"Dying Inside: To End Deaths of Despair, Address the Crisis in Local Jails"

The title of this post is the title of this notable new issue brief that was produced by folks with the Addiction & Public Policy Initiative of the O’Neill Institute for National and Global Health Law (and, full disclosure, that was supported by funding from the Drug Enforcement and Policy Center).  Here is the starting text of the interesting eight-page document:

U.S. life expectancy has declined in recent years, primarily due to a series of converging public health crises that resulted in deaths from overdoses, suicides, and alcohol-related liver disease, sometimes referred to as “deaths of despair.”  More recently, COVID-19 has accelerated this trend.  These bleak numbers shine a spotlight on the historic challenges of treating medical conditions, mental health conditions, and substance use disorder (SUD), particularly in settings like local jails, which are traditionally separate from the general health care system.

Individuals entering jails and other correctional settings are more likely to have a chronic health condition or infectious disease, resulting in an increased risk to their physical health and well-being while incarcerated.  A close look at statistics from local jails demonstrates that, far from being a safe haven from these converging crises, a failure to prioritize implementation of adequate policies and protocols addressing these issues in many local jails are fueling these crises for the individuals inside and everyone in our communities.

According to the latest data available from 2018-2019, deaths in jail custody have increased.  Each and every one of these lost lives is a tragedy.  In addition to the human cost, deaths in jail custody also account for hundreds of millions of dollars in financial costs and legal liability for governments and jail personnel.

Efforts at the local, state, and federal levels have begun a shift toward adopting more public healthoriented approaches in correctional settings, largely driven by an acknowledgement that addressing the health care and treatment needs of incarcerated people can positively impact both these individuals and the overall health of communities.  However, government leaders and advocates at every level must undertake significant policy and practice changes to reduce deaths in jail custody and accelerate reform.

This brief outlines the legal framework on the right to adequate care and treatment for medical, mental health, and substance-related conditions in jails.  The brief also highlights the findings of original research on litigation related to deaths in jail custody and provides recommendations for reform.

Two of the authors of this report, Regina LaBelle and Shelly Weizman, authored this related commentary in The Hill titled "We can’t ignore the ties binding US deaths of despair and incarceration."