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Date: November 25, 2024 Mon
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Results for mentally ill inmates
26 results foundAuthor: Parsonage, Michael Title: Diversion: A Better Way for Criminal Justice and Mental Health Summary: This report assesses the case for diversion for offenders with mental health problems from a value for money perspective. Details: London: Sainsbury Centre for Mental Health, 2009. 64p. Source: Year: 2009 Country: United Kingdom URL: Shelf Number: 113862 Keywords: Alternatives to Prison (Economic Aspects)Mental Health ServicesMentally Ill Inmates |
Author: Brooker, Charlie Title: Short-Changed: Spending on Prison Mental Health Care Summary: This report analyses public spending in the U.K. on mental health care in prisons. It compares spending between different regions, by type of prison and in comparison with spending on all types of health care in prisons and with mental health spending in the wider community. Details: London: Sainsbury Centre for Mental Health, 2008. 15p. Source: Year: 2008 Country: United Kingdom URL: Shelf Number: 115739 Keywords: Mental Health ServicesMentally Ill InmatesMentally Ill Offenders |
Author: Brooker, Charlie Title: Short-Changed: Spending on Prison Mental Health Care Summary: This report analyses public spending in the U.K. on mental health care in prisons. It compares spending between different regions, by type of prison and in comparison with spending on all types of health care in prisons and with mental health spending in the wider community. Details: London: Sainsbury Centre for Mental Health, 2008. 15p. Source: Year: 2008 Country: United Kingdom URL: Shelf Number: 115739 Keywords: Mental Health ServicesMentally Ill InmatesMentally Ill Offenders |
Author: Frank, Richard Title: Mental Health Treatment and Criminal Justice Outcomes Summary: Are many prisoners in jail or prison bacause of their mental illness? And if so, is mental health treatment a cost-effective way to reduce and lower criminal justice costs? This paper reviews and evaluates the evidence assessing the potential of expansion of mental health services for reducing crime. Details: Cambridge, MA: National Bureau of Economic Research, 2010. 51p. Source: NBER Working Paper Series: Working Paper 15858 Year: 2010 Country: United States URL: Shelf Number: 118426 Keywords: Mental Health ServicesMentally Ill Inmates |
Author: Hayes, Lindsay M. Title: National Study of Jail Suicide: 20 Years Later Summary: This report presents the most comprehensive updated information on the extent and distribution of inmate suicides throughout the country, including data on the changing face of suicide victims. Most important, the study challenges both jail and health-care officials and their respective staffs to remain diligent in identifying and managing suicidal inmates. Details: Washington, DC: U.S. National Institute of Corrections, 2010. 68p. Source: Internet Resource Year: 2010 Country: United States URL: Shelf Number: 119104 Keywords: Inmate SuicidesJail SuicideJailsMental Health ServicesMentally Ill Inmates |
Author: O'Keefe, Maureen L. Title: One Year Longitudinal Study of the Psychological Effects of Administrative Segregation Summary: One of the most widely debated topics in the field of corrections – the use of long‐term administrative segregation (AS) – has suffered from a lack of empirical research. Critics have argued that the conditions of AS confinement exacerbate symptoms of mental illness and create mental illness where none previously existed. Empirical research has had little to offer this debate; the scant empirical research conducted to date suffers from research bias and serious methodological flaws. This study seeks to advance the literature in this regard. This study tested three hypotheses: (1) offenders in AS would develop an array of psychological symptoms consistent with the security housing unit (SHU) syndrome, (2) offenders with and without mental illness would deteriorate over time in AS, but at a rate more rapid and extreme for the mentally ill, and (3) inmates in AS would experience greater psychological deterioration over time than the comparison groups. Study participants included male inmates who were placed in AS and comparison inmates in the general population (GP). Placement into AS or GP conditions occurred as a function of routine prison operations. GP comparison participants included those at risk of AS placement due to their institutional behavior. Inmates in both of these study conditions (AS, GP) were divided into two groups – inmates with mental illness (MI) and with no mental illness (NMI). A third comparison group of inmates with severe mental health problems placed in San Carlos Correctional Facility, a psychiatric care prison facility, was also included. A total of 302 inmates were approached to participate in the study, and 55 refused to participate or later withdrew their consent. Participants were tested at 3‐month intervals over a yearlong period. Standardized test data were collected through self‐report, correctional staff and clinical staff measures. Tests with demonstrated reliability and validity were selected to assess the eight primary constructs of interest: (1) anxiety, (2) cognitive impairment, (3) depression‐hopelessness, (4) hostility‐anger control, (5) hypersensitivity, (6) psychosis, (7) somatization, and (8) withdrawal‐alienation. Extensive analyses of psychometric properties revealed that inmates self‐reported psychological and cognitive symptoms in remarkably reliable and valid ways. The results of this study were largely inconsistent with our hypotheses and the bulk of literature that indicates AS is extremely detrimental to inmates with and without mental illness. Similar to other research, our study found that segregated offenders were elevated on multiple psychological and cognitive measures when compared to normative adult samples. However, elevations were present among the comparison groups too, suggesting that high degrees of psychological disturbances are not unique to the AS environment. In examining change over time patterns, there was initial improvement in psychological well‐being across all study groups, with the bulk of the improvements occurring between the first and second testing periods, followed by relative stability for the remainder of the study. Patterns indicated that the MI groups tended to be similar to one another but were significantly elevated compared to the NMI groups, regardless of their setting. Contrary to our hypothesis, offenders with mental illness did not deteriorate over time in AS at a rate more rapid and more extreme than for those without mental illness. Finally, although AS inmates in this study were found to possess traits believed to be associated with long‐term segregation, these features cannot be attributed to AS confinement because they were present at the time of placement and also occurred in the comparison study groups. Implications for policy and future research are discussed. Details: Colorado Springs, CO: Colorado Department of Corrections; University of Colorado - Colorado Springs, Department of Psychology, 2010. 150p. Source: Internet Resource: Accessed February 14, 2011 at: http://www.ncjrs.gov/pdffiles1/nij/grants/232973.pdf Year: 2010 Country: United States URL: http://www.ncjrs.gov/pdffiles1/nij/grants/232973.pdf Shelf Number: 120766 Keywords: Inmate ClassificationInmate SegregationMaximum SecurityMentally Ill Inmates |
Author: Stewart, Lynn A. Title: An Initial Report on the Results of the Pilot of the Computerized Mental Health Intake Screening System (CoMHISS) Summary: With indications that the rate of mental disorder among federally sentenced offenders is increasing, Correctional Service of Canada (CSC) requires tools that can provide efficient standardised methods for screening of offenders who may require mental health intervention. The large numbers of offenders coming into reception centres over a year makes it attractive to look at an automated method that will allow administrators to compile institutional, regional and national statistics and provide quick and accurate profiles of the offenders who are showing significant symptoms of distress. The Computerized Mental Health Intake Screening System (CoMHISS) combines two self report measures tapping psychological problems, the Brief Symptom Inventory (BSI) and Depression Hopelessness and Suicide Screening Form (DHS), with the Paulhus Deception Scales (PDS). From February 2008 to April 2009 over 1,300 male offenders incarcerated on a new sentence at the regional reception centres completed the measures. In this study, cut-off scores based on psychiatric patient norms determined that less than 3% of the federal male population would be screened in for further service or evaluation. However, using non patient norms almost 40% of the population would be screened in. Further research is required to establish CSC specific norms and appropriate cut off scores. Preliminary data indicate relative higher rates of psychological symptoms among the Aboriginal specific population, but these differences were not statistically significant. Comparative data on the results of the assessment across regional reception centres demonstrated the highest rates of symptomology in the Atlantic region. A profile of the offenders who completed the assessment is presented and compared to those who refused the assessment or produced invalid results. Further research is required to confirm the accuracy of the measures in identifying seriously mentally disordered offenders who will require additional services. Future possible developments of the CoMHISS may include incorporation of measures of cognitive deficits and attention deficit disorder and the merging of the mental health assessments with results from the Computerised Assessment of Substance Abuse which will provide estimates of rates of concurrent disorders. Details: Ottawa: Research Branch, Correctional Service of Canada, 2010. 79p. Source: Internet Resource: Research Report 2010 Nº R-218: Accessed March 26, 2011 at: http://www.csc-scc.gc.ca/text/rsrch/reports/r218/r218-eng.pdf Year: 2010 Country: Canada URL: http://www.csc-scc.gc.ca/text/rsrch/reports/r218/r218-eng.pdf Shelf Number: 121121 Keywords: Mental Health ServicesMentally Ill InmatesMentally Ill Offenders (Canada) |
