DOJ Report -Indicators of Mental Health Problems

• June 1, 2017 • Locations: United States of America • Topics: Conditions of Confinement, Mental Health

Download original document:
Brief thumbnail

Document text

This text is machine-read, and may contain errors. Check the original document to verify accuracy.

U.S. Department of Justice
Office of Justice Programs
Bureau of Justice Statistics

JUNE 2017

Special Report

NCJ 250612

Indicators of Mental Health Problems
Reported by Prisoners and Jail
Inmates, 2011-12
Jennifer Bronson, Ph.D., BJS Statistician
Marcus Berzofsky, Dr. P.H., RTI International

bout 1 in 7 state and federal prisoners (14%) and 1 in
4 jail inmates (26%) reported experiences that met
the threshold for serious psychological distress (SPD)
in the 30 days prior to a survey that was conducted between
February 2011 and May 2012 (figure 1). Similarly, 37% of
prisoners and 44% of jail inmates had been told in the past
by a mental health professional that they had a mental
disorder. Half of prisoners (50%) and a third of jail inmates
(36%) either did not meet the threshold for SPD or had not
been told they had a mental health disorder.
This report presents two prevalence estimates of mental
health problems among state and federal prisoners and local
jail inmates: met the threshold for SPD and told by a mental
health professional as having a mental disorder. The Kessler
6 (K6) nonspecific psychological distress scale was used to
assess SPD among prisoners and jail inmates in the 30 days
prior to the survey. The estimates are from self-reported
data and should not be interpreted as representing a clinical
diagnosis of a mental disorder. (See Measurement of mental
health indicators text box.) In this report, SPD in the past
30 days prior to the interview is defined as a current mental
health problem. In this report having ever been told by a
mental health professional as having a mental disorder is
defined as having a history of a mental health problem.

Figure 1
Mental health status of prisoners and jail inmates, by type
of mental health indicator, 2011–2012
Percent
70

Jail inmates
Prisoners*

60
50
40
30

Jail inmates**

Prisoners*

10
0

Serious psychological
distressa

History of a mental
health problemb

No indication of a mental
health problemc

Note: See appendix table 3 for percentages, standard errors, and significance tests.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes inmates with a score of 13 or more on the K6 scale. See Methodology.
bIncludes inmates who reported they had ever been told by a mental health
professional they had a mental disorder.
cIncludes inmates with a score of 7 or less on the K6 and who had never been
told by a mental health professional they had a mental disorder.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

HIGHLIGHTS

More jail inmates (26%) than prisoners (14%) met the
threshold for serious psychological distress (SPD) in the past
30 days.

Fourteen percent of prisoners and 10% of jail inmates who
met the threshold for SPD in the past 30 days were written up
or charged with assault.

Among those who had been told they had a mental
disorder, the largest percentage of prisoners (24%) and
jail inmates (31%) reported they had a major depressive
disorder.

A larger percentage of females in prison (20%) or jail (32%)
than males in prison (14%) or jail (26%) met the threshold
for SPD in the past 30 days.

More prisoners (14%) and jail inmates (26%) met the
threshold for SPD in the past 30 days than the standardized
general population (5%).

More white prisoners and jail inmates met the threshold for
SPD in the past 30 days than black or Hispanic prisoners and
jail inmates.

Prescription medication was the most common treatment
type for prisoners and jail inmates who met the threshold
for SPD in the past 30 days.

Prisoners incarcerated for a violent crime (17%) were as
likely as those incarcerated for a property crime (16%) to
have met the threshold for SPD in the past 30 days.

This report examines the prevalence of the two mental
health indicators by different time periods, demographics,
criminal justice history, and current offenses. The percentage
of inmates who had a mental health indicator and who
received mental health treatment while incarcerated are
also presented. Estimates are based on the Bureau of Justice
Statistics’ (BJS) 2011-12 National Inmate Survey (NIS-3).
NIS-3 data were self-reported, and analyses include state and
federal prisoners and local jail inmates.

To facilitate comparisons to the general population,
data from the National Survey on Drug Use and Health
(NSDUH) were standardized to match the prison
population and the jail population by age, sex, race, and
Hispanic origin (see Methodology). In addition, the
general population was divided into three groups based
on self-reported involvement with the criminal justice
system in the year prior to the interview: no involvement,
under supervision (probation or parole), or arrested.

Measurement of mental health indicators
The 2011-12 National Inmate Survey (NIS-3) assessed the
prevalence of serious psychological distress (SPD) in the
30 days prior to the interview and the percentage who had
ever been told they had a mental disorder by a mental health
professional. These two measures are used as indicators
that an inmate likely has a current mental health problem
or a history of a mental health problem. The estimates are
from self-reported data and should not be interpreted
as representing a clinical diagnosis of a mental disorder.
Findings also should not be used to infer causation between
an indicator of a mental health problem and incarceration,
because the temporal relationship is unknown.
SPD – The Kessler 6 (K6) nonspecific psychological distress
scale was used to assess those who met the threshold
for SPD in the 30 days prior to the interview. The K6 is a
six-question tool developed to screen for serious mental
illness among adults age 18 or older in the general U.S.
population, with a score of 13 or higher indicating SPD.1
Inmates were asked how often during the 30 days prior to
the interview they felt—

nervous

hopeless

restless or fidgety

so depressed that nothing could cheer them up

everything was an effort

worthless.

The response options were (1) all of the time, (2) most of
the time, (3) some of the time, (4) a little of the time, and
(5) none of the time. The responses were recoded from
1Kessler,

R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C.,
Hiripi, E., Howes, M., Zaslavsky, A. M., et al. (2003). Screening for
serious mental illness in the general population. Archives of General
Psychiatry, 60(2), 184–189. Kessler, R. C., Green, J. G., Gruber, M. J.,
Sampson, N. A., Bromet, E., Cuitan, M., Zaslavsky, A. M., et al. (2010).
Screening for serious mental illness in the general population with the
K6 screening scale: results from the WHO World Mental Health survey
initiative. International Journal of Methods in Psychiatric Research,
19(Supp. 1), 4-22.

4 to 0, with 4 assigned to “all of the time” and 0 assigned
to “none of the time.” A summary scale with a range of
0 to 24 was then produced by combining the responses
from all six items. Inmates with a score of 13 or higher
were considered to have SPD, inmates with a score of
8 to 12 were considered to have an anxiety disorder (not
reported), and inmates with a score of 7 or fewer were
considered to not have an indicator of a current mental
health problem (see Methodology).
History of a mental health problem – This measure
is based on the question, “Have you ever been told by
a mental health professional, such as a psychiatrist or
psychologist, that you had (1) manic depression,
bipolar disorder, or mania; (2) a depressive disorder;
(3) schizophrenia or another psychotic disorder;
(4) post-traumatic stress disorder; (5) another anxiety
disorder, such as panic disorder or obsessive compulsive
disorder; (6) a personality disorder, such as antisocial
or borderline personality; or (7) a mental or emotional
condition other than those listed above?” Inmates who
answered positively to this question were considered to
have a history of a mental health problem.
The time period in which an inmate was told they had
a mental disorder is unknown (e.g., told last week or
last year). This measure is also affected by a person’s
access to professional mental health care. These two
indicators are not mutually exclusive. An inmate could
have met the threshold for SPD and a history of a mental
health disorder. Relatedly, an inmate may have met
the threshold for SPD, but not have ever been told by
a mental health professional that they had a mental
disorder. Or, they could have been told they had a
mental disorder but did not meet the threshold for SPD.
Trends are not presented because prior inmate surveys
did not include the K6 scale. In addition, prior BJS inmate
surveys were collected with different modes (e.g., audio
computer assisted self-interview versus computer-assisted
personal interviewing). This could introduce bias when
comparing prevalence estimates of mental health indicators
across survey years.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

