.

Martin, M. S., Crocker, A. G., Potter, B. K., Wells, G. A., Grace, R. M., & Colman, I. (2018).

Mental health screening and differences in access to care among prisoners. The Canadian

Journal of Psychiatry, 63(10), 692-700.

Stogner, J., Miller, B. L., & McLean, K. (2020). Police stress, mental health, and resiliency

during the COVID-19 pandemic. American journal of criminal justice, 45(4), 718-730.

Sugie, N. F., & Turney, K. (2017). Beyond incarceration: Criminal justice contact and mental

health. American Sociological Review, 82(4), 719-743.

Vogel, M., Stephens, K. D., & Siebels, D. (2014). Mental illness and the criminal justice system.

Sociology Compass, 8(6), 627-638.

Williams, R. (2015). Addressing Mental Health in the Justice System. NCSL legisbrief, 23(31),

1-2.