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1
Correctional psychiatry: Practice guidelines and strategies. Kingston, NJ: Civic Research Institute, 2007.
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2
Webster, Christopher D. Release decision making: Assessing violence risk in mental health, forensic and correctional settings. Hamilton, Ont: Forensic Service, St. Joseph's Healthcare Hamilton, Centre for Mountain Health Services, 2003.
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4
W, Wanberg Kenneth, and Gagliardi Barbara A, eds. Criminal conduct and substance abuse treatment for women in correctional settings: Adjunct provider's guide : female-focused strategies for self-improvement and change-pathways to responsible living. Thousand Oaks: Sage Publications, 2008.
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5
Chard-Wierschem, Deborah J. Patients at Central New York Psychiatric Center discharged from the New York State Department of Correctional Services. Albany, N.Y: New York State Dept. of Correctional Services, Program Planning, Research and Evaluation, 1996.
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6
Lescarboura, Angeles Cáceres. Los habitantes del pozo: Vida y muerte en una cárcel-manicomio. 2nd ed. Alicante: Editorial Aguaclara, 1992.
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7
E, Gfeller Kate, and Thaut Michael H, eds. An introduction to music therapy: Theory and practice. Dubuque, IA: Wm. C. Brown Publishers, 1992.
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8
E, Gfeller Kate, and Thaut Michael H, eds. An introduction to music therapy: Theory and practice. 2nd ed. Boston, Mass: McGraw-Hill, 1999.
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10
Steelman, Diane. The mentally impaired in New York's prisons: Problems and solutions. New York, NY: The Correctional Association of New York, 1987.
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11
Arbeitstagung der Leitenden Strafvollzugsbeamten Österreichs (30th 1994 Vienna, Austria). 70 Jahre Justizwache Österreichs: Das Verhältnis zwischen Strafgerichtsbarkeit, Sicherheitsbehörden und Strafvollzug : Strafvollzug und Medien : Strafvollzugsnovelle 1993, erste Erfahrungen : der Psychiater im Strafvollzug : Vorträge und Berichte der Beratungsergebnisse der Arbeitskreise bei der 30. Arbeitstagung der leitenden Strafvollzugsbeamten Österreichs vom 4. Oktober bis 10. Oktober 1994. Edited by Hadrbolec Johann and Arbeitsgemeinschaft der leitenden Strafvollzugsbeamten Österreichs. Wien: Bundesministerium für Justiz, 1995.
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12
1942-, Lightner David L., ed. Asylum, prison, and poorhouse: The writings and reform work of Dorothea Dix in Illinois. Carbondale, Ill: Southern Illinois University Press, 1999.
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13
Morgan, Rodney. Young people and crime: Improving provision for children who offend. London: Karnac on behalf of the Winnicott Clinic of Psychotherapy, 2006.
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14
New Jersey. Legislature. General Assembly. Regulatory Oversight Committee. Committee meeting of Assembly Regulatory Oversight Committee: Testimony concerning the management and operation of nursing homes and psychiatric community residences, the quality of care residents receive, facility conditions, and the role of the state government in ensuring the well-being of residents : [September 20, 2002, Trenton, New Jersey]. Trenton, N.J: The Unit, 2002.
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15
Aufderheide, Dean. Communication in correctional psychiatry. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0009.
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When the competing cultures and communication styles of correctional and health care professionals clash, communication is compromised and the potential for problems and unwanted outcomes is compounded. Notwithstanding the inherent cultural differences among interdisciplinary staff, effective communication in a correctional setting is especially challenging for psychiatrists. Whether transitioning from the protective structure of a residency, or moving from a private practice or other mental health setting, psychiatrists working in a jail or prison will likely experience their new environment as replete with competing interests and priorities. Also, unlike in a health care setting, where physicians are at the top of the hierarchy, psychiatrists working in a jail or prison are further down the organizational hierarchy. It is in such an environment that it becomes critically important for psychiatrists to develop communication strategies that are successful in creating effective and sustainable working relationships not only with patients, but also with the facility’s leadership, security staff, treatment team members, and other interdisciplinary staff. This chapter will discuss ways in which psychiatrists play a critical role in mission requirements that necessitate effective communication skills with interdisciplinary staff in jails and prisons. From identifying the variables in the correctional culture that shape communication to improving interdisciplinary collaboration, this chapter will explore the ways in which correctional psychiatrists can model effective communication styles and strategies that enhance professional credibility and improve treatment outcomes.
16
Metzner, Jeffrey, Robert Trestman, and Kenneth Appelbaum. Oxford Textbook of Correctional Psychiatry. Oxford University Press, Incorporated, 2015.
