By Michael Rempel, Krystal Rodriguez, and Kellyann Bock from the Data Collaborative for Justice at John Jay College, and Yonah Zeitz, gabriel sayegh, and Melanie Dominguez from the Katal Center for Equity, Health, & Justice.

The New York City Council established a legal deadline of August 31, 2027 for closing the jails on Rikers Island and building smaller modern jails in the City’s four large boroughs. The replacement jails, when combined with over 300 secure hospital beds for people with serious medical or mental health conditions, will hold a citywide capacity of about 4,200 people on any given day. However, since reaching a low watermark of 3,809 in April 2020, the City’s daily jail population has grown to nearly 7,000—alongside a ballooning sub-population in need of mental health treatment.  Today, Rikers is the largest mental health facility in New York City and among the largest in the country.5 The goals of the current research and policy brief are threefold: 1. Present updated data about the mental health needs of people held in the NYC jails. 2. Reveal the individuals behind these facts through select case studies. 3. Identify a continuum of safe and effective jail diversion strategies for this population. Latest Facts About Mental Health in NYC Jails Currently, close to 7,000 people are held in the City’s jails, of whom 85% have been detained before trial. Black people make up 58% of the jail population, compared to 23% of the City’s general population. In absolute terms, over twice as many Black people as the next highest racial/ ethnic group are in jail while flagging for mental health. ■ Mental Health Prevalence: Over the same 2020-to-2025 timeframe that saw a significant jail increase, overall, the fraction of the jail population receiving mental health services climbed from 44% to 60%, 6 and the fraction diagnosed with a serious mental illness rose from 17% to 22%. 7 The latest health data also indicates that 25% have an opioid use disorder, 30% have an alcohol use disorder, and 28% are homeless or “likely to be homeless” when released,8 a figure that rises to 42% for those with a serious mental illness.9 ■ Medical Conditions: As of September 2025, 28% of people held in jail were diagnosed with lung disease, 15% with cardiovascular disease, 8% with neurologic disease (e.g., epilepsy or stroke history), 6% with diabetes, 4% with hepatitis B or C, 3% with stage 3+ chronic kidney isease, 3% with HIV/AIDS, and 1% with a malignancy.10 ■ Missed Appointments: In September 2025, there were 15,823 missed medical appointments compared to 3,626 in September 2020.11 A recent monitors’ report indicated that from July to September 2024, people were produced for only 53% of scheduled mental health appointments and 77% of reentry planning appointments.12 ■ Disproportionate Gender Impact: Of close to 500 women jailed at Rikers as of October 2025, 87% have needed mental health services, compared to 58% of men.13 ■ Disproportionate Length of Stay: On average, as of October 31, 2025, people in the latest jail population needing mental health services had been held for 281 days, compared to 212 days for people not needing such services. Controlling for people’s background characteristics, a recent analysis found that flagging for mental health within ten days of jail intake predicted a total length of stay 34 days longer than people who never flagged.

By The U.S. Government Accountability Office

U.S. Customs and Border Protection (CBP), through its components U.S. Border Patrol and Office of Field Operations, detains individuals who unlawfully enter the U.S. at short-term holding facilities. CBP personnel process individuals and determine the next course of action, such as transferring them from custody or removing them from the country. For the past decade, CBP has used contracted medical personnel at facilities along the southwest border to provide health screenings and treatment of basic medical conditions to individuals in custody. 

GAO found that CBP developed policies and guidance for providing medical care to individuals in custody but has not consistently implemented them. For example, CBP requires some populations, such as children, pregnant individuals, and adults who indicated they might have an illness or injury, to receive a basic physical exam known as a medical assessment. Although CBP introduced new guidance and improved the percentage of individuals who received medical assessments, GAO found that some individuals still did not receive assessments, as required. For example, 57 percent of adults with a potential illness or injury and 20 percent of pregnant individuals did not receive medical assessments from August 2023 to August 2024, as required. Without an oversight mechanism to ensure that people in custody receive the required medical assessments, CBP may not be aware of medical needs and cannot ensure it takes the appropriate next steps for any necessary medical care. GAO also found that CBP and contracted medical personnel did not consistently implement additional care requirements for individuals in custody who had serious injuries or illnesses (i.e., those who were medically high-risk). For example, from August 2023 to August 2024, contracted medical personnel did not conduct medical monitoring checks required for medically high-risk adults and children approximately 40 percent of the time. In July 2025, CBP developed new tools to inform its oversight efforts, but did not explain how it will use them to systematically assess whether medically high-risk individuals received their medical monitoring checks on time. Developing and implementing a mechanism to monitor this requirement and others would help CBP better ensure these individuals receive required care, and personnel are monitoring their conditions. CBP did not consistently provide medical records and prescriptions—referred to as medical summary forms—as required, to individuals with medical issues leaving CBP custody. By not providing the medical summary forms, CBP can create challenges with continuity of care. GAO also found CBP’s oversight reports did not include data from facilities that do not have contracted medical personnel. These facilities send individuals to local hospitals or urgent care facilities for medical care, including medical assessments. Without these data, CBP cannot ensure all individuals in custody received required medical assessments to decrease the risk of adverse medical outcomes. Moreover, GAO’s analysis showed that CBP did not consistently manage or oversee its medical services contracts.

