Published on: Monday, February 19, 2018

Last week, the Government Accountability Office released a report to congressional committees titled Federal Prisons: Information on Inmates with Serious Mental Illness and Strategies to Reduce Recidvisim. The report notes that an estimated 44.7 million adults in the United States suffered from mental illness in 2016, with about 10.4 million suffering from a serious mental illness, such as schizophrenia, bipolar disorder, major depression, and severe post-traumatic stress disorder.  As of May 27, 2017, BOP incarcerated about 187,910—BOP considered only 7,831 (4.2 percent) of these inmates to have a serious mental health illness.  BOP defines “serious mental illness” in accordance with BOP Program Statement 5310.16, Treatment and Care of Inmates with Mental Ilness (May 1, 2014).  Query whether BOP’s estimate is low given that the Bureau of Justice Statistics, in a 2006 report, estimated that the prevalence of mental health problems among jail and prison inmates is much higher. 

Here are some highlights from the GAO’s report:

About two-thirds of inmates with a serious mental illness in the Department of Justice’s (DOJ) Federal Bureau of Prisons (BOP) were incarcerated for four types of offenses—drug (23 percent), sex offenses (18 percent), weapons and explosives (17 percent), and robbery (8 percent)—as of May 27, 2017. GAO’s analysis found that BOP inmates with serious mental illness were incarcerated for sex offenses, robbery, and homicide/aggravated assault at about twice the rate of inmates without serious mental illness, and were incarcerated for drug and immigration offenses at about half or less the rate of inmates without serious mental illness. GAO also analyzed available data on three selected states’ inmate populations and the most common crimes committed by inmates with serious mental illness varied from state to state due to different law enforcement priorities, definitions of serious mental illness and methods of tracking categories of crime in their respective data systems.

BOP does not track costs related to incarcerating or providing mental health care services to inmates with serious mental illness, but BOP and selected states generally track these costs for all inmates. BOP does not track costs for inmates with serious mental illness in part because it does not track costs for individual inmates due to resource restrictions and the administrative burden such tracking would require. BOP does track costs associated with mental health care services system-wide and by institution. System-wide, for fiscal year 2016, BOP spent about $72 million on psychology services, $5.6 million on psychotropic drugs and $4.1 million on mental health care in residential reentry centers. . . .

DOJ, Department of Health and Human Service’s Substance Abuse and Mental Health Services Administration (SAMHSA), and criminal justice and mental health experts have developed a framework to reduce recidivism among adults with mental illness. The framework calls for correctional agencies to assess individuals’ recidivism risk and substance abuse and mental health needs and target treatment to those with the highest risk of reoffending. To help implement this framework, SAMHSA, in collaboration with DOJ and other experts, developed guidance for mental health, correctional, and community stakeholders on (1) assessing risk and clinical needs, (2) planning treatment in custody and upon reentry based on risks and needs, (3) identifying post-release services, and (4) coordinating with community-based providers to avoid gaps in care. BOP and the six states also identified strategies for reducing recidivism consistent with thisguidance, such as memoranda of understanding between correctional and mental health agencies to coordinate care. Further, GAO’s literature review found that programs that reduced recidivism among offenders with mental illness generally offered multiple support services, such as mental health and substance abuse treatment, case management, and housing assistance.

(emphasis added).  The Training Division provides resources on mental health issues here, and resources on the BOP generally, including prior GAO reports about BOP mental health, here.