Community Mental Health Journal

, Volume 41, Issue 5, pp 557–569

Race and Ethnicity, Mental Health Services and Cultural Competence in the Criminal Justice System: Are we Ready to Change?

  • Annelle B. Primm
  • Fred C. Osher
  • Marisela B. Gomez


By the end of 2003, 3.2% of the U.S. adult population or 6.9 million adults were incarcerated, on probation or on parole. While non-whites constitute approximately 25% of the general U.S. population, they represent the majority of the prison (62%) and jail population (57%), a 33% increase since 1980. Approximately 15% of this prison and jail population has active symptoms of serious mental illness with two-thirds likely to have a co-occurring substance use disorder diagnosis. Meanwhile, the lack of adequate mental health and substance abuse treatment within all levels of the criminal justice system continues to exist. This is further exaggerated by the dearth of evidence showing appropriate cultural awareness and competence in delivery of these much needed services to a majority non-white population. This article will review the existing racial disparities present in the criminal justice system, the lack of appropriate psychiatric services, and the effect of cultural dissonance in service provision when services do exist. Policy implications and recommendations are included in the conclusion with a call for action to all agencies directly and indirectly affected by this multifaceted problem.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Atkins, D.L., Pumariega, A.J., Rogers, K. 1999Mental health and incarcerated youth. I:␣Prevalence and nature of psychopathologyJournal of Child and Family Studies8193204CrossRefGoogle Scholar
  2. Beck, A.J., Maruschak, L.M. 2001Mental Health Treatment in State PrisonsBurea of Justice StatisticsWashington, DCReport No. NCJ-188215Google Scholar
  3. Beck, A.J., Karberg, J.C., Harrison, P.H. 2002Prison and Jail Inmates at Midyear 2001Bureau of Justice StatisticsWashington, DCReport NCJ-191702Google Scholar
  4. Centers for Disease Control. National Center for Health Statistics. (2003) Scholar
  5. Culhane, D., Kuhn, R. 1998Patterns and determinants of public shelter utilization among homeless adults in New York City and PhiladelphiaJournal of Policy Analysis and Management172343CrossRefGoogle Scholar
  6. Dennis, D.L., Steadman, H.J. 1991The criminal justice system and severely mentally ill homeless persons: An overview. Report prepared for the Task Force on Homelessness and Severe Mental IllnessPolicy Research AssociatesDelmar, NYGoogle Scholar
  7. Ditton, P.M. 1999Mental Health and treatment of inmates and probationersBureau of Justice StatisticsWashington, DCReport NCJ-174463Google Scholar
  8. Drug Policy Alliance. (2004). What’s wrong with the war on drugs? Mandatory Minimum Sentences. New York, NYGoogle Scholar
  9. Duclos, C.W., Beals, J., Novins, D.K., Martin, C., Jewett, C.S., Manson, S.M. 1998Prevalence of common psychiatric disorders among American Indian adolescent detaineesJournal of the American Academy of Child and Adolescent Psychiatry37866873CrossRefPubMedGoogle Scholar
  10. Garland, A.F., Hough, R.L., McCabe, K.M., Yeh, M., Wood, P.A., Arons, G.A. 2001Prevalence of psychiatric disorders in youths across five sectors of careJournal of the American Academy of Child and Adolescent Psychiatry40409418CrossRefPubMedGoogle Scholar
  11. Gilliard, D.K., Beck, A.J. 1998Prisoners in 1997Bureau of Justice StatisticsWashington, DCReport NCJ-170014Google Scholar
  12. Glaze, L.E., Palla, S. 2004Probation and Parole in the United States, 2003Bureau of Justice StatisticsWashington, DC2003. Report NCJ-205336Google Scholar
  13. Greenfeld, L.A., Snell, T.L. 1999Women offendersBureau of Justice StatisticsWashington, DCRep. No. NCJ 175688Google Scholar
  14. Hamparian, D., Leiber, M. 1997Disproportionate confinement of minority juveniles in secure facilities: 1996 national reportCommunity Research AssociatesChampaign, ILGoogle Scholar
  15. Harrison, P.M., Karbert, JC. 2004Prison and Jail inmates at midyear 2003Bureau of Justice StatisticsWashington, DCRep. No. NCJ 203947Google Scholar
  16. Hills, H., Siegfried, C., Ickowitz, A. 2004Effective prison mental health services: Guidelines to expand and improve treatmentNational Institutes of Corrections. U.S. Department of JusticeWashington, DCGoogle Scholar
