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• W778293394 abstract "INTRODUCTION: PUBLIC MENTAL HEALTH POLICY I. THE COMMUNITY MENTAL HEALTH MODEL II. ALTERNATIVES TO INCARCERATION III. THE COMMUNITY MENTAL HEALTH MODEL IN CORRECTIONS A. A Definition of Mental Health in Corrections B. Requisite Components of Mental Health in Corrections C. Intermediate Care: A Crucial Component of Mental Health Services D. Suicide and Self-Harm E. A Note About Trauma IV. SOME ISSUES UNIQUE TO CORRECTIONAL SETTINGS A. Isolative Confinement and Supermax Security B. Medications and Medication-over-Objection C. Disturbed/Disruptive Prisoner D. Use of Force E. Therapeutic Cubicles F. Malingering V. SOME GUIDING PRINCIPLES CONCLUSION INTRODUCTION: PUBLIC MENTAL HEALTH POLICY Some social policies are carefully designed, vigorously debated, and then put into practice through legislation. Medicare is an example; the federal law culminates public debate and establishes a strong social policy regarding medical care for seniors. Other policies are not as clearly formulated and ultimately prove foolhardy, but they are similarly effected through legislation. imprisonment binge of the past several decades is an example. Legislation, presumably mirroring public opinion, shapes ever longer prison sentences for a growing number of charges. designers of that social policy, however, failed to see the long range costs in higher recidivism rates, decimation of inner city communities, and mandated medical care for a huge population of older prisoners. Then there are social policies that are never actually articulated, are not guided by specific legislation, and seem to have no champions. incarceration of people with serious mental illness is like that, and even though unplanned, it has been accelerating for decades. There really are no advocates for incarcerating people with serious mental illness. Sheriffs and wardens universally complain that it should not be their job to take care of people with mental illness, and they certainly were not trained for the task. There are a number of historic events that combined to send so many people with serious mental illness to jail and prison, including deinstitutionalizaton, The on Drugs, and changes in the criteria for a psychiatric defense. De-institutionalization involves the downsizing and closing of state and Veterans Affairs mental hospitals with the expectation that former patients (or, today, individuals who would have been candidates for state hospitals until the 1960s) would receive quality mental health care in the community. (4) But community mental health care, after an infusion of federal funds with President Kennedy's 1963 Community Mental Health Centers Act, would experience successive budget cuts and eventually, by the 1990s, prove vastly inadequate for the task of providing public mental health services. (5) In the same period, there was the War on with attendant sentencing guidelines that sent an unprecedented number of low-level drug offenders to prison for longer terms. Of course, since dual diagnosis, that is, psychiatric disorder plus substance abuse, is very prevalent, the on Drugs landed a huge number of individuals with serious mental illness in our jails and prisons. Meanwhile, the criteria for determining that a defendant is insane have changed. third prong of many states' statutes on insanity, the criterion whereby a defendant, on account of a mental illness or defect, is unable to control himself and refrain from the criminal act, was taken off the books. (6) This change made it more difficult to prove a defendant is not guilty by reason of insanity (NGRI), resulting in more individuals with mental illness going to prison. growing proportion of prisoners with serious mental illness created a huge over-subscription for correctional mental health services and a glaring crisis in correctional mental health care today. …" @default.
• W778293394 created "2016-06-24" @default.
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• W778293394 date "2015-04-01" @default.
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• W778293394 title "A Community Mental Health Model in Corrections" @default.
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