Report Highlights Mental Health Treatment Shortcomings in Iowa Jails

hands and jail cell bars

by Andy Jones
January 18, 2017

Disability Rights Iowa released an extensive new report last month, documenting a plethora of ways that Iowa jails are denying people with mental illness necessary medical treatments and medications in its county jails.

“The Eighth and Fourteenth Amendments to the United States Constitution require jails to provide inmates with adequate mental health care,” the report states. “Courts have determined that an inmate’s right to mental health treatment is no different than their right to physical health treatment…

“Treatment provided must ‘meet an acceptable standard of treatment and care in terms of modern medicine and technology and current beliefs about medical treatment.’”

For the report, DRI investigators visited 30 of the state’s 97 county jails, which hold people awaiting trial or incarcerated for sentences of less than one year.

Last year, Iowa closed two of its four main psychiatric centers, but, as described in the report, failed to add promised capacity at the remaining two centers. Likewise, a severe shortage of community-based services, especially in rural areas, further exacerbates the state’s reliance on county jails for treating people with severe mental illness.

Of the jails surveyed, DRI found that 30 percent of the facilities did not provide any mental health care beyond basic medication management, negatively impacting hundreds of inmates. Furthermore, many of the jails relied on non-physicians to make decisions regarding the inmates’ prescriptions.

Many inmates surveyed reported that jail staff had denied them medications based on non-medical factors, such as cost and for disciplinary reasons.

To reduce the number of people with mental illness entering the county jail system, the report calls on Iowa to expand the use of a variety of preventive interventions, such as Crisis Intervention Training for law enforcement, mobile crisis teams and mental health courts.

“Unfortunately, without major systemic reform, mentally ill individuals will continue to end up in county jails in unnecessarily large numbers," the report stated. "The difference between county jails and mental health institutions in reality exists in name only. In every other way each facility is in the position of housing seriously mentally ill individuals and being responsible for their basic needs.

"By relying on Iowa’s jails to serve as the last resort for those with significant mental illness, Iowa echoes the dangerous, dehumanizing, and fundamentally unsound approaches to mental health treatment of generations past. We can and must do better."

In Jail and Out of Options [PDF], the 44-page report, can be read here. 

In Washington, DRW's AVID Jail Project has produced several reports and videos exposing conditions for inmates with disabilities in Washington's county jails. Reports released in 2016 include, "Cruel But Not Unusual: Solitary Confinement in Washington's County Jails", and "County Jails, Statewide Problems: A Look at How Our Friends, Family and Neighbors with Disabilities are Treated in Washington's Jails".

Disability Rights Washington and Disability Rights Iowa are the designated protection and advocacy agencies in Washington and Iowa, respectively, and are members of the National Disability Rights Network.