February 25, 2014

Corrections Responds To U.S. Department Of Justice Mental Health Services Review

The U.S. Department of Justice Civil Rights Division Monday issued the findings of its investigation of the Pennsylvania prison system's mental health services for seriously mentally ill inmates.
The statewide investigation began on May 31, 2013, and stemmed from the U.S. DOJ's investigation of mental health services at SCI Cresson. SCI Cresson closed on June 30, 2013.
Since the U.S. DOJ announced its original investigation of SCI Cresson in December 2011, Pennsylvania Department of Corrections Secretary John Wetzel has emphasized that, "The DOC and the U.S. DOJ are working toward the same goal – appropriate delivery of mental health services."
The report represents only the U.S. DOJ's conclusions and pertains to the period spanning from January 2012 through June 2013. U.S. DOJ and DOC will mutually discuss the U.S. DOJ's findings in coming weeks.
"Because the report focuses on data gathered from January 2012 through June 2013, it does not reflect the reality of how the Pennsylvania prison system currently operates or provides services to inmates," Wetzel said. "It also is not representative of the services and work that the DOC's dedicated mental health and correctional staff provides."
Since 2011, one of the priorities of DOC has been to enhance treatment for mentally ill offenders. The growth of inmate populations with mental illness has been a tremendous challenge for prison systems across the country.
Prior to the U.S. DOJ's expanded investigation, the DOC had already begun significant improvements in the area of enhancing services for mentally ill offenders. Pennsylvania's DOC has worked diligently to develop and implement these transformative initiatives to provide effective programs and enhanced services for the mentally ill.
Many of these programs are innovations that the DOC was the first to develop and implement and they have had tremendous results:
-- Solitary Confinement for SMI Offenders: The development of new treatment units and implementation of more robust misconduct diversionary procedures for inmates with SMI has resulted in a steep decline in the number of inmates with SMI who are currently housed in restricted units for disciplinary reasons. Currently, less than 150 inmates who are diagnosed as SMI are housed in restrictive housing units, down from nearly 850 inmates previously.
-- Vera Segregation Reduction Project: The DOC has partnered with the nationally recognized Vera Institute of Justice. Vera's Segregation Reduction Project will examine the DOC's use of segregation for the overall inmate population and develop strategies to safely reduce the use of costly segregation through training, policy modifications and other initiatives.
-- Enhanced Classification and Treatment for Seriously Mentally Ill Offenders: The DOC has updated its definition of Serious Mental Illness (SMI) to better capture and track those individuals who suffer from the most severe forms of mental illness, requiring the most treatment services. Because the new definition is diagnosis driven, it better identifies individuals in need of services and ensures that they are connected to needed resources. For those inmates who require intensive treatment, a recovery model individual treatment plan is generated – with the inmate's participation – to identify and isolate certain treatment goals that the inmate and treatment team will strive to meet together.
-- Certified Peer Support Specialist Program: DOC's certified peer support specialist program has trained over 300 inmates to provide support and counseling services to other inmates on a variety of issues, including participation in mental health treatment.
-- Crisis Intervention Team (CIT) Training: CIT training, first used to educate police officers to respond mental health issues that they encounter in the community, has been modified by the DOC into an extensive multi-day training course to provide our correctional officers with an understanding of the ways in which mental illness may affect the inmates they deal with daily, and provide them with skills to deescalate crisis situations. Trainings occur several times per year and classes typically include dozens of officers and corrections personnel. Those officers whose position within institutions put them in close contact with the mentally ill have been prioritized for this critical training. The DOC is planning to offer this training to the Pennsylvania county prisons in the future.
-- Mental Health First Aid Training: The DOC will train all employees in mental health first aid by the end of fiscal year 2014. The training equips employees to understand, recognize and respond to the symptoms of mental illness.
-- Improved Treatment Units: The DOC developed several new specialized units to address the different treatment needs of inmates with SMI, including Secure Residential Treatment Units, Residential Treatment Units and Short Term Residential Treatment Units. The variety of treatment units ensures that inmates are receiving individualized care specific to their particular needs regardless of their security level. Additionally, inmates in specialized units receive – at a minimum, and often far in excess of – 20 hours of structured and unstructured programs out of their cells each week; for those inmates in general population, treatment units have even greater out-of-cell program opportunities.
-- MHM performance contracting: The contract with MHM Services for inmate mental health care, includes performance-based incentives and penalties. The contract provides incentives for positive outcomes for offenders to further the DOC's goal that inmates leaving the system are better than when they entered it. The contract incentivizes treatment that reduces misconduct and mental health recommitment rates for the mentally ill. Additionally, MHM will be required to maintain or exceed an established baseline medication compliance rate.
-- Partnering with NAMI, Rutgers, etc.: The DOC has partnered with various advocacy groups and leading researchers in the field of mental illness to analyze current systems and develop initiatives to improve mental health care. Partners include the National Alliance for the Mentally Ill and Rutgers University.
-- Development of Suicide Prevention Committees: Each state correctional institution has instituted a Suicide Prevention Committee, which includes a multi-disciplinary team of mental health and security personnel, to review serious incidents of self-harm, attempted and completed suicides. These committees will monitor policy compliance, conduct training exercises and make recommendations for improvements to policy and procedure.
-- Trauma Screening: All female inmates received at SCI Muncy will undergo a thorough trauma screening upon their reception to the institution and be connected with appropriate follow-up services.