The Stepping Up initiative supports local jurisdictions in establishing and reaching measurable goals that demonstrate reduced prevalence of serious mental illness across the justice system.
Document Category: Medical and Behavioral Health
During the reentry process, people work across various sectors to offer support to people who are being released from incarceration by providing connections to care for behavioral health, housing, transportation, and other supportive services. While there are challenges providing connections to care, there are also some success stories that Second Chance Act grantees can offer insight on. This webinar features two grantees who have utilized innovative ways to provide post-release connections to care for people who are returning to various communities. Video Run Time: 1 hr., 12 mins
Individuals entering jails and other correctional settings are more likely to have a chronic health condition or infectious disease, resulting in an increased risk to their physical health and well-being while incarcerated. A close look at statistics from local jails demonstrates that, far from being a safe haven from these converging crises, a failure to prioritize implementation of adequate policies and protocols addressing these issues in many local jails are fueling these crises for the individuals inside and everyone in our communities
The number of incarcerated women increased by more than 750% from 1980 through 2017, with women of color being disproportionately incarcerated at 1.3 (for Hispanic women) to 2 (for Black women) times the rate of white women in 2017. Incarcerated women are more likely to experience a range of violence and other victimizations, as well as other traumatic experiences, prior to being incarcerated. All play a major role in their pathways to involvement with the criminal justice system. Furthermore, incarcerated women are more likely to experience victimization while incarcerated.
The overrepresentation of individuals with mental illness in the criminal/legal system is well documented. While professional associations urge diversion towards treatment, little is known about the practices these institutions use to identify this population. One understudied space in the criminal/legal continuum is jails. This exploratory study compares two types of mental health identification at jail booking to assess jail- and community-based service outcomes by identification type (N = 2956): (a) staff observation and (b) a standardized screening instrument. Individuals identified through staff observation were significantly more likely to receive jail- and community-based services, even though current symptomology and substance misuse were both significantly higher for individuals identified only by the screening instrument. These findings point to the importance of jails in providing stabilizing services during incarceration, but further, show the impact that identification practices have on individuals as they transition to the community. Community context showed varied rates of jail staff observations of mental illness, showing greater risks for individuals in rural communities. Implications include a need for system-level changes by instituting evidence-based identification practices in jails, and improving professional collaboration practices between mental health and criminal/legal practitioners as individuals enter and exit jails.
As telehealth expands, communities across the country are looking for information on how best to facilitate connections to care for people with serious mental illnesses being discharged from jail. This webinar hosted by the Stepping Up partners focuses on increasing connections to care in a changing world, featuring tips and strategies directly from counties.
In 2017, the National Association of State Mental Health Program Directors (NASMHPD) and the Substance Abuse and Mental Health Services Administration (SAMHSA) partnered in advocating for policy makers to consider what it would take to look “Beyond Beds” in state hospitals as a single solution to all the challenges and instead develop a path toward a robust continuum of accessible, effective psychiatric care. Now, three years later, NASMHPD and SAMHSA highlight the first point of entry into that continuum of care- to prevent and manage crises in a way that offers an immediately accessible, interconnected, effective and just continuum of crisis behavioral health services. By enhancing crisis response, community needs can be met, and lives can be saved with services that reduce suicides and opioid-related deaths, divert individuals from incarceration and unnecessary hospitalization and accurately assess and stabilize and refer individuals with mental health, substance use and other behavioral health challenges. This paper, Crisis Services: Meeting Needs, Saving Lives, furthers the Beyond Beds strategy by describing this vision. By knitting together several bodies of work on crisis services, it sets the stage for the next iteration of a national dialogue for developing and expanding that much needed continuum of quality mental health and substance use care for all who need it, when they need it.
The United States has the second highest rate of incarcerating women internationally, second only to Thailand. In recent decades, there has been a dramatic increase in the U.S. correctional population, and women are a rapidly growing segment of this population. In the United States, 64.6 women per 100,000 are incarcerated, with the highest rate of 142 per 100,000 occurring in Oklahoma.4 Most women who are incarcerated are within their reproductive years, and many women are pregnant at reception.
Currently, there are no mandatory standards of care for pregnant women in U.S. prisons and jails, and many incarcerated women receive inadequate obstetric care. These facts prompted Sufrin to study pregnancy outcomes in U.S. prisons through funding she received from NIH’s Building Interdisciplinary Research Careers in Women’s Health Program.
Like most other individuals, prisoners sometimes need medical attention for ailments, injuries and diseases. However, there appears to be a misconception about prisoners’ medical rights among physicians, medical administrators, prison and jail staff, and law enforcement officials. This article will review some of the medical rights and court rulings that are pertinent to prisoners, including issues such as medical decision-making, medical information privacy, force-feeding and forcible medical procedures.