By the staff of Democratic Sen. Jon Ossoff and Republican Rep. Jen Kiggans

U.S. Senator Jon Ossoff of Georgia and Representative Jen Kiggans of Virginia have launched a bipartisan investigation into the incarceration of children with mental health conditions in juvenile detention facilities (“facilities”)—centers designed to detain children charged with or sentenced for delinquent offenses—across the United States. As part of this investigation, beginning in May 2024, Sen. Ossoff and Rep. Kiggans surveyed facilities about what circumstances lead to the prolonged detention of children with mental health conditions and children who have not been charged with offenses. In survey responses, 75 facilities across 25 states reported incarcerating children who could be eligible for release to mental health care programs outside the facility but remained incarcerated because the care they needed was not yet available. More than half of these facilities reported incarcerating children in these circumstances for at least one month, and some reported incarcerating children in these circumstances for up to a year. Facilities reported incarcerating children who are on the autism spectrum, who have general neurodevelopmental issues, or who engage in severe self-harm, who could be eligible for release to an external program or health facility. One facility in North Dakota reported that children “with neurodevelopmental issues sometimes are held the longest, while waiting on forensic evaluations of competency.” Twenty responding facilities in 13 states reported incarcerating children either with no charges or with charges that would not ordinarily lead to placement in juvenile detention. Many of these facilities reported incarcerating these children because they needed mental health services outside of the facility that were not yet available or needed mental health care available at the facility and not outside. One facility reported that, in the year before the survey was administered, it held as many as 29 children without charges or with charges that would not ordinarily lead to detention due to a lack of available offsite mental health care. Another facility reported that, in the year before the survey was administered, it held 10 children in these circumstances solely so that they could access internal mental health services not available outside the facility. Another reported incarcerating children in these circumstances for more than a year due to lack of offsite mental health care. Six facilities reported incarcerating children beyond their expected release dates after their charges were dropped or sentences completed, due to lack of available offsite mental health care. One facility reported that it had held roughly 50 children under these circumstances in the year before the survey was administered alone.According to experts in pediatric care, incarcerated children have high rates of physical, mental health and developmental needs that may be undiagnosed or under-addressed in custodial facilities. Incarcerated children also face limited access to evidence-based medical care and a lack of educational opportunities. Other experts warn that incarcerating children can cause adverse lifelong medical and mental health outcomes including higher rates of depression, and suicidality.

By Taleed El-Sabawi, Shelly Weizman, Regina LaBelle

Civil litigation provides a novel and underutilized source of information about deaths in U.S. jails, particularly when official data are incomplete. This study systematically analyzes verdicts, settlements and judgments to explore patterns in practices linked to preventable mortality in U.S jails. Results: Content analysis of facts alleged in 90 cases filed between 2015 and 2020 revealed thematic patterns related to inadequate or delayed medical care. Alleged facts routinely included observable signs of serious medical need—such as incoherence, convulsions, or pleas for help—followed by failures to provide timely or medically appropriate care. In cases of suicide, allegations commonly describe known mental health conditions, discontinued medication, and lapses in monitoring or suicide prevention protocols. Despite repeated warnings—by the individuals themselves, fellow incarcerated persons, or family members—jail staff frequently failed to act. A small subset of cases resulted in judgments for the defense, often where some care was provided or protocols were followed, even if outcomes were still fatal. Conclusion: These findings suggest that in cases resulting in reported settlements, verdicts or judgments incustody deaths in the U.S. could be prevented through improved intake screening, timely medical monitoring, care coordination, and adherence to established protocols. Litigation records offer important insight into how systemic failures contribute to jail mortality, with implications for policy, public health, and correctional practice.

By Matthew Brooks, Jessica Glynn, Hannah Fawcett, Aminah Barnes, Rachael Carew, David Errickson, Maria Livanou

Objectives

Prior research indicates that jury duty can be distressing for some jurors. This study examined: (1) the influence of prior trauma characteristics (type, exposure, time since trauma), medical fear and mental health difficulties on stress and emotional responses during a mock trial and 1 week later; and (2) associations between early stress reactions during a trial on subsequent stress and emotional reactivity after exposure to skeletal evidence and 1 week later.

