Decarceration of older adults with mental illness in the USA – beyond the COVID-19 pandemic

• DOI: https://doi.org/10.1108/IJPH-06-2021-0049
• Published date: 19 May 2022
• Date: 19 May 2022
• Pages: 213-226
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Lauren N. Tronick,Benjamin Amendolara,Nathaniel P. Morris,Joseph Longley,Lauren E. Kois,Kelli E. Canada,Dallas Augustine,Nickolas Zaller

Decarceration of older adults with mental

illness in the USA –beyond the

COVID-19 pandemic

Lauren N. Tronick, Benjamin Amendolara, Nathaniel P. Morris, Joseph Longley,

Lauren E. Kois, Kelli E. Canada, Dallas Augustine and Nickolas Zaller

Abstract

Purpose –Aging and mental illnessboth represent significant publichealth challenges for incarcerated

people in the USA. The COVID-19 pandemic has further highlighted the vulnerabilities of incarcerated

people becauseof the risks of infectious disease transmissionin correctional facilities.Focusing on older

adults with mental illness, this paper aims to examine efforts to decarcerate US correctional facilities

during the COVID-19pandemic and whether these approachesmay lead to sustainable reforms beyond

the pandemic.

Design/methodology/approach –A narrative literature review was conducted using numerousonline

resources, including PubMed, Google Scholar and LexisNexis. Search terms used included

‘‘decarceration pandemic,’’ ‘‘COVID-19 decarceration,’’ ‘‘aging mental illness decarceration,’’ ‘‘jails

prisons decarceration,’’ ‘‘early release COVID-19’’ and ‘‘correctional decarceration pandemic,’’ among

others. Given the rapidly changing nature of the COVID-19 pandemic, this narrative literature review

included content fromnot only scholarly articles and federal and state government publicationsbut also

relevant media articlesand policy-related reports. The authors reviewedthese sources collaboratively to

synthesize a review of existing evidence and opinions on these topics and generate conclusions and

policy recommendationsmoving forward.

Findings –To mitigate the risks of COVID-19, policymakers have pursued various decarceration

strategies across the USA. Some efforts have focused on reducing inflow into correctional systems,

including advising police to reduce numbers of arrests and limiting use of pretrial detention. Other

policies have sought to increaseoutflow from correctional systems, such as facilitating earlyrelease of

people convicted of nonviolent offenses or those nearing the end of their sentences. Given the well-

known risks of COVID-19 among olderindividuals, age was commonly cited as a reason for diverting or

expediting release of people fromincarceration. In contrast, despite their vulnerability to complications

from COVID-19, people with seriousmental illness (SMI), particularly those with acute treatmentneeds,

may have beenless likely in some instances to be divertedor released early from incarceration.

Originality/value –Although much has been written about decarceration during the COVID-19

pandemic, little attention has been paid to the relevance of these efforts for older adults with mental

illness. This paper synthesizes existing proposals and evidence while drawing attention to the public

health implications of aging and SMI in US correctional settings and explores opportunities for

decarcerationof older adults with SMI beyond the COVID-19 pandemic.

Keywords Substance use disorder, Mental illness, Incarceration, Coronavirus,

Geriatric, Decarceration

Paper type Literature review

Introduction

Despite having just 5% of the world’s population, the USA is home to over 20% of the

world’s incarcerated people (Wagner and Bertram, 2020). In 2019, there were more than

two million people incarcerated in US correctional facilities at a given time (Kang-Brown

(Informationabout the

authorscan be found at the

end of this article.)

Received 9 June 2021

Revised 18 December 2021

Accepted 29 April 2022

The authors would like to thank

Aging Research in Criminal

Justice & Health Network.

DOI 10.1108/IJPH-06-2021-0049 VOL. 18 NO. 2 2022, pp. 213-226, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 213