By Paula M. Ditton

BJS Statistician

At midyear 1998, an estimated 283,800

mentally ill offenders were incarcerated

in the Nation’s prisons and jails. 

In recent surveys completed by the

Bureau of Justice Statistics, 16% of

State prison inmates, 7% of Federal

inmates, and 16% of those in local jails

reported either a mental condition or an

overnight stay in a mental hospital.

About 16%, or an estimated 547,800

probationers, said they had had a

mental condition or stayed overnight 

in a mental hospital at some point in

their lifetime.

Based on information from personal

interviews, State prison inmates with a

mental condition were more likely than

other inmates to be incarcerated for a

violent offense (53% compared to

46%); more likely than other inmates to

be under the influence of alcohol or

drugs at the time of the current offense

(59% compared to 51%); and more

than twice as likely as other inmates to

have been homeless in the 12 months

prior to their arrest (20% compared to

9%). Over three-quarters of mentally ill

inmates had been sentenced to time in

prison or jail or on probation at least

once prior to the current sentence.

Over 30% of male mentally ill inmates

and 78% of females reported prior

physical or sexual abuse. Since admission 61% of mentally ill inmates in State

prison and 41% in local jails reported

they had received treatment for a

mental condition in the form of counseling, medication, or other mental health

services. 

 ̆ About 10% of prison and jail

inmates reported a mental or

emotional condition; and 10% 

said they had stayed overnight 

in a mental hospital or program.

 ̆ Together, 16% or an estimated

283,800 inmates reported either a

mental condition or an overnight

stay in a mental hospital, and 

were identified as mentally ill.

 ̆ About 53% of mentally ill inmates

were in prison for a violent offense,

compared to 46% of other inmates.

 ̆ Mentally ill offenders were less 

likely than others to be incarcerated 

for a drug-related offense 

(13% versus 22%).

 ̆ Mentally ill State prison inmates 

were more than twice as likely as 

other inmates to report living on the

street or in a shelter in the 12 months

prior to arrest (20% compared to 9%).

 ̆ Nearly 8 in 10 female mentally ill

inmates reported physical or sexual

abuse. Males with a mental condition

were more than twice as likely as 

other males to report abuse.

 ̆ 6 in 10 mentally ill State inmates

reported receiving mental treatment

since admission to prison. 

 Highlights

 Counseling 44.1 16.2

 Medication 50.1 34.1

Any treatment 60.5% 40.9%

Mentally ill inmates 

State prison Jail

Mental health treatment

since admission

Mentally ill inmates were more likely than others to be in prison 

for a violent offense

*Reported either a mental or emotional condition or 

an overnight stay in a mental hospital or program.

16.2% 7.4% 16.3% 16.0%

Estimated to be

mentally ill*

10.7 4.7 10.2 8.2

Overnight stay in a

mental hospital

10.1% 4.8% 10.5% 13.8%

Mental or emotional

condition

ProbaJail tionFederal 

prison

State

Reported a... prison 

Over a quarter million mentally ill incarcerated in prison or jail

Priors 81.2 78.8

None 18.8% 21.2%

Criminal history

Public-order 9.9 9.8

Drug 12.8 22.2

Property 24.4 21.5

Violent 52.9% 46.1%

Other 

inmates

Mentally ill

Offense inmates

State prisoners

Nearly 6 in 10 mentally ill offenders reported they were under the 

influence of alcohol or drugs at the time of their current offense

In month before offense 58.8% 56.1%

Drug use

At time of offense 58.7% 51.2%

Alcohol/drug use

Female 78.4 50.9

Male 32.8% 13.1%

Physical/sexual abuse

prior to arrest 20.1% 8.8%

Homeless in 12 months

Other

inmates

Mentally ill

Before entering prison inmates

 State prisoners

U.S. Department of Justice

Office of Justice Programs

Bureau of Justice Statistics

Special Report

Mental Health and Treatment

of Inmates and Probationers

July 1999, NCJ 174463
2 Mental Health and Treatment of Inmates and Probationers

Prevalence of mental illness among

correctional populations based on

offender self reports

The findings in this report are based on

the 1997 Survey of Inmates in State or

Federal Correctional Facilities, the

1996 Survey of Inmates in Local Jails,

and the 1995 Survey of Adults on

Probation. In each survey, offenders

selected through nationally representative samples were asked a series of

mental health related questions.

Respondents were asked if they have a

mental or emotional condition and

whether they had ever received treatment for a mental or emotional

problem, other than treatment related

to drug or alcohol abuse. (See survey

questions in the box above.)

16% of State prisoners identified 

as mentally ill

For this report, offenders were identified as mentally ill if they met one of the

following two criteria: they reported a

current mental or emotional condition,

or they reported an overnight stay in a

mental hospital or treatment program.

An estimated 1 in 10 State prison

inmates reported a current mental or

emotional condition (table 1). A slightly

larger percentage (11%) of State

inmates said they had been admitted

overnight to a mental hospital or treatment program at some point in their

life. Overall, nearly a third of all

inmates reported they had a current

mental condition or they had received

mental health service at some time.

To take into account underreporting of

current mental or emotional problems,

past admission to a mental hospital

was included as a measure of mental

illness. Overall, 16% of State prisoners

met these criteria, including 10% who

reported a current mental condition and

an additional 6% who said they did not

have a mental condition but had stayed

overnight in a mental hospital, unit, or

treatment program.

 

Previously estimated rates of mental

illness among incarcerated populations

vary, depending on the methodology of

the study, the institution, and the definition of mental illness. Estimates range

from 8% to 16% among studies with

more rigorous scientific methods,

including random sampling and a

standardized assessment or psychological testing. (See the box on this

page.)

 

Past estimates of the rate of mental

illness among incarcerated populations

are higher than those for the U.S.

general population. Among a sample

of male jail detainees in Cook County

(Chicago), Teplin found 9.5% had

experienced a severe mental disorder

(schizophrenia, mania, or major

depression) at some point in their life,

compared to 4.4% of males in the U.S.

general population. The Epidemiologic

Catchment Area program found that

6.7% of prisoners had suffered from

schizophrenia at some point, compared

to 1.4% of the U.S. household population (Robins and Regier).

