Research shows that people on probation and parole have high mortality rates, two and three times higher than the public at large. That suggests community supervision systems are failing at their most important — and basic — function: ensuring people on probation and parole succeed in the community.
The Prison Policy Initiative did a deep dive into the extensive National Survey on Drug Use and Health (NSDUH). The results of this survey, administered by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA), provide insights into these specific — and often unmet — needs faced by people under community supervision.
Because this survey asks respondents if they were on probation or parole in the past 12 months, this dataset comes closer than any other source to offering a recent, descriptive, nationally representative picture of the n probation and parole population.
The data show that people under community supervision have high rates of substance use and mental health disorders and extremely limited access to health care, likely contributing to the high rates of mortality.
The data show that people on probation and parole experience high rates of chronic health conditions and disability, are extremely economically marginalized, and have family obligations that can interfere with the burdensome — often unnecessary — conditions of probation and parole.
Three in 10 people under community supervision have substance use disorders, four times the rate of substance use disorders in the general population. Similarly, 1 in 5 people under community supervision has a mental health disorder, twice the rate of the general population.
NSDUH data illustrate that most people on probation and parole do not have adequate access to health care, implying that probation and parole offices are failing to match people with the services they need to succeed in the community.
Nearly one-third of people on probation and parole with a mental health disorder report an unmet need for mental health treatment. Over two-thirds of people with substance use disorders report needing treatment, but not receiving it. Similarly, only about one-third of people on community supervision with opioid use disorder report receiving medication-assisted treatment (MAT), the “gold standard” of care.
Finally, many people on probation and parole have no health insurance, even though many people on probation and parole have incomes low enough to qualify them for Medicaid. Some 25% of people on probation and 27% of people on parole were uninsured at the time of this survey. This lack of treatment access reported by people under community supervision represents a massive failure of probation and parole offices.
The Prison Policy Initiative concludes that probation and parole systems are failing to link people to the health care they need, despite all the evidence showing disproportionate rates of serious illness and death within supervised populations.
These “alternatives” to incarceration, ostensibly created to help people address in a community setting the problems that led to their conviction, set people up to fail with burdensome, often unnecessary requirements that show little regard for people’s individual circumstances, including low incomes and child care obligations.
The clearest example of these conditions is the requirement to abstain from drugs or alcohol; given that so many supervised people with substance use disorders do not receive treatment, what hope do they have of staying out of jail when a positive drug test may constitute a “violation”?