Psychiatric Services In Correctional Facilities

The 15 years since publication of the second edition of the American Psychiatric Association’s task force report on psychiatric services in correctional facilities have seen increasing rates of incarceration of mentally ill individuals, continuing criminalization of substance use disorders, and a lack of accessible and appropriate care in the community. The purpose of the new edition, Psychiatric Services in Correctional Facilities, and the aim of the work group that authored it over many years of research, dialogue, and development, is to provide leadership in addressing the needs of the often disenfranchised population of the incarcerated and to provide guidance to mental health clinicians working in correctional settings. Urging an expanded role in leadership and advocacy, the work group members present the foundational principles that apply to providing care in correctional facilities, outline the basic types of services that should be provided, and apply the principles and guidelines previously established to specific disorders, patient populations, treatment modalities, and special needs. Working with these patients and in these settings presents particular challenges that clinicians are unlikely to have encountered elsewhere in practice, such as the use of seclusion and restraint and administrative issues. Psychiatric Services in Correctional Facilities provides critical guidance and support for mental health professionals operating in this often frustrating environment, enabling them to provide both effective treatment and informed advocacy for their patients.

The long-awaited report of the APA's Work Group to Revise the APA Guidelines on Psychiatric Services in Correctional Facilities, Psychiatric Services in Correctional Facilities comes at a time of growing incarceration rates, more rigid sentencing policies, harsher sanctions, and tougher public attitudes toward crime. The result is a near-doubling of the incarcerated population since the first report was issued in 1989 and a significant increase of inmates with serious mental health issues. The work group members address the implications of this troubling state of affairs for psychiatrists and other mental health practitioners who diagnose and treat within the correctional environment. On the basis of extensive input from multiple sources and perspectives, they have developed clear guidelines that equip clinicians to navigate the special challenges they face. This edition has been thoroughly updated and is structured to flow from the foundational principles that govern the delivery of psychiatric care in correctional facilities, to the guidelines for screening, referral, evaluation, treatment, and community reentry planning, to special applications of the principles and guidelines to specific disorders/ syndromes, patient populations, housing locations, treatment modalities, and inmate special needs. Readers will find the book well written, with clear guidance for the clinician, as well as challenges to think beyond the needs of individual patients to the larger relationship between mental illness and incarceration. Approximately three of every four incarcerated people with a serious mental illness have a co-occurring substance use disorder, complicating both diagnosis and treatment. The book offers strategies for treating co-occurring disorders and explores the need for evidence-based screening tools. Because some inmate populations have unique evaluation and treatment needs because of their disorders, demographics, or other characteristics, separate sections are devoted to women; youths in adult correctional facilities; geriatrics; lesbian, gay, bisexual, and transgender patients; veterans; and patients with intellectual and developmental disabilities. New management and programmatic topics include hospice, mental illness and segregation, seclusion and restraint, telepsychiatry, and the spiritual lives of inmates. The appendix is a valuable resource that includes a selection of APA position statements on topics relevant to psychiatric services in correctional settings, such as capital punishment, access to care for transgender and gender-variant individuals, and the adjudication of youths as adults in the criminal justice system. Correctional psychiatry is an evolving field, and serious questions remain. The work group sees an expanded role for clinicians as physician leaders, managers, and directors, more effectively advocating for their patients and helping to shape optimal care delivery systems that empower patients and support successful transition back to the community. Psychiatric Services in Correctional Facilities provides the current knowledge and professional support clinicians need to meet these challenges.

For the past decade, the first edition of this unique book has lighted the way for those seeking to navigate the perilous shoals of providing mental health services in jails and prisons. These guidelines have been used and cited extensively in many contexts: educational, planning, and legal. They also have been used by surveyors and monitors of correctional facilities. Since the publication of the first edition, American jails and prisons have seen many changes, including considerable litigation, the development of consumer groups, and the creation of some exemplary programs. However, there has also been a dramatic increase in the population of U.S. jails and prisons. In September 1989, when the first edition of these guidelines was published, our nation's jails and prisons held an estimated 1.2 million men and women. This number is now 1.8 million. Many studies have consistently demonstrated that about 20% of these inmates have serious mental illnesses, and as many as 5% are actively psychotic. With upward of 700,000 men and women entering the U.S criminal justice system each year with active symptoms of serious mental disorders, with 75% of these people having co-occurring substance abuse disorders, and with these persons likely to stay incarcerated four or five times longer than similarly charged people without mental disorders, what are our duties and responsibilities? How do we live up to our personal moral principles, our professional ethics, and our public service obligations in the face of these overwhelming numbers? This is the question to which this book is addressed. This book is intended both to prod to action and to provide comprehensive guidance on how to fulfill these responsibilities to ourselves, our profession, and these badly underserved patients. We have the technologies for treatment and the knowledge and the skills, yet limited resources and public and professional resistance often impede appropriate response. We believe that these guidelines can help overcome many of these sources of resistance through informed action. More active involvement of our profession, as described in these guidelines, is needed, is possible, and will make a difference.

This collaborative text addresses the full range of issues faced by correctional psychologists and other mental health service providers who offer programs and services within correctional institutions--from critical program development and management issues to specific treatment options for special populations.

This textbook brings together leading experts to provide a comprehensive and practical review of common clinical, organisational, and ethical issues in correctional psychiatry.

The jail and prison population is at an all-time high, and those inmates with a mental disorder constitute a rapidly growing proportion of persons involved with the criminal justice system. The challenge of assessing and treating these individuals has never been greater. Fortunately, Handbook of Correctional Mental Health is now available in a new, expanded and updated second edition that provides practical, up-to-date guidelines for mental health care providers who work in a correctional setting. In 20 state-of-the-art chapters, nationally recognized providers and correctional mental health experts address the most pressing issues facing clinicians on the frontlines--psychiatrists, psychologists, social workers, nurses, and other professionals who serve the inmate population. This new edition includes eight new chapters that include clinically focused guidelines on the assessment and treatment of inmates with substance use disorders, geriatric offenders, juvenile offenders, inmates with self-injurious behaviors, offenders who have experienced various traumas during their lives, and inmates housed on maximum security units and death row. Targeted to multiple disciplines, not just psychiatry, and reflecting current research and opinion, Handbook of Correctional Mental Health is an indispensable resource that assists the reader in understanding and providing the standard of care in a correctional setting.

Over the past four decades, the rate of incarceration in the United States has skyrocketed to unprecedented heights, both historically and in comparison to that of other developed nations. At far higher rates than the general population, those in or entering U.S. jails and prisons are prone to many health problems. This is a problem not just for them, but also for the communities from which they come and to which, in nearly all cases, they will return. Health and Incarceration is the summary of a workshop jointly sponsored by the National Academy of Sciences(NAS) Committee on Law and Justice and the Institute of Medicine(IOM) Board on Health and Select Populations in December 2012. Academics, practitioners, state officials, and nongovernmental organization representatives from the fields of healthcare, prisoner advocacy, and corrections reviewed what is known about these health issues and what appear to be the best opportunities to improve healthcare for those who are now or will be incarcerated. The workshop was designed as a roundtable with brief presentations from 16 experts and time for group discussion. Health and Incarceration reviews what is known about the health of incarcerated individuals, the healthcare they receive, and effects of incarceration on public health. This report identifies opportunities to improve healthcare for these populations and provides a platform for visions of how the world of incarceration health can be a better place.