Publication: The relationship between community public health, behavioral health service accessibility, and mass incarceration

Over 15 million adults in the United States (U.S.) pass through the doors of the criminal justice system with more than 7.2 million having mental health disorders. U.S. jails are de facto mental health facilities with around 10 times as many individuals with serious mental illness in prisons and jails than in state psychiatric hospitals. In a recent study, George Mason University (GMU) scientists Faye S Taxman (study PI) and Niloofar Ramezani (study co-I and biostatistician), along with other collaborations from GMU, Michigan State University and University of Central Florida, explored the factors contributing to the size of the jail populations across 3,100 counties in the U.S. This study used scientific methods to identify key factors contributing to the over-use of incarceration in county jails in the face of increased mental health challenges among individuals in the community and overcrowding in the carceral system.

Using advanced statistical modeling and machine learning methods with extant data from Vera Institute’s incarceration database, Robert Wood Johnson Foundation’s County Health Rankings and Roadmaps, Uniform Crime Report, and the U.S. Census, Dr. Ramezani comments that “We explored over 100 characteristics ranging from the demographics of the county to crime and justice performance rates to the health care. By using well-established statistical and machine learning methods we were able to build models which identified the most important factors in predicting the jail population size”. The researchers found that access to affordable healthcare services and behavioral health treatment in the community reduces the jail population size. The data clearly showed that increasing access to services, the number of the mental health providers in a community, and improving the affordability of healthcare including substance abuse treatment are key factors to reduce incarceration rates. “The data collected and analysis conducted for this study demonstrate the strong connection between public health and public safety, where the quality of the community support and health care are critical to reducing the use of the criminal justice system and improving rates of incarceration. In fact, communities should invest in expanding programs, mental health workforce providers, and funding to reduce the jail population across the U.S. Criminal justice reforms must emphasize expanding access to services in the community to have an impact on crime” lead scientist Dr. Faye Taxman commented.

Crime rates was not found to be an important factor in how counties use the local jail.  For example, the violent crime rate in communities, the size of the minority population, and the rurality of the community do not predict the population size of the local jails. The factors related to how a jail is used in a community are a more concentrated police presence and an inaccessible health care system. Expanding services /programs in the community will likely reduce the number of individuals currently incarcerated in the local jail systems.

Publication Link: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08306-6

Citation: Ramezani, N., Breno, A.J., Mackey, B.J. et al. The relationship between community public health, behavioral health service accessibility, and mass incarceration. BMC Health Serv Res 22, 966 (2022). https://doi.org/10.1186/s12913-022-08306-6

Funded by the National Institute of Mental Health, National Institute of Health (R01 MH118680; Taxman and Johnson).