Center on Sentencing and Corrections


U.S. Prisons and Offenders with Mental Illness


Abramsky, Sasha and Jamie Fellner. Ill-Equipped: U.S. Prisons and Offenders with Mental Illness. Human Rights Watch, 2003.

“Prisons were never intended as facilities for the mentally ill, yet that is one of their primary roles today. … In the United States, there are three times more mentally ill people in prisons than in mental health hospitals, and prisoners have rates of mental illness that are two to four times greater than the rates of members of the general public. … Drawing on interviews with correctional officials, mental health experts, prisoners and lawyers, this report seeks to illuminate [their] fate [behind bars]. We identify the mentally ill in prison — their numbers, the nature of their illnesses, and the reasons for their incarceration. …  We review their access to mental health services and the treatment they receive. We examine the various levels of care available to them, their confinement in long-term segregation facilities, the way prisons respond to their self-mutilation and suicide attempts, and the services they receive upon release from prison. … [Mental health professionals] face daunting obstacles — including facilities and rules designed for punishment. … Our research also indicates the persistence in many prisons of deep-rooted patterns of neglect, mistreatment, and even cavalier disregard for the well-being of vulnerable and sick human beings.”

Click here to view the report.

Keywords: mental illness, disciplinary segregation, harmful effects, adverse outcomes, self harm, suicide, human rights