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Mental Health Services

The Department of Justice has closed its investigation into the way Pennsylvania treated its prisoners with mental illness or intellectual disabilities.  Read our reaction here: 
 
Nearly three years ago, the U.S. Department of Justice announced it was going to investigate the way Pennsylvania treated its prisoners with mental illness or intellectual disabilities.
Last week, in a letter to Governor Tom Wolf, the U.S. Department of Justice wrote that it was closing its investigation because the Pennsylvania Department of Corrections had already made so many significant changes and improvements.
“We are confident that, through the reforms Pennsylvania Department of Corrections has initiated and with its committed pursuit of reforms going forward, thousands of prisoners with serious mental illness and/or intellectual disabilities throughout the Pennsylvania Department of Corrections’ system will experience improvements in their treatment and care,’’ the letter read.
“Our department took these suggestions to heart from the beginning,’’ Pennsylvania Secretary of Corrections John E. Wetzel said. “One-fourth of our prison population suffers from some sort of mental illness, and the treatment of these individuals was a significant concern.’’
“We are committed to doing the right thing and this was an important change that needed to be addressed,’’ Wetzel added. “As we always do, our staff immediately embraced the opportunity to make our system better, to protect the safety of all who work and live in our institutions, and improve the outcomes of those in our care.’’
The U.S. Department of Justice, thanking Wetzel and his staff, cited several positive changes and reforms, including:
·         Solitary Confinement and Discipline. The Pennsylvania DOC created specialized treatment units for offenders with serious mental illness and intellectual disabilities. Problems are resolved informally or with mental health staff and discipline is no longer permitted for self-injurious behavior.
·         Out-of-Cell Options. Inmates with mental illness or intellectual disabilities are offered at least 20 hours per week out-of-cell time for activities and treatment. Treatment units are less stark, featuring colorful murals and recovery-based messages, resulting in greater participation and fewer incidents of harm.
·         Mental Health Diagnosis and Classification. The classification process has been expanded to include all prisoners with a current or past diagnosis, protecting them from restrictive housing.
·         Mental Health Care Delivery. By designating certain facilities to specialize in the treatment for prisoners with mentally illness or intellectual disabilities, offenders can benefit from expanded treatment services and mental health personnel.
·         Training. The PaDOC has trained hundreds of corrections officers and more than 500 peer specialists (inmates) to reinforce the efforts of mental health staff and to support prisoners in need of treatment and suicide prevention.
 
The Justice department recommended that Pennsylvania’s DOC continue and expand its efforts to improve treatment of offenders with mental health issues to ensure they are receiving appropriate care.
Governor Wolf has supported the work of Pennsylvania DOC in finding the most effective ways to help offenders with mental illness and learning disabilities, including support of diversionary courts.
But these changes do not come without cost, Wetzel said, and we hope all government officials will continue to support our commitment toward greater success in the future.  
 “We have devoted time and resources to training staff and developing best practices,’’ Wetzel said. “Pennsylvania is proud to be a national leader in these and many other initiatives to make our facilities better and safer.’’
 
Accomplishments in the area of Mental Health Services Provided to Inmates 
 
Solitary Confinement for SMI Offenders
The development of new treatment units and implementation of more robust misconduct diversionary procedures for inmates with serious mental illness (SMI) has resulted in the elimination of such inmates being housed in restricted units.  When a misconduct is incurred, out of cell time is required by policy and must relate to a treatment plan.
 
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
The DOC's certified peer support specialist program has trained more than 500 inmates to provide support services to other inmates on a variety of issues, including participation in mental health treatment.  The training has proven very beneficial to the DOC staff and inmate population as we have been able to realize de-escalation of situations, improved mental health for inmates and Peers alike. The CPS initiative is an evidenced based program that inspires hope in individuals that recovery is possible through their own lived experience and example of modelling recovery. The service is designed to promote empowerment, self-determination, understanding, coping skills, and resiliency through mentoring and service coordination supports that allow individuals with severe and persistent mental illness and co-occurring disorders to achieve personal wellness and cope with the stressors and barriers encountered when recovering from their disabilities.  Peers are used throughout all housing units and to assist in education and hospice programs, and they receive specialized training including suicide prevention.  DOC certified peers also will be trained in a newly developed trauma training in an effort to increase support to inmates who have experienced trauma which continues to impact their lives.
 
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 
As of March 31, 2015, every DOC employee was trained in the area of Mental Health First Aid through a collaboration with the PA Commission on Crime and Delinquency.  Moving forward, new DOC employees will receive the course during their basic training.
 
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.
Appointed a Mental Health Advocate
In May 2015, the DOC established a newly-created Office of Mental Health Advocate.  Reporting directly to the secretary of corrections, this individual works independently from the DOC’s Psychology Office ensuring offenders are getting the treatment they should while in prison and that they are connected with eligible benefits upon release from prison.

 
Department of Corrections Mental Health Initiatives

o Task Force to include Law Enforcement, District Attorneys, Department of Human Services, providers and other key stakeholders.

Goal: To define some of the issues related to mental illness and criminal justice/incarceration. Once the issue is defined, the long term goal is to determine how to maximize local community resources, interventions and other intercept points to prevent mentally ill individuals from becoming incarcerated or involved in the CJ system.
o  Interagency meetings (DHS, OMHSAS, DOC) to address issues, needs and next steps relating to the forensic populations with mental illness. Meetings are conducted between the Department Secretaries to develop high level policy to the field.
o  Interagency reentry committee: DOC and DHS/OMHSAS staff meet internally and with county partners to develop re-entry planning and intercept efforts to address the needs of individuals maxing out of prison (served full sentence) to facilitate mental health and drug and alcohol treatment in the community to include community placement when applicable. This occurs through state level policy and procedures that includes early identification and information sharing of inmates that are being released to initiate the reentry planning process.
o Housing Initiative (early phase-probably not for public release yet). DHS/DOC have initiated an interagency collaboration to begin aggressive planning for housing initiatives to serve the mentally ill inmate population maxing out of prison but at risk for homelessness.

 

This page was last updated on 04/27/2016.