Prisoners and jail inmates were more likely to have
ever been told they had a major depressive disorder
than other mental disorders

Prisoners and jail inmates were three to five times as
likely to have met the threshold for SPD as adults in
the general U.S. population

Prisoners and jail inmates who had been told in the past
by a mental health professional that they had a mental
disorder were asked to specify the disorder. Nearly a
quarter (24%) of the prisoners who had ever been told
they had a mental disorder said they were told they had
major depressive disorder, a larger percentage than any
other mental disorder (table 1). The second most common
disorder reported by prisoners was bipolar disorder (18%).
An estimated 13% of prisoners reported they were told they
had post-traumatic stress disorder (PTSD) or a personality
disorder, such as antisocial or borderline personality
disorder. Less than 1 in 10 (9%) prisoners said they were
told they had schizophrenia or another psychotic disorder.

The percentage of prisoners who met the threshold for
SPD (14%) was more than three times that of adults in the
standardized total U.S. general population (5%) or those in
the standardized general U.S. population with no criminal
involvement in the past year (4%) (figure 2). However, the
percentage of prisoners who met the threshold for SPD
was almost the same as those in the standardized general
population who had been arrested (13%) in the year prior
to the interview.

Of those jail inmates with a history of a mental health
problem, 31% had been told they had major depressive
disorder, compared to being told they had bipolar disorder
(25%), an anxiety disorder (18%), or PTSD (16%). With the
exception of personality disorder, jail inmates were more
likely than prisoners to have been told they had each type of
mental disorder.
TABLE 1
Prevalence of mental health indicators among prisoners and
jail inmates, by type of indicator, 2011–2012
Mental health indicator
No indication of a mental health problema
Current indicator of a mental health
problemb
Serious psychological distressc
History of a mental health problem
Ever told by mental health professional
they had mental disorder
Major depressive disorder
Bipolar disorder
Schizophrenia/other psychotic
disorder
Post-traumatic stress disorder
Anxiety disorderd
Personality disordere

Prisoners*
49.9%

FIGURE 2
Prisoners and adult general population who met the
threshold for serious psychological distress, 2009–2012
Prisoners*
a
Adult general population**
—
Total

With no criminal involvement**b
Under supervision**c
Arrested**d

Jail inmates
36.0%**

14.5%

26.4%**

36.9%
24.2
17.5

44.3%**
30.6**
24.9**

8.7
12.5
11.7
13.0

11.7**
15.9**
18.4**
13.5

Note: See appendix table 4 for standard errors.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes persons with a score of 7 or less on the K6 scale and who had never
been told by a mental health professional they had a mental disorder.
bCurrent at time of the interview.
cIncludes persons with a score of 13 or more on the K6 scale. See Methodology.
dIncludes panic disorder and obsessive compulsive disorder, and excludes
post-traumatic stress disorder.
eIncludes antisocial and borderline personality disorder.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

Percent
Note: Includes persons with a score of 13 or more on the K6 scale. See Methodology.
See appendix table 5 for percentages, standard errors, and significance tests.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aGeneral population estimates were standardized to the prison population based
on sex, race, Hispanic origin, and age.
bIncludes respondents from the 2009–2012 NSDUH who indicated they had not
been arrested or on probation or parole in the past 12 months.
cIncludes respondents from the 2009–2012 NSDUH who indicated they had
been on probation or parole in the past 12 months.
dIncludes respondents from the 2009–2012 NSDUH who indicated they had been
arrested in the past 12 months.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012; and
Substance Abuse and Mental Health Services Administration, National
Survey on Drug Use and Health (NSDUH), 2009–2012.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

The percentage of jail inmates who met the threshold
for SPD (26%) was five times higher than the percentage
of adults who met the threshold for SPD in the total
standardized general U.S. population (5%) or those in
the standardized general population with no criminal
involvement in the past year (4%) (figure 3). The percentage
of jail inmates who met the threshold for SPD was almost
double the percentage of adults in the standardized general
population who had SPD who were on probation or parole
(11%) or who had been arrested in the past year (14%).
Female prisoners and jail inmates were more likely to
have met the threshold for SPD than males
A larger percentage of female prisoners than male
prisoners met the threshold for SPD or had been told by a
mental health professional that they had a mental health
disorder (table 2). Among prisoners, 20% of females and
14% of males met the threshold for SPD. More females
(66%) than males (35%) in prison also had a history of a
mental health problem. Like prisoners, a larger percentage
of female jail inmates (32%) met the threshold for SPD
FIGURE 3
Jail inmates and adult general population who met the
threshold for serious psychological distress, 2009–2012

than male jail inmates (26%). Females in jail (68%) were
also more likely to have been told they had a mental
disorder than males in jail (41%).
Seventeen percent of white prisoners met the threshold for
SPD, which was larger than the percentage of black (12%)
and Hispanic (12%) prisoners with SPD. Inmates of other
races (20%) were more likely than white prisoners to have
met the threshold for SPD. White prisoners (50%) were
also more likely than black prisoners (30%) to have ever
been told they had a mental disorder. An estimated 48%
of prisoners of other races had ever been told they had a
mental disorder, which did not statistically differ from their
white counterparts.
The pattern of SPD among jail inmates by race and Hispanic
origin was also similar to that of prisoners. An estimated
31% of white jail inmates met the threshold for SPD, which
was larger than the 22% of black jail inmates and 23% of
Hispanic jail inmates. White (57%) jail inmates were also
more likely than black (36%) or Hispanic (31%) jail inmates
to have ever been told they had a mental disorder.
TABLE 2
Prevalence of mental health indicators among prisoners and
jail inmates, by demographic characteristics, 2011–2012
Serious psychological
distressa
Prisoners Jail inmates
14.5%
26.4%

Jail inmates*
a
Adult general population**Total
—

With no criminal involvement**b
Under supervision**c
Arrested**d
0

15
Percent

Note: Includes persons with a score of 13 or more on the K6 scale. See
Methodology. See appendix table 6 for percentages, standard errors, and
significance tests.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aGeneral population estimates were standardized to the jail population based
sex, race, Hispanic origin, and age.
bIncludes respondents from the 2009–2012 NSDUH who indicated they had not
been arrested or on probation or parole in the past 12 months.
cIncludes respondents from the 2009–2012 NSDUH who indicated they had been
on probation or parole in the past 12 months.
dIncludes respondents from the 2009–2012 NSDUH who indicated they had
been arrested in the past 12 months.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012; and
Substance Abuse and Mental Health Services Administration, National Survey
on Drug Use and Health (NSDUH), 2009–2012.

