Mentally Ill Persons in Corrections

•  A brief review of the origins, background and framework of the Massachusetts Community Justice Project and workshop;
•  A Sequential Intercept Map as developed by the group during the workshop;
•  A summary of the information gathered at the workshop;
• A list of best practices and resources to help the partners in the Lawrence region action plan and achieve their goals

A discussion paper that identifies key questions and issues every policymaker should consider when seeking to help people leaving prison and jail connect to needed mental health and substance use treatment.

In this paper commissioned by the National Institute of Justice, authors reviewed the available evidence on the impact of institutional programming on pre- and post-release outcomes, prison misconduct, recidivism, post-release employment, and costs avoided through the prevention of crime.

"The development of culturally responsive clinical skills is vital to the effectiveness of behavioral health services. According to the U.S. Department of Health and Human Services (HHS), cultural competence “refers to the ability to honor and respect the beliefs, languages, interpersonal styles, and behaviors of individuals and families receiving services, as well as staff members who are providing such services … This Treatment Improvement Protocol (TIP) uses Sue’s (2001) multidimensional model for developing cultural competence. Adapted to address cultural competence across behavioral health settings, this model serves as a frame-work for targeting three organizational levels of treatment: individual counselor and staff, clinical and programmatic, and organizational and administrative. The chapters target specific racial, ethnic, and cultural considerations along with the core elements of cultural competence highlighted in the model. These core elements include cultural awareness, general cultural knowledge, cultural knowledge of behavioral health, and cultural skill development. The primary objective of this TIP is to assist readers in understanding the role of culture in the delivery of behavioral health services (both generally and with reference to specific cultural groups)" (p. xv). These six chapters follow an executive summary: introduction to cultural competence; core competencies for counselors and other clinical staff; culturally responsible evaluation and treatment planning; preparing organizational cultural competence; behavioral health treatment for major racial and ethnic groups—African and Black Americans, Asian Americans, Native Hawaiians, and other Pacific Islanders, Hispanics and Latinos, Native Americans, and White Americans ; drug cultures and culture of recovery. Appendixes included: Instruments to Measure Identity and Acculturation; Tools for Accessing Cultural Competence; Screening and Assessment Instruments; Cultural Formulation in Diagnosis and Cultural Concepts of Distress; Cultural Resources; and glossary.

“Prisons and jails have become America’s “new asylums”: The number of individuals with serious mental illness in prisons and jails now exceeds the number in state psychiatric hospitals tenfold. Most of the mentally ill individuals in prisons and jails would have been treated in the state psychiatric hospitals in the years before the deinstitutionalization movement led to the closing of the hospitals, a trend that continues even today. The treatment of mentally ill individuals in prisons and jails is critical, especially since such individuals are vulnerable and often abused while incarcerated. Untreated, their psychiatric illness often gets worse, and they leave prison or jail sicker than when they entered. Individuals in prison and jails have a right to receive medical care, and this right pertains to serious mental illness just as it pertains to tuberculosis, diabetes, or hypertension. This right to treatment has been affirmed by the U.S. Supreme Court … [this report] is the first national survey of such treatment practices. It focuses on the problem of treating seriously mentally ill inmates who refuse treatment, usually because they lack awareness of their own illness and do not think they are sick. What are the treatment practices for these individuals in prisons and jails in each state? What are the consequences if such individuals are not treated?” (p. 6). This publication is divided into four parts: history of the problem—whether we have learned anything in 200 years; legal background for treating mentally ill persons in prisons and jails; the state survey results; and findings and recommendations.