The Overwhelming Crisis of Mentally Ill Inmates: A Broken System in Need of Action

Ben H.

Ben H.

Dec 01, 20233 min read


The Overwhelming Crisis of Mentally Ill Inmates: A Broken System in Need of Action


The intersection of mental health and the criminal justice system is becoming increasingly problematic in the United States. With an alarming number of mentally ill individuals languishing in jails, the shortage of space in psychiatric hospitals is reaching a breaking point. This article will explore the challenges faced by mentally ill inmates, the role of specialty pharmacies in addressing these issues, and the urgent need for comprehensive reform.

The Overcrowding Dilemma:

According to a Wall Street Journal analysis of state data, the number of mentally ill jail inmates has reached unprecedented levels, overwhelming the already limited space in psychiatric hospitals. This crisis is exacerbated by the fact that many inmates are awaiting court-ordered treatment, unable to stand trial or yet to be convicted. The ineptitude of the current system is evident as mentally ill individuals spend excessive amounts of time in jail without receiving the necessary care they require.

The Role of PerformSpecialty:

PerformSpecialty, a fully owned and integrated specialty pharmacy launched in 2014, offers a solution to the challenges faced by mentally ill inmates. By combining clinical culture and member-centric programs, PerformSpecialty provides high-touch specialty pharmacy services to individuals with complex conditions. This personal attention ensures that specialty medication users experience fewer gaps in care, resulting in a more holistic and healthful approach to treatment.

Addressing Medication Challenges:

Incarcerated individuals often face significant obstacles when it comes to accessing appropriate medications. Unlike psychiatric hospitals, jails are typically unable or unwilling to force inmates to take medication. This leads to limited prescription options, complicated adjustment processes, and a lack of monitoring by healthcare professionals. Moreover, the presence of law enforcement and the confinement environment can contribute to the exacerbation of psychotic delusions.

The Scarcity of Behavioral-Health Services:

Compounding the crisis is the severe shortage of behavioral-health services and professionals. State leaders and mental-health advocates have expressed concerns about the dire situation, with waiting lists for psychiatric-hospital beds growing longer each day. In Missouri alone, there are currently 229 inmates waiting for one of the state's 897 psychiatric-hospital beds, all of which are already occupied. This raises questions about the size of the network and whether these facilities are state-run.

Actionable Steps Towards Reform:

  • 1. Increase Funding and Resources: It is crucial for policymakers to prioritize and allocate sufficient funding and resources to expand the capacity of psychiatric hospitals. This includes investing in additional beds, hiring more healthcare professionals, and improving the overall infrastructure of these facilities.
  • 2. Promote Collaboration Between Justice and Healthcare Systems: Establishing effective collaboration between the criminal justice and healthcare systems is essential. This can be achieved through the creation of specialized diversion programs that redirect mentally ill individuals away from incarceration and towards appropriate treatment facilities.
  • 3. Implement Mental Health Training for Law Enforcement: Training law enforcement officers on mental health issues can help them identify and appropriately respond to individuals in crisis. This training should focus on de-escalation techniques, empathy, and understanding the unique needs of mentally ill individuals.


The crisis of mentally ill inmates languishing in jails is a glaring symptom of a broken system. By recognizing the role of specialty pharmacies like PerformSpecialty, we can begin to address the challenges faced by mentally ill individuals in the criminal justice system. However, comprehensive reform is urgently needed to rectify the supply-demand imbalance for psychiatric facilities, align incentives to let the private market work, and ensure that mentally ill individuals receive the care and support they desperately need. By taking action, we can build a more compassionate and effective system that prioritizes the well-being of all individuals, regardless of their mental health status.

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