Author: Osher, Fred Title: Adults with Behavioral Health Needs under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery Summary: The large numbers of adults with behavioral health disorders (mental illnesses, substance use disorders, or both) who are arrested and convicted of criminal offenses pose a special challenge for correctional and health administrators responsible for their confinement, rehabilitation, treatment, and supervision. As corrections populations have grown, the requirements for correctional facilities to provide health care to these inmates has stretched the limits of their budgets and available program personnel. They often lack the resources to provide the kinds of services many of these individuals need for recovery and to avoid reincarceration. Addressing the needs of individuals on probation or returning from prisons and jails to the community also raises difficult issues for the behavioral health administrators and service providers who have come to be relied on for treatment. Individuals with behavioral health issues who have criminal histories often have complex problems, some of which are difficult to address in traditional treatment settings. The reality is, however, that public healthcare professionals are already struggling to serve them. A significant number of individuals who receive services through the publicly funded mental health and substance abuse systems are involved in the criminal justice system. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the criminal justice system is the single largest source of referral to the public substance abuse treatment system, with probation and parole treatment admissions representing the highest proportion of these referrals.1 Overlapping populations similarly exist for corrections administrators and mental healthcare providers.2 With state and local agencies enduring dramatic budget cuts, resources are already scarce for serving and supervising individuals with substance abuse and mental health needs who are, or have been, involved in the criminal justice system. The question that many policymakers and practitioners are asking is whether those resources are being put to the best use in advancing public safety and health, as well as personal recovery. They are examining whether allocations of behavioral health resources are increasing diversion from the criminal justice system when appropriate and reducing ongoing criminal justice involvement for individuals under correctional control and supervision.3 The answer, frankly, is we do not think that the scale of the investments in these efforts has come close to addressing the extent of the problem or that resources are always properly focused. The dedication of resources made behind the bars and in the community does not appear to stop the individuals with substance abuse and mental health disorders from cycling through the criminal justice system—in many cases, they are simply insufficient to effect a systemwide change or do not focus narrowly enough on the people who would most benefit from the interventions. These investments in treatment and supervision have traditionally not been coordinated and sometimes even work at cross-purposes. Just as the substance abuse and mental health systems used to operate in silos—but now frequently come together to provide integrated co-occurring treatment options—a similar challenge is now before the corrections and behavioral health systems. The vast majority of inmates eventually return to their home communities from prisons and jails (650,000 or more individuals each year from state prisons alone,4 and more than 9 million individuals from jail).5 This influx of returning inmates has sparked an urgent need for corrections and behavioral healthcare administrators to reconsider the best means to facilitate reentry and service delivery to the many individuals with substance abuse and mental health problems. Despite the overlap in the populations they serve, little consensus exists among behavioral healthcare and community corrections administrators and providers on who should be prioritized for treatment, what services they should receive, and how those interventions should be coordinated with supervision. Too often, corrections administrators hear that “those aren’t my people” from behavioral healthcare administrators and providers. And just as often, the behavioral health community feels they are asked to assume a public safety role that is not in synch with their primary mission. Misunderstandings about each system’s capacity, abilities, and roles, as well as what types of referrals are appropriate, have contributed to the problem. This white paper presents a shared framework for reducing recidivism and behavioral health problems among individuals under correctional control or supervision—that is, for individuals in correctional facilities or who are on probation or parole. The paper is written for policymakers, administrators, and practitioners committed to making the most effective use of scarce resources to improve outcomes for individuals with behavioral health problems who are involved in the corrections system. It is meant to provide a common structure for corrections and treatment system professionals to begin building truly collaborative responses to their overlapping service population. These responses include both behind-the-bars and community-based interventions. This framework is designed to achieve each system’s goals and ultimately to help millions of individuals rebuild their lives while on probation or after leaving prison or jail. Details: New York: Council of State Governments, Justice Center, 2012. 82p. Source: Internet Resource: Accessed September 29, 2012 at: http://consensusproject.org/jc_publications/adults-with-behavioral-health-needs Year: 2012 Country: United States URL: http://consensusproject.org/jc_publications/adults-with-behavioral-health-needs Shelf Number: 126500 Keywords: Health CareMental Health ServicesMentally Ill InmatesPrisoners (U.S.)RecidivismRehabilitationTreatment Programs |
Author: American Civil Liberties Union of Colorado Title: Out of Sight, Out of Mind: Colorado's continued warehousing of mentally ill prisoners in solitary confinement Summary: This report examines past and continued use of solitary confinement by the Colorado Department of Corrections (CDOC) to manage mentally ill prisoners; considers the moral, fiscal, safety and legal implications of CDOC's continued warehousing of mentally ill prisoners in solitary confinement; and makes recommendations to bring Colorado's prisons in line with modern psychiatric, correctional and legal standards. The report draws on 18 months of research by the American Civil Liberties Union (ACLU) of Colorado, which included correspondence with mentally ill prisoners housed in solitary confinement by CDOC; analysis of data provided by the CDOC in response to over a dozen public records requests by the ACLU, as well as other publicly available CDOC records; in-depth review of several prisoner mental health files; extensive written and in-person dialogue with CDOC's executive team; on site visits to CDOC; and multiple consultations with correctional and psychiatric experts. Details: Denver: ACLU of Colorado, 2013, 25p. Source: Internet Resource: Accessed March 28, 2014 at: http://aclu-co.org/wp-content/uploads/files/imce/ACLU-CO%20Report%20on%20Solitary%20Confinement_2.pdf Year: 2013 Country: United States URL: http://aclu-co.org/wp-content/uploads/files/imce/ACLU-CO%20Report%20on%20Solitary%20Confinement_2.pdf Shelf Number: 132013 Keywords: Mentally Ill InmatesMentally Ill OffendersSolitary Confinement |
Author: American Civil Liberties Union of Texas Title: A Solitary Failure: The Waste, Cost and Harm of Solitary Confinement in Texas Summary: The Texas Department of Criminal Justice (TDCJ) confines 4.4 percent of its prison population in solitary confinement. Texas locks more people in solitary-confinement cells than twelve states house in their entire prison system. On average, prisoners remain in solitary confinement for almost four years; over one hundred Texas prisoners have spent more than twenty years in solitary confinement. The conditions in which these people live impose such severe deprivations that they leave prison mentally damaged; as a group, people released from solitary are more likely to commit more new crimes than people released from the rest of the prison system. Yet in 2013, TDCJ released 1,243 people directly from solitary-confinement cells into Texas communities. These prisoners return to society after living for years or decades in a tiny cell for twenty-two hours a day, with no contact with other human beings or access to educational or rehabilitative programs. Here's a summary of the report, which explains why less solitary confinement is not about going "soft" on crime, it's about being smart on crime. Background - Explore sthe early failure of solitary confinement, the misguided return of solitary confinement in the late 20th century, and the renewed consensus: solitary is a dangerous and expensive correctional practice. Solitary Confinement increases crime - Solitary permanently damages people who will one day return to Texas communities. The consequences of over-using solitary is more crime in Texas communities. Solitary is a huge cost to taxpayers - Solitary confinement costs Texas taxpayers at least $46 Million a year. Overuse of solitary increases prison violence - Solitary confinement makes prison less safe and deprives officers of the option to incentivize good behavior. Violence escalates when officers deny people in solitary basic needs. Other states have improved prison safety by reducing solitary confinement. Mentally ill people deteriorate - The universal consensus: never place the seriously mentally ill in solitary. Yet, Texas sends thousands of people with mental illnesses to solitary confinement and inadequately monitors and treats them. Details: Houston: ACLU of Texas; Texas Civil Rights Project, 2015. 60p. Source: Internet Resource: Accessed February 9, 2015 at: http://www.aclutx.org/2015/02/05/a-solitary-failure/ Year: 2015 Country: United States URL: http://www.aclutx.org/2015/02/05/a-solitary-failure/ Shelf Number: 134571 Keywords: Mentally Ill InmatesPrisonersPrisonsSolitary Confinement (Texas) |
