Corrections_Today_January_February_2024_Vol.86_No.1

– Screening on intake; – Outpatient services for the detection, diagnosis, and treatment of mental illness, to include medication management and/or counseling, as appropriate; – Crisis intervention and the management of acute psychiatric episodes; – Stabilization of the mentally ill and the prevention of psychiatric deterioration in the correctional setting; – Elective therapy services and preventive treatment, where resources permit; – Provision for referral and admission to mental health facilities for offenders whose psychiatric needs exceed the treatment capability of the facility; – Procedures for obtaining and documenting informed consent; and – Follow up with offenders who return from an inpa tient psychiatric facility In essence, practitioners and correctional systems must look to community standards and professional standards to guide types of treatment provided and create systemic polices that ensure best practices are used to help make their system as litigation proof as possible. Final thoughts — summary The 8 th Amendment ensures circumstances within our correctional facilities do not constitute cruel and unusual punishment. As the law has evolved, the courts have provided a road map to examine the adequacy of the care provided. An offender can establish a constitutional claim of deliberate indifference by showing systemic, grossly inadequate care or that medical decisions are based on a desire to take an easier but less efficacious course of

treatment. This standard can be satisfied when the need for treatment is obvious, yet prison officials merely pro vide medical care which is so cursory as to amount to no treatment at all. In essence, practitioners and correctional systems must look to community standards and profes sional standards to guide types of treatment provided and create systemic polices that ensure best practices are used to help make their system as litigation-proof as possible. Behavioral health clinicians (and other correctional professionals) are well served to follow best practices as it relates to screening, evaluating, diagnosing and treatment planning. An individualized assessment and a tailored treatment plan are excellent steps to ensuring not only constitutionally adequate care, but also quality care. When resources are stretched within a system of care, directors and supervisors may consider using the “Bow ring Test” (especially if you are regionally covered by the 4 th Circuit) to ensure that the constitutionally minimum standard of care is applied in each case. At the system level, recognizing the minimum standards identified by Ruiz v. Estelle and similarly reflected in 5-ACI-6A-28 can further guide procedures to ensure the most efficient use of resources to meet these mandates. All of these safeguards will assist in creating the most effective and efficient system possible but be warned – the law is always evolving. While the citations within this article are valid as of today, changes in the Supreme Court and future decisions could create a new narrative. A dissenting opinion written by Justice Alito in Miller v. Alabama (2012) hinted at an erosion of the standard of decency pillar of the Estelle ruling. He was comment ing on the difficult ways courts have attempted to make decisions based on societal standards – particularly when examining sentencing guidelines for youthful offend ers. The current Court has been re-examining many long standing precedents and there are a number of correction al healthcare cases related to COVID-19 that are working their way through our judicial system. It is important to be aware of any changes in the application of Constitu tional standards when looking to create a quality system for the future. ENDNOTES 1 In 1996, the Prison Litigation Reform Act (PLRA) was enacted by Congress which began placing restrictions on offender litigation. In particular, offenders must exhaust all administrative remedies (e.g. the grievance process) before filing. →

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