Survey items used to measure mental illness

Do you have a mental or emotional condition? * Yes

(prison and jail inmates only) * No

Have you ever been told by a mental health professional 

such as a psychiatrist, psychologist, social worker, or * Yes

psychiatric nurse, that you had a mental or emotional disorder? * No

(probationers only)

 

Because of an emotional or mental problem, have you ever &

 Taken a medication prescribed by a psychiatrist or other doctor? * Yes

* No

 Been admitted to a mental hospital, unit or treatment program 

 where you stayed overnight? * Yes

* No

 

 Received counseling or therapy from a trained professional? * Yes

* No

 

 Received any other mental health services? * Yes

* No

mental health services 3.3 30.2

Received other 

counseling or therapy 21.8 29.7

Received professional

medication 18.9 23.9

Taken a prescribed

a hospital overnight 10.7% 16.2%

Been admitted to

inmate had —

or emotional problem,

Because of a mental 

or emotional condition 10.1% 10.1%

Reported a mental 

Percent percent

lative

CumuState prison inmates

Table 1. Measures of mental illness

among State prison inmates, 1997

Previous studies of the prevalence of severe mental illness in prison or jail

Study Sample Mentally ill*

Guy, Platt, Zwerling, Philadelphia jail 

 and Bullock (1985) pretrial admissions 16%

Teplin (1990) Cook County jail

admissions (males) 10%

Steadman, Fabisiak, Dvoskin, New York State

 and Holohean (1987) prisoners 8%

*Generally includes schizophrenia, bipolar disorder, and major depression. 

See individual studies for variations in definition.
283,800 mentally ill in prison or jail;

547,800 on probation

Using the same criteria described for

State prison inmates, 16% of offenders

in local jails or on probation and 7% of

inmates in Federal prisons were identified as mentally ill in recently completed

BJS surveys (table 2). Probationers

were somewhat less likely than inmates

in State prisons or local jails to report

an overnight stay in a mental hospital

or treatment program but more likely to

report a mental or emotional problem.

Federal inmates had lower rates on

both measures. 

Assuming these rates have not

changed since the surveys were

conducted, an estimated 283,800

inmates in prison or jail were mentally

ill as of June 30, 1998 (table 3). State

prisons held an estimated 179,200

mentally ill offenders; Federal prisons

held 7,900; and local jails, 96,700. Of

those on probation at yearend 1998, 

an estimated 547,800 were mentally ill.

White inmates more likely than

blacks or Hispanics to report a

mental illness

Nearly a quarter of white State prison

and local jail inmates and a fifth of

white offenders on probation were

identified as mentally ill (table 4). The

rate of mental illness among black and

Hispanic inmates and probationers was

much lower. Among black offenders,

14% of those in State prison and local

jails, and 10% of those on probation

were identified as mentally ill. About

11% of Hispanic State prison and local

jail inmates, and 9% of Hispanic offenders on probation had a mental illness. 

Black and Hispanic inmates in Federal

prison were half as likely as white

inmates to report a mental illness.

About 6% of black inmates and 4% 

of Hispanic inmates reported a mental

condition or an overnight stay in a

mental hospital, compared to 12% 

of white Federal prison inmates.

The prevalence of mental illness also

varied by gender, with females reporting a higher rate of mental illness than

males. Nearly 24% of female State

prison and local jail inmates, and 22%

of female probationers were identified

as mentally ill, compared to 16% of

male State prison and jail inmates 

and 15% of male probationers.

Offender mental illness highest

among the middle-aged 

Offenders between ages 45 and 54

were the most likely to be identified as

mentally ill. About 20% of State prisoners, 10% of Federal prisoners, 23% of

jail inmates, and 21% of probationers

between ages 45 and 54 had a mental

illness, compared to 14% of State

inmates, 7% of Federal inmates, 13%

of jail inmates, and 14% of probationers age 24 or younger.

The highest rates of mental illness

were among white females in State

prison. An estimated 29% of white

females, 20% of black females, and

22% of Hispanic females in State

prison were identified as mentally ill.

Nearly 4 in 10 white female inmates

age 24 or younger were mentally ill. 

 Mental Health and Treatment of Inmates and Probationers 3

*Based on midyear 1998 counts from the National Prisoner Statistics

and Annual Survey of Jails and preliminary yearend 1998 counts from

the Annual Probation Survey.

to a mental hospital 118,300 5,000 60,500 281,200

Admitted overnight 

emotional condition 111,300 5,200 62,100 473,000

Reported a mental or

Identified as mentally ill 179,200 7,900 96,700 547,800

prison prison jail Probation

State Federal Local

Estimated number of offenders*

Table 3. Estimated number of mentally ill inmates

and probationers, 1998

*Reported either a mental condition or an overnight stay in a mental hospital 

or treatment program.

hospital or treatment program 10.7 4.7 10.2 8.2

Admitted overnight to a mental

or emotional condition 10.1 4.8 10.5 13.8

Reported a mental 

Identified as mentally ill* 16.2% 7.4% 16.3% 16.0%

inmates, 1997 inmates, 1997 1996 1995

State prison Federal prison Jail inmates, Probationers,

Table 2. Mental health status of inmates and probationers

*Excludes Hispanics.

 55 or older 15.6 8.9 20.4 16.0

 45-54 19.7 10.3 22.7 21.1

 35-44 18.4 7.5 19.3 19.8

 25-34 14.8 5.9 15.7 13.8

 24 or younger 14.4% 6.6% 13.3% 13.8%

Age

 

 Hispanic 11.0 4.1 11.1 9.0

 Black* 13.5 5.6 13.7 10.4

 White* 22.6% 11.8% 21.7% 19.6%

Race/Hispanic origin

 Female 23.6 12.5 22.7 21.7

 Male 15.8% 7.0% 15.6% 14.7%

Gender

characteristic inmates inmates inmates tioners

Offender State Federal Jail ProbaPercent identified as mentally ill

Table 4. Inmates and probationers identified as mentally ill,

by gender, race/Hispanic origin, and age

35 or older 33 21 23

25-34 23 20 21

24 or younger 37 17 23

 Total 29% 20% 22%

Age White Black Hispanic

Percent of females in State 

prison identified as mentally ill
Mentally ill more likely than other

offenders to have committed a

violent offense 

Fifty-three percent of mentally ill State

prisoners, compared to 46% of other

State prisoners, were incarcerated for a

violent crime (table 5). Approximately 

13% of the mentally ill in State prison

had committed murder; 12%, sexual

assault; 13%, robbery; and 11%,

assault. Among inmates in Federal

prison, 33% of the mentally ill were

incarcerated for a violent offense,

compared to 13% of other Federal

inmates. More than 1 in 5 mentally ill

Federal prisoners had committed

robbery (predominantly bank robbery).

