Criminal Justice and Public Health: A Need for Cross-System Collaboration Between Jails and Medicaid to Reduce Recidivism

Abstract

According to a report from the Council of State Governments Justice Center, 16.9% of the adults in a sample of local jails had a serious mental illness - three to six times the rate of the general population. If these rates were applied to the 13 million jail admissions reported in 2007, the study findings suggest that more than two million bookings of a person with a serious mental illness occur every year1. Many offenders with mental illnesses don't receive treatment during incarceration. Without treatment, conditions can worsen and offenders can become a greater threat to themselves and to others when they leave jail or prison. This is not only a disservice to the offenders and their families; it is also a threat to public safety. Mental health cases remain a challenge within the criminal justice system. A significant change in substantive law made by the Affordable Care Act (ACA) presents new opportunities for bridging the two systems (health care and criminal justice) that serve this high-needs population. This paper (1) describes challenges in providing substance use and mental health care services to incarcerated populations; and (2) identifies how these challenges shed light on what best practices can be implemented to bridge the gap between the criminal justice system and health care system, thereby improving public health, improving public safety, and reducing costs to society.