Mental Health and Substance Use Issues Prevalent in Prison Populations

Researchers have long known that managing an inmate population requires addressing problems other than violence. “The assessment of co-occurring mental health and substance use disorders is a critical task in managing criminal offenders,” said the authors of a new study focused on identifying the prevalence of these issues in inmates. “Offenders have prevalent rates of alcohol and drug problems that are much higher than those found in the general population. Their substance use is often tied to criminal offending and high risk behavior,” said the team, comprised of researchers at the University of South Florida, Texas A&M University, Simon Frasier University and Emory University. Because of this dynamic, the team believes that it is imperative to address these issues in order to see positive outcomes. They said, “Indeed, many consider addiction treatment an essential component of offender rehabilitation and community re-entry.”

The researchers evaluated 3,288 offenders from various institutions and administered the Personality Assessment Inventory (PAI), a multi-scale report that identifies 344 specific items, and the Mental Health Screening Form-III, an 18 item tool created to evaluate the mental health status of someone with substance misuse issues. They found that “thirty-two percent of the sample had clinically significant alcohol problems, 67% had clinically significant drug problems, and 27% had elevations in both domains.” Additionally, the researchers discovered that 70% of those evaluated also had a substance use issue.

The researchers also discovered that mental health and co-occurring substance problems were persistent in the inmate population sampled and raised the risk for suicidal ideation and also violent behavior. They said, “Additionally, offenders with substance problems were more likely than others to have mental health problems associated with risk factors for suicide and aggression.” They believe their findings emphasize the importance of treating all of the issues present in this population. They added, “Increasingly, it is recognized that effective management and rehabilitation of offenders will require clinicians to address addictive problems.”

Ruiz, Mark A., Kevin S. Douglas, John F. Edens, Natalia L. Nikolova, and Scott O. Lilienfeld. “Co-occurring Mental Health and Substance Use Problems in Offenders: Implications for Risk Assessment.” Psychological Assessment (July25, 2011). Advance online publication. doi: 10.1037/a0024623

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • shaun


    August 3rd, 2011 at 12:18 PM

    most people dread prisons,not just because of lack of freedom to move around and go to places but because of the people and conditions there.we have to punish the wrong doers but putting them together creates a new problem.this is something unavoidable but we will have to know that these people are better off with counselling and talking to rather than be forced to obey orders.drugs in prisons will not stop unless the people in there stop wanting to get them.and that will happen only after being spoken to,being explained about what they are doing to themselves and creating that hope in them,the hope of a clean slate and a normal life once they are out.

  • Kim


    August 4th, 2011 at 12:20 PM

    Compassion can make even hardened criminals people again.They were not born criminals,they acquired that tag.And if they can acquire,they can lose it as well.The society makes it difficult for them even I’d they want to become clean I’ve they are out of prison.We need to ensure that they are properly counseled and assured that they will get another shot at life once they are out.

  • Ted.V


    August 4th, 2011 at 7:17 PM

    While most of the guys in prison might have had a drug habit even before they were imprisoned,I’m sure there would be a Lt of them there that would have picked up the habit afterwards.

    Your environment affects you and the drug problem in prisons is like a communicable disease.

  • Hope Nolan

    Hope Nolan

    August 7th, 2011 at 7:26 PM

    Unless they have committed a serious violent crime, I don’t see the need to keep those with addictions in a jail. I’m not advocating that they get off scot free either. Sentence them to a special locked down rehab clinic instead. Make their punishment fit the crime and have them come out the other end a better person. Isn’t that what rehabilitation is all about?

    Incarcerating a guy in a traditional jail who got into a bar fight because of his alcoholism or a drug addict who burgled a home isn’t going to make him any less of a problem when he gets out because all he’s doing is biding his time until his sentence is over. They need need intensive counseling, not mere containment.

  • Harris Stiller

    Harris Stiller

    August 19th, 2011 at 3:19 PM

    Co-occurring substance problems? In prison, you get searched regularly, and if that one movie about the boxer is to believed whose name escapes me, strip searched before being able to see your visitors. So how are they able to get substances in?

    Are our jail staff so incompetent and uncreative that illegal drugs manage to get inside a facility which is under constant surveillance by staff and cameras? Tell me I’m wrong.

  • B.I.


    August 19th, 2011 at 4:19 PM

    @Harris: You’re not wrong; only looking in the wrong place as far as I’m concerned. The actual source of the problem I believe are rogue prison guards. They are the only ones that could get it past the security. Not all prison guards are good guys, and I believe that some could be bribed or coerced into passing on drugs to inmates. That’s my opinion and it’s based in fact.

    There was an FBI sting just last year where corrections officers in two Florida jails were caught helping protect and hide cocaine smuggling. And we’re talking kilos of it. They ain’t Snow White.

  • richard a. fuller

    richard a. fuller

    August 19th, 2011 at 5:01 PM

    Incarceration alone does nothing to solve the problem with reoffenders. You go to prison to repay your debt to society. What happens in reality? Gangs, drugs, violence, murder, and rape. If anything, prison will make a man worse going out than when he came in. And if the guards are that corrupt, they should be on the other side of that cell door.

    Addicts require treatment and prison’s the ideal place to put them through an intensive program. It’s not as if they can’t turn up nor devote lengthy periods of time to it.

  • Dylan Hopkins

    Dylan Hopkins

    August 20th, 2011 at 1:17 AM

    The prison system in the US simply doesn’t work. They don’t do anything to actually punish the criminals apart from take away their freedom. If all criminals were made to do hard labor, and had to pay back their own prison bill-which is roughly $100/day per head-when they got out, then perhaps the public would feel justice is being served.

    Instead we are giving them cable TV and free healthcare that the average low-income but honest family can’t afford. That makes me spitting mad. No wonder they reoffend-it’s a comfortable life in there!

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