Mentally Ill Inmates:

Better Data Would Help Determine Protection and Advocacy Needs

GGD-91-35: Published: Apr 17, 1991. Publicly Released: May 22, 1991.

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Pursuant to a congressional request, GAO reviewed the treatment of mentally ill inmates in correctional facilities, focusing on: (1) the extent to which correctional facilities subjected such inmates to abuse or neglect, as defined by the Protection and Advocacy for Mentally Ill Individuals Act; and (2) whether the act covered such inmates.

GAO found that: (1) the extent to which correctional facilities subjected mentally ill individuals to abuse and neglect was unknown; (2) the act provided for the establishment of protection and advocacy systems for the mentally ill (PAMI); (3) the National Institute of Mental Health (NIMH) reported in 1989 that 533 of the 18,498 cases PAMI handled dealt with prison and jail inmates, and Bureau of Prison (BOP) records indicated that, since 1986, 18 inmates had filed grievances involving mental health complaints, but some prisons may not have reported abuse or neglect cases to BOP or PAMI; (4) congressional testimonies suggested that state prisons and jails subjected mentally ill individuals to abuse and neglect; (5) two provisions of the act allowed inmates to be eligible for PAMI services; (6) in August 1990, NIMH revised its policy allowing PAMI to provide protection and advocacy services to mentally ill inmates in the general population and nonfederal facilities; (7) in 1987, the Department of Health and Human Services issued a determination that the act did not cover inmates in federal facilities; and (8) more PAMI involvement with inmate complaints and effective PAMI activity reporting could result in more accurate data concerning the extent of abuse or neglect in correctional facilities.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: HHS stated that the recently revised form requires advocacy groups to identify the number of complaints received from prisoners. While not in formats recommended, the action taken, according to HHS, responds to needs addressed by the GAO recommendation.

    Recommendation: The Secretary of Health and Human Services should require NIMH to have PAMI identify in their annual reports to NIMH the number and types of complaints received and their status and disposition by type of facility for inclusion in the Secretary's annual report to Congress on protection and advocacy matters.

    Agency Affected: Department of Health and Human Services


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