Characteristic
All inmates
Sex
Male*
14.0%
Female
20.5**
Race/Hispanic originc
White*
17.3%
Black
12.5**
Hispanic
11.5**
Otherd
19.7**
Age
18–24*
14.9%
25–34
14.8
35–44
14.1
45–54
15.1
55–64
13.1
65 or older
9.5**

History of a mental
health problemb
Prisoners Jail inmates
36.9%
44.3%

25.5%
32.3**

34.8%
65.8**

40.8%
67.9**

31.0%
22.3**
23.2**
31.5

50.5%
30.0**
25.6**
47.9

56.8%
36.2**
31.3**
55.8

26.3%
25.9
26.1
28.8**
25.2
20.2

36.3%
37.3
36.4
37.9
37.3
30.8**

42.3%
43.6
44.4**
47.7**
50.4**
39.9

Note: See appendix table 7 for standard errors.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes inmates with a score of 13 or more on the K6 scale. See Methodology.
bIncludes inmates who reported they had ever been told by a mental health
professional they had a mental disorder.
cExcludes persons of Hispanic or Latino origin, unless specified.
dIncludes American Indian or Alaska Natives; Asian, Native Hawaiian, or Other
Pacific Islanders; and persons of two or more races.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012; and
Substance Abuse and Mental Health Services Administration, National Survey on
Drug Use and Health, 2009-2012.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

Prisoners age 65 or older were less likely to have a
mental health indicator, compared to other age groups
There was little variation in the prevalence estimates
of mental health indicators among prisoners by age
group. One in six (15%) prisoners ages 18 to 64 reported
experiences that met the threshold for SPD (not shown).
Prisoners age 65 or older (10%) were less likely than
prisoners ages 18 to 24 (15%) to have met the threshold
for SPD. Similarly, the percentage of prisoners who had
ever been told they had a mental disorder also varied little
across age groups. An estimated 37% of prisoners in each
age category, from ages 18 to 64, reported ever being
told they had a mental disorder. A smaller percentage of
prisoners age 65 or older (31%) than prisoners ages 18 to
24 (36%) had ever been told they had a mental disorder.
Prevalence estimates of SPD among jail inmates varied
somewhat by age. An estimated 26% of jail inmates
ages 18 to 44 and ages 55 to 64 reported experiences that
met the threshold for SPD. Jail inmates ages 45 to 54 (29%)
were more likely to have met the threshold for SPD than
those ages 18 to 24 (26%). Approximately 42% of jail
inmates ages 18 to 24 met the threshold for SPD, compared
to those ages 35 to 44 (44%), ages 45 to 54 (48%), and
ages 55 to 64 (50%).
Prisoners who were married were less likely to have met
the threshold for SPD than prisoners with other marital
statuses
Married prisoners (12%) were less likely to have met the
threshold for SPD than prisoners who were widowed (18%),
divorced (15%), separated (16%), or never married (15%)
(table 3). Married prisoners (31%) were also less likely
to have ever been told they had a mental disorder than
prisoners with other marital statuses.

An estimated 28% of married jail inmates met the threshold
for SPD, which was similar to the percentage of widowed
(31%), divorced (28%), or separated (29%) jail inmates who
met the threshold for SPD. However, the percentage of never
married jail inmates who met the threshold for SPD (25%)
was less than the percentage of married jail inmates who had
SPD (28%).
Married jail inmates were the least likely to have ever been
told they had a mental disorder (40%) when compared
to inmates with other marital statuses. Approximately
58% of jail inmates who were widowed, 51% who were
divorced, 50% who were separated, and 43% who were never
married had ever been told they had a mental disorder.
Prisoners and jail inmates with a college degree were
more likely than high school graduates to have a history
of a mental health problem
An estimated 16% of prisoners with less than a high school
education met the threshold for SPD. This was larger than
the percentage who met the threshold for SPD and who were
high school graduates (12%) or who had a college degree or
more (13%). An estimated 38% of prisoners with less than
a high school degree had ever been told they had a mental
disorder, compared to 32% of those with a high school
degree. However, prisoners with at least a college degree
(41%) were more likely than those without a high school
degree or equivalent (38%) to have been told they had a
mental disorder.
Among jail inmates, 27% of those with less than a high
school education met the threshold for SPD. This did not
statistically differ from the percentage of jail inmates with
some college education (26%). An estimated 45% of jail
inmates with less than a high school degree had ever been
told they had a mental disorder, compared to 39% with a
high school degree or equivalent, 47% with some college,
and 50% of those with a college degree or more.

TABLE 3
Indicators of a mental health problem among prisoners and jail inmates, by marital status and education, 2011–2012
Characteristic
All inmates
Marital status
Married*
Widowed
Divorced
Separatedc
Never married
Education
Less than high school*
High school graduate
Some college
College degree or more

Serious psychological distressa
Prisoners
Jail inmates
14.5%
26.4%

History of a mental health problemb
Prisoners
Jail inmates
36.9%
44.3%

12.2%
18.4**
15.4**
15.8**
14.6**

28.3%
31.3
27.9
28.7
25.0**

30.8%
45.0**
42.9**
38.1**
36.6**

39.8%
58.2**
51.2**
49.6**
43.0**

15.6%
12.1**
13.9
13.4**

27.1%
24.4**
26.4
28.2**

37.5%
32.1**
39.3
40.7**

45.2%
38.8**
47.2**
49.8**

Note: See appendix table 8 for standard errors.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes inmates with a score of 13 or more on the K6 scale. See Methodology.
bIncludes inmates who reported they had ever been told by a mental health professional they had a mental disorder.
cFor reasons other than incarceration.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

The percentage of prisoners incarcerated for a violent
offense who met the threshold for SPD was similar to
those incarcerated for a property offense who met the
threshold for SPD
Prisoners incarcerated for a violent offense (17%) or a
property crime (16%) were equally likely to have met the
threshold for SPD (table 4). Likewise, the percentage of
prisoners incarcerated for a violent offense who had a
history of a mental health disorder (42%) was similar to
the percentage of prisoners incarcerated for a property
offense (41%) who had a mental health disorder. Prisoners
incarcerated for a violent crime were more likely to have
met the threshold for SPD than those incarcerated for a drug
crime (10%), DWI/DUI (14%), or other public order offense
(13%). Among prisoners with a history of a mental health
problem, those incarcerated for a drug offense (27%), a
DWI/DUI (32%), or other public order offense (36%) were
less likely to have ever been told they had a mental disorder
than prisoners incarcerated for a violent offense (42%).
TABLE 4
Indicators of a mental health problem among prisoners and
jail inmates, by current offense, sentence status and length,
and time served, 2011–2012

Serious psychological
distressa
Offense and time
served
Prisoners Jail inmates
Most serious offense
Violent*
16.6%
29.2%
Property
15.6
27.1**
Drug
10.2**
24.6**
DWI/DUI
14.0**
23.5**
13.2**
25.9**
Other public orderc
Sentence status
Unsentenced*
:
23.3%
Sentenced
:
29.3**
Sentence lengthd
Less than 1 year*
14.9%
22.5%
1–4 years
13.0
22.4
5 years or more
14.5
25.3**
Life sentence
17.4
:
Time served since
admission to
current facility
Less than
1 month*
16.6%
29.3%
1–5 months
14.8
25.8**
6–11 months
15.2
23.3**
1–4 years
13.7**
23.6**
5 years or more
14.1
:

History of a mental
health problemb
Prisoners Jail inmates
41.7%
41.4
26.8**
32.4**
35.6**

47.9%
49.8
39.8**
37.9**
45.4**

:
:

43.7%
45.1

35.7%
35.9
37.3
38.9

42.9%
45.6**
44.7
:

