In British Columbia, Canada, the challenge of caring for mentally disordered inmates in jails has been met with a two-tiered assessment approach: screening followed by comprehensive assessments. Intake interviewers evaluate mental disorder and risk for violence, suicide, self-harm, and victimization. The screening and risk management procedures were published in the Jail Screening Assessment Tool (JSAT). The results of two prospective studies of mental health screening with the JSAT in two samples of women inmates are presented. The first study reports the prevalence of mental health needs among female inmates based on results from JSAT and the Brief Psychiatric Rating Scale-Expanded (BPRS-E). The second study tested the validity of referrals to the mental health program based on ∼20 min. semi-structured intake interviews using the JSAT (includes the BPRS-E) compared to independent evaluations of mental disorder with the Structured Clinical Interview for DSM-IV Non-Patient Edition (SCID-I/NP). Results of both studies indicated a high rate of substance abuse and other serious mental illnesses among female inmates. In the second study, intake interviewers using the JSAT were in agreement with independent SCID assessments at a rate significantly better than chance; yielding a sensitivity of 70.6% and a specificity of 75.0%. These preliminary results suggest the JSAT is a potentially effective tool for identifying female inmates in need of mental health services and specialized placement.
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