Among inmates in local jails, 30% of

the mentally ill had committed a violent

offense, compared to 26% of other jail

inmates. An estimated 28% of mentally

ill probationers and 18% of other probationers reported their current offense

was a violent crime.

Nearly 1 in 5 violent offenders incarcerated or on probation were identified as

mentally ill. 

Unlike those in State prisons, the

majority of mentally ill offenders in jail

or on probation had committed a 

property or public-order offense.

Almost a third of mentally ill offenders

in jail and on probation had committed

a property offense, and a quarter had

committed a public-order offense.

Mentally ill offenders were less likely

than other inmates to be incarcerated

for a drug offense. About 13% of

mentally ill inmates and 22% of other

inmates in State prison were incarcerated for a drug offense. In Federal

prison, where the majority of inmates

are incarcerated for a drug offense,

40% of those identified as mentally ill

and 64% of other Federal inmates were

in prison for a drug-related crime.

4 Mental Health and Treatment of Inmates and Probationers

Note: Detail does not sum to total because of excluded offense categories.

*Includes nonnegligent manslaughter.

Public-order offenses 9.9 % 9.8% 17.0% 14.6% 23.2% 24.6% 24.7% 31.6%

 Trafficking 6.6 12.2 35.7 46.6 7.0 9.6 6.7 9.2

 Possession 5.7 9.4 3.9 11.9 7.3 12.3 7.2 11.0

Drug offenses 12.8 % 22.2% 40.4% 64.4% 15.2% 23.3% 16.1% 20.7%

 Fraud 3.1 2.6 5.0 4.9 5.2 4.4 11.7 9.2

 Larceny/theft 4.6 4.1 1.3 0.4 8.4 7.9 5.3 8.8

 Burglary 12.1 10.5 1.0 0.3 9.1 7.4 6.4 4.3

Property offenses 24.4 % 21.5% 8.7% 6.7% 31.3% 26.0% 30.4% 28.5%

 Assault 10.9 9.0 3.8 1.1 14.4 11.0 14.0 10.5

 Robbery 13.0 14.4 20.8 9.1 4.7 6.9 2.0 1.4

 Sexual assault 12.4 7.9 1.9 0.7 5.2 2.8 6.8 4.1

 Murder* 13.2 11.4 1.9 1.4 3.5 2.7 0.5 0.9

Violent offenses 52.9 % 46.1% 33.1% 13.3% 29.9% 25.6% 28.4% 18.4%

 All offenses 100.0 % 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

Most serious offense inmates inmates inmates inmates inmates inmates probationers probationers

Mentally ill Other Mentally ill Other Mentally ill Other Mentally ill Other

State prison Federal prison Local jail Probation

Table 5. Most serious current offense of inmates and probationers, by mental health status 

6 in 10 violent mentally ill State

prisoners knew their victim

Mentally ill inmates who were incarcerated for a violent offense were

more likely to report that the victim of

the offense was a woman, someone

they knew, and under age 18. Nearly

61% of mentally ill State prison

inmates who had committed a 

violent offense knew their victim. 

An estimated 16% had victimized a

relative and 12% an intimate, such 

as a spouse, ex-spouse, boyfriend, 

or girlfriend. 

More than half of the mentally ill

reported that they had victimized a

female during the current offense. 

An estimated 15% reported that their

youngest victim was a child, age 12 

or under, and 12% reported the 

victim to be between ages 13 

and 17. A weapon was used by 44%

of the violent State prisoners who

were mentally ill.

Probationers 22.8

Jail inmates 18.5

Federal prison inmates 16.6

State prison inmates 18.2%

Percent mentally ill

among violent offenders

a

More than one victim may have been

reported.

b

Includes spouse, ex-spouse, boyfriend,

girlfriend, ex-boyfriend, and ex-girlfriend. c

Includes those known by sight only.

No 56.0 58.1

Yes 44.0% 41.9%

Use of weapon

Knew none of victims 39.1 47.9

Other 6.5 6.9 c

Friend/acquaintance 29.8 27.7

Intimate 11.6 8.6 b

Relative 15.6 10.3

Knew victima 60.8% 52.1%

Victim-offender relationship

55 or older 6.2 4.3

35-54 23.8 22.8

25-34 25.7 30.9

18-24 17.3 20.7

13-17 11.6 11.0

12 or younger 15.4% 10.2%

Age of youngest victim

Both males and females 11.7 10.9

Female 44.0 37.5

Male 44.3% 51.5%

Gender of victim(s)

inmates inmates

ill Other

Mentally

Victim characteristics and use 

of weapon, by mental health status 

of violent State prisoners
Half of mentally ill inmates reported

3 or more prior sentences

Mentally ill inmates reported longer

criminal histories than other inmates.

Among the mentally ill 52% of State

prisoners, 54% of jail inmates, and 49%

of Federal inmates reported three or

more prior sentences to probation or

incarceration (table 6). Among other

inmates, 42% of State prisoners and

jail inmates and 28% of Federal 

inmates had three or more prior

sentences. About 10% of mentally ill

prison inmates and 13% of jail inmates

reported 11 or more prior sentences.

Mentally ill more likely than other

inmates to be violent recidivists

Among repeat offenders, 53% of

mentally ill State inmates had a current

or past sentence for a violent offense,

compared to 45% of other inmates.

Forty-six percent of mentally ill jail

inmates and 32% of other jail inmates

with a criminal history had a current or

past sentence or current charge for a

violent crime. Among Federal prisoners with a prior sentence, the mentally

ill (44%) were twice as likely as other

inmates (22%) to have a current or

prior sentence for a violent offense.

