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18 Law & Psychol. Rev. 109 (1994)
Mental Health Services in Jails and Prisons: Legal, Clinical, and Policy Issues

handle is hein.journals/lpsyr18 and id is 113 raw text is: MENTAL HEALTH SERVICES IN JAILS AND PRISONS: LEGAL, CLINICAL, AND POLICY ISSUES James R. P. Ogloff Ronald Roesch* Stephen D. Hart' I. INTRODUCTION The United States has the largest per capita prison popula- tion in the industrialized world, with a total of over one million people incarcerated.1 At least as alarming are the results of studies indicating that between 6.5% and 10% of inmates suffer from a serious mental illness, and another 15% to 40% of in- mates suffer from a moderate mental illness.2 Based on these figures, the actual number of mentally ill people in correctional facilities is alarmingly high.3 Further, there are at least 419 * Associate Professor and Associate Chair, Department of Psychology, Simon Fraser University. J.D./Ph.D. University of Nebraska, Lincoln. ** Professor of Psychology and Director, Mental Health, Law, and Policy In- stitute, Simon Fraser University. Ph.D. University of Illinois, Champaign-Urbana. *** Assistant Professor of Psychology, Department of Psychology, Simon Fraser University. Ph.D. University of British Columbia. 1. The current incarceration rate in the United States is approximately 420 prisoners per 100,000 people. See Ron P. Jemelka et al., Prison Mental Health: An Overview, MENTAL ILLNESS IN AMERICA'S PRISONS 1 (Henry J. Steadman & Joseph J. Cocozza eds., 1993). 2. For a recent review see Sheilagh Hodgins, Assessing Mental Disorder in the Criminal Justice System: Feasibility versus Clinical Accuracy, INT'L J. L. & PSYCHIA- TRY (forthcoming). See also infra notes 8-28 and accompanying text. 3. Extrapolating from the rates and numbers conveyed above, there are approxi- mately 65,000 to 100,000 inmates with a serious mental illness in jails or prisons, and an additional 150,000 to 400,000 inmates with a moderate mental illness. As a point of comparison, Kiesler and his colleagues note that approximately 1.7 million psychiatric patients were treated in general hospitals in 1980. Of the 1.7 million, 1,140,905 people were treated for a major mental disorder and the remaining 557,220 were treated for alcohol or drug dependence or addiction. Charles A. Kiesler, Changes in General Hospital Psychiatric Care, 1980-1985, 46 AM. PSYCHOLOGIST 416, 417 (1991); see also Charles A. Kiesler et al., Who is Treated in Psychological Scatter Beds in General Hospitals? An Imputational Algorithm, 20 PROF. PSYCHOLOGY: RES. & PRAC. 236 (1989). These numbers raise the important question of whether correc- tional facilities are simply another forum for holding mentally ill and chemically dependent people. As discussed throughout, these figures pose difficulties for the inmates themselves as well as the correctional facilities in which they are incarcerat-

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