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Improving Evidence-Based Mental Health Screening and Treatment for Persons with Mental Disorders in the Justice System

NAMHC Concept Clearance


Denise Juliano-Bult, M.S.W.
Chief, Systems Research and Disparities in Mental Health Services Research Programs
Services Research and Clinical Epidemiology Branch
Division of Services and Intervention Research (DSIR)


This initiative solicits research to investigate the effectiveness of both new and existing strategies for the delivery of mental health treatments in criminal (adult) or juvenile justice settings.  Settings of interest include:  1) incarceration or detention; 2) community corrections (parole and probation); and, 3) programs to facilitate transition to community. 


A number of recent reports highlight the significant number of persons with mental illness in the criminal justice system, along with the lack of adequate treatment received there.  According to a 2005 Bureau of Justice Statistics survey, among prison and jail inmates who endorsed indicators of treatment need, only 34 percent of State prisoners, 24 percent of Federal prisoners, and 17 percent of jail inmates were actually receiving treatment.1   The quality of the treatment delivered is unknown.   Lack of attention to the mental health needs of this population contributes to poor continuity of care, problems with community integration, and recidivism to incarceration. 2, 3

To address the mental health needs of this underserved population, this initiative will support studies intended to validate effective strategies for the delivery of mental health treatments in criminal (adult) or juvenile justice setting.  Relevant interventions include strategies for diagnosis, treatment, and adherence to treatment for mental disorders.  Of interest are disorders commonly encountered in justice settings that have adverse impact on behavioral management and on pro-social community integration.  Examples of research to be encouraged include:

  • Prospective Studies of service delivery models for evidence-based mental health interventions that might focus on optimizing the fit between intervention and setting. The ultimate goal of this research is to test the effectiveness of strategies to facilitate delivery, improve outcomes, and foster broad uptake of interventions in a variety of justice settings.  To that end, these studies would also address the organizational and systems-level processes relevant to intervention uptake and implementation.   
  • Validation of Existing Programs:  Research using national, State, and county level administrative data bases might explore the impact of existing innovative programs and service models. Such studies might also track broad trends in treatment provision and service use, and evaluate the impact of new policies when they occur. This approach can provide a broad picture of trends and policies occurring nationally, providing a window into existing efforts to improve treatment in the justice system.

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1U.S. Department of Justice, Special Report: Mental Health Problems of Prison and Inmates, 2006, Office of Justice Programs, Bureau of Justice Statistics

2Human Rights Watch, Ill Equipped: U.S. Prisons and Offenders with Mental Illness, 2003.

3The Council of State Governments, Consensus Project, The Justice Center, 2002.