The past 20 years of rapid growth in the populations of America’s jails and prisons has reshaped the landscape of correctional health and health care. While there are many appropriate debates about the public benefits and costs of incarceration on such a scale, incarceration is a reality that provides an opportunity to change health care and health-related behavior with immediate and long-term benefit to the individuals affected. The public health burden that jails and prisons bear is enormous. A disproportionate number of incarcerated individuals are medically and/or psychiatrically compromised. This situation is an opportunity for us as health professionals to make a profound difference in the lives of individuals during incarceration.
UConn Health assumed responsibility for all global medical, mental health, pharmacy, and dental service provision from the Connecticut Department of Correction in November 1997. Connecticut is one of only five states with an integrated jail and prison system. It has an incarceration rate of 326 per 100,000. Jails (serving the unsentenced/pre-adjudicated) are located in Hartford, Bridgeport, New Haven, and Uncasville (male facilities) and Niantic (women). Jails have a high inmate admission and discharge rate, much higher per inmate costs, and present distinct management and clinical challenges. For example, the Hartford jail averages over 30 intakes every night. Statewide, each of the 22,084 annual admissions requires a medical and mental health intake health screening. Generally, one out of five requires prompt medical or mental health intervention. In virtually all categories, the incarcerated population has general medical and psychiatric disease prevalence rates significantly greater than those found in the community.