Two Challenges Affecting Access to Care for Inmates with Serious Mental Illness: Detecting Illness and Acceptable Services

The overrepresentation of people with serious mental illness in correctional facilities is a modern truism and troubling.1 What causes this overrepresentation is complex and controversial; what we need to do about it is relatively less controversial. The state clearly has a duty to attend the mental health needs of the people it chooses to incarcerate,2 recognising that this is a population of people who may well have been underserved for the mental health needs prior to incarceration. For a variety of reasons, prison inmates can be reluctant to accept care and treatment in custody. Correctional mental health services, therefore, must take positive and active steps to find the people we should be caring for and ensure that we offer treatment, or at least give the person the active chance to refuse it should he or she wish to do so.