Sociology Mind
2014. Vol.4, No.1, 31-35
Published Online January 2014 in SciRes (http://www.scirp.org/journal/sm ) http://dx.doi.org/10.4236/sm.2014.41004
Public Sector Responses to Jail Mental Health: A Review with
Recommendations for Future Research
Ronald Helms
1
, Ricky S. Gutierrez
2
, Debra Reeves-Gutierrez
3
1
Western Washington University, Bellingham, Washington, USA
2
California State University, Sacramento, Sacramento, California, USA
3
Alliant International University, San Francisco, California, USA
Email: Ronald.Helms@wwu.edu , rickyg@csus.edu , dreeves@alliant.edu
Received October 9
th
, 2013; revised November 21
st
, 2013; accepted December 13
th
, 2013
Copyright © 2014 Ronald Helms et al. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited. In accordance of the Creative Commons Attribution License all Copyrights ©
2014 are reserved for SCIRP and the owner of the intellectual property Ronald Helms et al. All Copyright ©
2014 are guarded by law and by SCIRP as a guardian.
The history of public mental health intervention in the US has been uneven and in some instances is cha-
racterized by a strong overtone of neglect. While clinical research in primarily private settings has gener-
ated findings that give a strong sense of “what works” in mental health diagnosis and treatment, this re-
view pays special attention to the distribution of mental illness among jailed populations. Local jail sys-
tems house a substantial number of mentally challenged individuals but receive less attention than is war-
ranted given their numbers. This paper concludes with a plea for research with a focus on the community
determinants of mental health systems in order to enhance delivery of services and increase the likelihood
of reaching those most in need of mental health treatment.
Keywords: Mental Health; Jails; Community Mental Health; Mental Health Research; Society and Mental
Health
Introduction
What seems to work in the field of mental health treatment?
Researchers, primarily in the US, have documented through a
substantial number of published studies, a series of answers to
this question. In the research note that follows, we summarize
the field of research with the intent to bring into a single space,
a brief on the history of mental health intervention as well as
findings regarding “what works” from the scholarly literature.
Since so many mentally ill individuals are discovered through
the intake process at county jails throughout the country, and
become subsequently “consumers of services” while incarcera-
ted in local jail facilities, we focus special attention on this cri-
tical aspect of mental health populations and delivery systems.
Doing so will allow for an assessment of questions that are less
clear cut and help direct attention to where research should fo-
cus in light of austere fiscal conditions and shifting parameters
of privatized support for intervention in the mental health
field.
Review of the Literature
The US Experience with Mental Illness
Mental health care at the level of the individual has been the
focus of concern throughout a substantial portion of American
history, and in particular during the past 150 years. The scho-
larly literature features a wide range of studies on mental health
issues, primarily focused on individual-level experiences, di-
agnostic issues, and treatment effects. Although there is docu-
mented evidence of substantial rates of occurrence of mental
illness in the developmental stages of our nation, the first at-
tempt to officially document the extent of mental illness and
mental retardation occurred with the inclusion of the categories
insane and idiotic during the collection of the Census of 1840.
By the late 1800s mental health crusaders such as Dorothy Dix
(1843; 1975) were instrumental in establishing and expanding
the state hospital system for the treatment and care of mentally
ill patients, thereby relieving to some extent, the burden of care
for these populations to the ill-equipped almshouses and local
jails (Torrey, Kennard, Eslinger, Lamb, & Pavle, 2010). Be-
tween 1850 and 1869, 35 new state hospitals were established,
and by 1890 another 59 additional state hospitals were estab-
lished. Those institutions being built after 1870 were substan-
tially larger than those built earlier in order to accommodate
more patients who represented an expanding scope of mental
and physical of conditions (Staples, 1990). The process of esta-
blishing state hospitals for the mentally ill, largely initiated by
Dix, continued to evolve and expand throughout the early
1950s, reaching its zenith by mid-decade.
At the high point, state facilities for involuntary commit-
ments of the mentally ill housed approximately 557,000 people
(Kerle, 2004). After years of controversy and documented
abuse of mental patients confined to such facilities, a federal
court ruling issued in Wyatt v. Stickney (1972) led to the wide-
spread deinstitutionalization of those mentally ill persons invo-
luntarily committed to state institutions and who did not fit
within a narrowly defined description, to wit, the presence of
documented evidence that institutional confinement was re-
OPEN ACCESS 31