Mental Health Services In Jails and Prisons: The Largest Mental Institution
By: Amy Kodrich
According to the National Alliance of Mental Illness, “In a mental health crisis, people are more likely to encounter police than get medical help. As a result, 2 million people with mental illness are booked into jails each year.” Once in jail, many individuals with mental illnesses are incarcerated longer than their counterparts due to the lack of services and treatments provided. The U.S Department of Justice reported that about one-third of inmates in the United States with mental health issues had received mental health treatment since admissions to their current facility. However, reports also show that 73 percent of jail inmates who met the threshold for serious psychological distress (SPD) said they have received mental health treatment at some time in their life.
Studies show that if individuals do not receive proper care and treatment once in prison, they often end up getting worse, not better. “This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison.” They are at risk of victimization and often their mental health conditions deteriorate. Many jails and prisons do not have proper funding, education, and resources to be able to provide individuals with the proper care. In some parts of the country, hiring and retaining mental-health staff is a challenge, and proven especially difficult for remote facilities. A recent study published in the American Journal of Preventive Medicine found that about half of rural communities in the United States don’t have access to a psychologist, and 65 percent don’t have a psychiatrist.
Lucas Malishchak, Director of the Pennsylvania Department of Corrections' Psychology Office, stresses the importance of mental health services, training, and the implementation of programs focused on suicide prevention. With regard to mental health services, the Department of Corrections recognized the need for system wide training initiatives. The Department of Corrections commenced the delivery of the Crisis Intervention Team Training for certain classifications of employees and Mental Health First Aid training for all employees. The unveiling of the mental health training initiatives to all Department of Corrections (DOC) employees is only the beginning of Pennsylvania’s strategy to change the culture of the seventh largest state correctional system in the United States (BJS, 2014). The Department of Corrections recognizes that every employee in the state correctional system is responsible for suicide prevention efforts. Consequently, newly implemented Suicide Response Drills are occurring intermittently at every State Correctional Institution in Pennsylvania. These drills are aimed at improving response times and best practices of all employees to these critical incidents. In addition to the training provided for DOC employees, all Pennsylvania State Correctional Institutions have trained select inmates as Certified Peer Specialists (CPS). These inmates receive an 80-hour training aimed at developing peer support skills for the purposes of augmenting staff service with active listening skills and support of other inmates.
“Mental health first aid was ruled out to all 16,000 Pensylvannia corrections staff, our primary thinking was the staff who work with the individuals incarcerated, what was also unique about our program was that mental health first aid was required to those who do not have contact with incarcerated individuals. Every single one of our employees received this training,” Malishchak said.
Marcy D'Orazio, Assistant Warden at Montgomery County Correctional Facility, stresses the importance of treatment and services for individuals with mental illnesses. “Criminal justice is a helping career...We are primarily here to make sure people are treated fairly and provide the treatment and services they need,” D’Orazio said. Montgomery County Correctional Facility has worked on many projects to be able to provide incarcerated individuals with proper treatment and services. They have an established partnership with Prime Care, a medical provider, that works with mental health inmates to provide services and treatment.
They work with an outside program called Justice Related Services that helps individuals stay out of jail. Justice Related Services, works with incarcerated individuals with mental illness to provide resources that include diversion from jail, a shorter length of stay in jail, and successful reentry into the community. “Jail is not the place for people with mental health. Jails are turning into mental health hospitals. We are facing a huge crisis with that.” D’Orazio said. Reentry programs are essential for individuals with mental illness because after leaving jail, many no longer have access to needed healthcare and benefits. A criminal record often makes it hard for individuals to get a job or housing. Many individuals, especially without access to mental health services and supports, wind up homeless, in emergency rooms and often re-arrested. About 54 percent of individuals with mental illness are re-incarcerated, 68 percent present co-occurring mental illness and substance abuse.
Justice Relief Services work with the Montgomery County Reentry Initiative (MCRI) and Family Services aim to reduce the risk factors for recidivism by reducing barriers for successful reentry into society by individuals incarcerated through the Montgomery County Correctional Facility (MCCF). This is why MCCF works to provide services, trying to ensure that individuals don't find themselves back in jail. “When people dont have those services in place (after leaving jail) they relapse or they get back into jail, where we hope our recidivism rate decreases with this partnership,” D’Orazio said. “There is never enough education for correctional staff and law enforcement when it comes to mental health.”
For more info: https://www.nami.org/Advocacy/Policy-Priorities/Divert-from-Justice-Involvement/Jailing-People-with-Mental-Illness