242317 Restructuring Mental Health Programming for the Mentally Ill in New York City's Jail System

Monday, October 31, 2011: 4:30 PM

Cynthia Summers, DrPH , Bureau of Health Planning, New York City Department of Health and Mental Hygiene, Long Island City, NY
Sarah Glowa-Kollisch, MPH , Bureau of Health Planning, Division of Health Care Access and Improvement, New York City Department of Health and Mental Hygiene, Queens, NY
New York City (NYC) has the nation's second largest jail system, with over 80,000 new annual admissions, and an average daily census of 13,500 inmates, almost all of whom are housed at Rikers Island. One-third of these inmates are mentally ill, and of these, twenty percent are severely mentally ill. NYC's Departments of Health and Mental Hygiene (DOHMH) and Correction (DOC) have a unique and historic collaborative relationship within the City's jail system. The DOC oversees the security and manages all new admissions to these jails. The DOHMH is responsible for medical, mental health, substance abuse, dental, discharge planning, and transitional health care services for all inmates. In addition, DOC and DOHMH leverage the large mental health and substance abuse systems that provide support to forensic clients in the community and the court system. In November 2010, the DOC and DOHMH implemented a pilot program to provide residentially-based cognitive behavioral therapy through a highly structured incentive-based program in three mental observation units in a jail facility on Rikers Island. The treatment team consists of mental health clinicians, social workers and correction officers, all of whom play an integral part in the success of the program. Goals of the program include: increased jail safety, active participation in post-release treatment, reduced recidivism, increased length of community survival, increased medication compliance, and improved staff morale through team building and training. Process and outcomes measures have been selected and are being tracked, and preliminary results will be available for presentation at the 2011 meeting.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Program planning
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
1. Identify the process through which a curriculum was chosen and programmatic training conducted for staff. a. Review types and distinctions between various available curricula. b. Review need for and possible methodologies for programmatic training for staff. c. Discuss challenges and strengths of a multi-disciplinary treatment team that includes mental health clinicians, discharge planners (social workers), and correction officers. 2. Define the population for which a program like this works. a. Review general categories of mental health classifications. b. Review general categories of security classifications for inmates. c. Discuss decisions made about how to designate the population for this program. 3. Recognize and learn to overcome the inherent challenges in programming such as this. a. Review clinical challenges for a jail setting. b. Review programmatic challenges for a mentally ill population. c. Explore methodologies for overcoming inherent pitfalls in groups involving patients of mixed mental health and security classifications.

Keywords: Correctional Health Care, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Executive Director of the Bureau of Health Planning, Cynthia has been involved in the Mental Health Program Restructuring Program from conception to implementation. She has been integral in all phases of its planning and execution and is overseeing its monitoring and evaluation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.