Doctoral Dissertation Research: Mental Health and Recidivism Rates in American Jails

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America's largest jails are also the country's largest providers of institutional mental health care. The overrepresentation of mental illness in jails has been a persistent challenge for public officials, even as major cities have pursued reforms to make jails more therapeutic and reduce their size. Jails, like prisons, have both punitive and custodial functions; in fact, jail and prison inmates are the only group in the United States who have a constitutional right to health care. Since they primarily confine those who are being tried in court, jails affect a large population and are dynamically related to wider processes of crime, police, and the law. Amidst that rapidly changing population, however, people diagnosed with serious mental illness are incarcerated longer and are more likely to be reincarcerated upon their release. Moreover, despite efforts by some counties to reduce the size of their jails, many of these counties have witnessed an increase in the rates of mental illness in their jails. Understanding the factors causing this trend is critical to guide criminal justice and mental health practice. In addition to providing funding for the training of a graduate student in anthropology in the methods of empirical, scientific data collection and analysis, the project would enhance scientific understanding by broadly disseminating its findings to officials and stakeholder groups.The research will be conducted in the New York City and Los Angeles jail systems. These are not only two of the largest systems in the county, but also two that have undergone major reforms in recent years. Legal and political pressure at both sites has sparked public debate about the adequacy of the jails to meet the needs of those incarcerated as well as overall jail size. However, while New York has witnessed a significant decline in its jail population, Los Angeles has achieved only modest declines. The investigators, who have done ethnographic research at both sites and are situated in clinical and social scientific training programs, are particularly well suited to study this simultaneously clinical, legal, political and cultural phenomenon. In examining the meaning of mental health care in these institutions, the investigators will focus their ethnographic attention on jail clinical teams. Complementing an analysis of how courts have arbitrated the constitutional right to jail care, the investigators will observe how clinicians interpret and enact that mandate in practice. The study will involve institutional ethnography, including participant observation, semi-structured interviews, and mapping, and legal analysis of public oversight hearings. They will also explore what factors influence diagnosis and treatment in these settings, as well as how social workers identify resources for inmates upon their release. These ethnographic findings will offer guidance to mental health advocates and clinicians, jail administrators and policy makers regarding the context-dependent variables that shape institutional care delivery and the capacity of counties to respond to serious mental illness.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.