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18
Trestman, Robert, Kenneth Appelbaum, and Jeffrey Metzner, eds. Oxford Textbook of Correctional Psychiatry. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.001.0001.
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The Oxford Textbook of Correctional Psychiatry addresses the history, structure, and processes of correctional psychiatry, including case law, human rights, ethics, organization and funding of systems, as well as stages of patient management that cover initial assessments through re-entry. It also discusses management issues, emergencies, psychopharmacology topics, sleep, detoxification, reassessment of community diagnoses and treatments, diversion programs, levels of care, malingering, substance use within facilities, and formulary management. It also covers common psychiatric disorders, relevant medical disorders, pain management, psychotherapeutic options, suicide risk management, and addictions treatment. Specific focus is given to aggression, self-injury, and other behavioral challenges, and it also reviews unique assessment and treatment needs of many distinct population groups. Special topics such as forensics, psychological testing, sexual assaults, quality improvement, training, and research are also covered, followed by a section devoted exclusively to current resources in correctional healthcare.
19
Appelbaum, Kenneth L., Robert L. Trestman, and Jeffrey L. Metzner. The Future of Correctional Psychiatry. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0071.
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Recent decades have seen many advances in the knowledge base and practice standards for correctional psychiatry. In many ways, however, the field remains in the early stages of development. As it continues to mature in the coming years, we hope and expect to see further progress. Establishment of evidence-based clinical practices and a firm foundation for ethical standards has begun, and the momentum will continue to build. The questions and dilemmas that we present do not all lend themselves to easy consensus. They do, however, require attention and resolution. Custodial and clinical practices in correctional settings continue to evolve and change. Some of those changes may occur in a rapid and dramatic way. Psychiatry should stake-out a place in the forefront of the ongoing debate. By being proactive instead of reactive we will have a greater chance of influencing the outcomes and we will fulfill our responsibilities for the inmate patients who we serve. No one can predict with certainty what the future holds. We feel safe, however, in predicting that changes, incremental and perhaps revolutionary, will occur. In this chapter we identify opportunities to expand the evidence-base of correctional psychiatry, the need to refine practice guidelines, and the role that psychiatry might play in influencing the use of incarceration. As part of our review we describe what we believe the future may hold in store for our subspecialty. We hope that this textbook contributes to a picture of where things stand and a vision of where we need to go.
20
Appelbaum, Kenneth L., Robert L. Trestman, and Jeffrey L. Metzner. The Future of Correctional Psychiatry. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199360574.003.0071_update_001.
Full textAbstract:
Recent decades have seen many advances in the knowledge base and practice standards for correctional psychiatry. In many ways, however, the field remains in the early stages of development. As it continues to mature in the coming years, we hope and expect to see further progress. Establishment of evidence-based clinical practices and a firm foundation for ethical standards has begun, and the momentum will continue to build. The questions and dilemmas that we present do not all lend themselves to easy consensus. They do, however, require attention and resolution. Custodial and clinical practices in correctional settings continue to evolve and change. Some of those changes may occur in a rapid and dramatic way. Psychiatry should stake-out a place in the forefront of the ongoing debate. By being proactive instead of reactive we will have a greater chance of influencing the outcomes and we will fulfill our responsibilities for the inmate patients who we serve. No one can predict with certainty what the future holds. We feel safe, however, in predicting that changes, incremental and perhaps revolutionary, will occur. In this chapter we identify opportunities to expand the evidence-base of correctional psychiatry, the need to refine practice guidelines, and the role that psychiatry might play in influencing the use of incarceration. As part of our review we describe what we believe the future may hold in store for our subspecialty. We hope that this textbook contributes to a picture of where things stand and a vision of where we need to go.
21
Correctional Psychiatry (Critical Issues in American Psychiatry and the Law). Springer, 1989.
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22
Ford, Elizabeth. Correctional Settings. Edited by Hunter L. McQuistion. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190610999.003.0018.
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Correctional settings could represent an opportunity to provide treatment and rehabilitation for the disproportionately large numbers of people with mental illness who are incarcerated. Public psychiatrists have developed compassionate models of care for these individuals in prisons throughout North America, and they have worked to prevent victimization of individuals in these contexts. Risks including substance use, violence, and suicide are among the challenges that psychiatrists manage in these settings, and continuity of care following release into the community presents broad systemic challenges as well. The forensic psychiatry chapter’s discussion of diversion and fitness restoration dovetails with the focus on care provision within correctional settings explored in this chapter.
23
Introduction to Forensic Psychology: Court, Law Enforcement, and Correctional Practices. Elsevier Science & Technology Books, 2012.
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24
Abubaker, S. Khalid, Tyler G. Jones, and Philip J. Candilis. Geriatric Psychiatry Research. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199374656.003.0040.
