Introduction

• Pages: xi-xiii
• DOI: https://doi.org/10.1016/S0196-1152(05)12011-0
• Date: 08 August 2005
• Published date: 08 August 2005
• Author: Stephanie Hartwell

INTRODUCTION

Since 1963, the promise of the Community Mental Health Centers Con-

struction Act (1963), the planned provision of community-based mental

health services, and advances in psychotropic medication and treatment

suggested that the mentally ill might be better managed and served in the

community than in hospital (Bachrach & Lamb, 1989; Grob, 1991). While

‘‘dehospitalization’’ proceeds today (Geller, 2000), large numbers of indi-

viduals with mental illness also return to the community from correctional

custody and bring with them complicated clinical profiles and service needs

(Laberge & Morin, 1995; Rice & Harris, 1997; Lamb & Weinberger, 1998;

Lamb et al., 1999). An increasing awareness of this phenomenon has re-

sulted in estimates that prisons contain four to five times the rate of persons

with mental illness found in the community (Morris & Tonry, 1990; Regier

et al., 1990; Morris et al., 1997; Rice & Harris, 1997; Wolff et al., 1997).

According to the 2000 Prison Census, about 150,900 or 1 in 10 state inmates

were in mental health programs; 114,400 or 1 in 13 were receiving psycho-

tropic medication; and 18,900 or 1 in 80 were in 24-hour psychiatric care

(Bureau of Justice Statistics, 2000). While the recent estimates suggest that

approximately 16% of all those incarcerated in state prisons (16% of all

males and 24%of all females) have some sort of mental illness (Ditton,

1999), a meta-analysis examining the prevalence of mental disorder with a

narrow criterion found that 10% of male and 18% of female inmates had an

Axis I major mental disorder of thought or mood (Pinta, 2001).

Individuals with mental illness who engage in criminality receive longer

sentences and serve them out due to legal representation, mandatory sen-

tencing, parole conditions, and crime severity (Lamb & Weinberger, 1998;

Healey, 1999; Travis, 2000). The vast majority is released from correctional

custody without mandated correctional monitoring or transitional services

aiding community re-entry or reintegration (Porporino & Motiuk, 1995;

Healey, 1999; Travis, 2000; Piehl, 2002). Upon release, living in the com-

munity with a mental illness and criminal history may be exacerbated by the

social isolation fostered through lengthy incarceration. Release from long-

term correctional custody signifies a change in structure, environment, and

daily life that can be difficult to manage for a population that is already

disenfranchised, disadvantaged, and stigmatized (Link et al., 1987, 1997;

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