Novel Mental Health Care in an Los Angeles Jail: trained Inmates attending to and treating each other inmates

This seems to be a very promising approach! Worth trying!

When mental institutions were systematically closed in the 1950s and 1960s, prisons became mental institutions. What was maybe a well meaning reform back then has come with serious negative side effects!

Then there was the 1962 book and 1975 move called "One Flew Over the Cuckoo's Nest"

"About half the people incarcerated in the Los Angeles County jail suffer from mental illness.

The need for treatment and the chronic inability to meet that need led two incarcerated men to create a peer-led initiative, in which participants are trained to assist others with severe mental illness.

In the Forensic Inpatient Stepdown program, now 4+ years old, the assistants provide emotional support, use de-escalation techniques, teach life skills, and encourage peers to follow treatment plans. 

Impact: Since 2021, the program has expanded to reach 400+ patients. 

Units using it report 6X fewer self-harm incidents and 35% fewer returns to hospitals.

Mental health advocates say the program offers a model for improving care and rehabilitation inside jails. ..."

"For years, the Los Angeles County jail has been known as the United States’ largest mental health institution. ...

For years, the U.S. Department of Justice has been monitoring the jail system – also the nation’s largest – to assess its mental health care. ...

And yet it’s making progress, particularly with a peer-to-peer program called Forensic Inpatient (FIP) Stepdown that the [Christian Science] Monitor reported on four years ago. Since then, the nascent program has grown more than sixfold overall, spreading to the women’s jail. Incarcerated people trained as mental health assistants are helping hundreds of others with severe mental illness who are held at the same facility. ..."

Global Health NOW: Argentina’s Health System Overhaul; The Legacy of Nuclear Testing in Kazakhstan; and Novel Mental Health Care in an L.A. Jail

‘Motivated and inspired’: California inmates are improving mental health behind bars

A floor painted by a former mental health assistant shines after a "Double Scrub Monday," which involves cleaning by incarcerated individuals at the Twin Towers Correctional Facility in downtown Los Angeles, on April 21, 2025.