More mentally ill people reported in US prisons

BMJ 1999; 319 doi: (Published 24 July 1999) Cite this as: BMJ 1999;319:210
  1. César Chelala
  1. New York

    A growing number of people with mental illness are being held in US prisons, according to a recent report by the US Department of Justice.

    The report is the first in-depth national study of mental illness in US prisons. It reported a total of 283800 prison inmates with some form of mental illness in mid-1998, which is about 16% of the total prison population. This figure was in line with a previous literature review, suggesting that 6-15% of people in city and county jails, and 10-15% of inmates in state prisons, had severe mental illness.

    The report suggested that one of the main reasons for the increasing number of mentally ill people in all US prisons was the wave of discharges from long stay hospitals that started in the United States in the 1960s. The number of people in state psychiatric hospitals decreased from 559000 in 1955 (out of a population of 165 million) to 72000 by 1998 (out of a total national population of around 250 million). At the same time, the number of prison beds has increased four times in the past 25 years, raising the number of prisoners to 1.8 million.

    The Department of Justice study found that mentally ill people in state prisons were twice as likely to have been homeless before their arrest as other prisoners and twice as likely to have been physically or sexually abused in childhood. In addition, it found that mentally ill inmates were far more likely than others to be regular users of alcohol and drugs.

    The study has been criticised because it relied on answers given by prison inmates themselves, who were asked whether they had any mental illness or had ever received treatment for this type of condition.

    Mental Health and Treatment of Inmates and Probationers is available on the internet at

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    Mentally ill people form 16% of the US prison population


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