Inmate mental health--table 3: treatment.
INMATE MENTAL HEALTH--TABLE 3: TREATMENT
Dual Diagnosis
Performed at
Time of Therapeutic Approaches Used for
Screening and Co-occurring Mental Illness and
SYSTEM Assessment Drug/Alcohol Disorder
ALABAMA Yes Internally developed
dual-diagnosis program
ALASKA No response No response
ARIZONA Yes Cognitive behavior, therapeutic
community and relapse prevention
ARKANSAS Yes Combination of services to address
both issues
CALIFORNIA Yes Therapy groups, including AA/NA
offered at most institutions;
individual treatment plans often
include substance abuse treatment
COLORADO Yes Small, dual-treatment therapeutic
community program
CONNECTICUT Yes Currently in process of
restructuring for this issue
DELAWARE Yes The mental health staff work with
the drug treatment staff to
coordinate treatment
DISTRICT OF Yes Depends on present acuity of the
COLUMBIA mental illness and substance abuse
disorder and history of proven
individualized treatment, coupled
with current best practice
FLORIDA No response No response
GEORGIA Yes Depends on the severity of the
mental illness; some are in
residential substance abuse
treatment units
HAWAII No Mental disorders are managed by
the medical staff, including
drug treatment
IDAHO Yes None
ILLINOIS No response No response
INDIANA Yes Medication psychoeducation,
counseling group, individual
therapy
IOWA No Mental health education
KANSAS Yes Fundamental lessons in psychology
for those in a formalized mental
health treatment setting
KENTUCKY Unknown Therapeutic community substance
abuse treatment with psychiatric
support
LOUISIANA Yes Psychoeducational
MAINE No response No response
MARYLAND Yes Therapeutic community
MASSACHUSETTS Yes Available treatment programs
MICHIGAN Yes No specific methods or programs
MINNESOTA Yes Mental illness/chemical dependency
treatment programs
MISSISSIPPI Yes Individual/group counseling and
medication management
MISSOURI No Cognitive-behavior therapy;
therapeutic communities;
substance abuse programs
MONTANA No response No response
NEBRASKA Yes, when Cognitive-behavior therapy in
possible separate programs, depending
on diagnosis
NEVADA No Bilateral approach
NEW HAMPSHIRE Yes Dual-based treatment program
NEW JERSEY Yes In-house drug programs and
specialized treatment units
that provide substance abuse
programming for mentally ill
inmates
NEW MEXICO Yes Therapeutic communities and
outpatient group therapy
NEW YORK Yes Residential substance abuse
treatment, AA/NA/substance abuse
groups within mental health
programs
NORTH CAROLINA No response No response
NORTH DAKOTA Yes Drug and alcohol treatment
OHIO Yes Therapeutic communities;
residential for mentally
ill/incompetent inmates
OKLAHOMA Yes Integrated treatment approach
OREGON Yes Bidirectional approach, which is
cognitive/behaviorally based
PENNSYLVANIA Yes Integrated treatment model;
therapeutic community; community
corrections centers
RHODE ISLAND Yes Nothing formal
SOUTH CAROLINA Yes Individual and group therapy
SOUTH DAKOTA Yes Individual and group therapy
TENNESSEE Yes Nothing formal
TEXAS Yes Treatment is provided by the
substance abuse treatment program;
all offenders with medical or
psychological special needs are
screened by the Texas Department
of Criminal Justice health
services liaison (1)
UTAH Yes Substance abuse treatment program
VERMONT No response No response
VIRGINIA No response No response
WASHINGTON Yes Separate program interventions
WEST VVIRGINIA No response No response
WISCONSIN Yes Limited number of beds in a
dual-diagnosis unit; treatment
may be provided along separate
tracks but often by the same
mental health staff
WYOMING No response No response
FEDERAL BUREAU No response No response
OF PRISONS
CANADIAN SYSTEMS
NEWFOUNDLAND Yes Medical/psychiatric intervention
NOVA SCOTIA Yes Nothing at the present time but
developing a concurrent disorders
program
ONTARIO Yes Treatment for both symptoms
CORRECTIONAL Yes Separate treatment interventions
SERVICE CANADA and a cognitive/behavioral
approach for substance abuse
Assessment Instruments Used for Determining
SYSTEM Risk of Violence
ALABAMA MMPI
ALASKA No response
ARIZONA N/A
ARKANSAS N/A
CALIFORNIA HPC and MMPI
COLORADO LSI, MCMI, but no test specific for violence
CONNECTICUT Occasionally Pal or HARE, but the department
is in the process of evaluating and processing
all maximum-security inmates
DELAWARE Comprehensive mental health evaluation
DISTRICT OF Aggression Inventory in conjunction with a
COLUMBIA comprehensive mental status examination
FLORIDA No response
GEORGIA PCL-R, when staff are available
HAWAII No special instrument but SLI-R for all male
offenders
IDAHO MMPI-2, PAI, PCL-R and clinical assessments
ILLINOIS No response
INDIANA As requested by the provider
IOWA Screening and testing by trained psychologists
KANSAS PCL-R, Violence Risk Appraisal Guide and
Static 99 (for recidivism risk for violent
behavior)
KENTUCKY N/A
LOUISIANA N/A
MAINE No response
MARYLAND Psychopathy check list and Hare check list
MASSACHUSETTS Psychological testing is available as needed
MICHIGAN No specific instruments are employed
MINNESOTA Standardized psychological instruments
MISSISSIPPI MCMI and clinical interviews
MISSOURI AIM given to all offenders; however, the mental
health staff currently are not administering a
risk-of-violence tool.