Methods

Mock jurors (n = 180) completed baseline self-report mental health measures, read a summary of a murder case and were then exposed to graphic skeletal evidence. Stress and/or emotional responses were collected at baseline, after reading the case summary, before and after viewing the skeletal evidence and 7 days post-trial.

Results

Participants reported a wide range of prior traumatic experiences, with nearly half reporting pre-existing mental health difficulties. Average traumatic stress symptoms tripled from baseline to follow-up, with 44% of participants meeting PTSD-type criteria 7 days later. Medical fear and mental health difficulties were positively associated with some stress and/or emotional responses throughout the trial, with mixed findings concerning trauma characteristics, stress and emotional reactivity. Initial stress and emotional responses to case evidence were linked to later stress and emotional reactions, after accounting for pre-existing trauma and mental health characteristics.

Conclusions

Past trauma experiences, mental health difficulties and immediate stress responses during a trial can exacerbate emotional and stress reactions. Addressing the psychological impacts of pre-existing trauma symptoms could improve juror well-being during this important civic duty

By I-An Su, John H. Blume and Stephen J Ceci

More than three decades ago, the Supreme Court of the United States (SCOTUS) ruled that individuals who are not competent (alternatively referred to by the Court as insane) at the time of their scheduled execution cannot be put to death. Despite the years that have passed since the Court's decision and the literal life-or-death stakes involved, competency for execution (CFE) remains underexplored in the psychological, psychiatric, and legal literature. A number of important legal and ethical issues that arise when a person on death row maintains they are not competent to be executed are still unresolved even after the landmark Supreme Court cases such as Ford v. Wainwright (1986), Panetti v. Quarterman (2007), and Madison v. Alabama (2019). In this first-of-its-kind descriptive study, we analyzed the demographic and case characteristics of the 28 successful Ford claimantsindividuals in the United States who have been found to be incompetent to be executed and compared them to the general death row population and homicide cases nationwide. Our findings reveal some similarities but also some differences between these claimants and the general death row population and homicide cases: the successful Ford claimants are exclusively male (in keeping with the general prison population on death row), relatively older, and underrepresented among White and Latinx inmates (i.e., Black claimants are more successful than their White and Latinx counterparts at evading execution). Nearly all (96%) suffer from schizophrenia, with 79% experiencing psychiatric comorbidity, yet only 54% received any significant treatment before or after the criminal offense. The claimants' cases also involve a higher proportion of child victims, male family members, and female non-family member victims, as well as more multiple-victim cases (not indiscriminate) and fewer intraracial homicides. Fewer victims are male, and more are female. However, the cases do not align with typical male-on-male violent crimes or femicide patterns, such as those involving sexual or domestic violence. Additionally, systematic psycho-legal deficiencies are prevalent, including a low rate of mental health evidence (61%) presented at trials and some cases lacking psychiatric involvement in CFE evaluations. Temporal influence and drastic state variations on CFE evaluation are also noted. Although the small sample size limits generalizability, this small-scale descriptive study offers a number of important insights into the complexities of CFE decisions and lays the groundwork for future research and policy development.

By Charlie Brooker, et al.

This study presents the first cross-European investigation into occupational stress and morale among probation staff across member jurisdictions of the Confederation of European Probation (CEP). Using a mixed-method design, data were collected from 357 individual probation officers across 20 European countries and organisational directors from 22 jurisdictions during summer 2025. The Maslach Burnout Inventory (MBI) was used to assess emotional exhaustion, depersonalisation, and personal accomplishment, while a complementary organisational questionnaire examined structural provisions for staff well-being, including primary, secondary, and tertiary prevention measures. Results revealed moderate levels of burnout across the sample, with mean MBI scores of 21.3 (emotional exhaustion), 6.8 (depersonalisation), and 30.7 (personal accomplishment). Approximately one-third of respondents (34%) were engaged, 32% ineffective, 23% overextended or disengaged, and 12% met the criteria for full burnout. Burnout was most prevalent among staff with high caseloads and longer tenure, but demographic variables such as age and gender were not significant predictors. Organisational analyses identified three national clusters—advanced, emerging, and minimal protection—based on the degree of institutionalisation of staff support systems. Jurisdictions such as Austria, the Netherlands, and Norway demonstrated comprehensive, multi-tiered prevention frameworks, while others relied on informal, ad hoc measures. Cross-mapping of individual and organisational data indicated that higher engagement levels corresponded closely with robust institutional prevention systems. The findings affirm that staff morale in probation work is primarily an organisational outcome rather than an individual trait. Sustainable well-being depends on formalised policies for workload governance, confidential support access, and structured reintegration after burnout. The report concludes that embedding well-being within probation systems’ governance and evaluation frameworks is essential for maintaining professional efficacy, reducing turnover, and safeguarding the rehabilitative function of community corrections across Europe.

