Incarcerated people with mental illness in Puerto Rico are facing severe treatment gaps and barriers to care. According to a 2024 Senate investigation, nearly three-quarters of the more than 7,000 incarcerated people in Puerto Rico need mental health care, yet the Department of Corrections and Rehabilitation (DCR) has inadequate psychiatric staffing. The DCR claims seven psychiatrists for adults and two for juveniles, but only three work full time; others work part time, some as little as 10 hours per week. The occupancy rate of psychiatric units at the Correctional Medical Center was 35%, with an average of 13 occupied beds out of 35 available.
Access Barriers and Self-Harm
According to an incarcerated person identified as Juan, self-harm or suicidal ideation became the only pathway to psychiatric care. During his eight years incarcerated with bipolar disorder and severe depression, he had only one psychiatric appointment lasting less than 10 minutes conducted via telemedicine, ending with prescriptions for Wellbutrin, Elavil, and Zoloft. His follow-up requests were ignored. A 2023 Senate report found that Physician Correctional, the private health provider, had the equivalent of five psychiatrists total to attend 10 DCR institutions. Clinical psychologist Kalitza Baerga noted that many inmates come to prison with untreated mental health conditions due to poverty and lack of access to professionals. The confinement itself can exacerbate existing conditions; studies have found incarceration is related to disorders such as depression, anxiety, and bipolar disorder, with factors such as overcrowding, isolation, and exposure to violence having negative impacts.
Staffing Shortage and New Hospital
Puerto Rico has about 200 psychiatrists to serve a population of 3.2 million. A 2024 Senate investigation concluded that at least 71 mental health professionals are needed to meet minimum standards. Despite this shortage, the government is advancing construction of an $80 million correctional psychiatric hospital funded through federal Community Development Block Grant for Mitigation funds, scheduled for inauguration in 2028 with capacity for up to 250 inmates. The project is in design stages; the DCR has not yet completed analysis of personnel needed or annual operational costs.
Release and Continuity of Care
Upon release, incarcerated individuals often face gaps in psychiatric care continuity. Juan reported that his release plan did not include continuation of psychiatric treatment and he was not given the two weeks of medication he was supposed to receive while finding services in the community. Nearly 24 hours after leaving prison without medications he had taken for almost a decade, his parents took him to a primary health center for psychiatric stabilization.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://periodismoinvestigativo.com/2025/07/puerto-rico-prisons-mental-health-crisis/