38.4%
37.0
38.9
35.5
37.7

43.9%
45.2
43.6
41.1
:

Note: See appendix table 9 for standard errors.
: Not calculated.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes inmates with a score of 13 or more K6 scale. See Methodology.
bIncludes inmates who reported they had ever been told by a mental health
professional they had a mental disorder.
cExcludes DWI/DUI.
dExcluded unsentenced inmates.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

An estimated 29% of jail inmates incarcerated for a violent
offense met the threshold for SPD. This was larger than the
percentage of jail inmates incarcerated for a property offense
(27%), a drug offense (25%), a DWI/DUI (24%), or other
public order offense (26%). The percentage of jail inmates
incarcerated for a violent crime who had ever been told they
had a mental disorder (48%) did not statistically differ from
the percentage of jail inmates incarcerated for a property
offense (50%). However, this was higher than the percentage
incarcerated for a drug (40%), DWI/DUI (38%), or other
public order (45%) offense.
The percentage of prisoners who met the threshold for
SPD did not differ by sentence length
Among sentenced prisoners, those sentenced to 1 to 4
years (13%), 5 years or more (14%), or a life sentence
(17%) were as likely to have met the threshold for SPD
as prisoners sentenced to less than 1 year (15%). There
was no statistical difference across sentence length in the
percentage of prisoners who reported they had ever been
told they had a mental disorder (about 36% across sentence
length categories).
Unsentenced jail inmates (23%) were less likely than
sentenced jail inmates (29%) to have met the threshold
for SPD. There was no statistical difference between the
percentage of unsentenced (44%) and sentenced (45%) jail
inmates who had ever been told they had a mental disorder.
Compared to jail inmates with a sentence of less than 1 year
(22%), those with a sentence of 5 years or more (25%) were
more likely to have met the threshold for SPD.
The percentage of inmates who had ever been told
they had a mental disorder did not differ by time served
since admission
Among prisoners, 17% who had served less than 1 month
since admission in the current facility met the threshold
for SPD. This percentage was not statistically different than
the percentage who had served 1 to 5 months (15%), 6 to 11
months (15%), or 5 years or more (14%). However, prisoners
who had served 1 to 4 years (14%) were less likely to have
met the threshold for SPD, compared to those with less than
1 month time served (17%). There was no difference by time
served and the percentage of prisoners who had ever been
told they had a mental disorder, averaging 37% across time
served groups.
Jail inmates who had served less than 1 month were more
likely to have met the threshold for SPD (29%) than inmates
who had been in the current facility for 1 to 5 months (26%),
6 to 11 months (23%), or 1 to 4 years (24%) since admission.
As was the case with prisoners, there was no difference
by time served and the percentage of jail inmates who
reported that they had been told they had a mental disorder
(about 43%).

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

A larger percentage of prisoners and jail inmates with
more than one arrest than those with one arrest had
been told they had a mental disorder
Prisoners with more than one arrest were more likely to
have a mental health indicator than prisoners with one
arrest (table 5). Twelve percent of prisoners with one arrest
met the threshold for SPD, compared to 14% of those
with 2 to 3 arrests, 15% with 4 to 10 arrests, and 18% with
11 or more arrests. Prisoners with one arrest (27%) were
less likely to have ever been told they had a mental disorder
than all other prisoners. For example, among prisoners who
reported 11 or more arrests in their lifetime, 49% had been
told at some point that they had a mental disorder.
TABLE 5
Indicators of a mental health problem among prisoners and
jail inmates, by criminal history, 2011–2012

Serious psychological
History of a mental
distressa
health problemb
c
Prisoners Jail inmates Prisoners Jail inmatesc

Criminal history
Number of times
arrested (lifetime)
1 time*
12.1%
2–3 times
13.5**
4–10 times
14.6**
11 times or more
18.1**
Total time in a correctional
facility prior to current facilityd
None*
13.4%
1–5 months
14.3
6–11 months
13.7
1–4 years
13.4
5 years or more
16.5**

23.4%
23.8
23.2
25.3

27.0%
32.0**
39.6**
48.9**

30.8%
36.7**
46.7**
55.9**

24.6%
24.1
23.9
22.5**
24.9

28.7%
35.4**
37.0**
37.8**
42.6**

35.1%
41.0**
45.4**
46.9**
54.0**

Note: See appendix table 10 for standard errors.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes inmates with a score of 13 or more on the K6 scale. See Methodology.
bIncludes inmates who reported they had ever been told by a mental health
professional they had a mental disorder.
cIncludes jail inmates who served 3 months or more since admission to
current facility.
dTotal time incarcerated as an adult or juvenile in a prison, jail, or other
correctional facility prior to admission to the current facility.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

Unlike prisoners, the percentage of jail inmates who met the
threshold for SPD did not increase with number of arrests.
About 24% of jail inmates in each arrest category met the
threshold for SPD. Like prisoners, jail inmates with multiple
arrests were more likely to have been told they had a mental
disorder. More than half (56%) of jail inmates who had
been arrested 11 times or more had been told they had a
mental disorder, compared to a third (31%) of jail inmates
with one arrest.
Prisoners who spent 5 years or more previously
incarcerated were more likely to have met the threshold
for SPD than those with no prior time served
Total time incarcerated in a correctional facility includes
the time spent as an adult or juvenile in a prison, jail, or
other correctional facility prior to admission to the current
facility. Among prisoners who met the threshold for SPD,
there was no statistical difference between those with no
prior incarceration time (13%) and those who spent up to
5 years incarcerated (an average of 14%). However, prisoners
who spent 5 years or more total time in a prior correctional
facility (17%) were more likely than those with no prior
incarceration time (13%) to have met the threshold for SPD.
Prisoners with no prior incarceration time were the least
likely to have been told they had a mental disorder (29%). An
estimated 37% of prisoners who were previously incarcerated
for 6 to 11 months, 38% of those incarcerated for 1 to 4 years,
and 43% of those incarcerated for 5 years or more had been
told they had a mental disorder.
Twenty-five percent of jail inmates with no prior incarceration
time met the threshold for SPD, which was more than the
22% of jail inmates incarcerated for 1 to 4 years. Jail inmates
with no prior incarceration (35%) were less likely than
inmates with any prior incarceration (41% to 54%) to have
been told they had a mental disorder. More than half (54%)
of jail inmates incarcerated for 5 years or more had been told
they had a mental disorder.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