MONTANA No response
NEBRASKA MMPI, MCMI, Status 99 (if sex offender),
M-SOST and SONAR
NEVADA HARE
NEW HAMPSHIRE Self-developed assessment tool (Knoll
Violence Assessment Scale)
NEW JERSEY MMPI or Million may be used for parole
purposes
NEW MEXICO No routine tests are used
NEW YORK HCR-20, clinical interview and case record
review
NORTH CAROLINA No response
NORTH DAKOTA Departmental human service centers are used
to determine if a civil commitment is necessary
prior to discharge
OHIO No specific instruments
OKLAHOMA No specific instruments
OREGON PAI and HARE
PENNSYLVANIA Level of Service Inventory-Revised and
Pennsylvania Clinical Risk Assessment
RHODE ISLAND Primarily interviews, but nothing formal
SOUTH CAROLINA Clinical interviews and behavioral observations
SOUTH DAKOTA Departmental AIMS code is used for all
inmates
TENNESSEE Some general assessment reviews and a
battery of assessments for sex offenders
TEXAS None
UTAH No reliable assessment instruments
VERMONT No response
VIRGINIA No response
WASHINGTON Level of Service Inventory-Revised, primarily
based on history of violence, age at
incarceration and on other demographic
measures
WEST VVIRGINIA
WISCONSIN In most cases, risk assessment is estimated
from file review and clinical interview,
but some facilities use Hare PCL or HCR-20
assessments
WYOMING No response
FEDERAL BUREAU No response
OF PRISONS
CANADIAN SYSTEMS
NEWFOUNDLAND Unknown
NOVA SCOTIA Several actuarial risk assessment tools are
used but primarily in the NCR/Unfit population
ONTARIO Level of Service Inventory-Ontario Revision
but clinicians may use other instruments as
deemed appropriate
CORRECTIONAL No separate instruments
SERVICE CANADA
Special Sanctions
Separate Housing in Use Imposed on Mentally III
for Inmates Determined Inmates Who Commit Acts
to be At Risk for of Violence Different
SYSTEM Committing Violence Than for Other Inmates
ALABAMA Yes No
ALASKA No response No response
ARIZONA No Yes, determined on a
case-by-case basis,
usually with
consideration of
offender's illness
and capabilities
ARKANSAS Yes No
CALIFORNIA No No
COLORADO Yes Yes, may be placed in
special housing for the
mentally ill
CONNECTICUT Yes Yes, an intensive mental
health unit is being
refined to specifically
accommodate the most
aggressive inmates
DELAWARE Yes, mental health units No
are in each major prison
DISTRICT OF Yes Yes, escorted movements
COLUMBIA and a representative
from mental health
services must be present
at adjustment board
hearings
FLORIDA No response No response
GEORGIA Yes Yes, determined on a
case-by-case basis
after an evaluation
HAWAII Yes No
IDAHO Yes Yes, with sanctions
determined by a
treatment team in
conjunction with the
disciplinary hearing
officer
ILLINOIS No response No response
INDIANA Yes, sometimes Yes, the impact of the
illness or behavior is
considered and/or the
sanctions
IOWA Yes No
KANSAS Yes Yes, mental health and
psychiatric treatment to
stabilize the offender's
mental status
KENTUCKY Yes No
LOUISIANA Yes Yes, depending on mental
health functioning
MAINE No response No response
MARYLAND Yes Yes, if evaluated
for competency and
responsibility at
time of infraction
MASSACHUSETTS Yes Yes, on the
recommendation of mental
health professionals
MICHIGAN No No
MINNESOTA Yes, in segregation Yes, taking into account
cells or mental health any acts/rule violations
unit related to the
offender's mental
illness
MISSISSIPPI Yes No
MISSOURI Yes Yes, severe mental
illness is taken into
consideration
MONTANA No response No response
NEBRASKA Yes, when possible No
NEVADA Yes No
NEW HAMPSHIRE Yes No
NEW JERSEY Yes Yes, if found guilty
of the disciplinary
infraction if mental
health reason was
responsible
NEW MEXICO No, not routinely Yes, a mandatory
screening to determine
whether mental illness
was a mitigating factor
NEW YORK No Yes, following formal
procedures for assessing
impact of mental illness
and appropriateness of
sanctions
NORTH CAROLINA No response No response
NORTH DAKOTA Yes, a special No
assistance unit
OHIO No No
OKLAHOMA Yes Yes, but depends on
competency and insanity
issues
