The Truth About Mental Illness in Prison

Currently, there are roughly 22,000 inmates on the mental health outpatient caseload and roughly 1000 in behavioral health facilities throughout Texas Prisons. Over 2M people with mental illness are jailed each year in Texas. However, many offenders with mental illness are not receiving proper mental healthcare.

Many inmates with mental illness go untreated. This is primarily for three reasons. Firstly, screening tools used to screen inmates for mental health are often not diagnostic tests, but rather are used to determine security risks for new inmate arrivals. Secondly, many symptoms of mental illness, such as hypersomnia, lack of motivation, and isolation, are to be expected of individuals who have become institutionalized. Security Officers are not trained mental health professionals and are likely to overlook possible symptoms of mental health disorders. Lastly, inmates are often hesitant to share mental and emotional problems because the inmate will likely be isolated in a solitary cell, without any personal property, for close observation.

As a current contract mental health caseworker for the Texas Department of Criminal Justice, I know first-hand how lack of mental health treatment can affect an individual in prison. Inmates who do not receive proper mental healthcare often experience worsening mental health symptoms and are at an increased risk of being victimized, as well as being more likely to get into fights with other inmates and security officers. Crowded living spaces and lack of privacy may exacerbate preexisting mental health symptoms and raise the risk of self-harm.

While mental health services are increasing statewide, many Texas prisons continue to lack mental health treatment. Additionally, in units that do offer mental health services, inmates are lucky to get one hour of one-on-one mental health treatment per month. While this is an improvement for the state of Texas, many inmates are still suffering from the lack of proper mental healthcare. Inmates who do not receive proper treatment for mental health disorders are at a higher risk of recidivism. Roughly 95% of inmates are released back into the community. This transition is a challenge for many. However, lack of proper treatment after release often makes the transition even more difficult. Nearly 80% of inmates with a mental health disorder are arrested within 6 years of release from TDCJ. However, Texas now offers programs, such as the TCOOMMI program, which offers inmates with mental and physical disorders assistance with reintegrating into the community.

While mental health treatment for Texas’s inmates has improved in recent years, there is still a long road ahead. With continuous efforts of mental health advocates, and additional legislative changes, the prognosis and rehabilitative success rate for inmates with mental illness is likely to improve greatly in coming years.