Health of Correctional Populations:
- State correctional agencies spent in excess of $2.68 billion on inmate health care in fiscal year 2002.
- State correctional agencies spent in excess of $1 billion on inmate treatment programs in fiscal year 2002.
- Nationally, more than $3.5 billion is spent on inmate health care per year
A highly disproportionate number of inmates suffer from infectious diseases compared with the rest of the nation's population. During 1996, about 3 percent of the U.S. population spent time in a prison or jail; however, between 12 percent and 35 percent of the total number of people with selected communicable diseases in the nation passed through a correctional facility during that same year. *1
Chronic Diseases
Asthma
The prevalence of asthma among federal, state and local inmates in 1995 is estimated to be between 8 percent and 9 percent, for a total of more than 140,000 cases nationwide. Prevalence rates for asthma are higher among inmates than among the total U.S. population.
Diabetes
The prevalence of diabetes in inmates is estimated to be about 5 percent, for a total of nearly 74,000 inmates.
Hypertension
More than 18 percent of inmates are estimated to have hypertension, for a total of more than 283,000 inmates.
HIV/AIDS
- The prevalence of AIDS among inmates is five times higher than among the general U.S. population.
- An estimated 34,800 to 46,000 inmates in 1997 were infected with HIV. Included among the HIV-positive inmates in 1997 were an estimated 8,900 inmates with AIDS.
- Seventeen percent of the estimated 229,000 people living with AIDS in the United States in 1996 passed through a correctional facility that year.
- An estimated 98,500 to 145,500 HIV-positive inmates were released from prisons and jails in 1996. An estimated 38,500 inmates with AIDS were released from prisons and jails in 1996.
- The estimated 98,000 to more than 145,000 prison and jail releasees with HIV infection in 1997 represented 13 to 19 percent of all HIV positive individuals in the United States.
- Between 2000 and 2001, the number of HIV-positive inmates decreased about 5 percent, while the overall prison population grew 1.1 percent during the same period. *2
- At year-end 2001, 3.2 percent of all female state prison inmates were HIV positive, compared to 2.0 percent of males. *2
- The number of AIDS-related deaths in state prisons decreased 75 percent from 1995 to 2001. *2
Hepatitis
Hepatitis B
- 36,000 inmates in 1997 and 155,000 releasees in 1996 had current or chronic hepatitis B infection.
- The estimated 155,000 releasees with current or chronic hepatitis B infection in 1996 indicate that between 12 percent and 15 percent of all individuals in the United States with chronic or current hepatitis B infection in 1996 spent time in a correctional facility that year.
Hepatitis C
- Between 303,000 and 332,000 prison and jail inmates were infected with hepatitis C in 1997; and between 1.3 and 1.4 million inmates released from prison or jail in 1996 were infected with hepatitis C.
- The 1.3 million inmates released from jail or prison infected with hepatitis C constitute 29 percent of the 4.5 million cases nationwide.
- The estimated 1.3 million to 1.4 million releasees infected with hepatitis C in 1996 suggest that an extremely high 29 percent to 32 percent of the estimated 4.5 million people infected with hepatitis C in the United States 12 served time in a correctional facility that year. The 17.0 percent to 18.6 percent prevalence range of hepatitis C among inmates is nine to 10 times higher than the estimated hepatitis C prevalence in the nation's population as a whole.
Tuberculosis
- About 12,000 people who had active TB disease during 1996 served time in a correctional facility during that year.
- More than 130,000 inmates tested positive for latent TB infection in 1997.
- An estimated 566,000 inmates with latent TB infection were released in 1996.
- Released inmates accounted for 35 percent of the 34,000 Americans with active tuberculosis in 1996.
- Of all people in the nation with active TB disease in 1996, an estimated 35 percent (12,200) served time in a correctional facility that year. The prevalence of active TB among inmates is between 4 and 17 times greater than among the total U.S. population.
STDs
There were an estimated 107,000 to 137,000 cases of STDs among inmates in 1997 and at least 465,000 STD cases among releasees.
Mental Illness
The estimated prevalence of mental illness among jail inmates is as follows:
- An estimated 1 percent have schizophrenia or another psychotic disorder.
- About 8 percent to 15 percent have major depression.
- Between 1 percent and 3 percent have bipolar disorder.
- Between nearly 2 percent and less than 5 percent of jail inmates are estimated to have dysthymia (less severe but longer-term depression).
- Between 14 percent and 20 percent have some type of anxiety disorder.
- Another 4 percent to less than 9 percent suffer from post-traumatic stress disorder.
The estimated prevalence of mental disorders among state prison inmates is as follows:
An estimated 2 percent to 4 percent have schizophrenia or another psychotic disorder.
Between 13 percent and less than 19 percent have major depression.
Between 2 percent and less than 5 percent have bipolar disorder.
Between 8 percent and less than 14 percent have dysthymia.
Between 22 percent and 30 percent have an anxiety disorder.
Between 6 percent and 12 percent have post-traumatic stress disorder.
- *1 Unless otherwise noted, statistics relating to inmate health status taken from National Commission on Correctional Health Care report titled Health Status of Soon to be Released Inmates. Published March 2002.
- *2 Bureau of Justice Statistics. HIV in Prisons, 2001.
Offender Mental Health
At midyear 1998, an estimated 283,800 mentally ill offenders were incarcerated in the nation's prisons and jails.
In recent surveys completed by the Bureau of Justice Statistics, 16 percent of state prison inmates, 7 percent of federal inmates, and 16 percent of those in local jails reported either a mental condition or an overnight stay in a mental hospital.
About 16 percent, or an estimated 547,800 probationers, said they had had a mental condition or stayed overnight in a mental hospital at some point in their lifetime.
