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Mentally Ill in Corrections - Treatment

AOT is a court order that requires certain persons with serious mental illness to stay in mandated and monitored treatment as a condition for living in the community. AOT reduces violence, arrest, hospitalization and incarceration of persons with serious mental illness in the 70% range and
thereby saves taxpayers 50% of the cost of care.

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.

"[H]istorical , legal, and ethical issues relevant to dealing with mental illness in the field of corrections" are discussed (p. iii). Chapters include: introduction; screening and assessment; mental health and substance abuse treatment; use of seclusion, segregation, and restraints; suicide prevention; treating women offenders; psychopharmacological intervention for psychiatric disorders; transitional services; treatment of special populations (e.g., persons with mental retardation or developmental disability, violent offenders, sex offenders, and older adults); and profiles of three states (Maryland, Oregon, and Texas).

Effective Prison Mental Health Services: Guidelines to Expand and Improve Treatment Cover

The GAINS Center focuses on expanding access to services for people with mental and/or substance use disorders who come into contact with the justice system.

This policy brief uses data from the Board of State and Community Corrections (BSCC)
to estimate the number of jail inmates who receive psychotropic medication and assess
the relative representation of this group among the jail population. To provide a measure
of the prevalence of mental illness in jail, we reviewed data from 45 counties that
completed the BSCC Jail Profile Survey from March 2012 to February 2017. We used
the receipt of psychotropic medications as an indicator of serious mental illness.

People with co-occurring mental illnesses and substance use disorders—also known simply as co-occurring disorders—have complex needs that require integrated responses across jails and behavioral health systems. However, staff often do not know how many people with co-occurring disorders reside in the jail or do not know how to respond when they recognize the symptoms. This brief outlines how jail administrators and staff can improve their responses to this population by implementing practices that focus on identification and provision of services: conducting standard screening and assessment for both, linking people to services through collaborative comprehensive case management, and assessing effectiveness through regular performance measurement tactics.

This report is a great introduction to strategies for treating offenders with serious mental illness (i.e., schizophrenia, schizoaffective disorder, bipolar disorder, or major depression) in jails, prisons, forensic hospitals, or community reentry programs. The researchers “identified some promising treatments for individuals with serious mental illness during incarceration or during transition from incarceration to community settings. Treatment with antipsychotics other than clozapine appears to improve psychiatric symptoms more than clozapine in an incarceration setting. Two interventions, discharge planning with Medicaid-application assistance and integrated dual disorder treatment programs, appear to be effective interventions for seriously mentally ill offenders transitioning back to the community” (p. vii).

Interventions for Adult Offenders With Serious Mental Illness Cover
This report provides a summary of the Community Justice Workshop,using Sequential Intercept Mapping, held for the Lawrence District Court jurisdiction.
The report includes:
  •  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

This "background analysis examines how individuals with mental illness are processed and treated in the criminal justice system and discusses the implications of insufficient or inadequate care for these individuals. In particular, the main objectives of this paper are to review current practice in the processing of mentally ill offenders, assess societal and economic costs associated with recidivism and insufficient care for this population, and highlight promising strategies to tackle challenges involved in the reintegration of mentally ill offenders into society" (p. 1). Sections following an executive summary are: introduction; research objective and focus—severe mental illness among individuals involved in the criminal justice system; data and methodology; findings related to the scope of the problem, costs associated with managing mentally ill individuals in the criminal justice system, current practice and policy, and criminal justice programs and interventions for mentally ill individuals; research and policy recommendations; and conclusion.

The Processing and Treatment of Mentally Ill Persons in the Criminal Justice System: A Scan of Practice and Background Analysis Cover

“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.

The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey cover


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