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Forensic research with older participants carries more ethical challenges than either geriatric or forensic research alone. Concerns with cognitive impairment, informed consent, and voluntariness combine to complicate investigations of criminal and civil competencies, aggression, and the needs of an aging correctional population. Despite the paucity of regulatory guidance, researchers have developed a number of tools for simplifying the complex requirements of forensic geriatric research. Formal assessments for capacity to consent, ongoing consent discussions and enhancements, use of surrogate decision-makers, attention to vulnerability and desperation, and research useful to the subjects themselves are all part of a best practice model that underscores the dignity and personhood of this vulnerable research population. This chapter addresses each of these elements of best practice in geriatric forensic research, as well as research ethics required in conducting geriatric psychiatry forensic research.
25
Scott, Charles L., and Brian J. Holoyda. Role of clinical trainees. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0068.
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Correctional settings are important and worthy training sites for medical students, general psychiatry residents, child and adolescent psychiatry residents, and forensic psychiatry fellows. Logically, educating future clinicians on how to best treat individuals with mental illness should occur in settings that most commonly treat them. In the United States, there are now more than three times as many persons with serious mental illness in jails and prisons than hospitals, making America’s jails and prisons the new and largest mental hospitals. Despite a resulting increased need for correctional psychiatrists, most general psychiatry residency programs do not provide training in a correctional site. In an online survey of U.S. general psychiatry residency program training directors, less than one third of responding programs reported that a correctional training site was mandatory for trainees. Correctional settings can provide appropriate and meaningful training opportunities for both medical school students and psychiatry residents. Despite a need for psychiatrists trained in correctional psychiatry, such training is not currently available in the majority of programs. Future educators interested in developing academic teaching affiliations should anticipate concerns by trainees and be prepared to address those concerns. The opportunity for matching current psychiatric training requirements with correctional settings abound. Providing care to individuals with mental illness where they live increasingly means providing care to those persons who are in incarcerated in jails and prisons.
26
Patterson, Raymond F. Leadership, training, and educational opportunities. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0067.
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Correctional settings hold a range of opportunities for Psychiatrists to assume leadership roles. The increase in the number of detainees and inmates who require mental health services has created numerous administrative and clinical opportunities for psychiatrists. The ‘front end’ of arrest and pretrial determinations has been a longstanding component of forensic practice, related to competence, criminal responsibility, and probation. Following incarceration, assessment of mental health needs, access to care, and provision of treatment as well as quality improvement partially constitute the jail and prison components of mental health services. The ‘aftercare’ aspect of mental health services in correctional psychiatry involves individuals released on parole with need and/or requirement for mental health treatment. The leadership role for psychiatrists working in correctional environments is distinctly different from typical psychiatric venues where the psychiatrist and other mental health professionals are ‘in control;’ in correctional environments, the dynamics are different and require collaboration and advocacy. Within correctional systems it is essential that ‘correctional culture’ be understood by the psychiatric/mental health leadership. With effective psychiatric leadership, mental health care delivery and its coordination with correctional management of prisoners both stand to be improved. The need for dedicated and qualified leadership for mental health services and appropriate education and training in correctional mental health practices provide remarkable opportunities for psychiatrists. Psychiatrists and other health care professionals must be educated and trained to provide the necessary leadership for these extraordinarily complex systems of care and confinement.
27
P, Farrington David, and Gunn John Charles, eds. Reactions to crime: The public, the police, courts, and prisons. Chichester: Wiley, 1985.
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28
Garcia, Erik J., and Warren J. Ferguson. General medical disorders with psychiatric implications. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0038.
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Traditionally the domain of consultation/ liaison psychiatry, the challenge of recognizing and then appropriately treating the psychiatric complications of general medical disorders requires thoughtful planning and attention in corrections. Medical conditions that have psychiatric symptoms represent a significant diagnostic dilemma, particularly in the correctional health setting. Over half of the inmates in the United States have symptoms of a major mental illness, but the pervasiveness of substance use disorders, the increasing prevalence of elderly inmates, and limited access to a patient’s past medical and psychiatric records all contribute to the challenge of discerning when a psychiatric presentation results from an underlying medical condition. One early study underscored this challenge, noting that 46% of the patients admitted to community psychiatric wards had an unrecognized medical illness that either caused or exacerbated their psychiatric illness. A more recent study observed that 2.8% of admissions to inpatient psychiatry were due to unrecognized medical conditions. Emergency room medical clearance of patients presenting for psychiatric admission has revealed an increased risk for such underlying medical conditions among patients with any of five characteristics: elderly, a history of substance abuse, no prior history of mental illness, lower socioeconomic status, or significant preexisting medical illnesses. This chapter examines several of these risk groups and focuses on the presenting symptoms of delirium, mood disorders, and psychosis and the underlying medical conditions that can mimic or exacerbate them.