Mental Health Treatment in State Prisons *3
1,394 of the nation's 1,558 state public and private adult correctional facilities (in 2000) reported that they provide mental health services to their inmates.
• One in every eight state inmates was receiving some mental health therapy or counseling services at midyear 2000.
• Nearly 10 percent were receiving psychotropic medications (including antidepressants, stimulants, sedatives, tranquilizers, or other anti-psychotic drugs).
• Fewer than 2 percent of state inmates were housed in a 24-hour mental health unit.
Mental Health Screening in State Prisons *4
Nearly 70 percent of facilities housing state prison inmates reported that, as a matter of policy, they screen inmates at intake.
65 percent conduct psychiatric assessments.
51 percent provide 24-hour mental health care.
71 percent provide therapy/counseling by trained mental health professionals.
73 percent distribute psychotropic medications to their inmates. 66 percent help released inmates obtain community mental health services.
*3 Source of information: Bureau of Justice Statistics. Mental Health Treatment in State Prisons, 2000.
*4 Source of information: Bureau of Justice Statistics. Mental Health Treatment in State Prisons, 2000.
More than one-quarter million mentally ill incarcerated in prison or jail
|
Reported a ... |
State Prison |
Federal Prison |
Jail |
Probation |
Mental or emotional condition |
10.1% |
4.8% |
10.5% |
13.8% |
Overnight stay in mental hospital |
10.7% |
4.7% |
10.2% |
8.2% |
Estimated to be mentally ill* |
16.2% |
7.4% |
16.3% |
16.0% |
• Reported either a mental or emotional condition or an overnight stay in a mental hospital or program.
• Together, 16 percent or an estimated 283,800 inmates reported either a mental condition or an overnight stay in a mental hospital, and were identified as mentally ill.
• About 10 percent of prison and jail inmates reported a mental or emotional condition; and 10 percent said they had stayed overnight in a mental hospital or program. |
|
Nearly six in 10 mentally ill offenders reported they were under the influence of alcohol or drugs at the time of their current offense
|
|
State Prisoners |
Before entering prison |
Mentally Ill Inmates |
Other Inmates |
Homeless in 12 months prior to arrest |
20.1% |
8.8% |
Physical/sexual abuse |
|
|
Male |
32.8% |
13.1% |
Female |
78.4% |
50.9% |
Alcohol/drug use |
|
|
In month before offense |
58.7% |
51.2% |
Drug use |
|
|
In month before offense |
58.8% |
56.1% |
Mental health treatment since admission |
Mentally Ill Inmates |
|
State Prison |
Jail |
Any treatment |
60.5% |
40.9% |
Medication |
50.1% |
34.1% |
Counseling |
44.1% |
16.2% |
• Mentally ill state prison inmates were more than twice as likely as other inmates to report living on the street or in a shelter in the 12 months prior to arrest (20 percent compared to 9 percent).
• Nearly eight in 10 female mentally ill inmates reported physical or sexual abuse. Males with a mental condition were more than twice as likely as other males to report abuse.
• Six in 10 mentally ill state inmates reported receiving mental treatment since admission to prison.
Source: Bureau of Justice Statistics. Treatment of Inmates and Probationers. July 1999. Available at www.ojp.usdoj.gov/bjs/pub/pdf/mhtip.pdf.
|
Substance Abuse and Treatment
One-fifth of state inmates are incarcerated for drug offenses.
More than 570,000 of the nation's inmates (51 percent) reported the use of alcohol or drugs while committing their offense.
83 percent of inmates reported past drug use (an increase from 79 percent in 1991).
57 percent of inmates were using drugs in the month before their offense (an increase from 50 percent in 1991).
37 percent of state inmates were drinking at the time of their offense (an increase from 32 percent in 1991).
Half of state inmates and one-third of federal inmates reported committing their current offense under the influence of alcohol or drugs |
|
Percent of Prisoners |
|
Self-reports |
1997 |
1991 |
• In 1997 more than 80 percent of state and more than 70 percent of federal inmates reported past drug use; about one in six of both reported committing their current offense to obtain money for drugs. |
Drug use |
|
|
In month before offense |
|
|
State |
57% |
50% |
Federal |
45% |
32% |
|
|
|
At time of offense |
|
|
• About 40 percent of state and 30 percent of federal inmates reported a prior binge drinking experience; more than 40 percent of both had driven drunk in the past. |
State |
33% |
31% |
Federal |
22% |
17% |
|
|
|
Alcohol use |
|
|
At time of offense |
|
|
State |
52% |
49% |
• Overall, three in four state and four in five federal inmates may be characterized as alcohol- or drug-involved offenders.
|
Federal |
34% |
24% |
|
|
|
Alcohol/Drug use |
|
|
At time of offense |
|
|
State |
52% |
49% |
Federal |
34% |
24% |
|
Since admission one in eight state inmates were treated for substance abuse, and one in four had participated in other alcohol or drug abuse programs.
|
• More than 50 percent of state and more than 40 percent of federal inmates had ever participated in treatment or other programs for substance abuse; one-third of state and one-quarter of federal inmates had participated since their admission. |
• Among both state and federal inmates who had used drugs in the month before the offense, about one in seven had been treated for drug abuse since admission; nearly one-third had enrolled in other drug abuse programs. |
• Since admission, 14 percent of both state and federal inmates drinking at the time of offense had been treated for alcohol abuse; one-third had enrolled in other alcohol abuse programs. |
Source: Bureau of Justice Statistics. Substance Abuse and Treatment State and Federal Prisoners, 1997. January 1999. |
Bureau of Justice Statistics. Substance Abuse and Treatment State and Federal Prisoners, 1997. January 1999.
