Mental Health Challenges and Considerations With Individuals in Rural Jails

The rural jail population has increased in recent years, even as urban jail populations have decreased. Due to their geographical location, rural jails face difficulties in providing proper care for those detained and connecting returning citizens to needed services prior to release. In many rural communities, county budgets are low and mental health resources in general are limited or nonexistent. This presents two primary problems for rural jails. First, there are few mental health providers who can contract with the jail to provide assessment, counseling, or crisis intervention. This often leaves few viable options for behavioral health interventions, with medication management by jail medical staff or placements in solitary units among the most common. Second, with nowhere else to go, many individuals who would otherwise be in psychiatric beds are being held in jails to mentally stabilize and await inpatient placement. The chapter also discusses innovations for reaching rural jail populations, with an emphasis on the rise of telehealth.