Although offenders on probation had

shorter criminal histories, nearly 3 in 10

of the mentally ill were recidivists with 

a current or past sentence for violence. 

Homelessness more prevalent

among mentally ill offenders

 

Mentally ill offenders reported high

rates of homelessness, unemployment,

alcohol and drug use, and physical and

sexual abuse prior to their current

incarceration. During the year preceding their arrest, 30% of mentally ill

inmates in jail and 20% of those in

State or Federal prison reported a

period of homelessness, when they

were living either on the street or in a

shelter (table 7). About 9% of other

State prison inmates, 3% of other

Federal inmates and 17% of other jail

inmates reported a period a homelessness in the year prior to their arrest.

Fewer inmates reported they were

homeless at the time of arrest. About

4% of mentally ill State and Federal

prison inmates and 7% of jail inmates

reported they were living on the street

or in a shelter when arrested for their

current offense. These rates were at 

least double those for inmates who

were not mentally ill. 

About 4 in 10 inmates with a mental

condition unemployed before arrest

Mentally ill offenders were less likely

than others to report they were working

in the month before arrest. About 38%

of mentally ill State and Federal prison

inmates and 47% of mentally ill jail

inmates were not employed in the

month before arrest, while 30% of other

State inmates, 28% of other Federal

inmates, and 33% of other jail inmates

were unemployed.

 

An estimated 30% of mentally ill and

13% of other inmates in State prison

received some type of financial support

from government agencies prior to their

arrest. More than 15% of the mentally

ill received welfare, 17% supplemental

security income or other pension, and

3% compensation payments, such as

unemployment or workman’s compensation.

 Mental Health and Treatment of Inmates and Probationers 5

 11 or more 10.0 5.3 9.7 2.2 13.2 7.8

 6 to 10 15.6 11.6 15.4 7.3 17.6 14.6

 3 to 5 26.3 25.5 23.6 18.9 23.5 19.7

2 13.8 17.0 12.9 14.7 10.1 11.5

1 15.5 19.4 14.0 18.2 14.7 17.9

0 18.8% 21.2% 24.3% 38.8% 21.0% 28.4%

incarceration sentences

Number of prior probation/

 Other recidivists 27.8 33.8 32.0 39.6 33.0 40.0

 Violent recidivists 53.4 44.9 43.7 21.6 46.0 31.6

 Priors 81.2 78.8 75.7 61.2 79.0 71.6

 None 18.8% 21.2% 24.3% 38.8% 21.0% 28.4%

Criminal history

inmates inmates inmates inmates inmates inmates

Mentally ill Other Mentally ill Other Mentally ill Other

 State prison Federal prison Local jail 

Table 6. Criminal history of inmates, by mental health status 

a

Detail sums to more than 100% because offenders may have reported more than one 

source of income. For prisoners detail includes any income received in the month prior 

to arrest. For jail inmates, detail includes any income received in the year prior to arrest. b

Includes Supplemental Security Income, Social Security, or other pension.

 Compensation payments 3.1 1.9 4.7 1.8 3.0 2.1

 Pension 17.3 4.1 16.5 3.7 18.4 4.9 b

 Welfare 15.4 7.8 13.7 3.9 21.9 12.3

 Illegal sources 23.4 27.0 22.5 28.8 19.4 14.4

 Family/friends 22.0 17.7 20.1 12.3 19.7 15.4

 Wages 56.7% 65.6% 54.0% 66.4% 62.9% 77.1%

Sources of incomea

 No 38.8 30.4 37.7 27.5 47.1 33.4

 Yes 61.2% 69.6% 62.3% 72.5% 52.9% 66.6%

before arrest

Employed in month

 At time of arrest 3.9 1.2 3.9 0.3 6.9 2.9

 In year before arrest 20.1% 8.8% 18.6% 3.2% 30.3% 17.3%

Homeless

inmates inmates inmates inmates inmates inmate

Mentally ill Other Mentally ill Other Mentally ill Other

 State prison Federal prison Local jail 

Table 7. Homelessness, employment, and sources of income of inmates, 

by mental health status

 Other recidivists 27.6 28.8

 Violent recidivists 29.1 17.1

 Priors 56.6 45.9

 None 43.4% 54.1%

Criminal history

Mentally ill Other

Probationers
Over half of mentally ill prison and jail

inmates reported wages as their source

of income prior to arrest, 23% of prison

inmates and 20% of jail inmates

reported income from illegal sources. 

Offenders on probation were asked

about their current employment and

sources of income in the past year.

Over half of mentally ill probationers

and three-quarters of other probationers were currently employed. An

estimated 52% of mentally ill probationers and 27% of other probationers said

they received income from government

agencies in the past year.

Family history of incarceration and

alcohol or drug use prevalent

among mentally ill

Overall, 55% of mentally ill State prison

inmates, 42% of Federal prisoners,

52% of jail inmates, and 40% of probationers reported a family member had

been incarcerated at some point (table

8). About 47% of other State prison

inmates, 39% of other Federal inmates,

45% of other jail inmates, and 34% of

other probationers reported a history 

of family incarceration. Nearly a

quarter of mentally ill State inmates

said their father or mother had served

time in prison or jail; 42% said a brother

or sister had been incarcerated.

When compared with other inmates

and probationers, the mentally ill also

reported higher rates of alcohol and

drug abuse by a parent or guardian

while they were growing up. Approximately 4 in 10 mentally ill State prisoners, jail inmates, and probationers, and

1 in 3 Federal inmates reported their

parent or guardian had abused alcohol

or drugs while they were growing up.

About 42% reported alcohol abuse by a

parent or guardian, and 13% reported

drug abuse.

At some point while growing up, a

quarter of mentally ill State prisoners

and local jail inmates lived in a foster

home, agency, or institution. One in six

mentally ill probationers reported living

in a foster home or institution for a

period of time during their childhood.

