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Oregon Department of Corrections

Oregon Department of Corrections. Daryl Ruthven, M.D. Behavioral Health Services. 1. ODOC Mission. To promote public safety by holding offenders accountable for their actions and reducing the risk of future criminal behavior. Brief DOC History.

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Oregon Department of Corrections

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  1. Oregon Department of Corrections • Daryl Ruthven, M.D. • Behavioral Health Services 1

  2. ODOC Mission • To promote public safety by holding offenders accountable for their actions and reducing the risk of future criminal behavior.

  3. Brief DOC History • Oregon State Penitentiary opened in 1866 in Salem. • Current Department of Corrections formed in 1987 by legislature. • Custody of all offenders sentenced to more than 12 months.

  4. Major Divisions • Operations • Offender Management & Rehabilitation • Community Corrections • Human Resources • General Services

  5. Operations: • Institutions: (14) • East Side: EOCI, TRCI, SRCI, PRCF, DRCM, WCCF • West Side: OSP, OSCI, SCI, MCCF, CCCF, CRCI, SFFC, SCCI • Maximum: 1 • Medium: 5 • Minimum: 8

  6. Operations • Health Services: • General Medical • Mental Health • Dental • Pharmacy

  7. Offender Management & Rehabilitation • Transition & Reentry • Education • Offender Management

  8. Community Corrections • Administrative Oversight • Funding • Douglas and Linn Counties (direct Parole & Probation services)

  9. Inmate Demographics (9/01/13) • Total Inmates: 14,526 • Age:Male:Female: • 18-24 1541 149 • 25-30 2509 265 • 31-45 5312 541 • 45-60 3135 260 • >60 783 31 • Totals:132801246

  10. 8th Amendment, US Constitution • Freedom from cruel and unusual punishment • Prisoners have a constitutional right to necessary medical and mental health care. • (Estelle v. Gamble 1976) • Oregon – at the level of an insured individual in the community.

  11. Intake Assessment • Inmates are screened for medical, dental, and mental health functioning at intake. • Triggers for further evaluation: • Reading/math scores • History of previous treatment • Current medications • Observed daily functioning • Inmate request

  12. Medical Services • Therapeutic Level of Care • Level 1 - Medically mandatory • Level 2 – Medically necessary • Level 3 – Medically acceptable, not necessary • Level 4 – Limited medical value

  13. Mental Health Services • MH3 - Psychosis, Bipolar Disorder, Major Depression, Organic Brain Syndrome (dementia, TBI, tumor/stroke, etc) • MH2 - Anxiety Disorders, Dysthymia, Borderline PD • MH1 - ADHD, Adjustment Disorders, Personality Disorders, Substance Abuse, Impulse Control D/O, Conduct D/O

  14. Developmental Disability • DD3 - IQ < 70 (Connections, Skills Training) • DD2 - IQ 70-79 (Connections, Skills Training) • DD1 - IQ 80-84 (No services unless other factors)

  15. Demographics: • MH3 - 1006 (7%) • MH2 - 2321 (16%) • MH1 - 3765 (26%) • DD3 - 81 (0.6%) • DD2 - 233 (1.6%) • DD1 - 865 (6%)

  16. Brain Injury among inmates • Majority appears to be acquired through cumulative effects of behaviors as opposed to specific trauma: • Cumulative drug and alcohol effects most common: • Huffing solvents • Methamphetamine • Alcohol • Toxic chemicals (cooking drugs) • Bath salts

  17. TBI among inmates • Motor vehicle accidents • Fighting / Assaults • High Risk Behavior • Contact Sports

  18. Difficulties in Assessment • Often overshadowed by other features: • Psychotic symptoms • Affective symptoms • Personality structure • ADHD

  19. Assessment • Not routinely tested for. • May be referred by staff who note difficulties in daily functioning. • Most are picked up by clinician after being referred for something else.

  20. Treatment • Limited neurocognitive assessment available • Highly structured environment in prison • Specialized housing if helpful • Medications if appropriate • Care companion

  21. Return to Community • Coordination starts 6-9 months prior to release • Housing/SSD • Parole/Probation coordination • Medical/Mental Health follow up

  22. Gaps: • Insufficient testing/evaluation resources • Significant problems in procuring community follow-up: • Offender status. • Often don’t meet criteria for community services. • Impulsive behaviors, sexually inappropriate, arson, drugs. • Antisocial behaviors worsened by ABI/TBI.

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