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Garcia, Erik J., and Warren J. Ferguson. General medical disorders with psychiatric implications. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199360574.003.0038_update_001.
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Traditionally the domain of consultation/ liaison psychiatry, the challenge of recognizing and then appropriately treating the psychiatric complications of general medical disorders requires thoughtful planning and attention in corrections. Medical conditions that have psychiatric symptoms represent a significant diagnostic dilemma, particularly in the correctional health setting. Over half of the inmates in the United States have symptoms of a major mental illness, but the pervasiveness of substance use disorders, the increasing prevalence of elderly inmates, and limited access to a patient’s past medical and psychiatric records all contribute to the challenge of discerning when a psychiatric presentation results from an underlying medical condition. One early study underscored this challenge, noting that 46% of the patients admitted to community psychiatric wards had an unrecognized medical illness that either caused or exacerbated their psychiatric illness. A more recent study observed that 2.8% of admissions to inpatient psychiatry were due to unrecognized medical conditions. Emergency room medical clearance of patients presenting for psychiatric admission has revealed an increased risk for such underlying medical conditions among patients with any of five characteristics: elderly, a history of substance abuse, no prior history of mental illness, lower socioeconomic status, or significant preexisting medical illnesses. This chapter examines several of these risk groups and focuses on the presenting symptoms of delirium, mood disorders, and psychosis and the underlying medical conditions that can mimic or exacerbate them.
30
Thomson, Lindsay D. G. International perspectives and practice differences. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0069.
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Across the developed world, services for those with mental disorder in prison have been established but are seldom equivalent to those found in the community. Prisoners are largely the socio-economically deprived with high rates of mental disorder. They have often been victimized. Prisons are our new asylums. In the United States three times as many mentally ill people are in prison than in psychiatric hospital. It is essential that whatever our geographical location, we learn from other jurisdictions and other systems. Rates of imprisonment, organization of psychiatric services, and location of treatment of mentally disordered offenders all vary; and it is easy to fall into the trap of assuming that the system with which you are familiar is the right one. There are major differences across the world in terms of rates of imprisonment, place of treatment of acutely ill prisoners, and the structure of our mental health services in prisons. Those requiring hospital care should be transferred out of prison for this. Independence of health services from correctional services would promote the development of the former. One challenging issue for correctional psychiatry in some jurisdictions is capital punishment and psychiatrists ethically should have no role in executions and be aware of the ethical stance of the World Psychiatric Association. This chapter examines correctional psychiatry in an international context and explores similarities and differences in our practices, and the cultural, political, and economic background to these.
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Thomson, Lindsay D. G. International perspectives and practice differences. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199360574.003.0069_update_001.
Full textAbstract:
Across the developed world, services for those with mental disorder in prison have been established but are seldom equivalent to those found in the community. Prisoners are largely the socio-economically deprived with high rates of mental disorder. They have often been victimized. Prisons are our new asylums. In the United States three times as many mentally ill people are in prison than in psychiatric hospital. It is essential that whatever our geographical location, we learn from other jurisdictions and other systems. Rates of imprisonment, organization of psychiatric services, and location of treatment of mentally disordered offenders all vary; and it is easy to fall into the trap of assuming that the system with which you are familiar is the right one. There are major differences across the world in terms of rates of imprisonment, place of treatment of acutely ill prisoners, and the structure of our mental health services in prisons. Those requiring hospital care should be transferred out of prison for this. Independence of health services from correctional services would promote the development of the former. One challenging issue for correctional psychiatry in some jurisdictions is capital punishment and psychiatrists ethically should have no role in executions and be aware of the ethical stance of the World Psychiatric Association. This chapter examines correctional psychiatry in an international context and explores similarities and differences in our practices, and the cultural, political, and economic background to these.
32
Sturmey, Peter, and Mary McMurran. Forensic Case Formulation. Wiley & Sons, Incorporated, John, 2011.
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33
Sturmey, Peter, and Mary McMurran. Forensic Case Formulation. Wiley & Sons, Incorporated, John, 2011.
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34
Sturmey, Peter, and Mary McMurran. Forensic Case Formulation. Wiley & Sons, Incorporated, John, 2011.
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35
Kapoor, Reena, and Ezra E. H. Griffith. Cultural competence. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0060.