Mentally ill report high rates of past

physical and sexual abuse

Mentally ill male State prisoners were

more than twice as likely as other

males to report physical abuse prior to

admission to prison (27% versus 11%)

and nearly four times as likely to report

prior sexual abuse (15% versus 4%,

table 9). Among male inmates 25% of

the mentally ill in Federal prisons or in

jails reported prior physical abuse,

compared to 5% of other male Federal

inmates and 8% of other male jail

inmates. Mentally ill male probationers

6 Mental Health and Treatment of Inmates and Probationers

Both 10.9 5.7 8.5 2.8 11.1 6.1 9.0 2.4

Drugs only 2.0 1.8 1.2 0.8 1.7 1.2 1.0 0.4

Alcohol only 30.6% 22.2% 24.6% 16.0% 29.3% 21.9% 32.4% 19.2%

alcohol or drugs

Parent or guardian abused

agency, or institution 26.1% 12.2% 18.6% 5.8% 24.1% 11.5% 15.9% 6.5%

Ever lived in a foster home,

While growing up —

 

Brother/sister 41.8 36.5 29.5 29.9 36.2 32.8 25.7 25.6

Parent 23.4 17.4 13.4 11.1 23.7 18.9 19.6 11.1

Family member ever incarcerated 54.9% 46.5% 41.5% 38.5% 51.5% 45.1% 40.3% 34.0%

inmates inmates inmates inmates inmates inmates probationers probationers

Mentally ill Other Mentally ill Other Mentally ill Other Mentally ill Other

State prison Federal prison Local jail Probation

Table 8. Family background of inmates and probationers, by mental health status

*More than one source of income may have

been reported.

 payments 10.2 7.7

Compensation 

Pension 24.5 7.6

Welfare 26.4 15.5

Family/friends 17.9 16.3

Wages 69.3% 86.8%

Sources of income*

 No 44.1 24.1

Yes 55.9% 75.9%

Currently employed

Mentally ill Other

Probationers

 Female 58.9 33.1 45.0 19.3 63.4 29.6 42.3 19.9

 Male 15.0 4.1 11.6 1.5 17.2 3.4 14.2 2.4

 Sexually abused 19.0% 5.8% 15.6% 2.7% 23.5% 5.9% 21.9% 5.8%

 Female 67.6 40.2 50.0 29.4 59.8 30.8 46.7 29.7

 Male 27.4 10.8 24.5 4.7 25.3 8.0 21.0 5.1

 Physically abused 31.0% 12.5% 27.5% 6.4% 30.0% 10.1% 28.1% 9.8%

 Female 78.4 50.9 64.1 36.1 72.9 40.3 59.4 35.7

 Male 32.8 13.1 30.0 5.5 30.7 9.6 31.0 6.5

Ever abused before admission 36.9% 15.2% 34.1% 7.6% 36.5% 12.5% 38.8% 12.1%

Reported by offender inmates inmates inmates inmates inmates inmates probationers probationers

Mentally ill Other Mentally ill Other Mentally ill Other Mentally ill Other

 State prison Federal prison Local jail Probation

Table 9. Prior physical or sexual abuse of inmates and probationers, by mental health status 
were 4 times as likely as other probationers to report prior physical abuse

(21% and 5%, respectively).

 

The rate of physical abuse reported 

by mentally ill female inmates was over

twice that reported by males. Nearly

70% of female State prisoners, 50% 

of female Federal prisoners, 60% of

female jail inmates, and 47% of female

probationers reported a history of

physical abuse. 

Nearly 60% of female mentally ill State

prisoners, 45% of female Federal

prisoners, 63% of female jail inmates

and 42% of female probationers

reported prior sexual abuse. 

6 in 10 mentally ill State inmates

under the influence of alcohol or

drugs at time of offense

Mentally ill inmates were more likely

than others to be under the influence of

alcohol or drugs while committing their

current offense. About 60% of mentally

ill and 51% of other inmates in State

prison were under the influence of

alcohol or drugs at the time of their

current offense (table 10). Rates of

alcohol and drug use at the time of the

offense were even higher among mentally ill jail inmates, where 65% of the

mentally ill and 57% of other jail

inmates were under the influence.

Among probationers, 49% of the

mentally ill and 46% of others reported

alcohol or drug use at the time of the

offense.

Like other inmates and probationers,

the mentally ill were more often under

the influence of alcohol than drugs at

the time of the current offense. About

43% of mentally ill State prison inmates

and 44% of jail inmates had been drinking when they committed their current

offense. Thirty-six percent of other

inmates in prison and jail reported they

were drinking at the time of the offense.

A third of mentally ill offenders

alcohol dependent

Based on the CAGE diagnostic instrument, 34% of mentally ill State prison

inmates, 24% of Federal prisoners,

38% of jail inmates and 35% of

mentally ill probationers exhibited a

history alcohol dependence (table 11).

CAGE is an acronym for four questions

used by the diagnostic instrument to

assess alcohol dependence or abuse.

Respondents are asked if they have

ever attempted to (C)ut back on drinking; ever felt (A)nnoyance at others’

criticism of their drinking; ever experienced feelings of (G)uilt about drinking;

and ever needed a drink first thing in

the morning as an (E)ye opener or to

steady their nerves. A person’s likelihood of alcohol abuse is assessed by

the number of positive responses to

these four questions. Clinical tests

involving hospital admissions, found

 Mental Health and Treatment of Inmates and Probationers 7

 At time of offense 42.7% 36.0% 27.9 % 19.8% 44.3% 36.0% 41.4% 39.7%

Alcohol use

 At time of offense 36.9 31.7 29.3 21.9 38.8 30.4 18.1 12.6

 In month before offense 58.8% 56.1% 48.1 % 44.6% 57.6% 47.3% 39.5% 30.3%

Drug use

 At time of offense 58.7% 51.2% 46.5 % 33.0% 64.6% 56.5% 49.0% 46.4%

Alcohol/drug use

reported by offender inmates inmates inmates inmates inmates inmates probationers probationers

Alcohol/drug use Mentally ill Other Mentally ill Other Mentally ill Other Mentally ill Other

 State prison Federal prison Local jail Probation

Table 10. Prior alcohol and drug use of inmates and probationers, by mental health status 

--Not asked of jail inmates.

