Report finds that the prevalence of mental illness in California jails is rising

A new report indicates that the prevalence of mental illness in California jails is rising. 

The report, conducted by California Health Policy Strategies, analyzed data reported from 50 counties regarding mental health cases and psychotropic medication prescriptions in jails between 2009 and 2019.

 

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The data looked at in the report came from the Board of State and Community Corrections (BSCC) Jail Profile Survey (JPS). Since 2002, the BSCC  has distributed the JPS monthly to collect data on local agency jails and jail systems. 

In the monthly survey, counties are asked to report the “number of inmates on the last day of the month who are receiving psychotropic medications for identified mental health disorders,” as well as the “number of open mental health cases on the last day of the month”.

Based on these county-wide figures, the report indicated that the share of California’s statewide jail population with an active mental health case or a psychotropic medication prescription increased significantly between 2009 and 2019.

The researchers found that in 2009, there were an average of approximately 15,500 open mental health cases reported by the counties on a monthly basis. In 2019, the same average jumped to about 22,000.  This represents a 42 percent increase in the number of active mental health cases reported by the counties on a monthly basis. 

Additionally, the proportion of incarcerated individuals in California jails with an open mental health case rose from 19 percent in 2009 to 31 percent in 2019. In 2009, there were 15,500 people with an open mental health case out of a total of 80,000 people in jail custody. But in 2019, there were a total of 72,000 people in jail custody and 22,000 people with an open mental health case. 

This means that between 2009 and 2019, the number of incarcerated individuals decreased while the number of incarcerated individuals with an open mental health case increased. 

The data regarding psychotropic medication prescriptions shows a similar trend. 

During 2009, there was an average of 10,500 incarcerated individuals receiving psychotropic medications. Whereas in 2019, there was an average of 19,000 incarcerated individuals receiving psychotropic medications; meaning that the raw number of incarcerated individuals receiving psychotropic medications increased by roughly 81 percent between 2009 and 2019.

There was also a proportional uptick of incarcerated individuals receiving psychotropic medications. The proportion of incarcerated Californians with a psychotropic medication prescription roughly doubled from 13 percent in 2009 to 26 percent in 2019. 

 

 

The report also revealed stark disparities between the counties’ share of the jail population experiencing mental illness.

In the median California county, approximately 32 percent of the jail population have an open mental health case. However, about 45 percent of San Diego’s jail population and roughly 42 percent of San Francisco’s have open cases. On the end of the spectrum, in Trinity or San Bernadino County only about 8 or 9 percent of the jail population have an active case. 

In terms of psychotropic medications, about 23 percent of the jail population receive at least one psychotropic medication in the median California county. However, in Kern and Santa Clara County, roughly 86 to 88 percent receive psychotropic medications. 

In Modoc and Siskiyou County, roughly 50 to 65 percent of the annual jail population receives psychotropic medications.  By contrast, in Glenn and Madera country only 8 or 9 percent of the jail population receives psychotropic medications. 

While nearly all California jails have experienced a cumulative rise in the share of their incarcerated population with some mental illness, researchers found significant differences in the degrees of change across county lines. 

The average county experienced a 15 percent increase in the segment of their incarcerated population with an active mental health case between 2009 and 2019. But in both Yolo and Yuba Counties, there was a 35 percent increase. In Orange County, there was only a 2 percent increase. 

The researchers offered a few different explanations for why the share of the statewide jail population with either a prescription for psychotropic medications or an active mental health case has increased over the last decade. 

The data could reflect a trend toward the increased incarceration of mentally ill individuals. Local factors in each county may also play a role, such as those with higher rates of homelessness or individuals found incompetent to stand trial. Alternatively, policy changes that occurred under the Public Safety Realignment that redirected lower level offenders who would have otherwise been sentenced to prison might also be reflected in the data. 

As far as the increase in the rate of incarcerated individuals with psychotropic medication prescriptions, the researchers noted that the increase may not be due to increased incarcerations of mentally ill individuals, but rather enhanced identification, diagnosis, and treatment of mentally ill inmates. 

Closing out the report, the researchers warned that as the proportion of mentally inmates increases in jails across California, it will become increasingly crucial to ensure more accurate data is available. The report demonstrates details about missing data points and offers suggestions for counties to improve the uniformity and consistency of data reporting.