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Disparities exist in the rate of incarceration of minorities, with substantial elevations occurring in African American, Latino, and Native populations. Cultural competence is an essential aspect of providing mental health care in any setting. An understanding of culture is even more important in correctional settings, as several unique factors may lead to conflict and misunderstanding if not adequately addressed. First, minority ethnic groups are vastly overrepresented in prisons and jails, so a familiarity with the predominant culture of those groups is necessary to engage inmates in treatment and diagnose them accurately. Second, mental health clinicians may be unfamiliar with law enforcement culture, which heavily influences the practices of corrections officers and differs significantly from health care culture. Third, many correctional psychiatrists grow up and train outside the United States, bringing their own cultural beliefs about crime and punishment into the American health care system. As the field of cultural psychiatry has developed, scholars have attempted to apply its principles to the correctional setting to deliver competent care in prisons and jails. These papers have provided guidance to correctional mental health clinicians on matters such as immigrant populations, language barriers, validity of psychological testing in different ethnic groups, stigma of mental illness in prison, religion’s role in coping with the stress of incarceration, and many others. This chapter reviews the evolution of cultural competence skills in correctional settings and current best practices in jails and prisons to optimize effective treatment outcomes.
36
Penn, Joseph V. Standards and accreditation for jails, prisons, and juvenile facilities. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0063.
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Numerous challenges confront correctional health staff in serving the needs of incarcerated adults and juveniles. Effective screening, timely referral, and appropriate treatment are critical. Their implementation requires interagency collaboration, adherence to established national standards of care, and implementation of continuous quality improvement practices and research on the health needs of this vulnerable patient population. Effective evaluation and treatment during incarceration meets important public health objectives and helps improve health services and effective transition into the community upon release. Many types of ‘free world’ health care organizations—such as hospitals, nursing homes, and psychiatric facilities—are accredited by the Joint Commission. Similarly, jails, prisons, juvenile detention, and other correctional facilities may be accredited by the National Commission on Correctional Health Care (a spinoff from the American Medical Association), the American Correctional Association, the Joint Commission, or a combination of the above. Although national accreditation is typically voluntary, it is often a contractual requirement for universities, other health care systems, and private vendors who provide health care services to correctional systems. In addition, when facilities undergo investigation or litigation, or are placed in receivership or federal oversight, they are often mandated to establish and maintain national accreditations. This chapter presents a brief historical narrative of the events that resulted in the development and adoption of national jail, prison, and juvenile correctional health care standards; a cogent review of jail and prison standards with particular relevance to psychiatry and mental health; and discussion of accreditation programs.
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Virdi, Sundeep, and Robert L. Trestman. Personality disorders. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0036.
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Personality disorders are highly prevalent and highly problematic in jails in prisons. Personality disorders, by definition, are associated with significant functional impairment of the affected individual and may negatively impact those around them. That impairment results from the way these individuals think and feel about themselves and others. Patients with personality disorder are often challenging to manage in the community. The difficulties associated with their care are accentuated in the confines and highly structured environments presented by jails and prisons. Inmates with personality disorders often require a disproportionate level of attention from correctional staff and their behavior can contribute to a dangerous environment inside a facility. Additionally, when compared to offenders with other psychiatric disorders or non-mentally disordered offenders, offenders with personality disorders have higher rates of violence, criminality, and recidivism. There are 4 personality disorders that are of particular clinical relevance to the correctional psychiatry setting: borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, and paranoid personality disorder. Research also reflects that these disorders have the highest correctional prevalence rates among the personality disorders. For each of these four disorders, this chapter presents in turn a description and some management concerns and challenges, data on correctional prevalence, appropriate psychotherapy, and potential psychopharmacologic interventions.
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Trestman, Robert L. Aggression. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0048.
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Managing aggression is a challenge for psychiatry in all settings. Recognizing opportunities for appropriate assessment and intervention in correctional settings is an important component of correctional psychiatry. Studies reflect significant risks of violence for both correctional officers and inmates. Although prison homicides occur at rates below estimated community homicide rates, the rate of non-lethal violence is substantial. The data for assault are less clear, as definitions of what constitutes assault vary. Inmate-on-inmate assault has been estimated to range from 2 per 1000 inmates to as high as 200 per 1000 inmates. However assault is defined, correctional officers who have been the target of offender violence have elevated risk of emotional exhaustion and burnout. Effectively addressing aggression requires a thoughtful and comprehensive approach that may incorporate elements of environmental management, evaluation of potential motivating factors, differential diagnosis, and a coordinated intervention. This always involves includes effective communication among stakeholders including the patient. Recommended milieu changes and psychotherapeutic and / or pharmacologic interventions need to be explicitly defined; available data are described in this chapter. Consistent oversight and follow up to measure the effects of each component of the intervention(s) is critical, as aggressive behavior may be both habitual and episodic. This chapter reviews the factors that contribute to the broad range of assaultive behavior observed in correctional settings, and some of the pragmatic issues and opportunities for assessment, diagnosis, and treatment of aggressive behaviors, both impulsive and predatory.
