TY - JOUR
AU - E. A. DiRosa
AU - T. Van Deinse
AU - G. S. Cuddeback
AU - A. Murray-Lichtman
AU - J. Carda-Auten
AU - D. L. Rosen
A1 - 
AB - BACKGROUND: Individuals with mental illnesses are disproportionately incarcerated in jails, which have become de facto mental health institutions across the US. Yet there is limited research describing mental healthcare practices from entry to release among multiple jails and states. METHODS: We conducted 34 semi-structured interviews with jail healthcare personnel across five Southeastern states and used the Framework Method to guide analyses. RESULTS: We report results on challenges and practices related to mental health staffing, screening, additional evaluations and services, and discharge planning in jails. Initial mental health screenings were often restricted to the detection of suicidality and history of treatment and medications as opposed to current mental health symptoms. Use of validated mental health screening forms was uncommon. We found delays in care between the initial health screening and being evaluated by a mental health professional. Most jails reported primary responsibilities for mental healthcare as preventing suicides and managing psychiatric medications. Jails reported mental healthcare as challenging to manage, with high volumes of individuals with mental health needs, yet limited resources, especially regarding staffing. Discharge planning was limited despite reports of poor continuity of mental health services. CONCLUSIONS: Jails have a constitutional duty to provide adequate healthcare to individuals with mental illnesses, yet practices are insufficient and resources are limited across jails. Based on our findings, we recommend 1) greater adoption and revisions of jail health standards 2) system improvement that expands identification of mental illnesses and quicker, less variable follow-up mental health evaluations, 3) improved linkages and supports for community resources that prevent incarceration of this population.
AD - Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US. elena_dirosa@med.unc.edu.; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US.; School of Social Work, Virginia Commonwealth University, Richmond, VA, US.; Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US.
AN - 41084023
BT - BMC Health Serv Res
C5 - Healthcare Disparities
CP - 1
DA - Oct 13
DO - 10.1186/s12913-025-13507-w
DP - NLM
ET - 20251013
IS - 1
JF - BMC Health Serv Res
LA - eng
N2 - BACKGROUND: Individuals with mental illnesses are disproportionately incarcerated in jails, which have become de facto mental health institutions across the US. Yet there is limited research describing mental healthcare practices from entry to release among multiple jails and states. METHODS: We conducted 34 semi-structured interviews with jail healthcare personnel across five Southeastern states and used the Framework Method to guide analyses. RESULTS: We report results on challenges and practices related to mental health staffing, screening, additional evaluations and services, and discharge planning in jails. Initial mental health screenings were often restricted to the detection of suicidality and history of treatment and medications as opposed to current mental health symptoms. Use of validated mental health screening forms was uncommon. We found delays in care between the initial health screening and being evaluated by a mental health professional. Most jails reported primary responsibilities for mental healthcare as preventing suicides and managing psychiatric medications. Jails reported mental healthcare as challenging to manage, with high volumes of individuals with mental health needs, yet limited resources, especially regarding staffing. Discharge planning was limited despite reports of poor continuity of mental health services. CONCLUSIONS: Jails have a constitutional duty to provide adequate healthcare to individuals with mental illnesses, yet practices are insufficient and resources are limited across jails. Based on our findings, we recommend 1) greater adoption and revisions of jail health standards 2) system improvement that expands identification of mental illnesses and quicker, less variable follow-up mental health evaluations, 3) improved linkages and supports for community resources that prevent incarceration of this population.
PY - 2025
SN - 1472-6963
SP - 1355
ST - Mental healthcare practices from entry to release across Southeastern jails
T1 - Mental healthcare practices from entry to release across Southeastern jails
T2 - BMC Health Serv Res
TI - Mental healthcare practices from entry to release across Southeastern jails
U1 - Healthcare Disparities
U3 - 10.1186/s12913-025-13507-w
VL - 25
VO - 1472-6963
Y1 - 2025
ER -