Jail Health: Behavioral Health Medications Reach Many Patients, but Gaps Remain for Some

Jail Health Services (Jail Health) has processes focused on stabilizing patients with high-severity behavioral health needs. We identified gaps for patients who have less severe issues but might still need behavioral health care. We found that Jail Health ordered most behavioral health medications within two days of a patient’s booking at the King County Correctional Facility and most patients received their medication within 24 hours of Jail Health placing the order. However, Jail Health placed some medication orders a month or more after booking. Many factors can affect how long it takes patients to receive a medication order, including wait times for psychiatric appointments. We found that some patients waited more than a month for psychiatric appointments, and some were released before their appointments could occur.

Jail Health sometimes changes or discontinues a patient’s existing medications according to its prescribing guidelines. Staff members, community advocates, and patients have stated that some of these medication changes or discontinuations can result in negative side effects and health or behavioral issues that can worsen a patient’s time at the jail or in their transition back into the community.

Lastly, while Jail Health can provide a supply of medication to patients at release, it does so for only a small percentage of people receiving behavioral health medications in the jail. For those who do receive a medication supply at release, the amount might be insufficient to last until the patient is able to obtain a new prescription in the community.

We make recommendations to reduce wait times for psychiatric appointments, improve processes for medication changes or discontinuations, improve patient communication, and expand access to medications at release. Implementing these recommendations will help ensure Jail Health improves continuity of care and increases patient participation in decisions about their behavioral health care.

King County has a commitment to provide incarcerated people in its care with quality and timely health care, including behavioral health. Jail Health provides behavioral health care and medication for thousands of incarcerated people every year, many of whom do not have access to health care outside of the jail. For almost 20 percent of bookings at the King County Correctional Facility in 2023, the patient received an order for at least one behavioral health medication. Disruptions to medication and untreated medical conditions can lead to serious consequences, including recidivism, patient suffering, and death.