*Measured by 3 or more positive CAGE responses. For description of the CAGE diagnostic measure see text.

 of beer, or 3 bottles of wine? 48.8 39.5 43.9 29.2 52.9 38.0 45.7 33.7

 in 1 day, 20 drinks, 3 six-packs

 Had as much as a fifth of liquor

 Gotten into a physical fight ? 45.7% 37.0% 36.4% 21.7% 49.8% 34.1% 43.9% 30.3%

While drinking have you ever &

 station? 35.2 28.3 30.7 18.3 41.5 30.7 45.7 41.1

 Been arrested or held at a police 

 dropping out of school)? 24.0 13.8 15.4 7.1 -- -- 25.2 10.5

 (such as demotion at work or 

 Had job or school trouble 

 Lost a job? 16.7% 9.0% 8.7% 4.7% 18.0% 10.3% 19.4% 5.3%

Because of your drinking, have you ever &

History of alcohol dependence* 34.4% 22.4% 23.9% 15.6% 37.9% 24.3% 34.8% 22.1%

inmates inmates inmates inmates inmates inmates probationers Probationers

Mentally ill Other Mentally ill Other Mentally ill Other Mentally ill Other

State prison Federal prison Local jail Probation

Table 11. Alcohol dependence and experiences of inmates and probationers while under the influence of alcohol,

by mental health history
three or more positive CAGE

responses carried a .99 predictive

value for alcohol abuse or dependence.

(See Substance Abuse and Treatment,

State and Federal Prisoners, 1997,

BJS Special Report, NCJ 172871, for

additional information on the CAGE

instrument.)

Mentally ill inmates and probationers

were more commonly alcohol dependent, reporting three or more positive

CAGE responses. About 38% of

mentally ill jail inmates reported signs

of alcohol dependence, while 24% of

other jail inmates reported signs of

dependence. Among State prison

inmates, 34% of the mentally ill and

22% of other inmates reported three or

more positive responses.

Mentally ill offenders report negative

life experiences related to drinking

In response to questions concerning

their life experiences with alcohol,

about 17% of mentally ill and 9% of

other inmates in State prison said they

had lost a job due to drinking. Among

jail inmates with a mental condition,

18% had lost a job due to drinking,

while 10% of other jail inmates reported

losing a job. Nearly 20% of mentally ill

probationers had lost a job; 5% of other

probationers.

Amid other alcohol-related problems

reported by the mentally ill, 35% of

State prisoners had been arrested or

held at a police station due to drinking,

and 46% had gotten into a fight while

drinking. Forty-nine percent of mentally

ill State prison inmates, 44% of Federal

inmates, 53% of jail inmates, and 46%

of mentally ill probationers said they

had consumed as much as a fifth of

liquor (about 20 drinks) in 1 day. 

Mentally ill jail inmates more often

reported a prior stay in a detoxification

unit for alcohol or drugs. An estimated

22% of the mentally ill in jail and 11% 

of other inmates reported they had

been put in a detoxification unit.

Mentally ill expected to serve 15

months longer than other inmates 

in prison

Overall, mentally ill State prison

inmates were sentenced to serve an

average of 171 months in prison, or

about 12 months longer than other

offenders (table 12). On average,

violent offenders with a mental illness

were sentenced to 230 months 

(5 months longer than other violent

inmates) and property offenders 128

months (10 months longer than other

inmates). 

Mentally ill jail inmates typically had

sentences shorter than other jail

inmates. On average, mentally ill

inmates had a maximum sentence of

20 months, while other inmates an

average of 26 months. Violent, drug,

and property offenders identified as

mentally ill had average sentences that

were 6 to 12 months shorter than other

offenders.

On average, mentally ill inmates in

State prison are expected to serve

more time in prison than other inmates.

From the time of admission to prison to

the time of the survey, mentally ill

offenders had served on average 5

months longer than other offenders in

State prison. Based on the time of

admission to the time of expected

release, mentally ill offenders expected

to serve a total of 103 months in prison,

15 months longer than other offenders.

The largest differences in time served

were among violent and property

offenders. The mentally ill expected 

to serve an average of at least 12

additional months for violent and

property offenses. 

Unlike State prisoners, mentally ill

inmates in local jails expected to serve

less time than inmates who are not

mentally ill. Overall, both mentally ill jail

inmates and other inmates had served

about 61⁄2 months from the time of

admission to the time of the survey.

On average, mentally ill inmates

expected to serve a total of 9 months 

in jail prior to release; other inmates

expected to serve about 11 months. 

8 Mental Health and Treatment of Inmates and Probationers

Note: Because data on sentence length and time served are restricted to persons in prison 

and jail, they overstate the average sentence and time to be served by those entering prison 

or jail. Persons with shorter sentences leave prison and jail more quickly, resulting in a 

longer average sentence among persons in the inmate samples. a

Based on the total maximum sentence for all consecutive sentences.

b

Based on time served when interviewed plus time to be served 

until the expected date of release.

Other 120 104 32.5 47.8 60.1 80.6

Public-order 83 81 29.1 27.8 50.8 47.6

Drug 103 111 30.3 28.5 49.8 49.5

Property 128 118 38.8 36.6 75.0 62.2

Violent 230 mo 225 mo 71.8 mo 69.7 mo 142.5 mo 130.7 mo

 All offenses 171 mo 159 mo 54.4 mo 49.3 mo 103.4 mo 88.2 mo

State prison inmates

Other 10 8 8.4 1.6 10.0 5.3

Public-order 8 20 5.0 3.3 7.0 5.7

Drug 18 25 8.9 8.4 8.6 13.5

Property 26 26 5.3 8.0 7.4 11.6

Violent 30 mo 37 mo 8.8 mo 9.3 mo 14.7 mo 16.0 mo

 All offenses 20 mo 26 mo 6.5 mo 6.7 mo 8.7 mo 10.7 mo

Local jail inmates

offense inmates inmates inmates inmates inmates inmates

Most serious Mentally ill Other Mentally ill Other Mentally ill Other

until releaseb sentence length To date of interview a

Mean maximum Total time to be served

Mean time served

Table 12. Maximum sentence length and time served by inmates, 

by offense and mental health status 
Disciplinary problems common

among mentally ill inmates 

Mentally ill inmates in State or Federal

prison, as well as those in jail, were

more likely than others in those facilities to have been involved in a fight, or

hit or punched since admission.

Among State prisoners 36% of mentally

ill inmates reported involvement in a

fight, compared to 25% of other

inmates (table 13). Mentally ill inmates

in Federal prison were over twice as

likely as others to report involvement in

a fight (21% compared to 9%). 

