The Los Angeles County jail system’s innovative peer mental health program has grown from a small pilot to serve over 400 patients, becoming a model for correctional facilities nationwide.
The Los Angeles County jail system faces a staggering challenge: nearly 6,000 inmates struggle with mental health issues, making it America’s largest mental health facility.
Four years ago, the system launched an unusual solution that has since become a national model for correctional mental health care: Training inmates as mental health assistants who work directly with peers experiencing severe psychological distress. The program is called Forensic Inpatient (FIP) Stepdown.
These assistants live alongside patients with conditions like schizophrenia and bipolar disorder, providing daily support that professional staff cannot offer around the clock. What began as a small pilot helping 70 patients has expanded to serve more than 400 people across 21 housing units in both men’s and women’s facilities, according to an article in The Christian Science Monitor.
How it Works
The county’s approach centers on structured daily activities and peer mentorship. Mental health assistants guide patients through intensive cleaning sessions, group therapy, and basic life skills training. Patients who complete weekly requirements earn privileges like personal radio time and special meals.
The program’s effectiveness stems from its practical focus on daily functioning and court readiness rather than complex therapeutic interventions. Patients learn basic hygiene, medication compliance, and social skills while receiving emotional support from peers who understand their circumstances.
The county’s willingness to trust inmates with significant responsibilities has created opportunities for both helpers and patients to rebuild their sense of purpose and dignity.
This systematic approach has produced measurable improvements: self-harm incidents dropped to one-sixth the rate of other units, while returns to the specialized psychiatric hospital decreased by 35 percent.
Filling a Gap
The program addresses a critical gap in correctional mental health care. With limited professional staff available, peer assistants provide continuous support that helps stabilize patients and prepare them for court proceedings. The county partners with The Prism Way, a nonprofit that provides six months of specialized training for the inmate assistants, ensuring they understand crisis intervention and basic therapeutic techniques.
California’s state prison system has taken notice of the county’s success, launching its own peer support initiative based on similar principles. The state program aims to place trained peer specialists in all prisons by June 2026, though implementation faces challenges related to prison culture and scale. Other correctional systems are studying the Los Angeles model as they seek solutions for their own mental health crises.
The success has resonated beyond the facility walls. As one former mental health assistant wrote after transferring to state prison and helping a distressed fellow inmate, as reported by The Christian Science Monitor, “The fact that I was able to identify and help someone again gave me that feeling I felt at FIP,” he said in a letter to Kerry Morrison, founder of Heart Forward, a nonprofit that works to transform mental health care with radical hospitality. “I’d be a liar if I said it didn’t make me feel good.”
Read the full article by Francine Kiefer in the May 16, 2025 issue of The Christian Science Monitor: ‘Motivated and inspired’: California inmates are improving mental health behind bars
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