Corrections_Today_Fall_2025_Vol.87_No.3

OFFICE OF CORRECTIONAL HEALTH

symptoms associated with a diagnosed mental illness. For non mentally ill individuals, weekly rounds are important for identifying any emergent symptoms associated with impairment in mental and/or adaptive functioning (e.g., risk fac tors associated with self-injurious behaviors). Early identification of problems allows for early interven tion, which prevents deterioration. ▶ GUIDING PRINCIPLE: An ounce of prevention is worth a pound of cure. als in restrictive housing in order to closely monitor any changes in mental status and associated impair ment in adaptive functioning. There should be defined criteria and clinical protocols to help staff know when a referral to a higher level of care (resi dential treatment unit, intermediary care facility, inpatient unit, etc.) may be clinically warranted. ▶ GUIDING PRINCIPLE: To get what you expect, you must inspect. 7. At least quarterly monitoring of compliance with program requirements It is imperative that there is a regular schedule for monitoring compli ance with the key components of the mental health program and treatment requirements in restrictive hous ing. After developing a standardized monitoring tool that assesses compli ance for specific requirements within each of the key components, the 6. Ongoing evaluation and monitoring It is crucial that there are regularly scheduled evaluations of all individu

tool can be used for self-monitoring by institutional staff and quarterly compliance monitoring by super vising staff who are external to the institution. Early identification of deficiencies allows for quick correc tive action to be implemented and will ensure proactive preparation for a successful audit. ▶ GUIDING PRINCIPLE: Don’t wait until it’s raining before you start fixing the hole in your roof. 8. Sufficient staff resources for mental health and security With a significant percentage of beds in restrictive housing occupied by individuals with mental illness, restrictive housing units tend to be staff intensive. Notwithstand ing staffing ratios, the critical issue is whether there are sufficient and qualified staff resources to ensure access to necessary mental health treatment commensurate with the identified mental health needs of the individuals. ▶ GUIDING PRINCIPLE: A secure environment and ensuring access to care should be the metric that determines staff resources. Security staff assigned to restrictive housing facilities should receive spe cialized mental health training both initially at the time of hire and annually thereafter. The training should focus on the demand characteristics and risk factors associated with managing individuals in administrative segre gation. Topics should include, but 9. Specialized mental health training

therapy, case management, medication management and other therapeutic activities, must be structured in such a way as to alleviate disabling symptoms of an individual’s mental disorder. Treatment plans need to be behaviorally written, reviewed and revised as needed, and have clear and measurable outcomes. ▶ GUIDING PRINCIPLE: Identifying care as necessary establishes legal responsibility to provide access to that care. 4. Individualized treatment and services plan developed by a multi disciplinary services team It is crucial to recognize that the “one size fits all” approach to treat ment is a strategy that is doomed to failure. The symptom severity of mental illness, like any chronic illness such as hypertension or dia betes, will wax and wane, constantly changing in response to internal and external factors. The mental health treatment and services plan, therefore, must be individualized, reviewed and revised in response to the changing clinical needs of the mentally ill individual. The bottom line is that you don’t want to throw everything at everybody all the time and in the same way. It is cost inef ficient and clinically ineffective. ▶ GUIDING PRINCIPLE: Effective change strategies are individual ized, and working together works. 5. Weekly rounds of all individuals by qualified mental health staff Weekly rounds are a very important mechanism to proactively identify any issues that may exacerbate

Fall 2025 | Corrections Today

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