The Experiences of People Who Are Incarcerated in Accessing Mental Health Care: A Qualitative Meta-Ethnography.

Overview: This meta-ethnography synthesizes the findings of seven qualitative studies on the experiences of people who are incarcerated in accessing mental health care with a goal of better understanding the scope of these experiences and identifying gaps in custodial mental health care. Noblit and Hare's meta-ethnographic approach was used.

Findings: Five themes were identified: stressful incarceration environments, lack of resources, care is not patient centered, lack of trust, and the value of therapeutic relationships. Findings suggest that the custodial mental healthcare system may provide care that is misaligned with the needs of people who are accessing it.

Limitations: Limitations of this meta-ethnography include the small number of studies identified for review, the diverse foci of the studies, the diversity of the custodial and mental health systems in the four countries from which the studies came, and the unaddressed mixing of jail and prison data in three of the studies.

Implications: Future research should focus on obtaining additional perspectives from people who are accessing custodial mental healthcare services in jail and prison, exploring the differences between the experiences of people in jail versus prison, and identifying ways to develop and maintain high-quality therapeutic relationships between people who are incarcerated and custodial mental healthcare providers, including nurses who work in custodial facilities.