Handbook of Mental Health Assessment and Treatment in Jails

• jail
• criminal justice system
• mental health
• mental illness
• treatment
• psychiatry

Jails pose a unique and challenging setting for screening, assessment, and treatment of mental illness. The increased prevalence of mental illness coupled with the unpredictable duration of incarceration for individuals in jail are two of numerous barriers to providing mental health treatment. The Handbook of Mental Health Assessment and Treatment in Jails comprehensively addresses the disparities of mental health care within jails and details the ongoing battles regarding the assessment and treatment of individuals involved. This handbook, available in e-book or hardcover by Oxford University Press, serves as an extensive framework to be used by a wide spectrum of clinical professionals, ranging from the correctional staff to mental health providers working to meet the ongoing challenges involving mental illness in jails. This handbook serves as a call for action to increase research efforts on the prevalence of mental illness in jails and to explore the efficacy of diverse treatment modalities in this unique environment.

All four editors are well recognized in the fields of psychology and psychiatry. Virginia Barber-Rioja, PhD, is an assistant adjunct professor in the Department of Psychology at New York University and former Co-Chief of Mental Health for the New York City correctional system. Alexandra Garcia-Mansilla, PhD, has an independent forensic assessment and consultation practice and is the former Clinical Director of Mental Health for the New York City correctional system. Bipin Subedi, MD, is a clinical assistant professor in the Department of Psychiatry at the New York University Grossman School of Medicine and Chief Medical Officer for the New York City correctional system. Ashley Batastini, PhD, is an assistant professor in the Department of Counseling, Educational Psychology, and Research at the University of Memphis.

This comprehensive handbook contains 18 chapters that are grouped into the following three parts: Assessment and Treatment, Special Populations, and Special Considerations. The chapters were written by 49 contributors who are experienced in the field of mental health treatment, including graduate students, professors, researchers, and clinicians.

Part one of the Handbook, comprising eight chapters, begins by describing the guidelines established by The National Commission on Correctional Health Care (NCCHC) for screening individuals for mental illness in jails. The authors make recommendations on treatment of mental health disorders in jails following three basic principles: human rights, rehabilitation, and recovery. They aim to provide a commitment to patient welfare with an emphasis on reducing recidivism and implementing a holistic and trauma-informed perspective to treatment. Furthermore, the Handbook outlines suicide prevention guidelines developed by the NCCHC and Vera Institute of Justice (VIJ) for correctional systems that emphasize training for all staff, identification of at-risk patients, and fostering collaborative communication within correctional systems. The authors provide illustrative scenarios of the factors contributing to heightened suicide risk rooted in anxiety, fear, hopelessness, motivation, and inadequate coping skills, which are important to consider, as suicide is the leading cause of death in jails. A significant portion of the population of individuals in jail are experiencing posttraumatic stress disorder (PTSD) and substance use disorders, and exhibiting violent behaviors. The authors dedicate a chapter to each condition, mentioning screening and treatment methods alongside their recommendations for future research.

Because of the high stress-inducing environment of jails, psychopharmacology is a necessary intervention for individuals with mental illness and triggered psychological responses. The authors frequently reference guidelines from the American Academy of Psychiatry and the Law Practice Resource for Prescribing in Corrections for prescribing psychotropic medications in correctional facilities for individuals with complex mental illnesses. Furthermore, the increasing demand for competency to stand trial evaluations has led to extensive waitlists, which prolongs detainees’ incarceration and increases potential exposure to traumatic events. Thus, the authors advocate a trauma-informed approach within correctional facilities, which can provide a way to mitigate the traumatic impact associated with the stress-inducing environment of jail.

Part two, consisting of four chapters, describes the special populations in jail facilities. These special populations include women, adolescents, emerging adults, individuals with intellectual disabilities, and multicultural groups. The authors dedicate a chapter to each group, detailing unique challenges regarding screening and treatment of their mental health. One interesting example discussed is implementing nursery programs in jails for infants up to the age of 18 months old, which has been shown to improve both recidivism rates and the well being of incarcerated women. The authors also discuss the importance of understanding the “gendered pathways to offending,” which proposes that women have a different trajectory entering the criminal justice system than men, largely because of factors such as unemployment, responsibility for minor children, and history of sexual assault. In addition, the authors consider the effects of policy change related to the ethics dilemma of comparing emerging adults, ages 18 to 24, to individuals over 25, as the former are in a crucial stage of neurological development and maturation. Emerging adults make up a quarter of the jail population and show very high rates of mental illness and substance abuse, which the authors use to demonstrate how this population is in need of more specialized care in jails. The authors also highlight how minority groups and the lesbian, gay, bisexual, transgender, queer (or questioning), and other LGBTQ+ individuals in jails face discrimination from correctional staff, leading to increased time in restrictive housing and decreased quality of mental health treatment. The authors stress the importance of utilizing The Cultural Formulation Interview and Structural Competency approach to patient evaluation. This strategy prioritizes individuals’ own experiences and approaches the screening interview with a culturally informed perspective. For this reason, part two of the Handbook provides important insight to the special populations included within the jail setting experiencing mental health disparities and unique opportunities for assessment and treatment.

Part three, including six chapters and titled “Special Considerations,” discusses recommendations for different aspects of the jail setting that were not previously discussed in the Handbook. These include jail reentry programs, legal and ethics concerns, restrictive housing, rural jails, and recruiting mental health providers. In Chapter 13, the authors present the case of Brad H, who was arrested 26 times and prescribed medications for his depression and psychosis while in jail, but each time he was released into the community, he was not able to receive mental health care. The authors emphasize the importance of reentry and diversion programs for individuals in jail, especially those receiving treatment for mental illness. Another barrier to effective mental health assessment and treatment in jails is high burnout for mental health providers because of secondary traumatic stress and compassion fatigue experienced at work. The authors discuss different ways that jails can recruit providers, one example being affiliation with an academic institution to increase awareness of the employment deficit in criminal justice settings. Despite a decrease in urban jail populations, rural populations have continued to increase. The authors discuss how the lack of resources, staff shortages, and growing jail populations may make the use of telehealth and electronic communication cost effective in these vulnerable areas. Part three highlights the important and unnoticed aspects of jails that must be considered when creating plans for those needing care.

The education in this handbook is pertinent to psychiatrists and mental health providers across various fields and levels of training. It underscores crucial topics that require further research to enhance the treatment of mental illness within the criminal justice system, consolidating all the information into a single handbook. Given that much of the existing literature regarding these topics focuses solely on prisons or the correctional system in general, it further demonstrates how significant this handbook is for mental health providers. In particular, this is a great resource book for individuals or groups implementing or taking over leadership of mental health services in jails. In summary, the handbook wonderfully explains the many challenges confronting mental health treatment in jails and expresses the importance of future research in this domain. It will be an invaluable resource to any staff member or clinician operating within this environment.

• © 2025 American Academy of Psychiatry and the Law