mental health treatment systems jolene rebertus, ma, lpcc, ncc corrections program director...
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Mental Health Treatment Systems
Jolene Rebertus, MA, LPCC, NCC Corrections Program DirectorBehavioral Health Release Planning
‖ Jolene Rebertus, MA, LPCC, NCC
‖ Corrections Program Director – Behavioral Health Release Planning
‖ Kathryn Lockie, MA, LPCC
‖ Corrections Program Director – MCF-Oak Park Heights
Treatment SystemsOverview
1. Review DOC treatment systems 2. Discuss offered release planning services
DOC Treatment Systems
Behavioral Health Mission "To provide effective, evidence-based behavioral health
services that enhance facility and public safety, reduce criminal recidivism, and foster healthier offender functioning."
DOC Background: MH Services
DOC Treatment Systems
Behavioral health includes Mental health Chemical dependency Sex offender Release planning
200+ staff All State employees
DOC Background: MH Services
DOC Treatment Systems
Mental Health Services by the numbers Approx 25% adult males utilize ongoing mental health
services Approx 22% adult males on psychotropic medications Approx 65% adult females utilize ongoing mental health
services Approx 68% adult females receiving psychotropic
medication
DOC Background: MH Services
DOC Treatment Systems
Continuum of Services Available through self, professional, or institutional referral
ANY DEPARTMENT STAFF MAY REQUEST A MENTAL HEALTH ASSESSMENT OF AN OFFENDER
Evaluations are provided at various levels of referral and need
DOC Background: MH Services & DOC Division Directive 500.303
DOC Treatment Systems
Offender Intake Screening and Processing New admit - mental health screen completed within 14
calendar days of admission Release violator – mental health screen completed within
14 calendar days of admission Transfer – behavioral health staff sending facility prepares
summary and need for follow up to receiving facility
MN DOC Division Directive: 202.040
DOC Treatment Systems
Mental Health Assessment Suicidal ideation History of suicidal behavior Prescribed psychiatric medication Current mental health complaint Out/inpatient history Substance use Observation of appearance Evidence of abuse or trauma Current symptoms Disposition
MN DOC Division Directive: 500.303
DOC Treatment Systems
Those with a history, suicidal ideation, and/or display symptoms participate in further evaluation
File review Additional clinical interviews Obtaining collateral material from outside resources Psychological testing
DOC Background: MH Services
DOC Treatment Systems
Mental Health Continuity of Care Ensure offenders receiving mental health care in the
community are provided appropriate care during admission, incarceration, transfer, and release
MN Department of Corrections Policy: 500.302
DOC Treatment Systems
Level 1 Volunteer assistance Referral to self-help groups
– AA– NA– Anger management– Parenting
DOC Background: MH Services
Level 2 Provided by DOC
professional staff Outpatient
intervention Psychoeducational
groups Psychotherapy
groups Individual
psychotherapy
INTERVENTION SERVICES
DOC Treatment Systems
Level 3 DOC professional staff Heightened level of supportive services
Chronically mentally ill Socially low functioning
Supportive Living Services (SLS) Residential level services
– Daily support– Designated area
DOC Background: MH Services
Level 4 Acute level of mental
illness Requires residential
care Specialty assessment Chronic mental health
care within a secure environment
INTERVENTION SERVICES
DOC Treatment Systems
Additional Services Psychiatric Services
All psychiatric providers are contract providers Psychiatric medication management Medical practitioners must provide non-neuroleptic,
psychotropic medications only when medically indicated for treatment of mental illness
MN Department of Corrections Policy: 500.301 & 500.321
DOC Treatment Systems
Additional Services Mental Health Services On-Call
1 or more licensed mental health providers are continuously on-call to provide urgent mental health services
Handle situations by telephone Schedule distributed
– Watch commander– Master control– Associate warden of operations– Health services administrator– All mental health providers
MN Department of Corrections Policy: 500.305
DOC Treatment Systems
Additional Services Mental Health Observation - COS
Comprehensive mental health and suicide prevention program
– Offender placed on restrictive conditions– Physical and electronic observation– Logging behavior– Directly observed medication administration– Behavioral health staff must meet with offender
daily– Termination determined by behavioral health staff
MN Department of Corrections Policy: 500.300
DOC Treatment Systems
Psychiatry and outpatient services provided at each DOC facility
What is unique to each facility?
