Lessons Learned: Brief Jail Mental Health Screen

Author: Leigh Lynes

Young man sitting in front of a chain link fence

Key Takeaways

  • Individuals with mental illness are overrepresented in incarcerated populations, and recidivism rates are higher for those with mental illness. Providing mental health screening at booking and offering mental health outreach after release reduces recidivism and increases participation in relevant mental health support services.
  • Mental health screening and outreach after release from jail reduces 360-day recidivism rates by 9 percentage points.


The Johnson County, Kansas Department of Corrections estimates that 27% of the individuals in their jails have a serious mental illness (SMI). This is higher than the estimated 5% of the general U.S. adult population who have an SMI. People experiencing SMI symptoms have more frequent contact with the criminal justice system—1 in 3 individuals identified at jail entry as having a mental illness had a subsequent booking, compared to only 1 in 5 for the general population.

To address this concerning trend, Johnson County began using the Brief Jail Mental Health Screen (BJMHS) in November 2016. The BJMHS is designed to determine if detainees need further mental health assessment and treatment. To understand the impact of the BJMHS on recidivism rates and connection to mental health services, Johnson County partnered with LEO to conduct a rigorous, quasi-experimental study.

Individuals who were booked at the Johnson County jail for the first time on or after November 1, 2016 and were released on or before November 30, 2018 were included in the study. The study did not include anyone who refused the screening, was unreachable after release, or lived outside of the three-county area of the study. A total of 9,757 individuals were included in the study, with 2,500 eligible for outreach services based on their screening responses.

Individuals who were identified by the BJMHS as showing SMI symptoms were separated into two groups—residents of Johnson County made up the treatment group, and residents of other counties comprised the control group. By comparing outcomes for these two groups, LEO was able to evaluate the impact of the BJMHS tool as well as the subsequent outreach services offered. LEO researchers used anonymous jail records and records from the Johnson County Mental Health Center to determine how the BJMHS and outreach services impacted recidivism rates and connection to mental health services.

What We Learned

Results of the BJMHS study in Johnson County indicate that the implementation of the BJMHS at intake decreases recidivism rates for those who qualify for mental health outreach. Individuals from Johnson County who qualified for mental health outreach had a 12-percentage point reduction in recidivism after 60 days, compared to a 4-percentage point increase for residents of other counties. Importantly, a decrease in recidivism rates is also observed after180 and 360 days—10 percentage points and 9 percentage points, respectively.

Additionally, those who had never received mental health care prior to their jail booking saw greatly reduced recidivism rates. Individuals from Johnson County who qualified for mental health outreach and indicated no prior mental health care had a 23-percentage point reduction in recidivism after 60 days.

Importantly, LEO researchers were able to show that outreach support efforts help connect individuals to mental health resources. Of those who were eligible for mental health outreach, 44% interacted with the outreach team, and 28% connected to mental health services.

Where We’re Going

Access to mental health services is just one of the barriers that previously incarcerated individuals face once they re-enter the community. This and other challenges—such as finding housing and a job, maintaining sobriety, and connecting with a healthy support system—can compound to make it difficult for a person to chart a new path forward.

But because systems of community corrections have not been the subject of significant research, we have many questions about how society can best serve the unique needs of people who have been involved with the criminal justice system.  To help answer these questions, LEO created a Criminal Justice Initiative research agenda to guide us as we build the evidence that is needed for greater impact in this space.

In early 2021, we launched a Criminal Justice Cohort of research projects in partnership with county correctional systems and service provider partners. Together, we will build evidence to help unleash the potential of the millions of Americans who are involved in the criminal justice system. 

Learn with us.