OREGON Yes Yes, but may be modified
based on functioning
level
PENNSYLVANIA Yes, special needs units Disciplinary policy
allows sanctions to be
removed/reduced for
particular inmates
RHODE ISLAND No No
SOUTH CAROLINA Yes No
SOUTH DAKOTA Yes Yes, reviewed on a
case-by-case basis
TENNESSEE Yes No
TEXAS Yes, but based on Yes, but only at
security classifications inpatient facilities
and behavior, not mental
illness
UTAH Yes No
VERMONT No response No response
VIRGINIA No response No response
WASHINGTON Yes Yes, limited placement
in intensive management
unit and the use of
force is minimized.
WEST VVIRGINIA No response No response
WISCONSIN Yes No, but communication
between psychology and
security is encouraged
and affected offenders
may be referred to a
hospital-like setting
WYOMING No response No response
FEDERAL BUREAU No response No response
OF PRISONS
CANADIAN SYSTEMS
NEWFOUNDLAND Yes Yes, limited freedom
of movement and, if
warranted, transfer to
a psychiatric hospital
NOVA SCOTIA No No
ONTARIO Yes No
CORRECTIONAL Yes No
SERVICE CANADA
(1) TEXAS: Three special needs substance abuse felony punishment
facilites are in use for offenders with crime-related substance
abuse problems and who have a current Axis-I psychiatric diagnosis
and/or a medical condition requiring ancillary services or who
have a severe mobility impairment.
INMATE MENTAL HEALTH--TABLE 3: TREATMENT
Dual Diagnosis
Performed at
Time of Therapeutic Approaches Used for
Screening and Co-occurring Mental Illness and
SYSTEM Assessment Drug/Alcohol Disorder
ALABAMA Yes Internally developed
dual-diagnosis program
ALASKA No response No response
ARIZONA Yes Cognitive behavior, therapeutic
community and relapse prevention
ARKANSAS Yes Combination of services to address
both issues
CALIFORNIA Yes Therapy groups, including AA/NA
offered at most institutions;
individual treatment plans often
include substance abuse treatment
COLORADO Yes Small, dual-treatment therapeutic
community program
CONNECTICUT Yes Currently in process of
restructuring for this issue
DELAWARE Yes The mental health staff work with
the drug treatment staff to
coordinate treatment
DISTRICT OF Yes Depends on present acuity of the
COLUMBIA mental illness and substance abuse
disorder and history of proven
individualized treatment, coupled
with current best practice
FLORIDA No response No response
GEORGIA Yes Depends on the severity of the
mental illness; some are in
residential substance abuse
treatment units
HAWAII No Mental disorders are managed by
the medical staff, including
drug treatment
IDAHO Yes None
ILLINOIS No response No response
INDIANA Yes Medication psychoeducation,
counseling group, individual
therapy
IOWA No Mental health education
KANSAS Yes Fundamental lessons in psychology
for those in a formalized mental
health treatment setting
KENTUCKY Unknown Therapeutic community substance
abuse treatment with psychiatric
support
LOUISIANA Yes Psychoeducational
MAINE No response No response
MARYLAND Yes Therapeutic community
MASSACHUSETTS Yes Available treatment programs
MICHIGAN Yes No specific methods or programs
MINNESOTA Yes Mental illness/chemical dependency
treatment programs
MISSISSIPPI Yes Individual/group counseling and
medication management
MISSOURI No Cognitive-behavior therapy;
therapeutic communities;
substance abuse programs
MONTANA No response No response
NEBRASKA Yes, when Cognitive-behavior therapy in
possible separate programs, depending
on diagnosis
NEVADA No Bilateral approach
NEW HAMPSHIRE Yes Dual-based treatment program
NEW JERSEY Yes In-house drug programs and
specialized treatment units
that provide substance abuse
programming for mentally ill
inmates
NEW MEXICO Yes Therapeutic communities and
outpatient group therapy
NEW YORK Yes Residential substance abuse
treatment, AA/NA/substance abuse
groups within mental health
programs
NORTH CAROLINA No response No response
NORTH DAKOTA Yes Drug and alcohol treatment
OHIO Yes Therapeutic communities;
residential for mentally
ill/incompetent inmates
OKLAHOMA Yes Integrated treatment approach
OREGON Yes Bidirectional approach, which is