Almost three-quarters of inmates who met the
threshold for SPD had received mental health treatment
in their lifetime
Approximately 3 in 4 prisoners (74%) and jail inmates
(73%) who met the threshold for SPD said they had
received mental health treatment in their lifetime
(table 6). About 42% of prisoners and 43% of jail inmates
who met the threshold for SPD said they had stayed overnight
in a hospital, and about 62% said they had taken prescription
medication during their lifetime for a mental health problem.
Of prisoners who had been told they had a mental disorder,
88% said they had received mental health treatment in
their lifetime, including 45% had stayed overnight in
a hospital, 76% had received prescription medicine,
and 75% had received counseling or therapy. Among
jail inmates, 90% of those who had ever been told they
had a mental disorder received mental health treatment
in their lifetimes, including 80% who had received
prescription medication.
Prisoners who had a mental health indicator were
more likely than similar jail inmates to have received
treatment since admission to their current facility
More than half (54%) of prisoners who met the threshold for
SPD had received mental health treatment since admission
to the current facility, compared to a third (35%) of jail
inmates. An estimated 46% of prisoners who met the
threshold for SPD had received prescription medication,
42% had received counseling or therapy, and 34% had

received prescription medication and counseling or
therapy. Among jail inmates who met the threshold for SPD,
30% had received prescription medication, 18% had
received counseling or therapy, and 13% had received
prescription medication and counseling or therapy
since admission.
Prisoners who had ever been told they had a mental
disorder (63%) were more likely than jail inmates (44%) to
have received treatment since admission. Among those
with a mental health problem, a greater percentage of
prisoners (49%) than jail inmates (24%) had received
counseling or therapy. Likewise, a greater percentage of
prisoners (39%) than jail inmates (18%) with a mental
health problem had received a combination of counseling
or therapy and prescription medication.
About a third of inmates with a mental health indicator
were currently receiving treatment
Inmates who had a mental health indicator were also
asked if they were currently receiving treatment for a
mental health problem. An estimated 36% of prisoners
and 30% jail inmates who met the threshold for SPD
said they were receiving treatment for a mental health
problem as of the time of the interview. There was no
statistical difference between the percentage of prisoners
and jail inmates who met the threshold for SPD and said
they were currently receiving prescription medication
(29% of prisoners and 26% of jail inmates). Jail inmates
who met the threshold for SPD were half as likely to
report receiving counseling or therapy (13%) as prisoners
who met the threshold for SPD (26%).

TABLE 6
Mental health treatment received by prisoners and jail inmates with an indicator of a mental health problem, by type of
indicator, time period, and treatment type, 2011–2012
Time period and treatment type
Ever received mental health treatment during lifetime
Ever overnight hospital stayc
Ever taken prescription medication
Ever had counseling/therapy from trained professionald
Mental health treatment since admission
Prescription medication
Counseling/therapy from trained professionald
Prescription medication and counseling/therapy
Currently treated for a mental health probleme
Prescription medication
Counseling/therapy from trained professionald
Prescription medication and counseling/therapy

Serious psychological distressa
Prisoners*
Jail inmates
74.2%
72.7%
41.8
43.1
62.8
61.3
60.9
54.9**
54.3%
35.0%**
45.8
30.0**
42.2
17.8**
33.9
12.9**
35.6%
29.7%**
29.1
25.7
25.8
12.6**
19.5
8.7**

History of a mental health problemb
Prisoners*
Jail inmates
88.1%
90.3%**
44.8
51.3**
76.4
80.4**
74.6
73.9
63.0%
44.5%**
52.6
38.3**
48.9
23.5**
38.7
17.5**
37.0%
37.8%
29.9
33.0
26.7
16.4**
19.7
11.8**

Note: See appendix table 11 for standard errors.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes inmates with a score of 13 or more on the K6 scale. See Methodology.
bIncludes inmates who reported they had ever been told by a mental health professional they had a mental disorder.
cIncludes inmates who stayed overnight or longer in any type of hospital or other facility to receive treatment or counseling for any problems with their emotions,
nerves, or mental health.
dIncludes a psychiatrist, psychologist, social worker, or nurse.
eAs of the time of the interview.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

Among inmates who had ever been told they had a mental
disorder, 37% of prisoners and 38% of jail inmates said
they were currently receiving treatment for a mental health
problem. An estimated 30% of each group said they were
currently taking prescription medication.
Prisoners and jail inmates who met the threshold for
SPD were more likely than those without SPD to be
written up or charged with an assault while incarcerated
Prisoners and jail inmates were asked if they had been
written up or charged with assaulting an inmate, physically
assaulting a correctional officer or staff, or verbally
assaulting a correctional office or staff since admission
to the current facility.2 Compared to prisoners without
an indicator of a mental health problem (4%), prisoners
2Estimates

who met the threshold for SPD (14%), or who had ever
been told they had a mental disorder (12%) were more
likely to be written up or charged with a verbal or physical
assault against a correctional officer, staff, or assault of
another inmate (table 7). Three percent of prisoners with
no indicator of a mental health problem were written up or
charged with assaulting another inmate, compared to 9% of
prisoners who met the threshold for SPD and 7% of those
who had been told they had a mental disorder.
Among jail inmates with no indicator of a mental health
problem, 4% were written up or charged with assault. This
group was less likely to be written up or charged with assault
than jail inmates who met the threshold for SPD (10%) or
who had been told they had a mental disorder (10%).

derived from the 90% sample only. See Methodology.

TABLE 7
Prisoners and jail inmates written up or charged with assault, by mental health status, 2011–2012
Type of assault
Total
Verbal assault of correctional officer or other staff
Physical assault of correctional officer or other staff
Assault against another inmate

No indicator of mental
health problem*a
Prisoners
Jail inmates
4.1%
4.2%
1.6
1.6
0.4
0.4
2.7
2.9

Serious psychological
distressb
Prisoners
Jail inmates
14.2%**
9.7%**
6.8**
4.6**
2.8**
1.3**
8.5**
6.2**

History of a mental
health problemc
Prisoners
Jail inmates
11.6%**
9.9%**
5.7**
4.6**
1.9**
1.2**
7.0**
6.6**

Note: Data comes from the 90% sample only. See Methodology. See appendix table 12 for standard errors.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes inmates with a score of 7 or less on the K6 scale and who had never been told by a mental health professional they had a mental disorder.
bIncludes inmates with a score of 13 or more on the K6 scale. See Methodology.
cIncludes inmates who reported they had ever been told by a mental health professional they had a mental disorder.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

Methodology
The 2011-12 National Inmate Survey
The 2011-12 National Inmate Survey (NIS-3) was conducted
in 233 state and federal prisons, 358 jails, and 15 special
facilities (military, Indian country, and Immigration and
Customs Enforcement (ICE) facilities) between February
2011 and May 2012. The data were collected by RTI
International under a cooperative agreement with the
Bureau of Justice Statistics (BJS).
The NIS-3 administered two questionnaires to inmates: a
survey about sexual victimization and an alternative survey
about mental and physical health, past drug and alcohol use,
and treatment for substance abuse. Inmates were randomly
assigned to receive one of the two questionnaires so that, at
the time of the interview, the content of the survey remained
unknown to facility staff and the interviewers.
A total of 106,532 inmates participated in NIS-3, receiving
either the sexual victimization survey or the randomly
assigned alternative survey. Combined, the surveys were
administered to inmates in state and federal prisons
(43,721), jails (61,351), military facilities (605), Indian
country jails (192), and ICE facilities (663).
The interviews, which averaged 35 minutes in length,
used computer-assisted personal interviewing (CAPI) and
audio computer-assisted self-interviewing (ACASI) data
collection methods. For approximately the first 2 minutes,
interviewers conducted a personal interview using CAPI to
obtain background information and the date of admission
to the facility. For the remainder of the interview, inmates
interacted with a computer-administered questionnaire using
a touchscreen and synchronized audio instructions delivered
via headphones. Respondents completed the ACASI portion
of the interview in private, with the interviewer either leaving
the room or moving away from the computer. The entire
ACASI questionnaire (listed as the National Inmate Survey-3)
is available on the BJS website.
A shorter paper questionnaire (PAPI) was made available for
inmates who were unable to come to the private interviewing
room or interact with the computer. The paper form was
completed by 751 prisoners (1.9% of all prisoner interviews)
and 264 jail inmates (0.5% of all jail inmate interviews).
Those who completed the PAPI were not asked about their
physical health, mental health, past drug and alcohol use, or
treatment for substance abuse.
Additional information on the methodology for sample
selection of facilities and inmates can be found in Sexual
Victimization in Prisons and Jails Reported by Inmates,
2011–12 (NCJ 241399, BJS web, May 2013).