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Trestman, Robert L. Aggression. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199360574.003.0048_update_001.
Full textAbstract:
Managing aggression is a challenge for psychiatry in all settings. Recognizing opportunities for appropriate assessment and intervention in correctional settings is an important component of correctional psychiatry. Studies reflect significant risks of violence for both correctional officers and inmates. Although prison homicides occur at rates below estimated community homicide rates, the rate of non-lethal violence is substantial. The data for assault are less clear, as definitions of what constitutes assault vary. Inmate-on-inmate assault has been estimated to range from 2 per 1000 inmates to as high as 200 per 1000 inmates. However assault is defined, correctional officers who have been the target of offender violence have elevated risk of emotional exhaustion and burnout. Effectively addressing aggression requires a thoughtful and comprehensive approach that may incorporate elements of environmental management, evaluation of potential motivating factors, differential diagnosis, and a coordinated intervention. This always involves includes effective communication among stakeholders including the patient. Recommended milieu changes and psychotherapeutic and / or pharmacologic interventions need to be explicitly defined; available data are described in this chapter. Consistent oversight and follow up to measure the effects of each component of the intervention(s) is critical, as aggressive behavior may be both habitual and episodic. This chapter reviews the factors that contribute to the broad range of assaultive behavior observed in correctional settings, and some of the pragmatic issues and opportunities for assessment, diagnosis, and treatment of aggressive behaviors, both impulsive and predatory.
40
Arrigo, Bruce A., and S. Lorén Trull. History of imprisonment. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0001.
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This chapter focuses on the evolution of the U.S. imprisonment system and examines the relevance of the system’s development in relation to correctional psychiatry. The first section of the chapter reviews the history of American prisons, including their shifting purposes, standards, and practices. The second portion of the chapter highlights the persistent lack of regard for prisoners with mental illness throughout the history of American penology, and explains how rehabilitation theory has intersected with the diagnostics and treatment of persons experiencing psychiatric disorders while criminally confined. Moreover, the swelling number of inmates with psychiatric disorders found in correctional settings today has converted jails and prisons into ill-equipped de facto institutions that warehouse the mentally ill much like the practice of the 19th century. Indeed, while American prison systems are beginning to implement some novel accommodations for persons with psychiatric disorders, they are often subjected to the same punitive treatment of isolative confinement that was popularized during the 19th century. The chapter concludes by discussing the current status of imprisonment in the United States, noting that as a consequence of the War on Drugs more than 31 million people have been arrested and convicted for these criminal offenses, leading to systematic mass incarceration that adversely and unequally impacts people of color.
41
Roskes, Erik J., and Donna Vanderpool. Forensic issues. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0061.
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A range of forensic psychiatry issues frequently present themselves in correctional settings. Incompetency to stand trial is one such concern. In some states, defendants found incompetent to stand trial must be managed in jail. Litigation is another important issue. Psychiatrists working in correctional settings often have increased litigation risks regarding professional negligence and other forms of liability. Especially important is understanding whether their insurer covers correctional work. One common form of litigation is habeas corpus. For example, a habeas petition could be brought to seek medical interventions denied by the detaining institution, and as such, the medical staff could be named defendants. Many class actions have involved correctional mental health care. Often clinicians working in correctional settings welcome these litigations, as they focus the attention of the courts on deficiencies in care related to inadequate resources. While such lawsuits can be sensitive, especially in the earlier phases when the outcome is in doubt, correctional psychiatrists and other clinicians may also serve as sources of information for each party to the case and to the court. Another key topic is the correctional disciplinary process. Mental health input into the disciplinary process does not address issues of responsibility but is limited to identifying mitigating factors related to mental illness when present, dispositional recommendations when clinically appropriate, and competency-to-proceed issues in the context of the disciplinary hearing. This chapter reviews key issues of relevance to correctional psychiatrists, such as competency restoration, court collaboration, and litigation related concerns.
42
Gage, Bruce C. Working inside the walls. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0007.
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This chapter is a pragmatic discussion of the experience of working as a psychiatrist in correctional settings, whether jails or prisons. To work inside the walls, the psychiatrist must come to terms with the realities of the correctional setting in order to be secure, satisfied with the work, and clinically effective. There is no monolithic correctional culture. Each system and facility has its own unique culture and has evolved in some degree of isolation, emphasizing different philosophical approaches to the correctional mission and to criminal causation. This chapter examines the context in which clinical work is embedded: physical environment and security, correctional culture, personal safety, typical stressors, and individual liability. It is clearly not for everybody but the rewards can be tremendous. The quality of care in many facilities, especially prisons, is superior to care in the community. The clinical problems are unendingly fascinating. And, despite its downsides, having a setting with limited access to drugs that provides food, clothing, shelter, and medical care can allow a degree of patient improvement that may be difficult to realize in the community. Opportunities for creativity in treatment and program development are unparalleled. In many ways, correctional psychiatry is poised to lead the way in the treatment of some of the most ill and behaviorally disordered members of society.
