According to the National Alliance on Mental Health (NAMI), “about two in five people who are incarcerated have a history of mental illness. This is twice the prevalence of mental illness within the overall adult population.” Mental illness disproportionately affects women inmates, with nearly 66% of women reporting a history of mental illness, which is nearly double the percentage of men.
With a constitutional obligation to provide both mental and physical healthcare to those housed in correctional facilities, the burden of providing treatment is something many facilities struggle with. Due to increasingly tightening budgets, larger populations, and an overall shortage of psychiatric and mental healthcare providers, adequate mental healthcare in correctional facilities is challenging.
According to an article in The Guardian on the role of mental health care in correctional facilities, “correctional facilities are struggling with the reality that they have become the nation’s de facto mental healthcare providers.” While the number of psychiatric hospitals and residential treatment centers has continued to decline over the last few decades, the prevalence of mental illness among the population has continued to climb.
Currently, the country’s largest providers of psychiatric care are not hospitals, but correctional facilities. Without adequate access to mental healthcare, it is arguably too common for someone dealing with a mental illness to end up in a correctional facility. In fact, in a report from the National Institute of Corrections, “the number of individuals with serious mental illness in prisons and jails now exceeds the number in state psychiatric hospitals tenfold.” This places the burden of treatment on the jails and prisons, many of which are unequipped to handle the mental health needs of inmates.
With the right to treatment affirmed by the United States Supreme Court, correctional facilities must provide care to those with mental illness. As budgets continue to tighten and correctional facilities are forced to stretch resources further than ever before, providing adequate psychiatric care is challenging. The National Alliance on Mental Health affirms that incarcerated people have constitutional rights to both medical and mental health care yet “nearly two-thirds of people with mental illness in jails and prisons do not receive mental health treatment.”
In addition to providing basic treatment and medications, incarcerated people could benefit greatly from supportive programs and therapies. With the ultimate goal being to rehabilitate incarcerated people and move them back into their communities, proper treatment of mental illness is crucial.
Without significant regulatory changes, the burden placed on correctional facilities to provide mental health care at the level needed is immense. One way that correctional facilities can provide psychiatric care with limited resources is through the use of vendor management.
Vendor management and a contingency workforce can be invaluable in terms of providing immediate care to those housed in correctional facilities. An important need regarding mental health care is a diagnosis, particularly in correctional facilities. With people living in such close quarters, identifying cases of mental illness where a person may pose a threat to themselves or others is of immediate concern. Some correctional facilities are large enough to warrant designated mental health units, specifically for housing those who may pose a threat to themselves or others. However, while some facilities have mental health units, they often struggle with being able to afford permanent full-time providers who can identify and diagnose cases at the onset of incarceration.
In this instance, temporary help can be a cost-effective method of ensuring the safety of those living and working in correctional facilities. A locum mental health care provider could review cases before or during the intake process, before placement to identify instances in which an inmate may pose a threat to themselves or others without immediate intervention. While this is important in any facility, it can be especially beneficial in areas where the population of both the correctional facility and the local community does not have access to full-time psychiatric services.
Like most healthcare providers, correctional facilities face tight budgets and increasing demand for services. The healthcare landscape is constantly evolving as providers struggle to meet demand with the resources they have available. With the COVID-19 pandemic, innovative telehealth became a more mainstream medical and mental healthcare tool.
The use of technology through telepsychiatry can broaden access to mental healthcare in correctional facilities. Solutions that utilize healthcare technology, like telepsychiatry, are more than convenient, they can also help mitigate cost barriers to treatment. Transportation, of both inmates and providers, can affect access to treatment and telepsychiatry can virtually eliminate those costs.
In addition to mitigating costs, telepsychiatry can be a safer method of treatment for providers. Feeling safe is imperative for providers to offer effective treatment, and telepsychiatry can increase the level of comfort of both the inmate and healthcare providers.
When considering mental healthcare and correctional facilities, it is clear that significant regulatory changes must happen. However, until regulations and guidelines broaden access to and budget for mental healthcare, using vendor management systems can be an efficient and affordable way to provide mental health services in correctional facilities.