Report: 95 percent of prison population has mental health, substance use disorders

CT Sentencing Commission aims for data to assist policymakers

A 2023 report from the Connecticut Sentencing Commission found that 95.5 percent of the incarcerated population currently or previously had mental health or substance abuse disorders or both.

The Department of Corrections reported 32 percent of prisoners currently need treatment for diagnoses such as post-traumatic stress disorder, mood disorders, antisocial personality disorder, and schizophrenia.

The data also showed 74 percent of Connecticut’s 10,000 inmates required treatment for substance abuse problems and 24 percent of the population had both mental and substance use disorders.

“It really has reached crisis levels and it has for years now,” said Alex Tsarkov, the Sentencing Commission’s executive director. “I think the numbers speak for themselves. Our jails and prisons have become de facto mental health institutions, and that’s very problematic.”

Tsarkov said the results reflect what judges, prosecutors, and public defenders are seeing in the courtroom every day.

Although DOC classification scores were used for previous reports, this time, the DOC obtained actual diagnosis data on specific mental health disorders, according to Tsarkov.

By looking at those specific diagnoses, along with demographics, controlling offenses, and sentence length, the Commission hopes to provide background for policymakers to use to better serve the incarcerated population with these needs, Tsarkov said.

“These issues won’t go away. We’ve barely scratched the surface here. But it’s exciting that more and more people are paying attention to what’s happening in prisons and justice systems as a whole,” he said.

The most common diagnoses was mood disorder, accounting for 24 percent or the prison population compared with the general U.S. population at 9.7 percent.

Individuals with psychotic disorders comprised eight percent of those incarcerated, compared with less than one percent in the general population. Additionally, 43 percent of individuals classified as having “severe” or “crisis-level” psychotic disorders have particularly high treatment needs.

The report showed more women having active mental health disorders requiring treatment (81 percent, compared to 28 percent of men).

Also, the rate of active mental health disorders was higher than average for inmates under 26 years old at 37.6 percent.

The rate of active mental health disorders varied significantly across racial groups: Native American (53 percent), White (41 percent), Asian (35 percent), Hispanic (30 percent), and Black (26 percent). However, at the time of the study, there were 36 Native Americans and 40 Asian individuals so the percentages reflect a relatively small number of observed cases, according to researchers.

While individuals with mood, anxiety, or PTSD had shorter than average sentences, people with personality or adjustment/acute stress disorder diagnoses tended to serve longer than average sentences.

Key substance abuse findings included 40 percent of the population having had a serious or extremely serious problem requiring residential or intensive outpatient treatment.

The prevalence of substance abuse requiring treatment was higher for women (84.4 percent) than men (73 percent), and highest for White individuals at 78.5 percent and people aged 26 to 55 (77.7 percent).

Tsarkov said The General Assembly appropriated $500,000 to conduct further research. The funding allows the Commission to continue its work with a more comprehensive study that expands to include probation, pretrial diversion, and parole populations as well as youths convicted as adults.

Future research will also look at mental health treatment, services, and programs in the Department of Correction.

“We formed a subcommittee to oversee this work that has major stakeholders from the criminal justice system. There are exciting possibilities and we have some in the works already,” Tsarkov said.

Co-author of the report was Reena Kapoor, MD, associate professor of psychiatry at Yale School of Medicine.