By Roni Ayalon
EASTHAMPTON, MASS – The Prison Policy Initiative (PPI) released new research this week suggesting individuals on probation and parole have high rates of mortality, most likely due in part to “high rates of substance use and mental health disorders and extremely limited access to healthcare.”
Mortality rates for probationers and parolees are “two and three times higher than the public at large,” said PPI, which said it looked into the National Survey on Drug Use and Health (NSDUH) and found incarcerated also “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.”
The research explores each of these factors and explains how each one is uniquely challenging for those on probation and parole as well as how it leads to higher mortality rates.
Substance abuse rates and mental health disorder rates are significantly higher among those on probation and parole than the general public, said the research, noting the rate for substance abuse disorders is “four times” the general population…1 in 5 people under community supervision has a mental health disorder, twice the rate of the general population.”
Access to healthcare is extremely poor, added PPI, with “nearly one-third of people on probation and parole with a mental health disorder report[ing] an unmet need for mental health treatment…over two-thirds of people with substance use disorders report needing treatment, but not receiving it.”
“Only about one-third of people on community supervision with opioid use disorder report receiving medication-assisted treatment (MAT), the “gold standard” of care,” said the PPI research, adding access to health insurance is also very poor and many people on probation and parole aren’t covered, “even though many… have incomes low enough to qualify them for Medicaid.”
Poor physical health and well-being as factors are also correlated with these populations, said PPI, commenting, “Criminal legal system involvement is concentrated among people who are socioeconomically disadvantaged and these same populations are at an elevated risk for a number of negative health outcomes.”
In a 2020 study, researchers found that “people under community supervision are more likely to report fair or poor health, more chronic conditions, a diagnosis of COPD, hepatitis B or C, or kidney disease than people in the general population,” the report said.
This population also has higher rates of disabilities, especially cognitive disabilities that “interfere with individuals’ ability to keep track of the 18 to 20 requirements a day people on probation must typically comply with,” PPI noted, adding, “the very high rates of disabilities within the probation and parole communities also “reflects the larger pattern of criminalizing people with disabilities.”
PPI wrote the NSDUH data also shows that probationers and parolees are “extremely economically marginalized, which can interfere with probation and parole conditions.” Three in five have incomes below $20,000 and “more than half have a high school education or less.” These populations “are three times more likely to be unemployed than the general population.”
Despite this economic reality, “people on probation and parole are required to pay unaffordable fees and costs associated with their supervision conditions,” PPI added.
Another PPI finding found many people on probation and parole, “more than half of women,” also have children, and “probation and parole requirements almost never consider childcare or eldercare responsibilities when setting supervision conditions, even as some states require courts to consider a defendant’s caretaker status when considering a sentence to incarceration.”
The PPI concludes the probation and parole systems are “failing to link people to the healthcare 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 the problems that led to their conviction in a community setting, also set people up to fail with burdensome, often unnecessary requirements that show little regard for people’s individual circumstances, including low incomes and childcare obligations,” said PPI, adding, one of the most problematic requirements is to abstain from alcohol and drugs, which is “counterproductive” considering that many of these individuals have substance disorders and yet aren’t being treated.
The PPI asserts “probation and parole systems can’t be seen as true ‘alternatives’ until they are overhauled to support people’s medical and personal needs instead of simply monitoring and punishing their mistakes.”
PPI’s report suggests that until this overhaul, governments “should double down on their investments in diversion programs that are proven to connect people with care — and, to that same end, keep people out of courts and jail as much as possible.”
