Jail Inmates' Mental Health Care Neglected; State and Federal Attention Needed

Studies indicate that from 20 to 60 percent of the jail population on any given day have mental health problems. But most jails do not identify all inmates in need of help or provide for their proper care. The Law Enforcement Assistance Administration (LEAA) established the National Advisory Commission on Criminal Justice Standards and Goals to formulate national criminal justice standards and goals at the State and local levels. The Commission found a general lack of funding and program innovation at the local level, and it concluded that few local communities, especially in sparsely settled areas, have sufficient resources to resolve jails' problems and provide appropriate health and other services. The Commission recommended that the States assume the responsibility for operating and controlling local jails by 1982. If States did not assume control, it recommended alternative actions which included: (1) adoption of professional, statewide standards for jails, and State inspections to ensure compliance; (2) State supervision of and assistance for training of jail personnel; and (3) State-supervised comprehensive planning to ensure that all appropriate community services agencies were used to provide services for inmates in jails or through community-based alternatives.

States have made only limited progress in implementing the Commission's recommendations. States generally have not assumed responsibility for operating and controlling local jails. Some States are adopting mandatory professional standards for jail mental health services. However, States have done little to overcome widespread inadequacies in the training of local jail personnel. Criminal justice and health systems continue to operate separately with little interaction or cooperation. None of the States GAO visited had comprehensively assessed inmates' mental health care needs and community agencies' capacity to meet them or linked criminal justice and health systems to provide services for inmates in jails and through community-based alternatives. Although improving mental health care in locally operated jails is not primarily a Federal responsibility, financial and technical assistance programs administered by the Department of Justice and the Department of Health and Human Services (HHS) could aid the States in bringing mental health care services for inmates up to acceptable standards. The two Federal Metropolitan Correctional Centers which GAO visited did not always adequately screen incoming inmates or provide for adequate treatment for inmates having behavioral disorders. Treatment deviated from professional standards in that neither had a program for drug addiction. Correction of management shortfalls would improve services and facilitate the better use of resources.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: No director on record Team: No team on record Phone: No phone on record