TDNet Discover

Background: Mental health disorders plague much of the inmate population within the United States criminal justice system. Not only are incarcerated inmates with mental health disorders more likely to serve longer sentences, have served prior sentences, and spend more time in segregation, but they are more likely to have higher rates of recidivism than those without mental illness. Treatment modalities such as prescription medication, counseling or therapy, or a combination of both are utilized, though variability between correctional facilities exists and definitive treatment interventions for prisoners are not mandated nationally. Objective: To conduct a full review of existing literature to determine if access to behavioral health services for prisoners with mental illness within correctional facilities is effective for reducing recidivism rates. Methods: A systematic review of the literature pertaining to recidivism rates of inmates who received treatment for mental health disorders while incarcerated, was performed by searching all available abstracts through databases: PubMed, Medline Complete, Google Scholar, CINAHL Complete, JSTOR, and Discover Search (South College Library Database). Final selection of articles was dependent on full text review, adherence to inclusion and exclusion criteria, and consensus among three individual researchers. In total, six articles were selected and analyzed according to the National Heart, Lung and Blood Institute quality assessment tool. Resultant data from each article was stratified by the study population, type of behavioral health intervention provided, minor outcomes, and the overall rate of recidivism. Results: Database research produced 6 viable retrospective cohort studies pertaining to behavioral health therapy for prisoners coping with mental illness for reducing recidivism rates. v Of the included articles, four were rated as “fair,” one was rated as “good,” and one was rated as “poor” for internal validity. With all included studies, there were a total of 17,931 participants ranging in age from 12-75 years old. Each study utilized a different behavioral health treatment program at their respective institution. All of the studies found that treatment of behavioral health disorders, while incarcerated, decreased a participant’s risk of rearrest within a 1-year release from incarceration. Conclusion: A definitive answer as to the type of behavioral therapy, the duration of participation, and the true efficacy of mental health therapy being the sole cause of reduced recidivism remains elusive. In congruence with previous research on this topic, there is a clear positive correlation between mental illness and rates of recidivism. Due to the nature of this research and limitations with internal validity, it would be rudimentary to suggest the most effective behavioral health therapy type for reducing recidivism rates of inmates with mental illnesses. Despite the fact that not all the data included in this study was found to be statistically significant, it can be concluded that inmate participation and completion of a structured behavioral therapy program involving either psychologic, psychiatric, or a combination of the two treatments while incarcerated, tended to reduce recidivism rates overall, especially within the first year.