Revisiting the Brief Jail Mental Health Screen in a Rural Jail Sample

The Brief Jail Mental Health Screen (BJMHS) is one of the most popular screening tools used at the time of jail admission to identify adults with current mental health needs. Prior work has documented the accuracy of the screen primarily in large urban or semi-urban correctional facilities according to diagnostic criteria established in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The current study was designed to evaluate the precision of the BJMHS in a smaller rural jail setting according to the current DSM-5 criteria in a sample of 210 adults. Responses from the BJMHS were collected and merged with diagnostic indications gathered from the Comprehensive Addictions and Psychological Evaluation. Mental health conditions were highly prevalent with 80% of participants presenting symptoms. The BJMHS accurately identified less than half (40%) of those with a mental health condition. The high false-negative rate of the BJMHS left many adults in need of services without the necessary diagnostic evaluation. Recommendations are provided to help increase the accuracy needed to correctly identify these needs in rural jail populations, which represent those incarcerated in most local detention centers in the U.S.