Prison Mental Health Care Can Be Improved by Better Management and More Effective Federal Aid

GGD-80-11: Published: Nov 23, 1979. Publicly Released: Nov 23, 1979.

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Correctional officials, courts, and legislatures have concluded, to varying degrees, that inmates must have access to adequate health care. Adequate mental health care involves identifying inmates' individual problems or needs and providing treatment tailored to meet their needs.

The mental health care delivery systems of most prisons did not identify all inmates needing help or provide proper care. While federal and state prisons required that new inmates be screened to determine their needs, this was not always adequate to identify mental health problems. The services provided inmates varied among prisons, but, in general, treatment efforts focused on inmates who were dangerous to themselves or others. Shortages of beds and staff limited the ability of most prisons to provide adequate care on either a daily or long-term basis. The Bureau of Prisons and three of the five states visited by GAO tended to treat behavioral disorders only when inmates requested help or when a crisis arose. A lack of standards hampered a Bureau effort to provide treatment programs for drug abusers, and the Bureau gave less attention to programs for alcohol abusers. State programs to treat drug and alcohol abusers reached relatively few inmates. Although limited funds and shortages of qualified staff will likely continue, improved administration could minimize many of the current inadequacies. In addition, better use of the variety of financial and technical assistance programs designed to help states improve the availability of treatment services for prison inmates could assist in bringing about coordinated planning by state criminal justice and health agencies to identify inmates' needs, support development of treatment programs and management, and provide research and training assistance.

Recommendation for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Bureau of Prisons should: (1) revise its inmate screening policy; (2) improve the basis for assessing program needs by regularly compiling and summarizing available information on the extent and nature of inmates' mental health problems; (3) require the establishment of a central psychological file for each inmate and reemphasize the need for adequate records of inmate problems and treatment actions; (3) establish greater management control over the quality and performance of substance abuse treatment programs; and (4) increase management surveillance of the quality of mental health services by expanded use of independent reviews by outside professional organizations. The Law Enforcement Assistance Administration should: (1) work with State criminal justice agencies to identify the extent of mental health problems in prisons, and (2) strengthen procedures for reviewing State criminal justice agencies' comprehensive plans to ensure that the plans adequately address the alcohol and drug treatment needs of prison inmates and provide for effective coordination with State substance abuse agencies to plan and program implementation actions. The Department of Health, Education, and Welfare should: (1) strengthen procedures for viewing State health and substance abuse agencies' comprehensive plans to ensure that the plans adequately address the mental health, alcohol, and drug treatment needs of prison inmates; and (2) revise program guidelines for participating State mental health and alcohol abuse agencies to make clear that the agencies should address the needs of prison inmates.

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