Mental health module
The analysis of the mental health module was restricted
to adult prisoners or jail inmates. Juvenile inmates who
were 16 or 17 years of age and inmates in military, Indian
country, or ICE facilities were excluded from this report.
To determine whether inmates had an indicator of a
current mental health problem, the NIS-3 included the
Kessler 6 scale for nonspecific psychological distress
(see Measurement of mental health indicators text box).
The NIS-3 also included questions to assess whether or
not an inmate had a history of a mental health problem,
defined as having ever been told by a mental health
professional that they had a mental disorder. The mental
health indicator questions were contained in a mental
health screener that was part of a mental health module.
Among inmates who received the sexual victimization survey
(90% of inmates surveyed), all inmates received the mental
health screener component. Respondents who completed the
core sexual victimization survey in less than 35 minutes were
eligible to receive the follow-up mental health component.
Respondents who did not indicate a mental health problem
legitimately skipped the items in the detailed follow up.
Based on these threshold, within prisons 37,359 inmates
received the mental health screener questions. Among
those respondents, 84% (31,508 prisoners) were eligible to
receive the detailed mental health follow-up items. Among
jail respondents, 52,384 inmates received the mental health
screener items. Among those, 92% (48,338 jail inmates) were
eligible to receive the detailed mental health follow-up items.
Among inmates who received the alternative survey on
mental and physical health, past drug and alcohol use, and
treatment for substance abuse (10% of inmates surveyed),
both mental health components were administered to
prisoners and jail inmates. All 4,304 prisoners and 6,704
jail inmates who were randomized to the alternative survey
received the full mental health module.
Nonresponse bias analysis
Bias occurs when the estimated prevalence of an outcome
is different from the actual prevalence of the outcome for a
given facility. One potential source of bias is nonresponse.
For each survey in the NIS-3, a nonresponse bias analysis
was conducted to determine whether inmates did not receive
the mental health module due to it only being administered
in ACASI. The PAPI respondents were found to have a
higher prevalence of sexual victimization and more likely to
reside in administrative segregation. These two conditions
may be correlated to an inmate’s mental health status. Given
that the PAPI respondents made up 1.9% of prisoners
and 0.5% of jail inmates, it was determined that a weight
adjustment could reduce the potential bias due to PAPI
respondents not receiving the mental health screener items.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

Weighting and nonresponse adjustments
Responses from interviewed inmates were weighted to
produce national-level estimates. Each interviewed inmate
was assigned an initial weight corresponding to the inverse
of the probability of selection within each sampled facility.
A series of adjustment factors was applied to the initial
weight to minimize potential bias due to nonresponse and
to provide national estimates. For the analysis of the mental
health module, these adjustments were one of two types:
1. adjustments to account for survey nonresponse
2. adjustments to account for survey mode nonresponse.
Methods to adjust for survey nonresponse are described in
detail in Sexual Victimization in Prisons and Jails Reported by
Inmates, 2011-12 (NCJ 241399, BJS web, December 2014).
Bias could result if the PAPI respondents were different
from the ACASI respondents. The adjustment for mode
nonresponse included a calibration of the weights so that
the weight from a PAPI respondent was assigned to an
ACASI respondent with similar characteristics. Because both
ACASI and PAPI respondents provided demographic and
criminal history information, these data were used in weight
adjustment. For each inmate, these adjustments were based
on a generalized exponential model, developed by Folsom
and Singh (2002), and applied to the sexual victimization
survey respondents.3
The mode nonresponse adjustment maintained the bench
marked totals designed to make national-level estimates
for the total number of inmates age 18 or older who were
held in jails at midyear 2011 or in prison at yearend 2011.
These benchmark totals represented the estimated number
of inmates by sex, from BJS’s 2011 Annual Survey of Jails
and 2011 National Prisoner Statistics. The national estimates
for state prisons were 1,154,600 adult males and 83,400
adult females; for federal prisons, 190,600 adult males and
13,200 adult females; and for jails (with an average daily
population of six or more inmates), 628,620 adult males,
and 91,551 adult females.
After the adjustment for potential nonresponse bias, a final
adjustment was conducted to combine the data from the
sexual victimization survey and the alternative survey. For
this adjustment, the weight for each responding inmate was
multiplied by the probability of receiving the survey type
received. In other words, the survey nonresponse and mode
3Folsom,

Jr., R. E., & Singh, A. C. (2002). The generalized exponential
model for sampling weight calibration for extreme values, nonresponse,
and poststratification. Proceedings of the American Statistical Association,
Survey Research Methods Section, 598-603.

nonresponse adjusted weight for the ACASI respondents
were multiplied by 0.90 and for respondents to the sexual
victimization survey and alternative survey.
Comparison of estimates by NIS-3 survey type
Prior to producing estimates from the combined set of
sexual victimization and alternative survey respondents, a
comparison of key estimates was conducted. This was done
to ensure that questions on sexual victimization did not alter
how inmates responded to the mental health screener items,
compared to inmates that were not asked about their sexual
victimization status.
Using the analysis weights created for each survey, estimates
were produced and tested to determine if they were
significantly different. For all key estimates, the sexual
victimization and alternative survey respondents had
statistically similar estimates. Therefore, it was determined
that the combined data could be used for all analyses.
Standard errors and tests of significance
As with any survey, the NIS-3 estimates are subject to error
arising from their basis on a sample rather than a complete
enumeration of the population of adult inmates in prisons
and jails. For each mental health indicator, the estimated
sampling error varies by the size of the estimate, number of
completed interviews, and intra-cluster correlation of the
outcome within facilities.
A common way to express this sampling variability is to
construct a 95% confidence interval around each survey
estimate. Typically, multiplying the standard error by
1.96 and then adding or subtracting the result from the
estimate produces the confidence interval. This interval
expresses the range of values that could result among
95% of the different samples that could be drawn.
To facilitate the analysis, rather than provide the detailed
estimates for every standard error, differences in the
estimates of sexual victimization for subgroups in this
report have been tested and notated for significance at the
95% confidence level. For example, the difference in the
percentage of female jail inmates who met the threshold
for serious psychological distress (SPD) (32.3%) compared
to male jail inmates (26.0%) is statistically significant at
the 95% confidence level (table 2). In all tables providing
detailed comparisons, statistically significant differences at
the 95% confidence level or greater have been designated
with two asterisks (**).

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

General population estimates

Standardization of general population estimates

In the general population, prevalence rates of SPD in the
past 30 days come from the National Survey on Drug Use
and Health (NSDUH). The NSDUH is an annual nationwide
survey that provides national and state-wide estimates on
the use of tobacco products, alcohol, illicit drugs, and the
prevalence of mental health problems among the general
U.S. population. Respondents are randomly selected at the
household level.4 This sampling method is unlikely to capture
persons who are homeless, in temporary shelters, transient
or highly mobile, or in hospitals or residential rehabilitation
or treatment centers—all populations who may have a higher
risk for mental disorders, substance use disorders, or both.

