Transcript Jolene Rebertus - NAMI Minnesota

Mental Health Treatment
Systems
Jolene Rebertus, MA, LPCC, NCC
Jolene Rebertus, MA, LPCC, NCC
Corrections
Program
Director
Corrections
Program
Director – Behavioral Health Release Planning
Behavioral Health Release Planning
Kathryn Lockie, MA, LPCC
Corrections Program Director – MCF-Oak Park Heights
Treatment Systems
Overview
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Review DOC treatment systems
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
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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
INTERVENTION SERVICES
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
DOC Treatment Systems
INTERVENTION SERVICES
Level 3
Level 4
 DOC professional staff
 Acute level of mental
illness
 Heightened level of supportive
Requires residential
services
care
Chronically mentally ill
 Specialty assessment
Socially low functioning
 Chronic mental health
 Supportive Living Services (SLS)
care within a secure
Residential level services
environment
– Daily support
– Designated area
DOC Background: MH 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
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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=rela
ted
Approach
 Prevention through planning and action
MN DOC Release Planners
 SPMI
 SO
 CD
 Medical
 TBI
Community “Philosophy”
Wisconsin
Minnesota
State population
5.6M
5.0M
Probation population
53K
130K
23-24K
9.5K
43%
7%
Prison population
% incarcerated
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)
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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
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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
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Rule 79 Assessment
 Each county has their own rule 79 assessment
 Certifies a person with a serious and persistent mental illness
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County involvement important in order to assist with
connecting offender to community mental health resources
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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