Author: Equality and Human Rights Commission Title: Preventing Deaths in Detention of Adults with Mental Health Conditions: An Inquiry Summary: Our Inquiry was launched in June 2014 to examine how compliance with human rights obligations can reduce 'non-natural' deaths of adults with mental health conditions in state detention. We looked at deaths in three state detention settings - prisons, police cells and hospitals - consulting with inspectorates, regulators and others with responsibilities in this area. The Equality and Human Rights Commission's (the Commission's) Inquiry examined the available evidence in relation to the deaths of 367 adults with mental health conditions who died of 'non-natural' causes while in police cells or as detained patients over the period 2010-13, plus a further 295 who died in prison custody, many of whom also had mental health conditions. This is a large number in itself, yet for each individual who died there are family members and other loved ones who suffer as a result of these deaths. Previous inquiries, investigations, inquests and court cases have established that, too often, the circumstances surrounding deaths in detention involve breaches of people's most basic human rights - including the right to life. We wanted to establish whether a focus on increased compliance with Article 2 of the European Convention on Human Rights, including the State's positive obligation to protect people's life, would reduce avoidable deaths. One in four British adults experience at least one mental health condition, and one in six are experiencing a mental health condition at any given time. Some people will experience more than one mental health condition. While many people continue to lead productive and fulfilling lives with very little involvement from the State, the Government recognises its role to provide specific care for people experiencing mental health conditions at a time of vulnerability. Details: Manchester, UK: Equality and Human Rights Commission, 2015. 84p. Source: Internet Resource: Accessed February 26, 2015 at: http://www.equalityhumanrights.com/sites/default/files/publication_pdf/Adult%20Deaths%20in%20Detention%20Inquiry%20Report.pdf Year: 2015 Country: United Kingdom URL: http://www.equalityhumanrights.com/sites/default/files/publication_pdf/Adult%20Deaths%20in%20Detention%20Inquiry%20Report.pdf Shelf Number: 134723 Keywords: Deaths in Custody (U.K.)Medical CareMental Health ServicesMentally Ill InmatesMentally Ill Offenders |
Author: Human Rights Watch Title: Callous and Cruel: Use of Force against Inmates with Mental Disabilities in US Jails and Prisons Summary: Staff in US correctional facilities are authorized to use force when necessary to control dangerous or highly disruptive prisoners. But officials have used violence needlessly against prisoners diagnosed with mental illness. Callous and Cruel - based on Human Rights Watch's review of several hundred individual and class action court cases and interviews with 125 current and former prison and jail officials, mental health professionals, lawyers, advocates and academics - documents a pattern of unnecessary, excessive, and even malicious force against such prisoners in US prisons and jails. It details incidents in which correctional staff have deluged prisoners with mental disabilities with painful chemical sprays, shocked them with powerful electric stun weapons, and strapped them for days in restraining chairs or beds. Such abuses have taken place in response to minor misconduct such as urinating on the floor, masturbating, complaining about not receiving a meal, refusing to come out of a cell, using profane language, or banging repeatedly on a door. Force is used against prisoners even when their misconduct is symptomatic of their mental health problems and even when those problems prevent them from being able to understand or comply with staff orders. The report concludes with recommendations on ending the abuses, including through improved mental health services in prisons and jails and use of force policies that address the unique needs and vulnerabilities of prisoners with mental disabilities, enforced through proper training, supervision, and accountability mechanisms. Details: New York: HRW, 2015. 133p. Source: Internet Resource: Accessed May 13, 2015 at: http://www.hrw.org/sites/default/files/reports/usprisoner0515_ForUpload.pdf Year: 2015 Country: United States URL: http://www.hrw.org/sites/default/files/reports/usprisoner0515_ForUpload.pdf Shelf Number: 135557 Keywords: Correctional InstitutionsDisabilityMental Health ServicesMentally Ill InmatesPrisoner Maltreatment |
Author: Ruzich, Dawn Title: Probable posttraumatic stress disorder in a sample of urban jail detainees Summary: Jails in the United States house large numbers of detainees who have urgent public and behavioral healthcare needs as well as various serious social, economic, and personal problems. Jails are often the primary (or only) settings for medical, psychiatric, and substance abuse treatment (McDonnell et al., in press). These settings provide unparalleled opportunities for studying and treating some of the most troubled and troublesome concentrations of people in the country (Watson, Hanrahan, Luchins, and Lurigio, 2001). The earliest epidemiological studies of psychiatric disorders in the United States found an overrepresentation of people with severe mental illness living in underclass communities, stemming in part from the stressors that arise from poverty and its onerous sequelae (e.g., Hollingshead and Redlich, 1958). Detainees generally live in decidedly disorganized and disorderly environments that are plagued by unemployment, housing instability, crime, violence, and other adverse conditions that can precipitate episodes of psychiatric illness among those with genetic or other susceptibilities (Lurigio, 2012). These overwhelmingly impoverished communities place detainees at high risk of exposure to a host of events that can lead to trauma and its psychiatric concomitant known as posttraumatic stress disorder (PTSD). This study is one of the few to investigate probable PTSD among men in jail. Details: Chicago: Illinois Criminal Justice Information Authority, 2014. 16p. Source: Internet Resource: Research Bulletin, Vol. 10, no. 1: Accessed May 16, 2015 at: http://www.icjia.state.il.us/public/pdf/bulletins/ptsd_1114.pdf Year: 2014 Country: United States URL: http://www.icjia.state.il.us/public/pdf/bulletins/ptsd_1114.pdf Shelf Number: 135683 Keywords: Jail Inmates Mentally Ill InmatesPost-Traumatic Stress Disorder |
Author: Canada. Office of the Correctional Investigator Title: Risky Business: An Investigation of the Treatment and Management of Chronic Self-Injury Among Federally Sentenced Women Final Report Summary: Over the last five years the number of self-injury incidents in federal correctional facilities has more than tripled. In 2012-13, there were 901 incidents of recorded prison self-injury, involving 264 offenders. A relatively small number of federally sentenced women offenders (37 of 264 total) disproportionately accounted for almost 36% of all reported self-injury incidents. Aboriginal offenders were involved in more than 35% of all self-harming incidents. Aboriginal women accounted for nearly 45% of all self-injury incidents involving the federally sentenced women offender population. Of the 264 federal offenders who self-injured in 2012-13, seventeen individuals engaged in chronic (or repetitive) self-injurious behaviour (i.e., 10 or more incidents). These 17 individuals accounted for 40% of all recorded incidents. Nine were of Aboriginal descent. Nine were women (6 of whom were Aboriginal offenders). In a series of Annual Reports, the Office has repeatedly raised concerns regarding the capacity of the Correctional Service of Canada (CSC) to appropriately manage chronic self-injury in federal penitentiaries: - over-reliance on use of force and control measures, such as physical restraints, and restrictions on movement and association to manage self-injurious offenders; - non-compliance with voluntary and informed consent to treatment protocols; - limited access to services for federally sentenced women offenders with complex mental health needs; - inadequate physical infrastructure, staffing complements, resources and capacity to meet complex mental health needs; and - inappropriate monitoring and inadequate oversight in the use of physical restraints. There is little doubt that management of self-injurious offenders is complex and demanding work. The Office continues to believe that a handful of the most prolific self-injurious offenders simply do not belong in a federal penitentiary. These offenders should be transferred to external psychiatric facilities that are better equipped to accommodate and care for acute and complex mental health needs underlying their self-injurious behaviours. The death in October 2007 of 19-year-old Ashley Smith, a young woman with an extensive history of self-injury who died as a result self-asphyxiation in the presence of CSC staff, underscored the importance of developing effective, evidence-based management and treatment strategies for complex self-injury cases. The Office's investigation into Ms. Smith's death revealed a number of individual and systemic failures that contributed to her tragic death. During 11.5 months of federal incarceration, Ashley's self-injurious behaviours were routinely met with control and security-focused interventions, which included the near-perpetual use of segregation, involuntary treatment (forced medical injections), numerous inter-regional transfers and over 150 documented use of force interventions. CSC's management of Ashley's behaviour served to intensify the frequency and severity of her self-injury. This investigation provides an opportunity to review CSC's capacity to balance the operational and treatment requirements of high-need, mentally ill federally sentenced women who engage in chronic self-injurious behaviour. Six years after Ashley Smith's preventable death, it serves to document how CSC responds to the mental health needs of these women and assesses the use and impact of disciplinary measures and security controls in the management and prevention of prison self-injury. Details: Ottawa: Office of the Correctional Investigator, 2013. 37p. Source: Internet Resource: Accessed June 4, 2015 at: http://www.oci-bec.gc.ca/cnt/rpt/pdf/oth-aut/oth-aut20130930-eng.pdf Year: 2013 Country: Canada URL: http://www.oci-bec.gc.ca/cnt/rpt/pdf/oth-aut/oth-aut20130930-eng.pdf Shelf Number: 135882 Keywords: Female InmatesFemale PrisonersGender Specific ResponsesMentally Ill InmatesPrisonsSelf-Injury |
