The Allegheny County Jail (ACJ) in Pittsburgh sits on the south bank of the Monongahela River at 950 Second Avenue — a mid-rise county correctional facility that houses the full range of Allegheny County's pretrial and sentenced population, including a significant proportion of people with serious mental illness. In 2023, the Allegheny County Controller's office published a performance audit of the jail's mental health services that documented systematic deficiencies — findings that took on additional weight against the backdrop of multiple in-custody deaths, including suicides, that the jail experienced that year.
What the Controller's Audit Found
The performance audit conducted by the Allegheny County Controller's office examined the ACJ's mental health infrastructure and concluded that the jail was falling short in three fundamental areas:
- Intake mental health screening: The initial mental health screening that people receive when booked into the ACJ was found to be inadequate to identify the full range of serious mental illness and suicide risk in the incoming population. A jail's intake screening is the first — and often most critical — opportunity to identify people who need mental health intervention before a crisis develops. Gaps in that screening mean people with unrecognized symptoms pass through intake without the monitoring and intervention they need.
- Staffing levels in the mental health unit: The number of licensed mental health professionals employed by the jail was insufficient to provide meaningful ongoing care to the proportion of the population with mental health needs. Brief check-ins rather than therapeutic engagement, and reactive response to crises rather than proactive care management, were among the patterns documented.
- Crisis monitoring: The systems for monitoring people who had been identified as being in mental health crisis — including those on suicide watch — were found to have gaps that reduced the effectiveness of those monitoring protocols.
The Deaths That Framed the Audit
The audit was conducted against a backdrop of elevated in-custody deaths at the ACJ, including suicides. A county jail with a high proportion of people in acute mental health crisis — often incarcerated because the community mental health system failed to prevent the crisis in the first place — presents a fundamentally different mental health challenge than a state prison housing long-term sentenced people. Most people who die by suicide in county jails are in the first days or weeks of detention, before the classification and monitoring systems that eventually identify them have a chance to engage.
The Abolitionist Law Center and the Allegheny County Jail Collaborative — a coalition that includes the Department of Human Services and several mental health nonprofits — had long documented the jail's outsized role as a de facto mental health facility for Allegheny County's most vulnerable people. Many of those incarcerated at the ACJ would be more appropriately served in community-based mental health treatment settings, but the intersection of poverty, mental illness, and low-level criminal charges routes them through the jail system instead.
The ACJ's Response and Ongoing Challenges
The jail administration acknowledged the audit's findings and pointed to ongoing efforts including partnerships with Allegheny County's Department of Human Services to provide reentry mental health services, participation in the Sequential Intercept Model — a framework for identifying and diverting people with mental illness at each stage of the criminal justice system — and increased coordination with crisis services.
However, structural reform at a county jail is slow. The mental health workforce shortage that limits ACJ's clinical capacity is the same shortage that limits every mental health provider in Allegheny County. Recruiting licensed clinical social workers, psychologists, and psychiatrists to work in a jail setting — at public-sector salaries, in a physically constrained environment — is inherently difficult.
What Families of ACJ Detainees Should Know
If your loved one has a known mental health condition and is detained at the ACJ:
- Provide information about their diagnosis, medications, and mental health history to intake staff at the time of booking — this information shapes the initial classification and mental health screening
- If your loved one takes prescribed psychiatric medications, ask the ACJ medical unit about medication continuity — this is a documented point of failure in many jails
- Contact the Allegheny County Jail Collaborative through the Allegheny County DHS to connect with case managers who work inside and outside the jail
- If your loved one is in mental health crisis inside the jail, contact the Jail's Medical/Mental Health Unit directly and follow up in writing
Allegheny County Jail: 950 Second Avenue, Pittsburgh, PA 15219. Phone: (412) 350-2000. Website: alleghenyCounty.us/jail.