Utrecht: Confederation of European Probation, 2025. 32p.

By Emily Grisé; Alexander Cooke; David Cooper; Zane Oueja; Willem Klumpenhouwer; Amy HobbsOn transit systems across the United States, rising rates of drug use along with deteriorating safety conditions for customers and staff have become increasingly pressing and complex issues for transit agencies to solve. Many challenges surround agencies’ responses to drug use on transit, such as inconsistent data collection and the low uptake of support services.

TCRP Synthesis 179: The Impacts of and Response to Drug Use on Transit, from TRB's Transit Cooperative Research Program, documents and synthesizes the current practices of transit agencies in addressing the consumption and distribution of illegal drugs on their systems, as well as the resulting effects on customer and staff safety and security.

National Academies of Sciences, Engineering, and Medicine; Transportation Research Board; Transit Cooperative Research Program. 2025. p91.

By Richard J. Bonnie and Rebekah Hutton, Editors

Active shooter drills have become a standard practice in nearly all U.S. schools, yet their potential impact on students and educators has received limited attention. School Active Shooter Drills: Mitigating Risks to Mental, Emotional, and Behavioral Health explores how these drills are conducted and how to reduce potential harm while supporting school safety. Developed by a committee of experts in education, school safety, public health, pediatrics, child and adolescent development, psychiatry, psychology, neuroscience, public policy, and criminology, this report provides an in-depth review of current practices and offers guidance. The report provides suggestions for implementing practices that promote prevention and preparedness while supporting well-being, and foster learning environments where students and staff feel safe, capable, and supported.

School Active Shooter Drills finds that while drills aim to enhance preparedness, they often vary dramatically in intensity and design, from simple safety walk-throughs to unannounced, high-simulation events. Such inconsistencies can heighten anxiety, distress, and confusion, especially among vulnerable student populations. The report underscores that developmentally appropriate, trauma-informed practices are essential, and drills involving realistic simulations or deception should be avoided entirely.

School Active Shooter Drills outlines actionable recommendations for state and local policymakers, school leaders, researchers, and federal agencies, including banning harmful practices, supporting staff training, ensuring equitable inclusion, and increasing access to mental health resources. This report also calls for national guidance and sustained research to strengthen the evidence base and help schools foster safe, inclusive, and supportive learning environments so that schools not only prepare students and staff for emergencies but also protect their mental, emotional, and behavioral well-being.

National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Board on Children, Youth, and Families; Committee on Law and Justice; Committee on the Impact of Active Shooter Drills on Student Health and Wellbeing. 2025. p253.

By Umphress, E., and Thomas, J. M. (Eds.)

The 2018 National Academies report Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine recommends the creation of institutional policies that can improve an institution's climate, culture, and reporting options while supporting those who have experienced sexual harassment.

This perspective paper addresses the 2018 report recommendations by exploring how a procedural justice framework could help guide improvements and revisions to policies, processes, and practices within higher education institutions with the potential to mitigate the negative experiences and outcomes of those affected by sexual harassment. Based on previous research, this paper applies a principles-based perspective to highlight ideals, rules, and standards that institutions can implement to achieve this goal.

Washington, DC: The National Academies Press. https://doi.org/10.17226/26563. 2022. 33p.

Edited by Murdoch Watney

The chapters in this volume focus on the future of law and related disciplines: human rights and access to medical care, corruption and money laundering in state procurement, counterfeit medical products, IPR waiver on COVID-19 vaccines, emergency powers, freedom of expression, prison healthcare, the impact on labour law, access to courts and digital court processes, access to education and the impact on insurance law are but a few possible topics which are addressed.

Johannesburg, UJ Press, 2022. 288p.

By Kayla Tawa

As mental health concerns and awareness around mental health challenges have increased, policymakers have prioritized mental health policy. Within these conversations, there is a broad recognition that far too often people experiencing mental health challenges encounter the criminal legal system rather than accessing mental health supports. In response, many policymakers have championed policies that aim to divert people experiencing mental health challenges away from prisons and jails and into mental health treatment. However, some of these policies, particularly those involving forced treatment, rely on carceral tactics and replicate incarceration.

Washington, DC:  Center for Law and Social Policy (CLASP). 2024, 14pg