Author: Steinberg, Darrell Title: When did prisons become acceptable mental healthcare facilities? Summary: We can no longer ignore the massive oppression we are inflicting upon the mentally ill throughout the United States. Over a century ago, Dorothea Dix began a movement to improve the deplorable conditions of mentally ill prisoners. Despite her success in changing the country's perception and treatment of the mentally ill in prison, we are now right back where we started in the nineteenth century. Although deinstitutionalization was originally understood as a humane way to offer more suitable services to the mentally ill in community-based settings, some politicians seized upon it as a way to save money by shutting down institutions without providing any meaningful treatment alternatives. This callousness has created a one-way road to prison for massive numbers of impaired individuals and the inhumane warehousing of thousands of mentally ill people. We have created conditions that make criminal behavior all but inevitable for many of our brothers and sisters who are mentally ill. Instead of treating them, we are imprisoning them. And then, when they have completed their sentences, we release them with minimal or no support system in place, just counting the days until they are behind bars once again. This practice of seeking to save money on the backs of this population comes with huge moral and fiscal cost. It is ineffective because we spend far more on imprisonment of the mentally ill than we would otherwise spend on treatment and support. It is immoral because writing off another human being's life is utterly contrary to our collective values and principles. The numbers are staggering: over the past 15 years, the number of mentally ill people in prison in California has almost doubled. Today, 45 percent of state prison inmates have been treated for severe mental illness within the past year. The Los Angeles County Jail is "the largest mental health provider in the county," according to the former official in charge of the facility. California was at the forefront of the spiral towards imprisonment rather than treatment, when it turned its back on community based mental health programs. As usual, what started in California spread throughout the country. In 1971 there were 20,000 people in California prisons; by 2010 the population had increased to 162,000 people, of which 45 percent are estimated to be mentally ill. We in California now have an opportunity to lead again - this time to show that there is a better approach. We can begin a counter-revolution by setting a new standard for how we deal with people whose mental illness manifests through criminal activity. We will prove to the country that there is another, better approach - an approach that saves money and saves lives from being forsaken. Details: Palo Alto, CA: Stanford law School, Three Strikes Project, 2015. 23p. Source: Internet Resource: Accessed July 29, 2015 at: https://www.law.stanford.edu/sites/default/files/child-page/632655/doc/slspublic/Report_v12.pdf Year: 2015 Country: United States URL: https://www.law.stanford.edu/sites/default/files/child-page/632655/doc/slspublic/Report_v12.pdf Shelf Number: 136255 Keywords: Jail InmatesMental Health CourtsMental Health ServicesMentally Ill InmatesMentally Ill OffendersProblem-Solving Courts |
Author: Guy, Anna Title: Locked Up and Locked Down: Segregation of Inmates with Mental Illness Summary: Segregation disproportionately affects inmates with mental illness, according to a report released today by the AVID Prison Project, and experts assert most inmates acquire mental illness or experience worsened symptoms as a result of conditions in segregation. Today, 80,000 to 100,000 inmates are segregated in U.S. prisons. They will remain isolated in small single person cells, 22 to 24 hours per day, for up to years at a time. Even President Obama, the first sitting president to tour a prison, recognized that mental illness can worsen in segregation and inmates with mental illness are more likely to commit suicide. Locked Up and Locked Down: Segregation of Inmates with Mental Illness chronicles advocacy efforts undertaken across the country on behalf of inmates with mental illness. The Amplifying Voices of Inmates with Disabilities (AVID) Prison Project, in partnership with the National Disability Rights Network and protection and advocacy agencies from twenty states, released the report, which calls for national prison reform measures. Details: Seattle, Disability Rights Washington, AVID Prison Project, 2016. 36p. Source: Internet Resource: Accessed September 13, 2016 at: http://www.disabilityrightswa.org/sites/default/files/uploads/Locked%20Up%20and%20Locked%20Down%20--%20AVID%20Prison%20Project%20PDF%20w%20Pictures%20FINAL.pdf Year: 2016 Country: United States URL: http://www.disabilityrightswa.org/sites/default/files/uploads/Locked%20Up%20and%20Locked%20Down%20--%20AVID%20Prison%20Project%20PDF%20w%20Pictures%20FINAL.pdf Shelf Number: 147321 Keywords: DisabilitiesMentally Ill InmatesMentally Ill OffendersMentally Ill PrisonersPrisoner Segregation |
Author: Great Britain. National Audit Office Title: Mental health in prisons Summary: Government does not know how many people in prison have a mental illness, how much it is spending on mental health in prisons or whether it is achieving its objectives. It is therefore hard to see how Government can be achieving value for money in its efforts to improve the mental health and well being of prisoners. In 2016 there were 40,161 incidents of self-harm in prisons and 120 self-inflicted deaths. Government does not know how many people in prison have a mental illness, how much it is spending on mental health in prisons or whether it is achieving its objectives. It is therefore hard to see how Government can be achieving value for money in its efforts to improve the mental health and well being of prisoners, according to a report by the National Audit Office. Her Majesty's Prisons and Probation Service (HMPPS), NHS England and Public Health England have set ambitious objectives for providing mental health services but do not collect enough or good enough data to understand whether they are meeting them. Rates of self-inflicted deaths and self-harm in prison have risen significantly in the last five years, suggesting that mental health and well-being in prison has declined. Self-harm rose by 73% between 2012 and 2016. In 2016 there were 40,161 incidents of self-harm in prisons, the equivalent of one incident for every two prisoners. While in 2016 there were 120 self-inflicted deaths in prison, almost twice the number in 2012, and the highest year on record. Government needs to address the rising rates of suicide and self harm in prisons as a matter of urgency. In 2016, the Prisons and Probation Ombudsman found that 70% of prisoners who had committed suicide between 2012 and 2014 had mental health needs. The Ministry of Justice and its partners have undertaken work to identify interventions to reduce suicide and self-harm in prisons, though these have not yet been implemented. While NHS England uses health needs assessments to understand need these are often based on what was provided in previous years, and do not take account of unmet need. The NAO estimate that the total spend on healthcare in adult prisons, in 2016-17 was around $400 million. HMPPS does not monitor the quality of healthcare it pays for in the six privately-managed prisons it oversees. The prison system is under considerable pressure, making it more difficult to manage prisoners' mental well-being, though government has set out an ambitious reform programme to address this. NOMS' (National Offender Management Service) funding reduced by 13% between 2009-10 and 2016-17, and staff numbers in public prisons reduced by 30% over the same period. When prisons are short-staffed, governors may run restricted regimes where prisoners spend more of the day in their cells, making it more challenging for prisoners to access mental health services. Staffing pressures can make it difficult for prison officers to detect changes in a prisoner's mental health and officers have not received regular training to understand mental health conditions, though the Ministry plans to provide more training in future. In addition, NOMS did not always give NHS England enough notice when it has made changes to the prison estate. For example at Downview Prison NHS England was in the process of commissioning health services for a male prison, when NOMS decide to open it as a female prison instead. When NAO visited six months after it opened, the prison was still in the process of developing a healthcare service that could meet the needs of the female population. The challenges of delivering healthcare are compounded by the ageing prison estate, over a quarter of which was built before 1900 and without modern healthcare in mind. The Ministry has a programme to replace the ageing estate with modern buildings. While clinical care is broadly judged to be good, there are weaknesses in the system for identifying prisoners who need mental health services. Prisoners are screened when they arrive in prison, but this does not always identify mental health problems and staff do not have access to GP records, which means they do not always know if a prisoner has been diagnosed with a mental illness. NHS England is in the process of linking prison health records to GP records to address this. Mentally ill prisoners should wait no more than 14 days to be admitted to a secure hospital, but only 34% of prisoners were transferred within 14 days in 2016-17 while 7% (76) waited for more than 140 days. The process for transferring prisoners is complex and delays can have a negative impact on prisoners' mental health and they may be kept in unsuitable conditions such as segregation units Details: London: NAO, 2017. 54p. Source: Internet Resource: Accessed july 29, 2017 at: https://www.nao.org.uk/wp-content/uploads/2017/06/Mental-health-in-prisons.pdf Year: 2017 Country: United Kingdom URL: https://www.nao.org.uk/wp-content/uploads/2017/06/Mental-health-in-prisons.pdf Shelf Number: 146617 Keywords: Health ServicesMental Health ServicesMentally Ill InmatesMentally Ill OffendersMentally Ill PrisonersPrison Suicide |
