UC Davis

There are a disproportionate number of seriously mentally ill inmates in California jails. Rural and suburban communities incarcerate many inmates with significant mental health needs yet struggle to maintain sufficient mental health providers to treat this vulnerable population. Jail mental health providers have long faced staffing, treatment space and other resource obstacles in providing constitutionally appropriate care to mentally ill inmates, which were exacerbated by COVID-19. At the time of this study, many of California’s counties were undergoing new litigation and consent decrees to investigate and potentially improve jail safety conditions, including those related directly to mental health services. Guided by the Socio Ecological Model, this study aimed to explore the individual, interpersonal and organizational factors that support jail mental health providers in delivering mental health care services to inmates in rural and suburban California jails. Qualitative data were collected through individual telephone interviews with 14 rural and suburban jail mental health providers, which were recorded, transcribed and thematically analyzed. Themes were identified within 5 domains of the Socio Ecological Model (individual, interpersonal, organizational, community, and public policy levels). Two key findings emerged. First, the study identified needs for exposure to the jail environment as part of basic clinical education, and identified specific needs for mental health provider training, mentoring and clinical supervision that are both internal and external to the jail setting. Second, the study identified strengths of jail mental health providers and their networks to build upon including resiliency, collaboration and the support needed to navigate difficult experiences within the jail setting. Study findings highlight opportunities for educational institutions, county behavioral health and jail administrators, contracting agencies and correctional health care organizations to more fully understand how to train, mentor, recruit and retain jail mental health providers—especially for California’s rural and suburban counties.