44
Zahedi, Sohrab. Diagnostic review and revision. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0020.
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The criminalization of people with mental illness is a sad commentary on the United States’ mental health system. Yet, the phenomenon presents the field of psychiatry with an opportunity that is now scarce in civil society: lengths of sentence in terms of weeks to years that allow for in-depth observation and treatment of the inmate with mental illness. A few days in a hospital fails to provide the needed opportunity for a detailed and accurate evaluation. Today, people with mental illness account for more than one million annual arrests and many among these individuals will spend weeks to months in jail before being either transferred to a prison for sentences beyond one year or released back into the community. At its core, psychiatric diagnosis relies on the subjective complaints of the patient and objective signs noted on examination. Considering the chronic and fluctuating course of most psychiatric diagnoses, a thorough assessment also requires a review of past documented behaviors. When someone is hospitalized for a psychiatric condition, the first goal is often observation, followed by diagnosis, and then treatment. Psychiatric hospitals are being greatly constrained in the amount of time available for observation and accurate diagnosis; the correctional setting, as an unintended consequence of mass incarceration, provides an extended opportunity to achieve improved diagnostic accuracy. This chapter reflects on the diagnostic opportunities that a jail or a prison setting affords.
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Trestman, Robert L. Psychiatric aspects of pain management. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0039.
Full textAbstract:
Chronic pain differs from acute pain in many ways. First, by definition, it has become enduring and goes beyond the expected period of healing, whether post-trauma, post-surgery, or as part of a degenerative or progressive disease. The typical time frame used for defining chronic pain is defined as pain that persists beyond a six month window. Another characteristic that distinguishes chronic from acute pain is the emotional element of perceived suffering. This component of chronic pain becomes important in the assessment and subsequent treatment of chronic pain. Chronic pain management in a correctional setting is very challenging due to a host of factors. First, the majority of people being treated have a history of substance abuse disorders. Further, as a whole, the population of incarcerated adults has a disproportionate prevalence of significant chronic medical and psychiatric conditions. Finally, access to illicit drugs is limited, if not completely eliminated in correctional settings, shifting the environmental demand characteristics to prescription medication misuse. This chapter addresses issues of the psychiatric assessment and management of chronic pain in correctional settings. Information is provided regarding the factors to be elicited in a chronic pain interview, the methods used to assess chronic pain, and the assessment factors appropriate to integrate into a management plan. The methods used to manage chronic pain, including close coordination with a treatment team, cognitive behavioral interventions, and pharmacological management are presented. Tracking treatment outcomes from a psychiatric perspective in the correctional setting are then discussed.
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Trestman, Robert L. Psychiatric aspects of pain management. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199360574.003.0039_update_001.
Full textAbstract:
Chronic pain differs from acute pain in many ways. First, by definition, it has become enduring and goes beyond the expected period of healing, whether post-trauma, post-surgery, or as part of a degenerative or progressive disease. The typical time frame used for defining chronic pain is defined as pain that persists beyond a six month window. Another characteristic that distinguishes chronic from acute pain is the emotional element of perceived suffering. This component of chronic pain becomes important in the assessment and subsequent treatment of chronic pain. Chronic pain management in a correctional setting is very challenging due to a host of factors. First, the majority of people being treated have a history of substance abuse disorders. Further, as a whole, the population of incarcerated adults has a disproportionate prevalence of significant chronic medical and psychiatric conditions. Finally, access to illicit drugs is limited, if not completely eliminated in correctional settings, shifting the environmental demand characteristics to prescription medication misuse. This chapter addresses issues of the psychiatric assessment and management of chronic pain in correctional settings. Information is provided regarding the factors to be elicited in a chronic pain interview, the methods used to assess chronic pain, and the assessment factors appropriate to integrate into a management plan. The methods used to manage chronic pain, including close coordination with a treatment team, cognitive behavioral interventions, and pharmacological management are presented. Tracking treatment outcomes from a psychiatric perspective in the correctional setting are then discussed.
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Lee, Li-Wen. Interviewing in correctional settings. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0012.