Author: U.S. Department of Justice, Office of the Inspector General, Evaluation and Inspections Division Title: Review of the Federal Bureau of Prisons' Use of Restrictive Housing for Inmates with Mental Illness Summary: Introduction The Federal Bureau of Prisons (BOP) is responsible for confining offenders in environments that are safe, humane, cost-efficient, and appropriately secure. To do so, the BOP utilizes various forms of Restrictive Housing Unit (RHU) to confine certain inmates, including those with mental illness. However, according to recent research and reports, as well as the BOP's own policy, confinement in RHUs, even for relatively short periods of time, can adversely affect inmates' mental health and can be particularly harmful for inmates with mental illness. As of June 2016, of the 148,227 sentenced inmates in the BOP's 122 institutions, 9,749 inmates (7 percent) were housed in its three largest forms of RHU: Special Housing Units (SHU) in 111 institutions; 2 Special Management Units (SMU) at the U.S. Penitentiaries (USP) in Lewisburg and Allenwood, Pennsylvania; and the USP Administrative Maximum Security Facility (ADX) in Florence, Colorado. The Office of the Inspector General conducted this review to examine the BOP's use of RHUs for inmates with mental illness, including trends in the use of restrictive housing and the screening, treatment, and monitoring of inmates with mental illness who are housed in RHUs. We found significant issues with the adequacy of the BOP's policies and its implementation efforts in this critical area. Results in Brief BOP Policies Do Not Adequately Address the Confinement of Inmates with Mental Illness in RHUs, and the BOP Does Not Sufficiently Track or Monitor Such Inmates BOP guidance and policies do not clearly define "restrictive housing" or "extended placement." Although the BOP states that it does not practice solitary confinement, or even recognize the term, we found inmates, including those with mental illness, who were housed in single-cell confinement for long periods of time, isolated from other inmates and with limited human contact. For example, at the ADX, we observed an RHU that held two inmates, each in their own cell, isolated from other inmates. The inmates did not engage in recreation with each other or with other inmates and were confined to their cells for over 22 hours a day. Also, in five SHUs, we observed single-celled inmates, many with serious mental illness. One inmate, who we were told was denied ADX placement for mental health reasons, had been single-celled for about 4 years. Although the BOP generally imposes a minimum amount of time that inmates must spend in RHUs, it does not limit the maximum amount of time and does not monitor inmates' cumulative time in RHUs. The BOP also does not track its housing of inmates in single-cell RHU confinement, nor does it account for their confinement in all RHUs throughout BOP institutions. As a result, inmates, including those with mental illness, may spend years and even decades in RHUs. For example, we learned of an inmate with serious mental illness who spent about 19 years at the ADX before being transferred to a secure residential mental health treatment program. In addition, our sample of inmates with mental illness showed that they had been placed in the ADX for an average of about 69 months. Similarly, we found that between fiscal years (FY) 2008 and 2015, inmates with mental illness averaged about 896 consecutive days, or about 29 months, in the SMU. We further found that inmates with mental illness spend disproportionately longer periods of time in RHUs than their peers. Equally concerning, our review showed that 13 percent of the inmates with mental illness in our sample were released by the BOP directly into the community after spending nearly 29 months in the SMU prior to their release. By contrast, officials in six of the eight state departments of corrections told us that they limit the length of time inmates with mental illness can be placed in restrictive housing. In 2015, three states (Massachusetts, Mississippi, and New York) had at least a 30-day limit, while three other states (Colorado, Maine, and Pennsylvania) no longer placed inmates with serious mental illness in RHUs at all. Mental Health Staff Do Not Always Document Inmates' Mental Disorders, Leaving the BOP Unable to Accurately Determine the Number of Inmates with Mental Illness and Ensure that It Is Providing Appropriate Care to Them BOP data showed that, as of 2015, only 3 percent of the BOP's sentenced inmate population was being treated regularly for mental illness. Yet, the BOP's FY 2016 Performance Budget Congressional Submission cited an internal BOP study, which suggested that approximately 19 percent of federal inmates had a history of mental illness. Moreover, a 2006 Bureau of Justice Statistics report concluded that 45 percent of federal inmates had symptoms or a recent history of mental illness. We found that the BOP cannot accurately determine the number of inmates who have mental illness because institution staff do not always document mental disorders. The BOP's FY 2014 data estimates that approximately 12 percent of inmates have a history of mental illness; however, in 2015, the BOP's Chief Psychiatrist estimated, based on discussions with institutions' Psychology Services staffs, that approximately 40 percent of inmates have mental illness, excluding inmates with only personality disorder diagnoses. Similarly, one institution's Deputy Chief Psychologist estimated that 50 percent of that institution's inmates may have Antisocial Personality Disorder; nevertheless, we found that this disorder was documented for only about 3.3 percent of the BOP's total inmate population. Because mental health staffs do not always document inmates' mental disorders, the BOP is unable to ensure that it is providing appropriate care to them. Since the BOP Adopted Its New Mental Health Policy, BOP Data Shows a 30 Percent Reduction in Inmates Who Receive Regular Mental Health Treatment The BOP adopted a new mental health policy in 2014, increasing the standards of care for inmates with mental illness. However, since the policy was issued, the total number of inmates who receive regular mental health treatment decreased by approximately 30 percent, including 56 percent for inmates in SMUs, and about 20 percent overall for inmates in RHUs during the scope of our review. Based on our review, it appears that mental health staff may have reduced the number of inmates, including those in RHUs, who must receive regular mental health treatment because they did not have the necessary staffing resources to meet the policy's increased treatment standards. Indeed, we found that, as of October 2015, the BOP had filled only 57 percent of its authorized full-time Psychiatrist positions nationwide and that it had significant staffing issues with regard to Psychologist positions as well. This treatment trend was particularly pronounced among SMU inmates at USP Lewisburg, which confined over 1,100 SMU inmates as of June 2016. Based on our sample of SMU inmates, we found that, prior to the new policy, the number of inmates (16) whose mental health care level was increased equaled the number of inmates (16) whose care level was decreased. In contrast, after the new policy was adopted, all 27 inmates whose care level changed had a decrease and therefore ostensibly required less treatment. By May 2015, only about 2.5 percent of SMU inmates at USP Lewisburg were categorized as requiring regular treatment, compared to about 11 percent of ADX inmates and 7 percent of SHU inmates nationwide, which we believe raises treatment concerns for inmates in USP Lewisburg's SMU. While the BOP Has Taken Recent Steps to Mitigate Mental Health Concerns for Inmates in RHUs, Additional Actions Can Be Taken The BOP has taken a number of steps to mitigate the mental health concerns for inmates in RHUs. These efforts include diverting inmates with serious mental illness from placement in traditional RHUs (i.e., SHUs, the SMUs, and the ADX) and into alternative programs such as secure residential mental health treatment programs. While these are positive BOP initiatives, limited inmate capacities, slow inmate progression through the programs, high staffing needs, and a lack of formal performance metrics with which to measure the effectiveness of these programs limit their utility and the BOP's ability to expand their use to other institutions. Details: Washington, DC: Office of the Inspector General, U.S. Department of Justice, 2017. 103p. Source: Internet Resource: Evaluation and Inspections Division 17-05 : Accessed September 20, 2017 at: https://oig.justice.gov/reports/2017/e1705.pdf Year: 2017 Country: United States URL: https://oig.justice.gov/reports/2017/e1705.pdf Shelf Number: 147413 Keywords: Federal Bureau of PrisonsIsolationMental Health ServicesMentally Ill InmatesMentally Ill OffendersMentally Ill PrisonersRestrictive HousingSolitary Confinement |
Author: Stanford Justice Advocacy Project Title: Confronting California's continuing prison crisis: The prevalence and severity of mental illness among California prisoners on the rise Summary: The long-running problem of mental illness in California's justice system appears to be getting worse, according to data recently provided by the California Department of Corrections and Rehabilitation (CDCR) and other data presented for the first time in this report. Recent reforms to California's criminal laws have greatly improved the state's justice system: prison and jail crowding have reduced dramatically, sentences are fairer and more proportionate, recidivism rates among those freed early under the reforms are far lower than most released prisoners, and capacity to focus on dangerous crime has increased. Furthermore, since these reforms were enacted, overall crime rates in California have remained on a long-term downward trend. Despite these significant legislative and administrative reforms initiated in part to improve treatment and conditions for people with mental illness in California's justice system, the prevalence and severity of mental illness among California state prisoners are dramatically on the rise. Over 30 percent of California prisoners currently receive treatment for a "serious mental disorder," an increase of 150 percent since 2000. CDCR estimates that the population of prisoners with mental illness will continue to climb, increasing the need for additional psychiatric services in the years to come. Furthermore, there is evidence that CDCR's projections underestimate the current number of prisoners with mental illness. In addition, the severity of psychiatric symptoms of state prisoners is on the rise. The number of prisoners diagnosed with the most serious disorders and transferred to enhanced psychiatric services has increased dramatically over the past 5 years. There is also evidence that criminal defendants in California with mental illness receive longer prison sentences than defendants without mental illness. This disparity exists across all crime categories, from murder to drug possession. Prisoners sentenced to life terms are also more likely to be mentally ill. Finally, despite the substantial criminal justice reforms responsible for the dramatic reduction of California's prison population over the last decade, the population of inmates with mental illness has not decreased.8 Ironically, these reforms were largely initiated on behalf of inmates with mental illness suffering under unconstitutional treatment conditions. This report contains new and updated data about the growing problem of mental illness in California's justice system and describes how prisoners with mental illness do not benefit from some of the most important criminal justice reforms enacted in the state in recent years. Details: Stanford, California: Stanford Justice Advocacy Project, 2017. 10p. Source: Internet Resource: Accessed November 8, 2017 at: https://www-cdn.law.stanford.edu/wp-content/uploads/2017/05/Stanford-Report-FINAL.pdf Year: 2017 Country: United States URL: https://www-cdn.law.stanford.edu/wp-content/uploads/2017/05/Stanford-Report-FINAL.pdf Shelf Number: 148075 Keywords: Criminal Justice ReformMental Health ServicesMentally Ill InmatesMentally Ill OffendersMentally Ill Prisoners |
