The U.S. is recognized for uniquely high incarceration rates. Over recent decades, there has been a concurrent dramatic increase of jail detainees with mental disorders. Provision of adequate mental health services for jail inmates is constitutionally mandated, and has legal, ethical, quality of care, and fiscal implications for jails, families, communities, and detainees. Significant variation exists in the provision of mental health services across jails, and increased understanding of the factors that influence the adoption of such services may help guide jails to implement beneficial services, and ensure that such services reflect, reflect quality standards. This study used a mixed methods strategy to examine the influence of theoretically determined variables on the adoption of jail mental health services, and the quality assessment of such services. Data was gathered by survey instrumentation, secondary data review, and in-depth interviews with jail leaders. The study found that isomorphism has a significant effect on the structural adequacy of jail mental health services, innovation characteristics have a negligible relationship to structural adequacy and process integrity, structural adequacy mediates the effects of isomorphism on process integrity, and jail size has a significant effect on structural adequacy. This study advances the knowledge base in its specification of the roles of internal, external, and demographic factors in the adoption of jail mental health services, and in the testing and application of Donabedian's healthcare model to assess the quality of such services.
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Wan, Thomas T. H.
Doctor of Philosophy (Ph.D.)
College of Health and Public Affairs
Public Affairs; Health Services Management and Research
Length of Campus-only Access
Doctoral Dissertation (Open Access)
Clayton, Orville, "Jail Mental Health Innovations: Factors Influencing Mental Health Services Innovations for Jails" (2017). Electronic Theses and Dissertations. 5695.