Guest post on DOJ Report: Victimization of Mentally Ill Prison and Jail Inmates

Hello, all. I'm Lea Johnston, and I'd like to thank Doug Berman for inviting me to guest-blog about the new Department of Justice report released last week on sexual victimization in prisons and jails. I write in the area of mental disorder and sentencing, so I will focus on the mental health aspects of the data.

The DOJ report is based on inmate surveys conducted in over 600 state and federal prisons, local jails, and special correctional facilities between February 2011 and May 2012, and it includes the first national estimates of the sexual victimization of inmates with mental health problems.

The report found that inmates with serious psychological distress — elevated levels of nervousness, hopelessness, restlessness, depression, fatigue, or feelings of worthlessness — reported high rates of sexual victimization by staff and other inmates in 2011-12. In the words of the report:

• Among state and federal prison inmates, an estimated 6.3% of those identified with serious psychological distress reported that they were sexually victimized by another inmate. In comparison, among prisoners with no indication of mental illness, 0.7% reported being victimized by another inmate.
• Similar differences were reported by jail inmates. An estimated 3.6% of those identified with serious psychological distress reported inmate-on-inmate sexual victimization, compared to 0.7% of inmates with no indication of mental illness.
• Rates of serious psychological distress in prisons (14.7%) and jails (26.3%) were substantially higher than the rate (3.0%) in the U.S. noninstitutional population age 18 or older.

The report also found that inmates with a history of mental health problems had higher rates of victimization than other inmates. The report ascertained that these characteristics were correlated with significantly elevated rates of sexual victimization:

• Having been diagnosed with a mental disorder by a mental health professional;
• Having used prescription medications for a mental health problem at the time of the current offense;
• Having received therapy from a trained professional for a mental health problem; and
• Having stayed overnight in a facility for mental health treatment in the 12 months preceding the current admission to prison or jail.

These findings are significant because they demonstrate that mental disorder serves as a potent risk factor for victimization in correctional facilities. The report reinforces what academics — particularly Professor Nancy Wolff and her colleagues in important articles such as this one — have shown in recent years, but it goes further in detailing the current and historical offender characteristics that may signal risk of victimization.

There are three points related to this report that I think are worth making:

1)      Victimization rates may vary among facilities due to operational differences. The DOJ report shows that victimization rates vary widely among facilities for inmate populations as a whole. I suspect that victimization rates are especially likely to vary for mentally disordered prisoners, given differences in facilities’ housing policies for inmates with mental illnesses. Many facilities house offenders with serious mental illnesses (including clinical syndromes like schizophrenia, bipolar disorder, and major depression) with the general prison population until they reach a state of crisis — a potentially dangerous arrangement for a vulnerable inmate.  Some prisons, however, house disordered, vulnerable inmates in special facilities, wings, or units.  These arrangements may be temporary (designed to equip the offender, for instance, with coping mechanisms) or last for the entirety of the inmate’s confinement. Segregated housing may protect disordered inmates from abusive prisoners in the general population and yield lower rates of victimization.

2)      Victimization rates may improve under national standards released by the DOJ in May 2012 under the Prison Rape Elimination Act.  The PREA standards are aimed at detecting and preventing sexual abuse in correctional facilities and impose new screening, monitoring, reporting, and investigating requirements on prisons and jails.  Beginning in August, audits of facilities will take place every three years.

3)      Sexual victimization is not the only source of serious harm that mentally ill offenders face when incarcerated. They are prone to physical victimization due to their inability to assess danger sufficiently and to modify their behavior to ward off attacks. Cognitive and behavioral limitations can render strict conformance with prison rules difficult, and thus offenders with mental illnesses have elevated rates of disciplinary infractions. Consequently, disordered inmates are disproportionately punished in isolation, where they are especially susceptible to decompensation, psychotic breaks, and suicide ideation.  (I have explored this body of research in several articles, including one article on vulnerability and just desert.) 

As the aforementioned correlation between offenders’ history of mental disorder and sexual victimization suggests — and as the federal government has recognized in the PREA standards — it is possible to identify individuals at a heightened risk of sexual victimization at intake. This information is also available to judges at sentencing. 

My next guest blog will explore whether — and how — vulnerability to serious harm might inform the sentencing of offenders with mental illnesses.