Mental health services in jail: Identifying and quantifying barriers to implementation

Although jails are the largest provider of mental health care nationally, access to treatment in U.S. jails is limited. Limited empirical information on factors impacting the implementation of mental health services in jail may be contributing to low treatment rates. We documented potential barriers impacting the provision of a brief cognitive-behavioral group-based intervention for people with serious mental illness in jail, including the rates of participants' recruitment, as well as starting and completing the intervention; time required for each group from recruitment to completion; and the types and frequencies of obstacles encountered during treatment sessions. We organized the barriers according to the Consolidated Framework for Implementation Research. All potential treatment recipients' questions prior to treatment, and reasons provided for not starting the treatment, were also logged and analyzed using content analysis and frequency counts; tables of the themes, frequencies, and examples of participant concerns are presented. These results suggest that although many participants were interested in and incarcerated for sufficient time to complete the intervention, relatively few participants were able to begin the groups (44%). Over 150 obstacles to treatment were encountered during treatment provision (including recurring issues with client transportation within the facility and facility lockdown). Understanding participants' progression through the study (recruitment, start, completion), their questions and reasons for not participating, and interruptions to the sessions provide important information for increasing the usability of mental health care in jails. The current findings can improve the implementation of needed evidence-based treatment in this carceral setting. (PsycInfo Database Record (c) 2025 APA, all rights reserved).