Dual Diagnosis Among Incarcerated Populations: Exception or Rule?

ABSTRACT

Objectives: Over 2 million individuals were incarcerated in jails and prisons in the United States in 2004. Multiple studies indicate that the prevalence of mental illness and substance use disorders is substantially higher in correctional environments when compared with rates in the community. The objective of this paper is to provide information on the prevalence of dual diagnosis among those incarcerated and the importance of assessing comorbidity for determining treatment needs of inmates. For the purposes of this article, the definition of dual diagnosis includes mental disorders and coexisting substance use disorders, mental disorders and coexisting developmental disabilities, and developmental disabilities and coexisting substance abuse disorders.

Methods: An extensive electronic literature search was conducted through PubMed, Medline, Department of Justice, and the National Commission on Correctional Health Care. Studies examining the prevalence of mental illness and substance use in jails and prisons, female inmates, and inmates with developmental disabilities were reviewed.

Results: The literature reviewed indicated a high comorbidity of mental illness and substance use disorders in incarcerated individuals. Providers should be aware of issues regarding dual diagnosis in special populations among those incarcerated to include female offenders and offenders with developmental disabilities.

Conclusion: Providers who work in correctional environments must understand the significant prevalence of comorbid mental illness and substance use disorders in those incarcerated to more effectively assess and treat inmates.

KEYWORDS:

• Inmate
• female offender
• developmental disability
• substance use
• prevalence
• jail
• prison
• alcohol use