Author: Disability Rights New York Title: Report and Recommendations Concerning Attica Correctional Facility's Residential Mental Health Unit Summary: Disability Rights New York (DRNY) is the designated federal Protection and Advocacy System for individuals with disabilities in New York State. DRNY has broad authority under federal and state law to monitor conditions and investigate allegations of abuse or neglect occurring in any public or private facility, including state prisons. DRNY monitored and investigated Attica Correctional Facility's Residential Mental Health Unit (RMHU), one of several residential mental health treatment units (RMHTU). The New York State Department of Corrections and Community Supervision (DOCCS) operates segregated disciplinary confinement units called Special Housing Units (SHU) and Long-Term Keeplock Units. Individuals diagnosed with serious mental illness must be removed from SHU or LongTerm Keeplock and placed into a RMHTU. The RMHTUs are jointly operated by DOCCS and the New York State Office of Mental Health (OMH). DRNY conducted a site visit and in-person interviews at Attica in August 2015, corresponded with incarcerated individuals from August 2015 through December 2016, reviewed security and mental health records and policies, and communicated with DOCCS and OMH executive staff. DRNY finds that DOCCS and OMH abused and neglected RMHU participants, and violated New York Correction Law provisions governing RMHTUs, collectively known as the SHU Exclusion Law. Specifically, DRNY finds DOCCS and OMH violated New York Correction Law - 2(21), 401(1), 401(2), and 401(6). 1. DOCCS and OMH neglected and abused RMHU participants by imposing cell shields in the RMHU without consideration of an individual's mental health condition and without clinical input by OMH, in violation of the SHU Exclusion Law. 2. DOCCS's regulations fail to require OMH clinical input and consideration of mental health status before issuing and when renewing cell shield orders, thereby violating the SHU Exclusion Law. 3. DOCCS's use of cell shields in the RMHU violates state regulations and due process by failing to justify implementation and continuation of cell shield orders. 4. DOCCS and OMH neglected and abused RMHU participants by failing to clinically assess their therapeutic needs prior to imposing programming restrictions, despite the requirement of the SHU Exclusion Law, and by failing to provide a safe environment. 5. DOCCS neglected RMHU participants and violated the SHU Exclusion Law by staffing the RMHU with SHU officers and other untrained staff. DOCCS continued to neglect individuals and violate the law by failing to correct the problem after notification by DRNY. 6. DOCCS and OMH neglected RMHU participants by providing "alternative therapy" cellside, including in some cases when participants are behind cell shields, thereby denying RMHU participants appropriate treatment. 7. DOCCS does not provide an adequate therapeutic setting for RMHU participants. DOCCS and OMH must take immediate action to ensure a therapeutic environment that is free from abuse and neglect. Details: Albany: Disability Rights New York, 2017. 27p. Source: Internet Resource: Accessed February 6, 2018 at: http://new.drny.org/docs/reports/attica-rmhu-report-9-12-2017.pdf Year: 2017 Country: United States URL: http://new.drny.org/docs/reports/attica-rmhu-report-9-12-2017.pdf Shelf Number: 149012 Keywords: Attica Correctional FacilityCorrectional HealthHealth CareMental Health CareMentally Ill InmatesPrison Health |
Author: U.S. Government Accountability Office Title: Federal Prisons: Information on Inmates with Serious Mental Illness and Strategies to Reduce Recidivism Summary: About two-thirds of inmates with a serious mental illness in the Department of Justice's (DOJ) Federal Bureau of Prisons (BOP) were incarcerated for four types of offenses-drug (23 percent), sex offenses (18 percent), weapons and explosives (17 percent), and robbery (8 percent)-as of May 27, 2017. GAO's analysis found that BOP inmates with serious mental illness were incarcerated for sex offenses, robbery, and homicide/aggravated assault at about twice the rate of inmates without serious mental illness, and were incarcerated for drug and immigration offenses at about half or less the rate of inmates without serious mental illness. GAO also analyzed available data on three selected states' inmate populations and the most common crimes committed by inmates with serious mental illness varied from state to state due to different law enforcement priorities, definitions of serious mental illness and methods of tracking categories of crime in their respective data systems. BOP does not track costs related to incarcerating or providing mental health care services to inmates with serious mental illness, but BOP and selected states generally track these costs for all inmates. BOP does not track costs for inmates with serious mental illness in part because it does not track costs for individual inmates due to resource restrictions and the administrative burden such tracking would require. BOP does track costs associated with mental health care services system-wide and by institution. System-wide, for fiscal year 2016, BOP spent about $72 million on psychology services, $5.6 million on psychotropic drugs and $4.1 million on mental health care in residential reentry centers. The six state departments of corrections each used different methods and provided GAO with estimates for different types of mental health care costs. For example, two states provided average per-inmate costs of incarceration for mental health treatment units where some inmates with serious mental illness are treated; however, these included costs for inmates without serious mental illness housed in those units. DOJ, Department of Health and Human Service's Substance Abuse and Mental Health Services Administration (SAMHSA), and criminal justice and mental health experts have developed a framework to reduce recidivism among adults with mental illness. The framework calls for correctional agencies to assess individuals' recidivism risk and substance abuse and mental health needs and target treatment to those with the highest risk of reoffending. To help implement this framework, SAMHSA, in collaboration with DOJ and other experts, developed guidance for mental health, correctional, and community stakeholders on (1) assessing risk and clinical needs, (2) planning treatment in custody and upon reentry based on risks and needs, (3) identifying post-release services, and (4) coordinating with community-based providers to avoid gaps in care. BOP and the six states also identified strategies for reducing recidivism consistent with this guidance, such as memoranda of understanding between correctional and mental health agencies to coordinate care. Further, GAO's literature review found that programs that reduced recidivism among offenders with mental illness generally offered multiple support services, such as mental health and substance abuse treatment, case management, and housing assistance. Details: Washington, DC: GAO, 2018. 75p. Source: Internet Resource: GAO-18-182: Accessed February 27, 2018 at: https://www.gao.gov/assets/700/690279.pdf Year: 2018 Country: United States URL: https://www.gao.gov/assets/700/690279.pdf Shelf Number: 149264 Keywords: Federal PrisonsMental Health ServicesMentally Ill InmatesPrisonersPrisonsRecidivism |
Author: Huh, Kil Title: Jails: Inadvertent Health Care Providers. How county correctional facilities are playing a role in the safety net Summary: Every year, millions of people are booked into U.S. jails. During 2015, the latest year for which data are available, there were 10.9 million admissions to these correctional facilities, which hold individuals who are awaiting trial or serving short sentences. The government running the jail-usually a county-has a constitutional mandate to provide people booked into these facilities with necessary health care. Counties designing a jail health care program targeted to meet the needs of their incarcerated population have the opportunity to improve the health of people in jail and the broader community, spend public dollars more effectively, and, in some cases, reduce recidivism. Yet little is known about how jails administer their health care programs and whether these programs further county public health and safety goals. Research is limited on how counties organize their jail health care services, what care they make available and when, and how they ensure they receive value for their investment in health care. Despite growing awareness of the connection between community services for recently released individuals-especially those with mental illness or substance use disorders, collectively known as behavioral health disorders-and a reduction in recidivism, information about how to achieve this result is scarce. In an effort to give counties tools to improve delivery of services to an underserved population with high needs, The Pew Charitable Trusts, with the assistance of Community Oriented Correctional Health Services, reviewed 81 requests for