cognitive/behaviorally based
PENNSYLVANIA Yes Integrated treatment model;
therapeutic community; community
corrections centers
RHODE ISLAND Yes Nothing formal
SOUTH CAROLINA Yes Individual and group therapy
SOUTH DAKOTA Yes Individual and group therapy
TENNESSEE Yes Nothing formal
TEXAS Yes Treatment is provided by the
substance abuse treatment program;
all offenders with medical or
psychological special needs are
screened by the Texas Department
of Criminal Justice health
services liaison (1)
UTAH Yes Substance abuse treatment program
VERMONT No response No response
VIRGINIA No response No response
WASHINGTON Yes Separate program interventions
WEST VVIRGINIA No response No response
WISCONSIN Yes Limited number of beds in a
dual-diagnosis unit; treatment
may be provided along separate
tracks but often by the same
mental health staff
WYOMING No response No response
FEDERAL BUREAU No response No response
OF PRISONS
CANADIAN SYSTEMS
NEWFOUNDLAND Yes Medical/psychiatric intervention
NOVA SCOTIA Yes Nothing at the present time but
developing a concurrent disorders
program
ONTARIO Yes Treatment for both symptoms
CORRECTIONAL Yes Separate treatment interventions
SERVICE CANADA and a cognitive/behavioral
approach for substance abuse
Assessment Instruments Used for Determining
SYSTEM Risk of Violence
ALABAMA MMPI
ALASKA No response
ARIZONA N/A
ARKANSAS N/A
CALIFORNIA HPC and MMPI
COLORADO LSI, MCMI, but no test specific for violence
CONNECTICUT Occasionally Pal or HARE, but the department
is in the process of evaluating and processing
all maximum-security inmates
DELAWARE Comprehensive mental health evaluation
DISTRICT OF Aggression Inventory in conjunction with a
COLUMBIA comprehensive mental status examination
FLORIDA No response
GEORGIA PCL-R, when staff are available
HAWAII No special instrument but SLI-R for all male
offenders
IDAHO MMPI-2, PAI, PCL-R and clinical assessments
ILLINOIS No response
INDIANA As requested by the provider
IOWA Screening and testing by trained psychologists
KANSAS PCL-R, Violence Risk Appraisal Guide and
Static 99 (for recidivism risk for violent
behavior)
KENTUCKY N/A
LOUISIANA N/A
MAINE No response
MARYLAND Psychopathy check list and Hare check list
MASSACHUSETTS Psychological testing is available as needed
MICHIGAN No specific instruments are employed
MINNESOTA Standardized psychological instruments
MISSISSIPPI MCMI and clinical interviews
MISSOURI AIM given to all offenders; however, the mental
health staff currently are not administering a
risk-of-violence tool.
MONTANA No response
NEBRASKA MMPI, MCMI, Status 99 (if sex offender),
M-SOST and SONAR
NEVADA HARE
NEW HAMPSHIRE Self-developed assessment tool (Knoll
Violence Assessment Scale)
NEW JERSEY MMPI or Million may be used for parole
purposes
NEW MEXICO No routine tests are used
NEW YORK HCR-20, clinical interview and case record
review
NORTH CAROLINA No response
NORTH DAKOTA Departmental human service centers are used
to determine if a civil commitment is necessary
prior to discharge
OHIO No specific instruments
OKLAHOMA No specific instruments
OREGON PAI and HARE
PENNSYLVANIA Level of Service Inventory-Revised and
Pennsylvania Clinical Risk Assessment
RHODE ISLAND Primarily interviews, but nothing formal
SOUTH CAROLINA Clinical interviews and behavioral observations
SOUTH DAKOTA Departmental AIMS code is used for all
inmates
TENNESSEE Some general assessment reviews and a
battery of assessments for sex offenders
TEXAS None
UTAH No reliable assessment instruments
VERMONT No response
VIRGINIA No response
WASHINGTON Level of Service Inventory-Revised, primarily
based on history of violence, age at
incarceration and on other demographic
measures
WEST VVIRGINIA
WISCONSIN In most cases, risk assessment is estimated
from file review and clinical interview,
but some facilities use Hare PCL or HCR-20
assessments
WYOMING No response
FEDERAL BUREAU No response
OF PRISONS
CANADIAN SYSTEMS
NEWFOUNDLAND Unknown
NOVA SCOTIA Several actuarial risk assessment tools are
used but primarily in the NCR/Unfit population
ONTARIO Level of Service Inventory-Ontario Revision
