Needs for and barriers to correctional mental health services: inmate perceptions.

OBJECTIVES: Because of increasing numbers of mentally ill offenders without concomitant increases in mental health staffing, issues of service utilization and priority populations have become paramount. The aim of this study was to expand upon previous studies of correctional mental health service utilization by examining the underlying factor structure of problems for which inmates may seek services and by examining the barriers hindering inmates' willingness to seek services. Additionally, this study investigated whether previous treatment experiences had an impact on inmates' willingness to seek services or barriers to seeking services.
METHODS: Participants consisted of 418 incarcerated adult males who voluntarily participated in this study and were from three security levels (that is, reception and diagnostic unit, minimum security, and maximum security). Participants completed a three-page survey inquiring about use of mental health services before and during incarceration.
RESULTS: Factor analysis indicated five types of problems for which inmates may request mental health services (behavioral dyscontrol, physical health concerns, negative affect, interpersonal relationships, and institutional relations) and four types of potential barriers to service utilization (self-preservation concerns, procedural concerns, self-reliance, and professional service provider concerns). Inmates with no prior history of mental health service use were more likely to present with self-preservation concerns about services and present as self-reliant.
CONCLUSIONS: Results of this study provide an overarching conceptualization of barriers hindering inmates' willingness to seek services, as well as the types of problems for which they are likely to seek services. Also, inmates' mental health treatment history affected their current perceptions of services.