Screening of individuals during intake is key to jail safety. It is part of a larger information-gathering process that begins with the individual’s initial contact with the justice system. As part of the intake process, it is vital for jail leaders and staff to have information on an individual’s risk for suicide, mental health conditions or needs, substance use, and potential for substance withdrawal. Early detection or identification of each individual’s risks and needs enables critical interventions to occur sooner and often lead to better outcomes for individuals who enter the jail.

Universal screening is key to effective jail management and reducing the risk of death or harm in custody. Everyone being admitted into the facility, regardless of length of stay or conviction status, is screened for physical health conditions, infectious disease(s), mental health conditions, risk for suicide, and substance use disorders. The screening process identifies people entering the jail who may be at risk of death or harm and who are likely to require a full clinical assessment or additional services.

Screening determines if an individual is at risk of death or harm due to physical health, mental health, substance use, withdrawal from alcohol or drugs, or suicide. To evaluate risk effectively and accurately within the jail, people being booked into jails should be screened for the following:

  • Physical health conditions or needs
  • Infectious diseases
  • Substance use
  • Current withdrawal from stimulants, alcohol, opioids, or other unknown substances
  • Mental health conditions or needs
  • Suicide risk
  • Need for medication (for example, prescribed medications that should be continued during incarceration or medication necessary for treating a known medical condition)

Screening should be done at intake, during booking, or soon after. Many older jails were not built to provide intake and release functions in privacy; however, this does not mean that improvements cannot be made. Collection of potentially sensitive personal information should be conducted in a semi-private area where individuals feel more comfortable discussing such sensitive or personal matters. Use of a private or semi-private setting is likely to increase the accuracy and validity of the information needed to inform critical operational decisions on the individual’s medical, housing, and programming needs.

A staff person or health care provider who has been trained to administer the screening instrument should conduct the screening. In many jails, custodial, medical, mental health, and programming staff are all involved in screening and assessing individuals in some way. All staff conducting screenings should participate in training on the screening instrument and protocol. The level and nature of training should be directly related to the screening and/or assessment instrument being used.

Screening should occur at intake, or soon after, to identify an individual’s physical and mental health conditions and needs, substance use history, risk of drug or alcohol withdrawal, and suicide risk.

Screening is the first opportunity to capture critical, actionable information about a person's risk for death or harm. Information obtained during the screening process determines if a more comprehensive clinical assessment is warranted. Screening results also inform jail housing classification, programs, and/or interventions. Effective screening practices help jail administrators understand who is entering the jail and how to best use existing resources to mitigate the risk of death or harm. Screening at intake is meant to fulfill five primary purposes:

  • Identify and meet any urgent health needs of individuals during the intake process.
  • Identify and meet any known or easily identifiable health needs that require medical intervention.
  • Identify and isolate individuals who may be contagious.
  • Obtain a written medical clearance, when necessary, prior to accepting custody of the individual during the intake process.
  • Collect and provide information to inform jail housing classification determination(s).

Questions to consider when selecting a screening instrument include the following:

  • Is the screening instrument valid and reliable (i.e., does the instrument measure what it says it measures, and does it measure those items consistently)?
  • Has the instrument been validated for your jail population, or could it be validated for your jail population (i.e., the instrument has been tested and proven to produce reliable and accurate results for the population you serve in your jail)?
  • Is there a cost associated with using the screening instrument?
  • How much staff time is needed to administer the screening instrument?
  • How much training is required to administer the screening instrument?
  • Is the screening instrument available in multiple languages?
  • Is the screening instrument available in an electronic format?