Full textAbstract:
Conducting psychiatric interviews is oftentimes a unique challenge in jails and prisons. Interviews are conducted in a wide array of conditions and settings, acute or chronic, privacy and safety issues, contentious or collaborative. According to the Bureau of Justice Statistics in 2005, more than half of all jail and prison inmates had a recent history of symptoms of a mental health problem. This high rate of mental illness is both an opportunity for, and a challenge to, providing much needed treatment. Without adequate assessment and treatment, inmates with mental illness may harm themselves, other inmates, correctional staff, become victimized, or disrupt facility operations. An essential component in assessment and appropriate management is the psychiatric interview. While there are helpful standards and guidelines regarding mental health services in correctional settings, relatively little has been written about the specific impact of the correctional setting on conducting mental health interviews, or on the specific features of the correctional population that should be understood when conducting the mental health interview. Given the importance of the interview in providing mental health treatment, the essential elements and complexities involved in conducting an effective interview in the correctional setting will be presented in the following chapter. Various aspects of the psychiatric interview will be reviewed with particular attention given to how the correctional population and setting can impact the interview process. Issues of countertransference are also present and are discussed. This chapter discusses both the contexts as well as the practices that are appropriately adapted to correctional settings.
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Saleh, Fabian M., Albert J. Grudzinskas, and H. Martin Malin. Treatment of incarcerated sex offenders. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0059.
Full textAbstract:
Sex offenders are incarcerated in substantial numbers for a variety of non-violent and violent crimes, with or without diagnoses of paraphilias. The treatment of sex offenders in correctional contexts is arguably one of the most challenging undertakings for psychiatrists. Sex offenders comprise a highly stigmatized population that typically engenders intense negative feelings in both the professional and lay communities. The growing number of sex offenses in recent years has had a profound impact on public perception. In 2012, the latest year for which comprehensive data have been compiled, there were 73,080 incidents of sex ‘crimes against persons’ in the United States involving 79,625 individual victims and individual 76,927 offenders. The potential contributions of psychiatry to sex offender management span a considerable segment of the patient’s life: from post-arrest evaluation and emergent care, through adjudication in the courts, incarceration, possible civil commitment, and supervised release. Nevertheless, psychiatrists, as physicians and healers, bring much needed medical expertise to the discussion. Foremost is the ability of psychiatry to demonstrate that sex offenders are a heterogeneous population. Further, a rational, effective, and humane approach to the social problem of sex offending depends upon accurate assessment, diagnosis, and treatment approaches to the offender. Psychiatrists can also inform the ongoing debate about competency, dangerousness, the appropriateness of civil commitment, life-long sex offender registration, compulsory medication and other medically relevant issues in sex offender management. This chapter reviews the nosology, assessment, diagnosis, best and evidence-based practice issues relevant to the care of convicted sex offenders in correctional settings.
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Holzer, Jacob, Robert Kohn, James Ellison, and Patricia Recupero, eds. Geriatric Forensic Psychiatry. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199374656.001.0001.
Full textAbstract:
Geriatric Forensic Psychiatry: Principles and Practice is one of the first texts to provide a comprehensive review of important topics in the intersection of geriatric psychiatry, medicine, clinical neuroscience, forensic psychiatry, and law. It will speak to a broad audience among varied fields, including clinical and forensic psychiatry and mental health professionals, geriatricians and internists, attorneys and courts, regulators, and other professionals working with the older population. Topics addressed in this text, applied to the geriatric population, include clinical forensic evaluation, regulations and laws, civil commitment, different forms of capacity, guardianship, patient rights, medical-legal issues related to treatment, long term care and telemedicine, risk management, patient safety and error reduction, elder driving, sociopathy and aggression, offenders and the adjudication process, criminal evaluations, corrections, ethics, culture, cognitive impairment, substance abuse, trauma, older professionals, high risk behavior, and forensic mental health training and research. Understanding the relationship between clinical issues, laws and regulations, and managing risk and improving safety, will help to serve the growing older population.
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Knoll, James L. Individual psychotherapy. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0041.
Full textAbstract:
The abandonment of the medical model in corrections almost half a century ago left a scorched earth policy in terms of rehabilitation, and in turn, psychotherapeutic efforts with inmates. Fortunately, the promise of new progress is returning. Along with the imperative of improving psychiatric treatment in corrections, mental health has brought the science of psychotherapeutic intervention back into corrections, this time reinforced by a social science evidence base. In practice, much of the psychotherapy in jails and prisons is indeed based on individual interaction. It includes crisis intervention, the more traditional approach of supportive psychotherapy, and a growing body of manual-guided therapies. This chapter discusses practical and fundamental aspects of individual psychotherapy with inmate patients, followed by an overview of evidence based paradigms for psychotherapy in corrections. Therapeutic style, strategies to minimize the risks of therapeutic nihilism, the context of the treatment setting, and the limits of confidentiality are each reviewed. While much of the evidence base supports cognitive behavioral approaches (including motivational interviewing and mindfulness, among others), the importance of maintaining competence in psychodynamically informed therapy is discussed. Of enduring importance, recognition of countertransference themes in correctional settings is also explored in this chapter.