Mental health screening and brief assessments

Screening and assessment are a core component of psychiatric care in any setting. In jails and prisons, the process, structure, content and timing of screenings and assessments are vital parts of the healthcare system. While the number of incarcerated persons is clear, the actual number of incarcerated prisoners who suffer from a mental disorder or independent psychiatric symptoms is difficult to determine because of methodological issues (e.g., different definitions of mental illness, different thresholds of severity, etc.) as well as wide variation in the nature (e.g. prison, jail, police lockup), size, and mental health service delivery systems of various settings. However, despite differences in methodology, geographic area, and other issues (e.g., types of facility, when studies were conducted, etc.), virtually every relevant study has concluded that a significant number of prisoners have serious mental illnesses and that the numbers of mentally ill prisoners are increasing. Because people with mental illnesses are at risk of suicide and exacerbations of their mental illnesses, correctional institutions need to identify such persons in a timely manner and provide appropriate clinical interventions. This chapter addresses the initial mental health screening of persons entering prisons and jails, with a special emphasis on suicide risk screening and follow-up clinical assessments of prisoners whose receiving or intake screening results suggest the likelihood that treatment or suicide prevention efforts will be necessary.