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Mental Health Treatment Systems Jolene Rebertus, MA, LPCC, NCC Corrections Program Director Behavioral Health Release P

Mental Health Treatment Systems Jolene Rebertus, MA, LPCC, NCC Corrections Program Director Behavioral Health Release Planning. Jolene Rebertus , MA, LPCC, NCC Corrections Program Director – Behavioral Health Release Planning Kathryn Lockie, MA , LPCC

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Mental Health Treatment Systems Jolene Rebertus, MA, LPCC, NCC Corrections Program Director Behavioral Health Release P

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  1. Mental Health Treatment SystemsJolene 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

  2. Treatment Systems Overview 1. Review DOC treatment systems 2. Discuss offered release planning services

  3. 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

  4. DOC Treatment Systems • Behavioral health includes • Mental health • Chemical dependency • Sex offender • Release planning • 200+ staff • All State employees DOC Background: MH Services

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. Level 2 Provided by DOC professional staff Outpatient intervention Psychoeducational groups Psychotherapy groups Individual psychotherapy DOC Treatment Systems INTERVENTION SERVICES • Level 1 • Volunteer assistance • Referral to self-help groups • AA • NA • Anger management • Parenting DOC Background: MH Services

  12. Level 4 Acute level of mental illness Requires residential care Specialty assessment Chronic mental health care within a secure environment DOC Treatment Systems INTERVENTION SERVICES • 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

  13. 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

  14. 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

  15. 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

  16. DOC Treatment Systems • Psychiatry and outpatient services provided at each DOC facility • What is unique to each facility?

  17. 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

  18. 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

  19. DOC Treatment Systems • MCF-OPH • Outpatient services • Offered groups • “Doing Time” • Poetry • Outpatient MHU group • Anger management

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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)

  26. Release Planning in Behavioral Health • http://www.youtube.com/watch?v=AcBg1qfNoeM&feature=related • Approach • Prevention through planning and action • MN DOC Release Planners • SPMI • SO • CD • Medical • TBI

  27. Community “Philosophy” www.nicic.org/Features/StateStats

  28. 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

  29. 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

  30. 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

  31. Mental Health Release Planning • Importance • Enhance community safety • Reduce recidivism • Meet state legislatively mandated laws • Provide advanced notification to community social service agencies

  32. 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

  33. 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

  34. 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?

  35. 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.

  36. 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

  37. 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

  38. 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

  39. 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

  40. 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

  41. 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

  42. Mental Health Release Planning • Employment Resources • Vocational Rehabilitation Services – MN Field Offices • AMICUS • TASKS Unlimited • Goodwill – Easter Seals • New Leaf Workshop

  43. 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

  44. 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

  45. 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

  46. Mental Health Treatment Systems • Look back • DOC Treatment Systems • Mental Health Release Planning

  47. Mental Health Treatment Systems • QUESTIONS

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