Jail provides mental health and substance abuse services.
Several years ago, Sheriff James H. Dunning of Alexandria, Va., gave this invitation to city council members and various department heads at the council's annual budget meeting. At first, people were taken aback that a distinguished politician could have such a "neighborhood"--until he identified it as the city's adult detention center.
Sheriff Dunning went on to say that a high percentage of the nearly 500 residents of his neighborhood was sure to move into the council members' neighborhoods once released from jail. That night Sheriff Dunning brought home to the city's decisiomakers the very real message that a jail is not an institution which can be ostracized from the natural flow of city resources. Members of his neighborhood, he said, are citizens of Alexandria and therefore have every right to the same services--particularly mental health and substance abuse services--available to other citizens.
Jail officials work closely with the Alexandria Department of Mental Health, Mental Retardation and Substance Abuse to provide services to inmates in need of mental health treatment. Through a cost-sharing approach, 7.5 full-time staff members from the mental health and substance abuse department are assigned to the detention center. In addition, a host of specialists from the department provide a variety of services such as case management, training and research when needed.
Central to the success of the jail's mental health and substance abuse programming is the effective use of jail staff. The jail has designated "special management deputies" and unit counselors who receive ongoing mental health training. These individuals provide most of the first-line psychological intervention and triage, leaving only high priority cases for evaluation and treatment by the mental health department specialists.
The jail also has a Behavior Management Team composed of deputies, mental health, medical and classification staff that meets weekly. Team members must distinguish between inmates with traditional behavior problems and those who may be mentally ill, and then develop a coordinated adjustment plan among the various disciplines.
Perhaps the most visible services at the jail are two programs intended to duplicate intensive residential programs in the greater community--the critical care mental health unit and the Sober Living Units.
Critical care mental health unit. This 27-bed unit accommodates both men and women separately. Staffed by special management deputies trained in mental health, the unit provides 24-hour supervision. While classification and mental health staff select inmates for the unit, inmates must consent to any program of medication.
Typically, the unit includes suicidal, schizophrenic or chronically mental ill inmates, as well as those having serious difficulty adjusting to incarceration. Staff conduct ongoing evaluations of inmates' conditions and work to stabilize those with acute conditions. The setting and programs are based on a hospital model with intensive individual and group treatment provided daily.
An advantage of this unit is that individuals who typically do not meet the stringent commitment standards for hospitalization in the community will receive treatment appropriate for their condition. In most instances, they do not require expensive hospitalization outside the jail. Individuals return to the community in stable condition, having received the benefits of comprehensive discharge planning and case management services. These services can have a great impact on the community's problems with the homeless population, as well as probation violators who are non-compliant with their treatment programs.
Sober Living Units. The detention center has two Sober Living Units: a 29-bed men's unit and a 10-bed women's unit. These units provide a 90-day intensive residential program to help inmates prepare themselves to lead sober and productive lives after release. While in the unit, inmates attend educational programs and receive group and individual counseling.
Many "graduates" are released into the community better prepared to cope with life's daily stresses. Others receive continued treatment within the community. The program also helps sift out individuals who are not yet ready to benefit from expensive residential programs so often recommended as a part of the inmate's sentence. In these days of limited resources, it helps to know that only individuals who can truly benefit from costly residential programs will be referred to them.
Between these two programs, the Department of Mental Health, Mental Retardation and Substance Abuse provides daily and intensive intervention and treatment to roughly 20 percent of the jail's average daily population of 487. But the department's scope does not end there.
Another 10 percent of the population receives more common services such as evaluations for hospitalization and routine consultations with classification staff on risk assessments. Mental health staff also provide routine follow-up care through medication clinics to inmates in the general population who have been discharged from the critical care mental health unit. And finally, jail and mental health staff have developed a variety of education programs to help raise inmates' awareness of mental health issues. Using films and speakers, these programs address areas such as stress and anger management, life skills, nutrition, communication, and race relations.
A Community Perspective
Communities need to develop a new perspective regarding local jails, as the City of Alexandria has done. Jails are not just institutions to be used for the removal of unwanted citizens. Communities need to realize that these citizens, for the most part, are permanent members of the community. Jails can play an integral role in delivering comprehensive city services. What better time is there to teach, train or treat individuals than while they are in jail, where they can give focused, undivided attention to their problems and needs? In a state of crisis, many are ready to change. Left unserved, they will likely need more assistance when released.
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|Title Annotation:||Focus on Local Jails; Alexandria, Virginia|
|Date:||Oct 1, 1993|
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