Jails Underserve Mentally Ill Female Detainees

May 14, 1997

CHICAGO --- About 11 percent of women in jails have severe psychiatric disorders, but less than a quarter of them receive mental health services while incarcerated, a Northwestern University Medical School study has found.

Findings of the $1.4 million study, which was funded by the National Institute of Mental Health (NIMH), are reported in tomorrow's American Journal of Public Health.

Nationwide, there are more women in jail than ever before -- well over 50,000.

"Female jail detainees have special needs. Many have been physically or sexually abused and addicted to drugs," said Linda A. Teplin, a professor of psychiatry and behavioral sciences and director of the Psycholegal Studies Program at Northwestern, who headed the study.

The Cook County Department of Corrections in Chicago collaborated with Teplin and her colleagues Karen M. Abram and Gary M. McClelland to study the special needs of women in jail. They investigated what proportion of nearly 1,300 women detained in the Cook County Department of Corrections needed mental health services. They also assessed what proportion of these women actually received services and what factors determined who received them.

Teplin and colleagues found that, of the women who needed mental health services, only about 23.5 percent of the 1,272 studied received them while in jail. Women with a history of psychiatric treatment were more likely to receive services regardless of their current needs. Severely depressed women were less likely to receive services than women with schizophrenia.

"Perhaps depressed detainees are overlooked in the chaos of the jail milieu," Teplin said. "Improving services for detainees with depression may reduce jail suicide, which currently accounts for 36 percent of all jail inmate deaths nationally."

Teplin also said that because of their relatively small numbers, women in jails usually receive fewer services than male inmates.

"Ironically, because there are relatively few female inmates, the per capita cost is too high to provide them with services comparable to those available in men's facilities," she said.

Between 1983 and 1994, the national jail census increased from about 224,000 to nearly half a million. Yet, while the need for health care in correctional facilities is growing, funding for such services is not keeping pace with demand, the researchers concluded.

But, improving mental health services in jails is only the first step, Teplin said. Because only one third of jail detainees stay longer than four days, the public health system also must provide mental health services in the community for released detainees. However, providing effective programs will be difficult for several reasons.

First, many female jail inmates with severe mental disorders also may be substance abusers and, hence, are more difficult to treat. Second, most released detainees are poor, making it difficult for them to seek services and maintain a treatment plan. Poverty also causes many other psychological stressors -- poor people are more likely to be victims of crime, to have inadequate housing and to live in dangerous neighborhoods.

Finally, motherhood complicates service utilization, Teplin said. In the Northwestern study, over 60 percent of the women had children younger than 5 years, and most of the women were single parents. Few mental health programs provide child care.

"Successful public health delivery for released jail detainees must go beyond addressing psychopathology alone; it requires a systematic network of resources," she said.

(Contact: Linda A. Teplin at 312-503-3500 or l-teplin@nwu.edu)

(Media Contact: Elizabeth F. Crown at 312-503-8928 or e-crown@nwu.edu)

Northwestern University

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