but clinicians may use other instruments as
deemed appropriate
CORRECTIONAL No separate instruments
SERVICE CANADA
Special Sanctions
Separate Housing in Use Imposed on Mentally III
for Inmates Determined Inmates Who Commit Acts
to be At Risk for of Violence Different
SYSTEM Committing Violence Than for Other Inmates
ALABAMA Yes No
ALASKA No response No response
ARIZONA No Yes, determined on a
case-by-case basis,
usually with
consideration of
offender's illness
and capabilities
ARKANSAS Yes No
CALIFORNIA No No
COLORADO Yes Yes, may be placed in
special housing for the
mentally ill
CONNECTICUT Yes Yes, an intensive mental
health unit is being
refined to specifically
accommodate the most
aggressive inmates
DELAWARE Yes, mental health units No
are in each major prison
DISTRICT OF Yes Yes, escorted movements
COLUMBIA and a representative
from mental health
services must be present
at adjustment board
hearings
FLORIDA No response No response
GEORGIA Yes Yes, determined on a
case-by-case basis
after an evaluation
HAWAII Yes No
IDAHO Yes Yes, with sanctions
determined by a
treatment team in
conjunction with the
disciplinary hearing
officer
ILLINOIS No response No response
INDIANA Yes, sometimes Yes, the impact of the
illness or behavior is
considered and/or the
sanctions
IOWA Yes No
KANSAS Yes Yes, mental health and
psychiatric treatment to
stabilize the offender's
mental status
KENTUCKY Yes No
LOUISIANA Yes Yes, depending on mental
health functioning
MAINE No response No response
MARYLAND Yes Yes, if evaluated
for competency and
responsibility at
time of infraction
MASSACHUSETTS Yes Yes, on the
recommendation of mental
health professionals
MICHIGAN No No
MINNESOTA Yes, in segregation Yes, taking into account
cells or mental health any acts/rule violations
unit related to the
offender's mental
illness
MISSISSIPPI Yes No
MISSOURI Yes Yes, severe mental
illness is taken into
consideration
MONTANA No response No response
NEBRASKA Yes, when possible No
NEVADA Yes No
NEW HAMPSHIRE Yes No
NEW JERSEY Yes Yes, if found guilty
of the disciplinary
infraction if mental
health reason was
responsible
NEW MEXICO No, not routinely Yes, a mandatory
screening to determine
whether mental illness
was a mitigating factor
NEW YORK No Yes, following formal
procedures for assessing
impact of mental illness
and appropriateness of
sanctions
NORTH CAROLINA No response No response
NORTH DAKOTA Yes, a special No
assistance unit
OHIO No No
OKLAHOMA Yes Yes, but depends on
competency and insanity
issues
OREGON Yes Yes, but may be modified
based on functioning
level
PENNSYLVANIA Yes, special needs units Disciplinary policy
allows sanctions to be
removed/reduced for
particular inmates
RHODE ISLAND No No
SOUTH CAROLINA Yes No
SOUTH DAKOTA Yes Yes, reviewed on a
case-by-case basis
TENNESSEE Yes No
TEXAS Yes, but based on Yes, but only at
security classifications inpatient facilities
and behavior, not mental
illness
UTAH Yes No
VERMONT No response No response
VIRGINIA No response No response
WASHINGTON Yes Yes, limited placement
in intensive management
unit and the use of
force is minimized.
WEST VVIRGINIA No response No response
WISCONSIN Yes No, but communication
between psychology and
security is encouraged
and affected offenders
may be referred to a
hospital-like setting
WYOMING No response No response
FEDERAL BUREAU No response No response
OF PRISONS
CANADIAN SYSTEMS
NEWFOUNDLAND Yes Yes, limited freedom
of movement and, if
warranted, transfer to
a psychiatric hospital
NOVA SCOTIA No No
ONTARIO Yes No
CORRECTIONAL Yes No
SERVICE CANADA
(1) TEXAS: Three special needs substance abuse felony punishment
facilites are in use for offenders with crime-related substance
abuse problems and who have a current Axis-I psychiatric diagnosis
and/or a medical condition requiring ancillary services or who
have a severe mobility impairment.
COPYRIGHT 2004 American Correctional Association, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2004 Gale, Cengage Learning. All rights reserved.
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