6
Adults with Behavioral Health Needs under Correctional Supervision
• Adults with Substance Use Disorders on Probation or Parole:* In U.S. Department of Justice and SAMHSA surveys, 35 percent of parolees and 40 percent of probationers had drug or alcohol dependence or abuse “in the past year.” 18 • Individuals with Both Disorders: Studies suggest that the co-occurrence of mental health and substance use disorders is also common. In jails, of the approximately 17 percent with serious mental illness, an estimated 72 percent had a co-occurring substance use disorder.19 Approximately 59 percent of state prisoners with mental illnesses had a co-occurring drug or alcohol problem.20 People with mental illnesses and co-occurring disorders tend to have greater difficulties under correctional supervision than those without mental illness—both behind bars and in the community. Research shows that they tend to stay incarcerated longer than individuals without behavioral health disorders with the same charges and sentences. For example, a national study of individuals with mental illnesses in state prisons found those individuals, controlled for sentence terms, served an
Table 1. Estimated Proportion of Adults with Mental Health, Substance Use, and
Co-occurring Disorders in the U.S. Population and under Correctional Control and Supervision† General Public
State Prisons
Jails
Probation and Parole
Serious Mental Illness
5.4%21
16%22
17%23
7–9%24
Substance Use Disorders (Alcohol and Drugs) — Abuse and/or Dependence
16%
53%
68%
35–40%28
Drug Abuse Only29
1.4%
17%
18%
N/A
25
26
27
Drug Dependence Only
0.6%
36%
36%
N/A
A Co-occurring Substance Use Disorder When Serious Mental Illness Is Diagnosed‡
25%31
59%32
72%33
49%34
30
*There are estimates that are higher than the statistics cited in the text that refer to studies that measure “involvement” with drug or alcohol abuse rather than substance ”abuse” or “dependence.” The statistics highlighted in the text focus on the higher-need category of individuals. The attention to abuse and dependence parallels the emphasis of the reported mental health statistics on SMI and not on the broader group of individuals with mental health “problems.” † The
numbers used in this table are estimates that come from a variety of sources. The studies cited are from different years, use different methodologies and definitions, and combine different data sets. The table is intended to give the reader a general sense of the prevalence rates of behavioral disorders in corrections populations and is not intended to be the definitive epidemiologic dataset. ‡ Note that of those adults with serious mental illnesses, the percentages in this row reflect how many also have co-occurring substance use disorders.