Presentation on theme: "Mental Illness in Jail JJ Larson, MS, NCC, NCAC-II"— Presentation transcript:
1 Mental Illness in Jail JJ Larson, MS, NCC, NCAC-II Manager, Psychological Services DivisionGreenville County Detention CenterDepartment of Public Safety, Greenville CountyPresented by Kelly Troyer, Executive Director, NAMI Greenville
2 Bureau of Justice Statistics Sept 2006 At midyear 2005 more than half of all prison and jail inmates had a mental health problem, including 479,900 in local jails.This estimate represented 64% of jail inmates.The above findings in this BOJS report were based on data from personal interviews with State and Federal prisoners in 2004 and local jail inmates in 2002.
3 SO ? Persons with SPMI often slip through the “judicial” cracks Largest Psychiatric Facilities in the countryWithout planning & community support – can enter the revolving door
4 Bureau of Justice Statistics Sept 2006 MENTAL ILLNESSJail inmates had the highest rate of symptoms of a mental health disorder (60%) (compared to federal or state prisoners)Approximately, 24% of jail inmates reported at least one symptom of a psychotic disorder.SUBSTANCE ABUSEAmong inmates who had a mental health problem, local jail inmates had the highest rate of dependence or abuse of alcohol or drugs (76%),Among inmates without a mental health problem, 53% in local jails were dependent on or abused alcohol or drugs.
5 Bureau of Justice Statistics Sept 2006 Nearly a quarter of jail inmates who had a mental health problem, compared to a fifth of those without, had served 3 or more prior incarcerations.Female inmates had higher rates of mental health problems than male inmates.Local jails: 75% of females, 63% of malesOver 1 in 6 jail inmates who had a mental health problem had received treatment since admission
6 Mental Illness and Substance Abuse are prevalent problems amongst today’s criminal offender population.
7 Who is housed out the GCDC ? Persons who are sentenced to less than 90 daysPersons who are waiting for trialPersons who are sentenced through family court for child supportPersons with charges ranging from: disorderly conduct to assault and battery to burglary to murder and everything in betweenAverage daily census = 1400Book in & Release 100 persons per day (on average)Annual Booking for 2006 =22,000 - with 4,000 being repeat offenders in same year
8 Who is housed out the GCDC ? Average inmate – white male mid to late 20’s, charged with A&B or Burglary 2nd degreeAverage mental health inmate – could be any charge from disorderly conduct to assault & battery with intent to killMost often male, most often off medicationOf the 1400 inmates – 33% are on prescribed medicationOf those inmates % are on psychotropic medicationsMost Common Diagnosis appear to be– SCHIZOPHRENIA, BIPOLAR, MOOD DISORDERSTOP 4 Meds in OCT 07:DEPAKOTE, LEXAPRO, SEROQUEL, & RISPERDAL
9 What GCDC Has undertaken Improving & Enhancing Psychological Services provided to incarcerated personsSeeking to enhance community partnerships for improved pre-release and “discharge” planningPartnering with NAMI with Inmate & Family Support program
10 Staffing vs. Inmate Population 2000 with average of 855 Inmates –1 mental health clinicians1 psychiatrist, part-time2007 with average of 1400 Inmates –1 mental health administrator3 mental health clinicians1 administrative clerk
11 Psychological Services Mental Health EmergenciesInmates who have been identified with suicide distress or other crisis level mental illness symptoms – most often psychosis.Seen by clinician – may be referred to psychiatrist.Mental Illness - Crisis StabilizationClinician Evaluation/ Assessment of inmates who have active mental health symptoms needing resolve prior to housingRecommend and implement plan to bring about stabilizationGeneral Mental HealthInmates who have requested medical services through M360 system.Seen in their Housing Units; at times seen in Mental Health OfficeSubstance Abuse TreatmentGroups services offered to male and female inmates of detention center. Must apply and be screened as eligible – by disorders, charges, keep separates, anticipated length of stayPsychiatric ServicesInmates screened by mental health staff and assessed as requiring psychiatric or pharmacological interventions or adjustments
12 ZONES for Mental Health On-Call StaffWeekly rotation – responds to all after hours emergent issuesConducts Intake Mental Health Triage CareInmate RequestsResponds to requests for services in ZoneFirst responder for Mental Health Crisis in ZoneEmergent/ Phone-In ConcernsRespond to requests by officers/ concerned othersMay refer inmate to use of Inmate Request system (M360 form)Case ManagementTroubleshoot medication verificationAssist with discharge planning on inmate requestCoordinate pre-release planning based on needs assessmentMental Health & Suicide ObservationMonitor inmates on these protocols, monitor stabilization, recommend appropriate possessions and housing as neededMaintain mindfulness of safety –of self, of staff, of inmates
14 Commitment to Quality Care Estelle v. Gambel defined “Adequate Healthcare” for Correctional Facilities at a National Level.In 1976, the Supreme Court of the United States found in the Eighth Amendment to the Constitution that inmates had a constitutional right to medical care. The Court noted that an individual in custody is unable to seek medical care and is totally dependent on the employees of the institution for their health care. Therefore, failure to provide that care would be considered “cruel and unusual punishment.”
15 Commitment to Ongoing Quality Care Jails & Detention Facilities have become the largest psychiatric hospitals in the nationInmate acuity (aka – amount of time it takes to manage an inmate’s psychiatric needs) will continue to increase as the population grows/agesMore Psychiatric Needs = More Staffing NeedsProvision of recidivism reducing treatment
16 Inmates Seen 2006 – 5319 inmates seen by mental health 2007 – 3945 inmates seen for 1:1530 inmates seen in group sessions447584% of 2006 total – in just 1st six months of this year
17 Other Challenges Lack of Jail Diversion: Pre-Booking Occurs at at the point of contact with law enforcement officers and relies heavily on effective interactions between police band mental health/ substance abuse agencies.Most entail: specialized training by police and a no-refusal crisis drop-off centerOur county lacks crisis drop-off centerPost-BookingMental Health court referrals which entail collaborations with judicial and mental health or dual diagnosis treatment-- Can’t meet all demands –Transition Planning prior to release from Jail is evolving. Not yet a complete “Post-Booking” program; needs to be part of a community collaboration and recidivist reduction effort
18 Contact for more information: Ms. Jennifer “JJ” LarsonMain office number:Kelly TroyerNAMI Greenville