Understanding mental health and substance use needs during jail incarceration and while on probation in Colorado

Local jail incarceration and probation supervision worsen mental health and heighten substance use needs. Community-engaged, local approaches are needed to identify the criminal legal and structural factors that must be addressed in future interventions to improve health equity. Our objective was to understand how individuals’ experiences in local criminal legal systems impact their mental health and substance use needs locally. We conducted individual interviews (N = 30) with individuals currently in jail (n = 20) and under probation supervision (n = 10) in Colorado. We then conducted iterative thematic analysis. Almost all individuals disclosed mental health (n = 28) or substance use (n = 29) concerns. Three themes emerged: (1) “They just stick you in a box, because they don't know what to do with you:” Mental health de-prioritization over the life course; (2) “Nobody wants to feel pain:” substance use as coping; and (3) “Invisible incarceration:” Probation and other forms of institutionalization continue to ignore root causes. There is a need to attend to the root causes of individuals’ criminal legal involvement in a way that does not further their institutionalization but provides community care.