Representative Ted Strickland (D-Ohio), previously a consulting psychologist at an Ohio correctional facility, introduced HR2387 into the House with similar observations. "Generally the criminal justice system is not equipped to identify and ensure people with mental illness find appropriate treatment programs, either through diversion into community treatment or within a jail or prison," he said.
Although there are few indicators of the quality of mental health treatment provided in state prisons, the Bureau of Justice Statistics does indicate that treatment programs are being made available. According to a June 2000 survey of prisons, 1,394 of 1,558 (89.5%) state public and private adult correctional facilities provide mental health services (Beck and Maruschak, 2001). Screening for mental illness is purported to occur in almost 70% of state prisons; with 65% conducting psychiatric assessments and 51% providing 24-hour mental health care. Psychotherapeutic counseling by trained mental health care professionals occurs in 71% of the facilities, according to the report, and 73% distribute prescribed psychotropic medications. The report also indicated that 66% of the prisons have programs to assist newly released parolees in obtaining community mental health services.
Approximately 1.6% of all inmates (about 10% of those identified as mentally ill) were reported to be receiving 24-hour care in special housing or a psychiatric unit. Approximately 13% of all inmates (79% of those with mental illness) were reported to receive psychosocial therapy or counseling from a trained professional on a regular basis.
Despite the reported quantity of mental health care programs for offenders, many mental health care professionals familiar with prison settings, as well as advocates for prisoners' rights and for the mentally ill, consider services often inadequate or ineffective and prison conditions incompatible with therapeutic efforts.
When the Bureau of Justice Statistics report was issued, Jeffrey Metzner, M.D., chairperson of the American Psychiatric Association's Council on Judicial Action, commented that the apparent number of programs belied the inadequacy of facilities and scarcity of credentialed mental health staff. He was quoted as saying, "If the conditions of confinement involve being locked in a 70-square foot cell 23 hours a day for months at a time, it is unlikely that patients with mental illness could receive adequate mental health services" (Kupersanin, 2001).
Pomerantz (2003) recently noted that while the reported number of programs within the prison system is reassuring, there is no indication that treatments are continued for offenders after their release. One study of 17 New Jersey jails revealed that half "never or rarely" provided inmates with serious mental illnesses with medications or prescriptions once they were released (Wolff et al., 2002). Although eight of the jails had partnerships with community clinics for inmates with HIV/AIDS, none had similar partnerships with a community mental health system.
According to Pomerantz (2003):
It does not make either clinical or economic sense not to provide follow-up care in the community for mentally ill persons following their release from jails or prisons.