Twenty-four percent of mentally ill State

prison inmates had been involved in

two or more fights since admission, and

12% reported involvement in four or

more fights. Among jail inmates 10% 

of the mentally ill had been involved in

two or more fights, compared 6% of

those not mentally ill.

Consistent with their more frequent

involvement in fights, disciplinary

problems were more common among

mentally ill inmates than other inmates.

More than 6 in 10 mentally ill State

prison inmates had been formally

charged with breaking prison rules

since admission. About half of other

inmates reported they had been

charged with breaking the rules.

Among Federal prison inmates 41% 

of the mentally ill had been charged

with a rule violation, compared to 33%

of inmates not identified as mentally ill.

6 in 10 mentally ill received treatment while incarcerated

An estimated 60% of the mentally ill in

State and Federal prison received

some form of mental health treatment

during their current period of incarceration (table 14). Fifty percent said they

had taken prescription medication; 44%

had received counseling or therapy;

and 24% had been admitted overnight

to a mental hospital or treatment

program.

Among jail inmates, 41% of those

identified as mentally ill had received

some form of mental health services

since admission. The majority of those

receiving treatment (34%) had been

given medication. Fewer jail inmates

(16%) than State prisoners (44%) said

they had received counseling or

therapy since admission. 

Just over half of mentally ill probationers had received treatment since their

sentence to community supervision.

Counseling was the most common 

form of treatment (44%), followed 

by medication (37%), and an overnight

stay in a mental hospital or treatment

program (12%).

When sentenced to probation, an

offender may be required by the court

or probation agency to meet various

conditions of the sentence, such as

maintaining employment, submitting to

drug testing, or participating in treatment. An estimated 13% of probationers were required to seek mental health

treatment as a condition of their

sentence. Forty-three percent of those

required to participate in treatment had

done so by the time of the survey. 

Female mentally ill more likely than

males to report treatment

Nearly 70% of mentally ill females in

State prison, 77% of those in Federal

prison, and 56% in local jails received

mental health services while incarcerated, while 60% of males in State

prison, 57% in Federal prison, and 38%

in local jails reported treatment.

White mentally ill inmates reported

higher rates of treatment than black 

or Hispanic offenders. About 64% 

of white State prison inmates identified

as mentally ill had received treatment,

compared to 56% of black offenders

and 60% of Hispanic offenders. 

 Mental Health and Treatment of Inmates and Probationers 9

prison or jail rules 62.2% 51.9% 41.2% 32.7% 24.5% 16.0%

Charged with breaking

 

 4 or more 11.5 7.1 3.8 1.4 2.6 2.3

 2 to 3 12.8 7.8 5.2 2.5 7.0 4.1

1 11.4 9.6 11.6 5.2 9.4 7.0

None 64.3% 75.6% 79.4% 90.9% 80.9% 86.7%

since admission

Number of fights 

reported by inmate inmates inmates inmates inmates inmates inmates

Discipline problem Mentally ill Other Mentally ill Other Mentally Other

 State prison Federal prison Local jail 

Table 13. Fights since admission and violation of prison or jail rules, 

by mental health status

 Received any mental health service 60.5 59.7 40.9 56.0

 Received counseling or therapy 44.1 45.6 16.2 44.1

 Taken a prescribed medication 50.1 49.1 34.1 36.5

 mental hospital or treatment program 23.6% 24.0% 9.3% 12.2%

 Been admitted overnight to a 

Since admission, the offender had &

prison prison jail Probation

State Federal Local

Percent of mentally ill offenders 

Table 14. Mental health treatment in prison or jail or on probation 

for those identified as mentally ill

Hispanic 59.9 62.5 40.6

Black 56.4 50.0 34.2

White 64.1% 65.4% 44.7%

Race/

Hispanic origin

Female 67.3 76.5 56.2

Male 59.9% 57.4% 38.4%

Gender

prison prison jail

State Federal Local

Percent of mentally ill receiving mental health services
Overall, 17% of inmates in State prison,

10% in Federal prison, 11% in local

jails, and 12% of those on probation

had received some form of mental

health services since their current

admission to prison or jail or sentence

to probation. The most common form

of treatment in local jails was medication, reported by 9% of inmates.

Probationers were more likely to have

received counseling (10%) than to have

taken medication (6%) while under

supervision. Among State prison

inmates 12% said they received

medication while incarcerated, and

12% participated in counseling or

therapy.

Methodology

Data in this report are based on

personal interviews conducted through 

three BJS surveys, the 1997 Survey of

Inmates in State and Federal Correctional Facilities, the 1996 Survey of

Inmates in Local Jails, and the 1995

Survey of Adults on Probation.

Detailed descriptions of the methodology and sample design of each survey

can be found in the following: 

Substance Abuse and Treatment of

Adults on Probation, 1995 (NCJ

166611); Profile of Jail Inmates, 1996

(NCJ 164629); and Substance Abuse

and Treatment of State and Federal

Prisoners, 1997 (NCJ 172871).

Accuracy of the estimates

The accuracy of the estimates

presented in this report depends on two

types of error: sampling and nonsampling. Sampling error is the variation

that may occur by chance because a

sample rather than a complete numeration of the population was conducted.

Nonsampling error can be attributed to

many sources, such as nonreponses,

differences in the interpretation of

questions among inmates, recall difficulties, and processing errors. In any

survey the full extent of the nonsampling error is never known. The

sampling error, as measured by an

estimated standard error, varies by the

size of the estimate and the size of the

base population. Estimates of the

standard errors for selected characteristics have been calculated for each

survey (see appendix tables). These

standard errors may be used to

construct confidence intervals around

percentages. For example, the 95%

confidence interval around the percentage of State prison inmates who were

identified as mentally ill is approximately 16.2% plus or minus 1.96 times

0.40% (or 15.4% to 16.9%). 