When comparing two populations, differences found for
some characteristics or conditions may be statistically
different as a result of a true difference in the populations
or due to basic demographics differences that are associated
with the outcome of interest. Standardizing the estimates
is one method to determine if these demographic
differences are the sole cause for differences found in
other characteristics or conditions.

To be most comparable to the inmate population included in
the NIS-3, the survey years 2009 through 2012 of NSDUH
were used in this analysis. While the NIS-3 reference period
does not include 2009 or 2010, these years were included to
increase the precision in the general population estimates.
An analysis of the estimates of general population across
the 4 years found that the mental health estimates did not
change appreciably during this period. Therefore, including
additional years of data to increase precision would not shift
the study period estimates enough to alter any comparisons
to the 2011-12 inmate population.
The NSDUH includes indicators that measure a person’s selfreported past year criminal justice involvement. With this
information, the total general population was split into three
groups:

persons not involved in the criminal justice system during
the past 12 months

those on probation or parole during the past 12 months

those arrested in the past 12 months.

Standardization of survey estimates consists of calibrating
the survey weights for one population such that, for key
demographic characteristics that are known for each
population, the distributions are identical. This process
was done using SUDAAN’s PROC DESCRIPT procedure.
The resulting estimates are not a representation of the
standardized population by themselves (i.e., generalizations
about the population cannot be made from standardized
estimates), but are appropriate estimates for comparison
with other populations of interest.
In this report, estimates were standardized for each of the four
general population types (e.g., the total general population
and three criminal justice involvement subgroups). For each
general population type, estimates were standardized to the
inmate populations’ distribution by sex, race, Hispanic origin,
and age. Because the inmate populations for prisoners and
jail inmates differed, the general population was standardized
separately to each inmate population (see appendix tables 1
and 2). Figure 2 includes standardized estimates to the prison
population. Figure 3 includes standardized estimates to the
jail population.

These groups are not mutually exclusive in that a person can
be both on probation or parole and have been arrested in
the past 12 months. It is assumed that persons in the general
population on probation and parole or those arrested in the
past 12 months are more similar to the inmate populations
than those not involved with the criminal justice system
during the past 12 months.
4SAMHSA. NSDUH - About the Survey. Retrieved on March 30, 2016 from
https://nsduhweb.rti.org/respweb/project_description.html.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

APPENDIX TABLE 1
Characteristics of prisoners and jail inmates, 2011–2012
Prisonersa*
Number
Percent
1,441,800
100%

Characteristic
All inmates
Sex
Male
1,345,200
Female
96,600
Race/Hispanic originb
White
430,300
Black
506,100
Hispanic
341,400
Otherc
147,500
Age
18–24
179,600
25–34
458,500
35–44
397,800
45–54
281,800
55–64
98,800
65 or older
25,300
Marital status
Married
270,800
Widowed
26,400
Divorced
286,700
Separatedd
87,200
Never married
761,100
Education
Less than
high school
825,000
High school
graduate
283,400
Some college
230,100
College degree
or more
99,600

Jail inmates
Number
Percent
720,200
100%

93.3%
6.7

628,600
91,600

87.3%**
12.7**

30.2%
35.5
24.0
10.3

242,600
237,500
158,000
74,100

34.1%**
33.3
22.2
10.4

12.5%
31.8
27.6
19.5
6.9
1.8

186,000
251,100
150,700
102,400
26,200
3,800

25.8%**
34.9**
20.9**
14.2**
3.6**
0.5**

18.9%
1.8
20.0
6.1
53.1

134,900
11,600
104,000
52,800
412,000

18.9%
1.6
14.5**
7.4**
57.6**

57.4%

382,300

53.4%**

19.7
16.0

166,900
120,500

23.3**
16.8

6.9

46,500

6.5

Note: See appendix table 2 for standard errors.
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
aIncludes state and federal prisoners.
bExcludes persons of Hispanic origin, unless specified.
cIncludes American Indian or Alaska Natives; Asian, Native Hawaiian, or Other
Pacific Islanders; and persons of two or more races.
dFor reasons other than incarceration.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

APPENDIX TABLE 2
Standard errors for appendix table 1: Characteristics of
prisoners and jail inmates, 2011–2012
Characteristic
All inmates
Sex
Male
Female
Race
White
Black
Hispanic
Other
Age
18–24
25–34
35–44
45–54
55–64
65 or older
Marital status
Married
Widowed
Divorced
Separated
Never married
Education
Less than
high school
High school
graduate
Some college
College degree
or more

Prisoners
Number
Percent
79,900

Jail inmates
Number
Percent
32,800

79,800
8,600

0.68%
0.68

29,500
6,500

0.74%
0.74

27,300
38,600
29,300
10,700

1.08%
1.41
1.87
0.39

11,400
15,700
12,800
3,700

1.20%
1.30
1.33
0.34

13,300
25,300
25,800
17,800
7,500
2,300

0.72%
0.61
0.47
0.60
0.33
0.14

8,200
11,300
7,300
6,100
1,600
400

0.38%
0.41
0.29
0.33
0.14
0.05

15,800
1,600
19,600
5,100
47,400

0.78%
0.13
0.59
0.24
1.05

7,500
700
5,100
3,000
18,600

0.44%
0.08
0.34
0.18
0.62

46,800

0.82%

17,100

0.61%

17,500
15,100

0.53
0.44

8,000
6,700

0.41
0.37

6,200

0.25

3,000

0.22

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

APPENDIX TABLE 3
Percentages and standard errors for figure 1: Mental health
status of prisoners and jail inmates, by type of mental health
indicator, 2011–2012

Prisoners*
Jail inmates
Standard
Standard
Mental health indicators
Percent error
Percent error
Serious psychological distress
14.5%
0.46%
26.4%** 0.51%
History of a mental health problem 36.9
1.15
44.3**
0.79
No indication of a mental health
problem
49.9
1.07
36.0**
0.62
*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

APPENDIX TABLE 4
Standard errors for table 1: Prevalence of mental health
indicators among prisoners and jail inmates, by type of
indicator, 2011–2012
Mental health indicators
No indicator of a mental health problem
Current indicator of a mental health problem
Serious psychological distress
History of a mental health problem
Ever told by mental health professional
they had mental disorder
Major depressive disorder
Bipolar disorder
Schizophrenia/other psychotic disorder
Post-traumatic stress disorder
Anxiety disorder
Personality disorder

Prisoners
1.07%

Jail inmates
0.62%

0.46%

0.51%

1.15%
0.95
0.75
0.45
0.60
0.59
0.48

0.79%
0.66
0.62
0.43
0.45
0.54
0.32

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

APPENDIX TABLE 5.
Percentages and standard errors for figure 2: Prisoners and
adult general population who met the threshold for serious
psychological distress, 2009–2012
Population
Prisoners*
Adult general population
With no criminal involvement
Under supervision
Arrested

Serious psychological distress
Percent
Standard error
14.5%
0.46%
4.6**
0.15
4.0**
0.14
10.8**
1.13
13.0
1.12

*Comparison group.
**Difference with the comparison group is significant at the 95% confidence level.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12; Substance
Abuse and Mental Health Services Administration, National Survey on Drug Use
and Health, 2009–2012.

