Evidence-based practice for managing the mentally Ill inmate population

The number of mental health hospital beds in the United States began to decrease dramatically in the mid-20th century, and, since that time, jails and prisons have seen individuals with serious mental illness comprise a significant share of their population. In the region surrounding Charlottesville, VA, these individuals often rely on community service boards for mental health treatment after their release from correctional custody, but limited cross-agency coordination makes receiving this assistance and treatment difficult. To better serve the incarcerated population with serious mental illness and reduce the social and economic burden of re-incarceration, data spanning a 30-month period from July 2015 to December 2017 were obtained through research partnerships with criminal justice agencies and community service boards in the Charlottesville area to track the behavior of individuals with mental illness through every stage of the system. A cohort of individuals with identified serious mental illness from jail data was matched across data from different agencies, and the resulting merged, de-identified data regarding behavior and criminal justice outcomes were analyzed to improve understanding of this system and its service to the population with serious mental illness. 5,584 unique individuals were identified in Albemarle-Charlottesville Regional Jail (ACRJ) booking data, 3,531 were screened for serious mental illness, giving a 63% screening rate, and 1,129 of those screened met the criteria to be referred for serious mental illness, leading to a 32% referral rate of the screened population. Referred individuals were more likely than those not referred or not screened to receive treatment at Region Ten, the local community services provider. Referred individuals were also less likely than those not referred to successfully complete Offender Aid and Restoration probation. These insights help agencies and community stakeholders improve practice in the management of this population.