DOC Treatment Systems
MCF- Oak Park Heights Mental Health Unit
Process-type groups– Time to talk about person issues/struggles,
thoughts, feelings Psychoeducation-type groups
– Educational components» Symptom management» Adjustment to prison» MH cycle & interventions
DOC Treatment Systems
MCF- OPH Mental Health Unit
CD Pre-treatment groups– Does not fulfill mandatory CD requirements– Help prepare for future treatment– Resource for seeking CD information
Pre-release groups– For offenders within 1 year of release
» Housing, employment, supervision, medical/mental health aftercare
DOC Treatment Systems
MCF-OPH Outpatient services
Offered groups– “Doing Time”– Poetry– Outpatient MHU group– Anger management
DOC Treatment Systems
MCF- Stillwater Transitions Services Program (TSP)
Serious and persistent mental illness Roughly 10 inmates 2 inmate mentors Attend group counseling sessions 2x week
– General mental health education, symptom management, process group
Expectation of actively working towards general population, seeking employment, working knowledge of dealing with mental illness
DOC Treatment Systems
MCF-Rush City Supportive Living Services (SLS)
32 beds 2-3 groups a week
– Anger management– Community/Social skills– Depression management– Grief process– Special topics– STEPPS– Personal goals
DOC Treatment Systems
MCF- Lino Lakes Supportive Living Services (SLS)
Serious mental illness and/or significant cognitive impairment
Groups offered– Adaptive living skills group– Psychological education– Daily living skills– Mental health movie activity– Art and gardening– Recovery group
DOC Treatment Systems
MCF-LL Outpatient services
Coping Skills group– Offered 1x week– Relaxation skills– Problem solving– Goal planning– Sleep hygiene
Work readiness– Provide variety of tasks while under staff supervision– Allow to practice skills, working with others and self
discipline
DOC Treatment Systems
MCF- Shakopee Women of Wellness (WOW)
Supportive living unit Provides psycho-education, skills and therapy to
offenders in order to better manage mental health symptoms
Goal to return to general population 21 days
DOC Treatment Systems
MCF-SHK Women of Wellness – Pain Management (WOW-PM) Women of Wellness – Transition (WOW-T)
21 days Begin working
Women of Wellness – Extended (WOW-E) Women of Wellness – General Population Aftercare
(WOW-GPAC)
Release Planning in Behavioral Health
http://www.youtube.com/watch?v=AcBg1qfNoeM&feature=related Approach
Prevention through planning and actionMN DOC Release Planners
SPMI SO CD Medical TBI
Community “Philosophy”
Wisconsin Minnesota
State population 5.6M 5.0M
Probation population 53K 130K
Prison population 23-24K 9.5K
% incarcerated 43% 7%
www.nicic.org/Features/StateStats
Mental Health Release Planning
• Function as a mental health practitioner• Assess and review client management
needs• Create individualized discharge plan
aimed at successful integration into the community
Mental Health Release Planning
Introduction Significant increase in awareness of number of mentally ill
offenders in prison population Results in homelessness, unemployment, hospitalizations,
subjection to abuse and exploitation, alcohol and drug dependence
Mental Health Release Planning
Introduction 2002, MN State Legislature passed law requiring mental
health release planning for all SPMI offenders Community mental health services preplanned prior to
release
Mental Health Release Planning
Importance Enhance community safety Reduce recidivism Meet state legislatively mandated laws Provide advanced notification to community social service
agencies
Mental Health Release Planning
Importance To ensure offender access to state, county, and federal
health care Transition mental health services from prison to
community Medically based treatment that supports court’s objectives
and conditions for release Best possible aftercare for SPMI offenders
Mental Health Release Planning
Definition of Serious and Persistent Mental Illness (SPMI) A person has diagnosis of:
Schizophrenia Bipolar Disorder Major Depressive Disorder Borderline Personality Disorder Schizoaffective Disorder
Mental Health Release Planning
How to identify? Past records
Pre-sentence investigations Clinical records Case notes Police reports
Offender interview Have you ever been hospitalized? Have you seen a counselor or therapist? Do you have a mental health diagnosis? Medications?
Mental Health Release Planning
• Begin working with offender 120 days prior to release• Voluntary Service• Limits of Confidentiality• Assessment of need completed• Obtain emergency contact, recreational activities, etc.
Mental Health Release Planning
County Mental Health Case Management Rule 79 Assessment
Each county has their own rule 79 assessment Certifies a person with a serious and persistent mental illness
County involvement important in order to assist with connecting offender to community mental health resources Day tx. MI/CD groups Vocational programming Housing Funds
Mental Health Release Planning
ARMHS-Adult Rehabilitative Mental Health Services Medical Assistance required Intensive Community services that focus on offender’s
mental health stability in community
Mental Health Release Planning
MN Department of Economic Assistance GAMC (expired 02/28/11) MN Care MA Expansion (March 2011) MNSure SMRT Food Stamps Personal Needs Money
Mental Health Release Planning
Financial Benefits-Social Security Multi-stage process
Referral phone call to SSA representative at 120 days SSI phone interview with offender in prison Completion of important paperwork Possible psychiatric evaluation SSI provide a means of support to pay for housing, food,
and increase the offender’s health insurance coverage
Mental Health Release Planning
Housing Placement SPMI release planner involved in order to find appropriate
housing Rule 25 assessment for MI/CD programming Collaboration with various providers
Community agencies– Case manager– Housing manager– Economic Assistance
DOC case manager Field agent
Mental Health Release Planning
Community appointments Outpatient Psychiatry-medication monitoring
Release medication– 30 day supply– Written script #30
Outpatient Psychology-primary therapist Community Treatment Program
Sex offender MI/CD DBT Day treatment
Mental Health Release Planning
Employment Resources Vocational Rehabilitation Services – MN Field Offices AMICUS TASKS Unlimited Goodwill – Easter Seals New Leaf Workshop
Mental Health Release Planning
Community Support Crisis phone numbers and outreach Local hospitals AA/NA meeting directories Transit information The essentials
Clothing, food shelves, shelters
Mental Health Release Planning
Prevention Plan Reviewed and processed with the offender
To improve his/her cognitive thinking skills Build self-confidence in managing their mental health in
the community
Mental Health Release Planning
Summary and Key Points Frequent communication with various parties
Within Department of Corrections Community mental health agencies Field agents
Always aware of security of facility Limits of confidentiality
Mental Health Treatment Systems
‖ Look back‖ DOC Treatment Systems‖ Mental Health Release Planning
Mental Health Treatment Systems
‖ QUESTIONS