Exploring Racial Disparities in The Brief Jail Mental Health Screen.

Area of Science:

• Public Health
• Mental Health Services Research
• Health Disparities

Background:

• Jail screening tools are crucial for identifying mental health needs in incarcerated populations.
• Racial disparities in mental healthcare access and outcomes are well-documented.
• The Brief Jail Mental Health Screen (BJMHS) is a tool used for initial mental health assessment in jails.

Purpose of the Study:

• To investigate if race predicts screening outcomes on the BJMHS.
• To determine if specific BJMHS items contribute to racial differences in screening results.
• To assess whether observed racial differences reflect true mental health status or systemic barriers.

Main Methods:

• Analysis of validation data from 22,000 individuals screened in five jails.
• Use of binary logistic regression models to assess the impact of race on screening positive and item endorsement.
• Examination of specific BJMHS items related to symptoms and prior service utilization.

Main Results:

• Blacks and Latinos had lower odds of screening positive compared to Whites.
• Racial minorities were less likely to endorse symptom items and significantly less likely to report prior mental health service utilization.
• Differences were primarily driven by items reflecting barriers to accessing mental health services.

Conclusions:

• Racial differences in BJMHS results likely indicate the perpetuation of existing racial disparities in healthcare access.
• The BJMHS may inadvertently reflect systemic barriers rather than solely individual mental health status.
• Despite potential biases, the BJMHS may still offer an improvement over traditional jail screening methods.