APPENDIX TABLE 6.
Percentages and standard errors for figure 3: Jail inmates
and adult general population who met the threshold for
serious psychological distress, 2009–2012

Serious psychological distress
Percent
Standard error
26.4%
0.51%
5.1**
0.13
4.5**
0.12
11.4**
0.82
13.8**
0.90

Population
Jail inmates*
Adult general population
With no criminal involvement
Under supervision
Arrested

APPENDIX TABLE 7
Standard errors for table 2: Prevalence of mental
health indicators among prisoners and jail inmates, by
demographic characteristics, 2011–2012
Characteristic
All inmates
Sex
Male
Female
Race/Hispanic
origin
White
Black
Hispanic
Other
Age
18–24
25–34
35–44
45–54
55–64
65 or older

Serious psychological
distress
Prisoners
Jail inmates
0.46%
0.51%

History of a mental
health problem
Prisoners Jail inmates
1.15%
0.79%

0.49%
1.03

0.51%
0.89

1.16%
1.84

0.77%
1.25

0.61%
0.63
0.73
0.99

0.67%
0.73
0.70
1.09

1.26%
1.27
1.72
1.68

0.78%
1.11
1.08
1.23

0.99%
0.64
0.65
0.81
0.87
1.32

0.57%
0.68
0.80
0.90
1.61
3.40

1.66%
1.27
1.32
1.47
1.40
2.08

0.82%
0.96
1.07
1.05
1.79
4.52

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

APPENDIX TABLE 8
Standard errors for table 3: Indicators of a mental health
problem among prisoners and jail inmates, by marital status
and education, 2011–2012

Serious psychological
distress
Selected
characteristics Prisoners
Jail inmates
All inmates
0.46%
0.51%
Marital status
Married
0.66%
0.94%
Widowed
1.97
2.44
Divorced
0.71
0.96
Separated
1.16
1.06
Never
married
0.53
0.49
Education
Less than
high school
0.56%
0.61%
High school
graduate
0.71
0.70
Some
college
0.83
0.74
College
degree
or more
0.92
1.18

History of a mental
health problem
Prisoners Jail inmates
1.15%
0.79%
1.37%
2.44
1.24
1.70

1.14%
2.77
1.08
1.63

1.34

0.81

1.09%

0.83%

1.49

1.09

1.52

0.94

1.44

1.24

APPENDIX TABLE 9
Standard errors for table 4: Indicators of a mental health
problem among prisoners and jail inmates, by current
offense, sentence status and length, and time served,
2011–2012
Serious psychological
distress
Prisoners Jail inmates

History of a mental
health problem

Prisoners

Jail inmates

0.52%
0.91
0.61
1.31

0.75%
0.64
0.84
1.24

1.18%
1.72
1.46
2.82

0.96%
1.00
0.99
1.45

0.97

0.91

2.08

1.14

:
:

1.47%
0.77
0.44
1.01
7.90

0.56%
0.61
0.67%
0.81
1.12
4.84
10.31

Criminal history
Number of times
arrested (lifetime)
1 time
2–3 times
4–10 times
11 times or more
Total time in a
correctional facility
prior to current
facility
None
1–5 months
6–11 months
1–4 years
5 years or more

Serious psychological
distress
Prisoners Jail inmates

History of a mental
health problem
Prisoners Jail inmates

0.68%
0.52
0.61
0.86

1.34%
1.17
0.74
1.08

1.32%
1.10
1.30
1.56

1.82%
1.31
1.40
1.44

0.59%
0.77
0.72
0.65
0.70

0.90%
1.09
1.29
1.05
1.17

1.34%
1.46
1.44
1.30
1.29

1.42%
1.59
1.85
1.46
1.28

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

Criminal justice
status and
history
Most serious
offense
Violent
Property
Drug
DWI/DUI
Other public
order
Status
Unsentenced
Sentenced
Sentence length
Less than 1 year
1–4 years
5 years or more
Life sentence
Death sentence
Time served since
admission to
current facility
Less than
1 month
1–5 months
6–11 months
1–4 years
5 years or more

APPENDIX TABLE 10
Standard errors for table 5: Indicators of a mental health
problem among prisoners and jail inmates, by criminal
history, 2011–2012

:
:

2.77%
1.71
1.10
1.78
7.18

0.90%
0.85
1.08%
1.28
1.52
4.43
11.34

APPENDIX TABLE 11
Standard errors for table 6: Mental health treatment
received by prisoners and jail inmates with an indicator of
a mental health problem, by type of indicator, time period,
and treatment type, 2011–2012
Time period and
treatment type
Ever received mental health
treatment during lifetime
Ever overnight
hospital stay
Ever taken prescription
medication
Ever had counseling/
therapy from trained
professional
Mental health treatment
since admission
Prescription medication
Counseling/therapy from
trained professional
Prescription medication
and counseling/therapy
Currently treated for a
mental health problem
Prescription medication
Counseling/therapy from
trained professional
Prescription medication
and counseling/therapy

Serious psychological
distress
Jail
Prisoners inmates

History of a mental
health problem
Jail
Prisoners inmates

1.25%

0.79%

0.56%

0.35%

1.21

0.84

0.85

0.61

1.69

1.01

0.89

0.56

1.31

0.83

0.67

0.43

1.71%
1.92

1.11%
1.07

1.36%
1.69

1.06%
1.07

1.49

0.85

1.15

0.81

1.61

0.75

1.33

0.75

2.16%
1.92

1.07%
1.04

1.79%
1.56

1.07%
1.07

1.73

0.61

1.44

0.64

1.38

0.49

1.13

0.53

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

1.16%
0.76
0.86
0.57
0.76

0.64%
0.59
0.76
1.30
3.87

2.11%
1.43
1.37
1.51
1.37

0.87%
0.91
1.16
1.83
5.05

: Not calculated.
Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

APPENDIX TABLE 12
Standard errors for table 7: Prisoners and jail inmates written up or charged with assaults, by mental health status, 2011–2012
Type of assault
Total
Verbal assault of correctional officer or other staff
Physical assault of correctional officer or other staff
Assault against another inmate

No indicator of a mental
health problem
Prisoners
Jail inmates
0.31%
0.22%
0.16
0.13
0.08
0.06
0.23
0.18

Serious psychological
distress
Prisoners
Jail inmates
0.79%
0.47%
0.49
0.25
0.35
0.16
0.56
0.39

History of a mental
health problem
Prisoners
Jail inmates
0.55%
0.44%
0.32
0.20
0.22
0.10
0.46
0.35

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–2012.

INDICATORS OF MENTAL HEALTH PROBLEMS REPORTED BY PRISONERS AND JAIL INMATES, 2011-12 | JUNE 2017

The Bureau of Justice Statistics (BJS) of the U.S. Department of Justice is the
principal federal agency responsible for measuring crime, criminal victimization,
criminal offenders, victims of crime, correlates of crime, and the operation of
criminal and civil justice systems at the federal, state, tribal, and local levels. BJS
collects, analyzes, and disseminates reliable and valid statistics on crime and justice
systems in the United States, supports improvements to state and local criminal
justice information systems, and participates with national and international
organizations to develop and recommend national standards for justice statistics.
Jeri M. Murlow is acting director.
This report was written by Jennifer Bronson of BJS and Marcus Berzofsky of
RTI International. Todd Minton verified the report.
Caitlin Scoville and Jill Thomas edited the report. Steve Grudziecki produced
the report.
June 2017, NCJ 250612

NCJ250612

Office of Justice Programs
Building Solutions • Supporting Communities • Advancing Justice
www.ojp.usdoj.gov