These standard errors may also be

used to test the statistical significance

of the difference between two sample

10 Mental Health and Treatment of Inmates and Probationers

Probationers 11.5

Local jail inmates 11.4

Federal prison inmates 10.0

State prison inmates 17.4%

treatment

who received mental

Percent of all offenders

a hospital overnight 0.34 0.45 0.47 0.67

Been admitted to

problem, inmate had —

Because of a mental or emotional

or emotional condition 0.33 0.45 0.54 0.84

Reported a mental 

Identified as mentally ill 0.40% 0.55% 0.61% 0.89%

inmates inmates inmates Probationers

State prison Federal prison Jail

Estimated standard errors

Appendix table 1. Standard errors of mental health status

for inmates and probationers

0.52 0.13 1.50 0.12 1.69 0.63 -- -- At time of arrest

1.09 0.34 3.01 0.38 0.91 0.26 -- -- In year before arrest

Homeless

or punched after admission 1.31 0.52 3.16 0.63 1.48 0.60 -- --

Involved in fight or was hit -- --

 Females 1.93 1.30 5.63 4.03 2.38 1.46 5.92 3.03

 Males 1.37 0.43 3.92 0.52 2.14 0.52 3.24 0.72

Ever abused

History of alcohol dependence 1.29 0.50 3.32 0.79 1.72 0.74 2.89 1.10

 at time of offense 1.35 0.60 3.88 1.04 2.17 1.14 3.04 1.33

Alcohol/drug use

 Any priors 1.06 0.49 3.33 1.07 1.47 0.89 3.03 1.35

Criminal history

 Public-order 0.81 0.36 2.92 0.78 1.55 0.83 2.62 1.24

 Drug 0.91 0.50 3.81 1.05 1.23 0.72 2.23 1.08

 Property 1.17 0.49 2.19 0.55 1.64 0.76 2.79 1.20

 Violent 1.36% 0.60% 3.65% 0.75% 1.71% 0.84% 2.74% 1.03%

Current offense

characteristic inmates inmates inmates inmates inmates inmates probationers probationers

Selected Mentally ill Other Mentally ill Other Mentally ill Other Mentally ill Other

State prison Federal prison Local jail Probation

Estimated standard errors 

Appendix table 2. Standard errors of selected characteristics of mentally ill inmates and probationers
statistics by pooling the standard errors

of the two sample estimates. For

example, the standard error of the

difference between mentally ill State

prisoners and other inmates who were

incarcerated for a violent offense would

be 1.49% (or the square root of the

sum of the squared standard errors for

each group). The difference would be

1.96 times 1.49 (or 2.91%). Since the

difference of 6.8% (52.9% minus

46.1%) is greater than 2.91%, the

difference would be considered statistically significant.

Estimating the number of mentally 

ill offenders under correctional 

supervision

Estimates of the total number of

persons in prison, jail and on probation

with a mental illness were obtained by

multiplying the ratio of inmates or

probationers identified as mentally ill

from the personal interviews conducted

in the three BJS surveys referenced

above, by the total number of inmates

in State prison, Federal prison, and

local jails and the total number of

offenders on probation.

For example, the total number of State

prison inmates with a mental illness

was estimated by multiplying the ratio

of mentally ill offenders in State prison

(16.2%) obtained from the 1997 Survey

of Inmates in State Correctional Facilities, by the total State prison custody

population at midyear 1998 (1,102,653)

from the National Prisoner Statistics

data collection.

 Mental Health and Treatment of Inmates and Probationers 11

 Received any mental health service 1.33 3.84 2.16 3.03

 Received counseling or therapy 1.35 3.88 1.26 3.03

 Taken a prescribed medication 1.36 3.91 2.22 2.90

 mental hospital or treatment program 1.15% 3.32% 1.01% 2.00%

 Been admitted overnight to a 

Since admission, the offender had &

prison prison jail Probation

State Federal Local

Percent of mentally ill offenders 

Appendix table 3. Standard errors of mental health treatment in prison, 

jail or on probation for those identified as mentally ill

References

Guy, Edward; Jerome Platt; Israel Zwerling; and Samuel Bullock. 

“Mental health status of prisoners in an urban jail.” Criminal Justice and

Behavior. 12(1), 29-53, March 1985.

Monahan, John. “Clinical and Actuarial Predictions of Violence” in Faigman, D

and others, eds. Modern Scientific Evidence: The Law and Science of Expert

Testimony, vol. 1. St. Paul, MN: West Publishing Company, 1997.

Mumola, Christopher. Substance Abuse and Treatment, State and Federal

Prisoners, 1997. BJS Special Report, NCJ 172871, December 1998.

Powell, Thomas A.; John C. Holt; and Karen M. Fondacaro. “The Prevalence

of Mental Illness among Inmates in a Rural State.” Law and Human Behavior.

21(4), 427-438, August 1997.

Robins, Lee N., and Darrel A. Regier. Psychiatric Disorders in America: The

Epidemiologic Catchment Area Study. New York: Free Press, 1991.

Steadman, Henry; Stanley Fabisiak, Joel Dvoskin, and Edward Holohean. 

“A Survey of Mental Disability among State Prison Inmates.” Hospital and

Community Psychiatry. 38(10), 1086-1090, 1989.

Teplin, Linda A. “The Prevalence of Severe Mental Disorder among Male

Urban Jail Detainees: Comparison with the Epidemiologic Catchment Area

Program.” American Journal of Public Health. 80(6), 663-669, 1990.
12 Mental Health and Treatment of Inmates and Probationers

The Bureau of Justice Statistics 

is the statistical agency of the 

U.S. Department of Justice. 

Jan M. Chaiken, Ph.D., is director.

BJS Special Reports address a

specific topic in depth from one 

or more data sets that cover many

topics. 

Paula M. Ditton wrote this report

under the supervision of Allen J.

Beck. Christopher Mumola provided

statistical assistance. Tina Dorsey

and Tom Hester produced and edited

the report. Marilyn Marbrook,

assisted by Yvonne Boston,

prepared the report for publication.

July 1999, NCJ 174463

This report and others from the

Bureau of Justice Statistics are available through the Internet &

http://www.ojp.usdoj.gov/bjs/

The data from the 1997 Surveys of

Inmates in State and Federal Correction Facilities, the 1995 Survey of

Adults on Probation, and the 1996

Survey of Inmates in Local Jails are

available from the National Archive of

Criminal Justice Data, maintained by

the Institute for Social Research at

the University of Michigan, 1-800-

999-0960. The archive may also be

accessed through the BJS Internet

site.