Persons In Jails Research Articles

Highlights of the 1999 Institute on Psychiatric Services

Highlights of the 1999 Institute on Psychiatric Services

Deinstitutionalization and community care: social welfare policy as mental health policy.

Has deinstitutionalization failed, and if so, is it a failure of mental health policy—or of something else? Numerous articles1-5 in the news media and professional literature in the United States and the United Kingdom seem to reflect a public conclusion that the dual mental health policies of deinstitutionalization and community care are inadequate. The evidence offered includes high rates of homelessness among persons with mental illness and incidents of violence attributable to individuals having a history of contact with the mental health service system. Also cited are the confinement of disproportionate numbers of mentally ill persons in jails and nursing homes, the failure of individuals with a history of mental illness to participate in the work force, and the specter of discharged patients “smoking and rocking away their days” in quiet desperation in board-and-care homes or their own apartments.

Persons with severe mental illness in jails and prisons: a review.

The presence of severely mentally ill persons in jails and prisons is an urgent problem. This review examines this problem and makes recommendations for preventing and alleviating it. MEDLINE, Psychological Abstracts, and the Index to Legal Periodicals and Books were searched from 1970, and all pertinent references were obtained. Clinical studies suggest that 6 to 15 percent of persons in city and county jails and 10 to 15 percent of persons in state prisons have severe mental illness. Offenders with severe mental illness generally have acute and chronic mental illness and poor functioning. A large proportion are homeless. It appears that a greater proportion of mentally ill persons are arrested compared with the general population. Factors cited as causes of mentally ill persons' being placed in the criminal justice system are deinstitutionalization, more rigid criteria for civil commitment, lack of adequate community support for persons with mental illness, mentally ill offenders' difficulty gaining access to community treatment, and the attitudes of police officers and society. Recommendations include mental health consultation to police in the field; formal training of police officers; careful screening of incoming jail detainees; diversion to the mental health system of mentally ill persons who have committed minor offenses; assertive case management and various social control interventions, such as outpatient commitment, court-ordered treatment, psychiatric conservatorship, and 24-hour structured care; involvement of and support for families; and provision of appropriate mental health treatment.

Mentally disordered persons in jail

Mentally disordered persons in jail

Forensic and Jail Psychiatry in a Developing Tropical Region: Initiating a Consultation Program in Micronesia

This article summarizes 15 months' experience as the only psychiatrist available to jails, courts and attorneys for the huge tropical area of the Trust Territory of the Pacific Islands (Micronesia). Twelve percent of all psychiatric evaluations during this time were court- or jail-related. All but one of these “forensic” cases had a psychiatric illness at the time of evaluation, using strict diagnostic criteria. Even in this unsophisticated developing region, the Micronesian police recognized the most serious cases by identifying persons in jail who acted and talked “abnormally” as compared to the rest of the jail population.