Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011-12. (June 2017). Bureau of Labor Statistics

A history of mental health disorders was the rule rather than the exception in American jails and prisons in 2011-12, according to new data released by the US Department of Justice, Bureau of Justice Statistics (BJS).

Only about one-half of state and federal prisoners and one-third of jail inmates in 2011-12 had neither been diagnosed with a mental health disorder in the past nor met criteria for severe psychological distress (SPD) in the 30 days before they were surveyed, according to the federal government's 2017 update on mental health indicators among jail inmates and prisoners.

Women in jails and prisons were significantly more likely than men to meet one of the two criteria.

Two-thirds of all survey participants were receiving no treatment.

Rule Rather Than Exception

Serious psychological distress is a characterization that includes major depression, bipolar disorder and schizophrenia, anxiety and personality disorders, and post-traumatic stress, among others.

Based on official surveys conducted in 2011-2012:

• About 1 in 7 state and federal prisoners and 1 in 4 jail inmates self-reported experiences that met the agency's threshold for SPD in the 30 days before the survey. This is compared with about 1 in 19 people in the general population.
• More than 1 in 3 state and federal prisoners and nearly 1 in 2 jail inmates had been previously told that they had a mental health disorder.
• Combined, this means 50% of prisoners and 64% of jail inmates reported symptoms that met the threshold for SPD or had been told they had a mental health disorder.
• Major depressive disorder was the most commonly reported psychiatric condition in the sample with SPD (24% of prisoners, 31% of jail inmates), followed by bipolar disorder (18% of prisoners, 25% of jail inmates). Approximately 10% of prisoners had been told they had schizophrenia.
• Females with SPD were profoundly overrepresented in prisons and jails: Two-thirds of all women behind bars had been told they had a psychiatric disorder, nearly double the prevalence among men in both settings.
• More white prisoners and jail inmates met the threshold for SPD in the past 30 days than black or Hispanic prisoners and jail inmates.
• Prisoners with multiple arrests were more likely to have a mental health indicator than prisoners with one arrest. Among prisoners who reported 11 or more arrests in their lifetimes, 49% had been told at some point in their lives they had a mental health disorder.
• Approximately 3 in 4 prisoners (74%) and jail inmates (73%) who met the threshold for SPD said they had received mental health treatment in their lifetimes; only 1 in 3 were receiving prescription medication, counseling or therapy at the time of the survey. In the case of every form of treatment, prisoners were more likely to be treated than jail inmates.
• Prisoners and inmates with SPD were generally three times more likely to be written up or charged with a verbal or physical assault against a correctional officer, staff or assault of another inmate.

Slightly more than 100,000 prisoners and inmates participated in the sample of 233 state and federal prisons, 358 jails, and 15 special facilities (military, Indian country, and Immigration and Customs Enforcement) between February 2011 and May 2012.

Produced when funding is available, the survey represented the federal government's first update on mental illness behind bars in more than a decade.

Because the interviews took place in jails and prisons, pretrial detainees receiving legal competency restoration services or other psychiatric care in state hospitals were not included. As a result, the survey understates the number of people with serious mental illness in the criminal justice system. 

These populations are described in the Treatment Advocacy Center surveys Going, going, gone: Trends and consequences of eliminating state psychiatric beds (June 2016) and Emptying the 'new asylums': A beds capacity model to reduce mental illness behind bars (January 2017).