Healthcare in Jails

Jails are local correctional institutions that are on the front-line of healthcare in the criminal justice system. They process 13 million admissions a year.  Jail inmates are disproportionately male, people of color, and poor.

Many of these individuals experience serious health problems. Half of jail inmates and prisoners have a chronic health condition. Nearly two thirds of jail inmates meet clinical criteria for substance abuse or dependence, and more than 40 percent have a history of a mental health problem.

Public safety stakeholders are not unaware of this trend. Sheriffs and wardens throughout the country frequently comment about how their institutions have become de facto mental health institutions and how jails are poorly equipped to serve in that role.

Even though jails are not considered healthcare delivery sites, considerable resources are dedicated to medical care in these settings, including intake assessments, sick call, chronic medical and mental health care, emergency responses.

Whether a justice involved person receives treatment in a jail or the community, there is little coordination between jail and community providers. As a result, treatments are interrupted impacting the health of the individual and potentially the health of the community.

COCHS' Mission

Since its beginning Community Oriented Correctional Health Services (COCHS) has worked to bridge the gap between correctional and community providers. COCHS' major emphasis has been to re-frame jail healthcare not as a place separate from the rest of the community but as another healthcare delivery site within the community.

This perspective has many advantages. Coordination of care between community and correctional providers helps reduce interruption of treatments and the negative impact these interruptions can pose to individual health, community health, and community resources.

As part of its mission, COCHS provides technical assistance to assist communities in finding ways to improve healthcare in local correctional facilities as well as providing expertise on health information technology to create connectivity and data sharing. COCHS has also been the leader in identifying policies at the federal, state, and local levels that help local jurisdictions address the healthcare needs of their community members who are temporarily displaced within correctional institutions.

Stakeholders whether they be criminal justice professionals, policy makers, or health care providers seldomly interact. COCHS has convened multiple conferences and working groups so these groups can exchange ideas and find solutions to the health crises that lead many people to cycle through jails.

What's New

Stories and news items of note impacting healthcare within corrections
American Public Health Association - Supplement Issue
A supplement issue of the American Public Health Association examines the public health concerns surrounding mass incarceration, with research and perspectives on improving health outcomes for justice-involved populations, psychological distress in solitary confinement, the links between mass incarceration and climate change, the public health implications of criminal justice reform, and more. Included in this supplement is a review of Dr. Homer Venter’s book Life and Death in Rikers Island.
How Denver Health is helping inmates with opioid addiction get treatment
Jails, historically, aren’t known as places of drug rehabilitation. But Dr. Sasha Rai, the Director of Behavioral Health Services for the Denver Sheriff’s Department of Health Services, is providing people in the Denver jail that option. Dr. Rai launched a Medicated Assisted Treatment (MAT) program in Denver jails a couple of years ago with a small team of nurses and case managers from Denver Health. Last year, Rai’s team put 916 inmates on Opiate Withdrawal Protocol.
Think Debtors Prisons Are a Thing of the Past? Not in Mississippi
Mississippi appears to be the only state where judges lock people up for an indefinite time while they work to earn money to pay off court-ordered debts. While there is no comprehensive data, legal experts who study fines, fees and restitution say Mississippi is unique. Judges have sentenced hundreds of people a year to restitution centers around the state, almost always ordering them to stay until they pay off court fees, fines and restitution to victims.

COCHS' Media Scan

COCHS sends out a weekly media scan of news stories covering healthcare delivery within correctional institutions. These stories range from stories about local correctional institutions all the way to national initiatives. Occasionally, we will post announcements about COCHS or one of our partner organizations.