Many individuals in state and federal prisons who suffer from mental illness get no treatment, according to new research by the University of Texas Health Science Center at Houston (UTHealth) School of Public Health. The study is published in American Journal of Public Health.
Mental health disorders among prisoners have consistently exceeded rates of disorders in the general population. In fact, 26 percent of prisoners in the study reported a mental health condition, compared to 18 percent in the general population in 2012, according to the National Institutes of Health.
Although state and federal courts mandate that inmates must have access to adequate health services in prison, this typically only includes “severe or serious” mental illnesses, according to the paper.
“Individuals with untreated mental health conditions may be at higher risk for correctional rehabilitation treatment failure and future recidivism after release from prison,” said lead author Jennifer Reingle, Ph.D., assistant professor in the Division of Epidemiology, Human Genetics, and Environmental Sciences at UTHealth School of Public Health.
The researchers looked at data from a national sample of state and federal prisoners, which included 14,499 participants in state prisons and 3,686 in federal prisons.
Participants self-reported whether they had been taking medication for a mental health condition upon entering the facility and whether they were still taking medication while in prison, marking treatment continuity.
At the time of admission, 18 percent of each sample was taking medication for a mental health condition, but only 52 percent of that subset of the population in federal prisons and 42 percent in state prisons received medication during incarceration.
“Screening tools are not consistent across prisons, and inmates could be diagnosed with different conditions or not diagnosed at all when they get transferred to a new location,” said Reingle.
“A standardized mental health screening process could benefit the inmates and the prison system as a whole.”
This study also found evidence of racial differences in terms of medication continuity. African-American prisoners were 36 percent more likely than other inmates to have medication continuity in prison, regardless of their diagnosis. African-Americans were also more likely to suffer from schizophrenia than Caucasians.
Prisoners with schizophrenia were more than twice as likely to get medication in prison and receive continuous treatment.
“Prisoners with a severe mental illness that affects behavior, such as schizophrenia, may be more likely to receive medication to maintain security in the prison environment,” Reingle said.
Since depression does not pose an overt security risk, it’s less likely to be identified and treated, she added.
Prior research has found that former offenders who were diagnosed with a mental health condition were 70 percent more likely to return to prison, whereas in the general prison population, the rate is about 50 percent.
Of the prisoners who received medication for a mental health condition, 61 percent were given no other form of treatment. A more holistic, multidimensional approach to treatment, such as counseling or group therapy, may lead to better outcomes and lower criminal relapse rates, said Reingle.