proposals (RFPs) for contracted jail health care services and conducted in-depth case studies of three jurisdictions. (See the methodology for more detail.) This research revealed wide variation in the ways that counties arrange to provide health care in their jails and the information they supply to help vendors craft bids. Additionally, despite growing recognition of the health needs of those currently and formerly in jail, our analysis found varying approaches to whether and how jails prepare individuals to manage their health once released. The research found that: - Many jails contract with vendors to provide health care. In New York state, for example, 84 percent use vendors to provide at least some health care services. The arrangements that counties make with providers vary; for example, one vendor may be responsible for all services, or a county can use multiple vendors across types of health care services such as mental health and dentistry. Payment models can also vary: While some counties share financial risk for costly medical care with the contractor, others have their vendors assume all risk through a negotiated per-inmate, per-day rate. - The portion of a jail's budget spent on health care can vary widely by county. For instance, in Virginia, jails spend anywhere from 2.5 to 33 percent of their budgets on health care. - Although most jails conduct bookings 24 hours a day, many do not have medical or nursing staff on site to screen incoming individuals at all times. This can lead to delays in identifying and treating acute, possibly lifethreatening health problems, and missed opportunities to divert people with behavioral health disorders into treatment settings rather than jail. Jails with an average daily population (ADP) under 500 are less likely to offer round-the-clock clinical services than are larger ones, a situation probably driven by resource constraints. - Most of the RFPs that were examined look to national accrediting bodies such as the American Correctional Association and the National Commission on Correctional Health Care to guide how the jail offers health care services. Yet few RFPs laid out performance requirements and financial penalties or incentives that would hold contractors accountable for meeting service requirements. Details: New York: Pew Charitable Trusts, 2018. 41p. Source: Internet Resource: Accessed April 6, 2018 at: http://www.pewtrusts.org/~/media/assets/2018/01/sfh_jails_inadvertent_health_care_providers.pdf Year: 2018 Country: United States URL: http://www.pewtrusts.org/~/media/assets/2018/01/sfh_jails_inadvertent_health_care_providers.pdf Shelf Number: 149724 Keywords: Correctional InstitutionsHealth CareJail InmatesMentally Ill Inmates |
Author: Fischer, Aaron J. Title: Suicides in San Diego County Jail: A System Failing People with Mental Illness Summary: San Diego County faces a crisis in its jail system. It has the highest reported number of suicides in a California jail system over several years - more than 30 suicide deaths since 2010. The inmate suicide rate has been many times higher than the rate in similarly sized county jails in California, the State prison system, and jails nationally. This is a crisis demanding meaningful action. While the County reported just one inmate suicide in 2017, which is a welcome decrease compared to previous years, the system remains deeply challenged. The incidence of inmate suicide attempts and serious self-harm remains extremely high - a rate of approximately two (2) per week. The frequency of suicide attempts indicates that the County must improve its treatment of people with mental health needs. Recognition that San Diego County has a problem with suicides and other deaths at the jail is not new. There has been a steady drumbeat of calls to action, from the County's grand juries, the media, and people who have been incarcerated at the jail and their loved ones. As the designated protection and advocacy system charged with protecting the rights of people with disabilities in California, Disability Rights California (DRC) opened an investigation into conditions at the San Diego County jails in 2015. We conducted tours of the County's jail facilities, and completed extensive interviews with Sheriff's Department leadership, jail staff, and jail inmates. We have reviewed thousands of pages of relevant policies and procedures, Sheriff's Department records, and individual inmate records. Our investigation focuses on four interconnected aspects of San Diego's County jail and mental health systems. We provide specific Recommendations regarding each. Over-Incarceration of People with Mental Health Needs. First, we found that there is an extremely high number of jail inmates with significant mental health treatment needs. The County's mental health care system, both inside and outside of the jail, has long operated in a way that leads to the dangerous, costly, and counter-productive over-incarceration of people with mental health-related disabilities. This includes a historical failure to provide sufficient community-based mental health services and supports that help individuals with mental health needs to thrive and avoid entanglement with the criminal justice system and incarceration. There is an urgent need for a better approach. We found that the County's recently developed Mental Health Services Act Plan and related initiatives - including increased community based-services and diversion/reentry efforts - provide a reason for optimism. Of course, the County's efforts will be judged on outcomes in the months and years ahead. Deficiencies in Suicide Prevention. Second, our two subject matter experts, who reviewed inmate suicide cases as well as relevant policies, identified significant deficiencies in the County's suicide prevention practices. These experts, Karen Higgins, M.D., and Robert Canning, Ph.D., CCHP, have considerable expertise in suicide prevention and mental health treatment in detention facilities. They have completed a detailed written report (Appendix A), which identifies twenty-four (24) Key Deficiencies in the County's system and provides forty-six (46) Recommendations to address those deficiencies. While we are convinced that the Sheriff's Department has begun to take the issue of suicide prevention seriously, there remain many aspects of the system's treatment of people at risk of suicide that require urgent action. Failure to Provide Adequate Mental Health Treatment. Third, we found that the County's jail system subjects inmates with mental health needs to a grave risk of psychological and other harms by failing to provide adequate mental health treatment. Making matters worse, the County subjects inmates to dangerous solitary confinement conditions that take an enormous toll on individuals' mental health and well-being. A substantial number of the suicides in San Diego County's jails have occurred in designated segregation units and other units with solitary confinement conditions. Even with committed jail leadership and staff efforts to reduce solitary confinement and improve conditions, insufficient staffing and lack of other critical resources have caused these problems to persist. Lack of Meaningful, Independent Oversight. Fourth, we found that the existing systems of jail oversight have failed. The time has come for the County to create an independent and professional oversight entity to monitor jail conditions, suicide prevention and mental health treatment practices, and other jail operations. A truly effective independent oversight entity, building on the models developed in Los Angeles County, Santa Clara County, Sonoma County, and other jurisdictions across the country, would enhance the County's efforts to address its historical challenges in its jails, help to achieve and solidify system improvements, and strengthen the trust of the community through greater transparency. We have found that the County's jails have the great advantage of committed mental health staff and a number of strong leaders within the Sheriff's Department. They will need sustained investment and support from the County - along with true transparency and accountability - to achieve a durable solution to the inmate suicide crisis, the deficiencies in mental health treatment inside the jail, and the over-incarceration of people with mental health needs. Details: Sacramento: Disability Rights California, 2018. 71p. Source: Internet Resource: Accessed May 8, 2018 at: https://www.disabilityrightsca.org/system/files/file-attachments/SDsuicideReport.pdf Year: 2018 Country: United States URL: https://www.disabilityrightsca.org/system/files/file-attachments/SDsuicideReport.pdf Shelf Number: 150114 Keywords: Jail InmatesJail SuicidesMental Health ServicesMentally Ill InmatesMentally Ill PersonsSuicides |
Author: New Jersey Parents' Caucus Title: The Solitary Confinement of Youth with Mental Health Disabilities in New Jersey's Adult Prison System Summary: Being housed in solitary confinement has become conducive to the deterioration of my mental health. The things I have witnessed would shock and disgust many people. I have witnessed things like guards depriving inmates of their meals, mentally ill inmates throwing feces and other bodily fluids on each other, and officers spraying mace on inmates and letting them soak in the chemicals. All of these events and many more have in some way traumatized me and has led to me having many panic attacks and mental health issues. Indeed, there is a need for some kind of segregation for those who break the rules of the prison; however, when solitary confinement becomes so harsh and focuses solely on punishing individuals, any possibility of correction and rehabilitation to an inmate's behavior becomes impossible; consequently, the conditions become counterproductive. -DM, 20, NJSP. It is shocking and unacceptable that youth like DM, a New Jersey Youth Caucus Member, have spent over 1,000 days in solitary confinement while in an adult prison in New Jersey. As DM described, solitary confinement is harmful and traumatic. It is defined by isolation in a cell for up to 24 hours a day, as well as deprivation of social interaction, property, and often educational materials. In 2015, the U.S. Department of Justice under the Obama Administration began looking into the use of solitary confinement and the harmful psychological effects on inmates in prisons across the country. In an op-ed for the Washington Post, former President Obama wrote: Research suggests that solitary confinement has the