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Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey

NCJ Number
E. Fuller Torrey, M.D.; Mary T. Zdanowicz, Esq.; Aaron D. Kennard, M.P.A.; H. Richard Lamb, M.D.; Donald F. Eslinger; Michael C. Biasotti; Doris A. Fuller
Date Published
April 2014
116 pages
State-by-State findings are presented from a survey that solicited information from State and county officials on the treatment of persons with mental illness in prisons and jails.
The survey found that in State prisons, the treatment of mentally ill inmates who object to treatment can be accomplished administratively in 31 States through the use of a treatment review committee; however, even though this treatment mechanism is authorized in those 31 States, it is rarely used. In State prisons in the other States and the District of Columbia treatment over an inmate's objection are more varied and less clear. Many county jails require mentally ill inmates to be transferred to a State psychiatric hospitals for treatment, but since such hospital are almost always full, treatment does not occur in most cases. The use of other options, such as solitary confinement or restraining devices, is sometimes necessary and may contribute to the worsening of symptoms. As the "ultimate solution" to this unacceptable management of mentally ill offenders, the authors propose building and maintaining a public mental health treatment system that manages and treats mentally ill persons who come into contact with the criminal justice system. In order to facilitate this solution, this report recommends that public officials reform jail and prison treatment law; implement and promote jail diversion programs; use court-ordered outpatient treatment; encourage cost studies; establish effective intake screening; institute mandatory release planning; and provide appropriate mental illness treatment for inmates with serious psychiatric illness. A model law is proposed that authorizes city and county jails to administer non-emergency involuntary medication for mentally ill inmates who need treatment. Survey results are presented for each State and the District of Columbia. 56 references