Mental Illness and Prisoners: Concerns for Communities and Healthcare Providers

Samantha Hoke, MSN, PMHNP-BC, RN


Online J Issues Nurs. 2015;20(1) 

In This Article

Facts About Imprisonment

The above inmate's story is one reflection of the inundated prison system. There are approximately 2.2 million pre-trial and 1.6 million post-trial inmates in county, state, and federal prisons; this equates to approximately 756 per 100,000 people incarcerated in the United States (Carson & Golinelli, 2013; Exworthy, Samele, Urquia & Forrester, 2012). The United States has only 5% of the world's population, but 25% of the world's prisoners (Liptak, 2008). China, with a population four times the United States, has an average of 1.6 million prisoners (Liptak, 2008). Russia may be the only industrialized country that is close to the U.S. incarceration rate with an average of 627 per 100,000 (Liptak, 2008). The United Kingdom (U.K.) has an average of 152 per 100,000 people incarcerated, higher than other European countries that have an average of 120 (Exworthy et al., 2012). The U.S. prison system is thus the largest in the world.

In America, imprisonment was considered unusual in the beginning of the 18th century. Today the prison system is viewed as both a necessity to keep the public safe and as a mode of punishment for crimes. Imprisonment comes at an average cost per inmate of $31,286 per year (Henrichsen & Delaney, 2012). Medical care alone accounts for an estimated 12% of prison budgets, second only to security costs, which include employee salaries, insurance, and retirement costs (Stephan, 2004). Cost concerns are a pressing issue as accommodating the expanding inmate population results in increased individual taxes to fund the necessary budget.