potential to lead to devastating, lasting psychological consequences. It has been linked to depression, alienation, withdrawal, a reduced ability to interact with others and the potential for violent behavior. Some studies indicate that it can worsen existing mental illnesses and even trigger new ones. Those who do make it out often have trouble holding down jobs, reuniting with family, and becoming productive members of society. Imagine having served your time and then being unable to hand change over to a customer or look your wife in the eye or hug your children. As a result of the Department of Justice's review of solitary confinement, President Obama announced a ban on its use for youth in the federal prison system. In August 2015, the New Jersey Legislature passed and Governor Christie signed the Comprehensive Juvenile Justice Reform Bill S. 2003/A. 4299. This legislation eliminated the use of solitary confinement as a disciplinary measure in juvenile facilities and detention centers, as well as limited the time that solitary confinement could be imposed for reasons other than punishment, such as safety concerns. Unfortunately, these limitations on solitary confinement do not apply to youth in the adult prison system. As a result, the needs, stories, and trauma associated with youth placed in solitary confinement in adult prisons remain untold, unaddressed, and, ultimately, forgotten. In 2016, Governor Christie vetoed S. 51, legislation that would have dramatically reformed solitary confinement in New Jersey dictating that isolated confinement should only be used when necessary, and should not be used against vulnerable populations or under conditions or for time periods that foster psychological trauma, psychiatric disorders, or serious, long-term damage to an isolated person's brain. Christie's statement accompanying his veto of S. 51, which would have allowed solitary confinement only as a last resort, repeated his administration's claim that solitary confinement does not exist in our state, despite overwhelming evidence that it is used routinely, including as a form of discipline. In January 2018, Assemblywoman Nancy Pinkin and 19 other co-sponsors reintroduced the solitary reform bill, A. 314. As part of the New Jersey Youth Justice Initiative (NJYJI), we at the New Jersey Parents' Caucus have gathered comprehensive state data from the New Jersey Department of Corrections (NJ DOC) on 556 children tried, sentenced, and incarcerated in the adult prison system. The data largely covers the period of 2007-2016, though some information gathered dates back to 2003. In addition to the data retrieved from the NJ DOC, we have received qualitative data from a subset of the same population (163 youth) by means of a survey assessment provided to incarcerated youth and their parents, caregivers, and family members. Ninety-five youth answered questions about their experience in solitary confinement. Dr. Colby Valentine, Ph.D. analyzed NJYJI data, which includes self-reported questionnaires from ninety-two youth waived to the adult prison system, to understand the relationship between mental health and solitary confinement for youth in New Jersey prisons. Her analysis confirms that solitary confinement negatively affects the mental health of youth in New Jerseys adult prisons, adding to prior research that states that prolonged isolation may cause or exacerbate mental health problems in adult inmate populations. It is the position of the New Jersey Parents' Caucus, Inc. (NJPC) and its membership that the State must ban the imposition and use of solitary confinement or restricted housing units - another term for solitary confinement - which were found in either administrative segregation or the Management Control Unit, a form of solitary confinement used at administrators' discretion on youth in adult jails and prisons. Solitary confinement imposes further violence, harm, and psychological damage on youth before they return to their communities. If these youth return home without adequate mental health and rehabilitative care, it negates their ability to become productive members of our society. Their stories and their needs must be addressed through legislation to end this cruel, but unfortunately, common, practice on youth in the adult criminal justice system. Details: Elizabeth, NJ: The Caucus, 2018. 22p. Source: Internet Resource: Accessed May 31, 2018 at: http://newjerseyparentscaucus.org/wp-content/uploads/2018/05/NJPCSolitaryConfinementBriefFINAL.pdf Year: 2018 Country: United States URL: http://newjerseyparentscaucus.org/wp-content/uploads/2018/05/NJPCSolitaryConfinementBriefFINAL.pdf Shelf Number: 150421 Keywords: IsolationJuvenile DetentionJuvenile InmatesJuvenile OffendersMentally Ill InmatesRestrictive HousingSolitary ConfinementYouth in Adult Prisons |
Author: Vail, Eldon Title: Sacramento County Jail. Mentally Ill Prisoners and the Use of Segregation: Recommendations for Policy, Practice and Resources Summary: The use of segregation in the Sacramento County Jails is dramatically out of step with emerging national standards and practices and with what the research tells us about the dangers of segregation regarding placing mentally ill inmates in segregated housing. The SCSD jails make no provision to exclude the mentally ill from segregation despite the mounting evidence that this population is particularly vulnerable to serious risk of significant harm from such placement. The SCSD overuses segregation both for the mentally ill and the non-mentally ill. Because of the lack of sufficient out of cell time and programming opportunities, conditions in the jails for segregated inmates are very stark and unlikely to meet constitutional standards. Jail Psychiatric Services (JPS) provide mental health services in the SCSD jails. While JPS staff are dedicated and hard working, the authorized staffing levels are so meager that little treatment of the incarcerated mentally ill actually takes place. Services are primarily limited to medication management and crisis intervention. There is a near total lack of individual or group therapy, elements that in my experience as a correctional administrator over a state prison system are critical for the care of this vulnerable population. The level of custody staffing for both jails is startlingly and dangerously low for even their current operation and as a result they operate in a state of near perpetual emergency. Absent a significant reduction in the population of the jail, there is no way they could achieve compliance with the applicable standards for managing the mentally ill and segregated inmates with their current staffing levels. There must be a sizable increase in both mental health and custody staffing to properly provide treatment to the mentally ill and avoid what would likely be successful litigation should this matter go before the Federal court. The jail is in need of an updated Housing Plan. Currently, inmates with different custody levels and mental health needs are housed in units or pods that are not clearly defined by these important factors. It is possible that some of the recommended increases in custody staffing (included later in this report) could be reduced with a Housing Plan that houses maximum inmates with maximum inmates, medium with medium, etc. in the same pods or units. The same is true for levels of mental health acuity. Not all mentally ill inmates require maximum custody or restrictive housing. Some can do quite well in medium or minimum custody treatment units. It is recommended that the jail's classification system be reviewed and updated as part of establishing an improved Housing Plan. A complete list of recommendations is at the end of this report. Details: Sacramento: Disability Rights California, 2016. 45p. Source: Internet Resource: Accessed August 1, 2018 at: https://www.disabilityrightsca.org/system/files/file-attachments/%5B001-2%5D_Exhibit_B-Vail_Report_2018-07-31.pdf Year: 2016 Country: United States URL: https://www.disabilityrightsca.org/system/files/file-attachments/%5B001-2%5D_Exhibit_B-Vail_Report_2018-07-31.pdf Shelf Number: 150997 Keywords: Administrative SegregationJail InmatesJailsMentally Ill InmatesRestrictive Housing |
Author: Reichert, Jessica Title: Co-occurring Mental Health and Substance Use Disorders of Women in Prison: An Evaluation of the WestCare Foundations Dual Diagnosis Program in Illinois Summary: Co-occurring disorders (COD) - both substance use disorders (SUD) and mental health disorders (MHD)affect many women incarcerated in prison. Incarcerated women are diagnosed with COD more often than their male counterparts (BJS, 2017). This is due in part to risk factors such as childhood sexual abuse, physical abuse, and domestic violence that occur more often to women offenders and make them more likely to be diagnosed COD in their lifetime. To address the needs of women in prison with COD, evidence-based programming underpinned by principles of trauma-informed and gender-responsive frameworks are needed. Illinois Criminal Justice Information Authority (ICJIA) researchers conducted a process evaluation of the Dual Diagnosis treatment program operated by WestCare Foundation at Logan Correctional Center for women in Illinois. A process evaluation is intended to document how the program is currently implemented in relation to the original program design and promising or evidence-based practices. This report offers findings from that evaluation. Researchers specifically sought to learn how the program operated, about clients and their views on the program, and staff perceptions of the program. Specifically, the research team worked to answer the following research questions: - How did the program operate? - Who were the clients? - What did the clients and staff think of the program? - To what extent did the program reduce PTSD symptoms? - To what extent did the program reduce aggression? Details: Chicago, IL: Illinois Criminal Justice Information Authority, 2018. 53p. Source: Internet Resource: Accessed March 18, 2019 at: http://www.icjia.state.il.us/assets/articles/Co-occuring_mental_health_and_substance_use_disorders_of_women_in_prison_FULL_REPORT_100318.pdf Year: 2018 Country: United States URL: http://www.icjia.state.il.us/assets/articles/Co-occuring_mental_health_and_substance_use_disorders_of_women_in_prison_FULL_REPORT_100318.pdf Shelf Number: 155026 Keywords: Co-occurring disordersDrug AddictionDual DiagnosisFemale InmatesMentally Ill InmatesSubstance Abuse OffendersSubstance Abuse Treatment |