  17. Institute of Medicine of the National Academies2002Unequal treatment: what healthcare providers need to know about racial and ethnic disparities in healthcareThe National Academies PressWashington, DCGoogle Scholar
  18. Lamb, H.R., Weinberger, L.E. 1998Persons with severe mental illness in jails and prisons: A’reviewPsychiatric Services49483492PubMedGoogle Scholar
  19. Langan, P.A., Greenfield, L.A., Smith, S.K., Levin, D.J., Durose, M. 2001Contacts between Police and the Public-Findings from the 1999 National SurveyBureau of Justice StatisticsWashington, DCGoogle Scholar
  20. Mauer, M. 1995Young Black Americans and the Criminal Justice System: Five Years LaterThe Sentencing ProjectWashington, DCGoogle Scholar
  21. Mumola, C.J. 1999Substance Abuse and Treatment, State and Federal Prisoners, 1997Bureau of Justice StatisticsWashington, DCReport NCJ-172871Google Scholar
  22. National Center for Cultural Competence. (2004). Georgetown University Center for Child and Human Development. University Center for Excellence in Developmental Disabilities.Google Scholar
  23. National GAINS Center for People with Co-Occurring Disorders in the Justice System2001The Prevalence of Co-Occurring Mental Health and Substance Use Disorders in Jails, Fact Sheet SeriesThe National GAINS CenterDelmar, NYGoogle Scholar
  24. Pumariega, A.J., Andres, J., Glover, S., Holzer, C.E., Nguyen, H. 1998Utilization of mental health services in a tri-ethnic sample of adolescentsCommunity Mental Health Journal34145156CrossRefPubMedGoogle Scholar
  25. Pumariega, A.J., Atkins, D.L., Rogers, K., Montgomery, L., Nybro, C., Caesar, R., Millus, D. 1999Mental health and incarcerated youth. II: Service utilizationJournal of Child and Family Studies8205215CrossRefGoogle Scholar
  26. Randall, J., Henggeler, S.W., Pickrel, S.G., Brondino, M.J. 1999Psychiatric comorbidity and the 16-month trajectory of substance-abusing and substance-dependent juvenile offendersJournal of the American Academy of Child and Adolescent Psychiatry3811181124CrossRefPubMedGoogle Scholar
  27. Schiraldi V. & Ziedenbert J. (2003). Race and Incarceration in Maryland. Justice Policy InstituteGoogle Scholar
  28. Sharfstein S.S. (2000). The Impact of the Mentally Ill Offender on the Criminal Justice System. Testimony for the US House Subcommittee on Crime. House Judiciary Committee. September 21: 2000Google Scholar
  29. Sickmund, M 2004Juvenile facilities reported more juvenile delinquents in placement in 1999 than at any time since 1991OJJDP National Report Series Bulletin NCJ-202885Washington, DCGoogle Scholar
  30. Stephan, J.J., Karberg, J.C. 2003Census of State and Federal Correctional Facilities, 2000Bureau of justice StatisticsWashington, DCReport NCJ-198272Google Scholar
  31. Substance Abuse and Mental Health Services Administration2004Adults with Co-Occurring Serious Mental Illness and a Substance Use DisorderSubstance Abuse and Mental Health Services Administration of Health and Human ServicesRockville, MDGoogle Scholar
  32. Substance Abuse and Mental Health Services Administration. (2003). Results from the 2002 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NHSDA Series H-22: DHHS Publication No. SMA 03-3836). Rockville, MD.Google Scholar
  33. Teplin, L.A., Abram, K.M., McClelland, G.M., Dulcan, M.K., Mericle, A.A. 2002Psychiatric disorders in youth in juvenile detentionArchives of General Psychiatry5911331143CrossRefPubMedGoogle Scholar
  34. U.S. Department of Health and Human Services2001Mental Health: Culture, race and ethnicity-A supplement to Mental Health: A report of the Surgeon GeneralU.’S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental HealthRockville, MDGoogle Scholar
  35. Wray, HR. 1993Mandatory minimum sentences: Are they being imposed and who is receiving them? Administration of Justice Issues, before the Subcommittee on Crime and Criminal Justice, Committee on the Judiciary, House of RepresentativesUnited States General Accounting OfficeWashington, DCGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Annelle B. Primm
    • 1
    • 3
  • Fred C. Osher
    • 2
  • Marisela B. Gomez
    • 3
  1. 1.Johns Hopkins HospitalBaltimore
  2. 2.Department of Psychiatry, and is the Director of the Center for Behavioral Health Justice and Public PolicyUniversity of Maryland School of MedicineBaltimore
  3. 3.Social Health ConceptsBaltimore

Personalised recommendations