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Tereasa Jamison

The Bureau of Mental Health Services ensures access to quality care that eliminates needless suffering, improves functioning of the offender and increases safety.

Mental Health Care Within Ohio's Prison System

In July 1995, the Department of Rehabilitation and Correction (DRC) took over full responsibility for mental health services in Ohio's prisons. Prior to 1995, Ohio's prison mental health care system was administered jointly by the DRC and the Department of Mental Health (DMH). DMH had primary responsibility for psychiatric services and DRC had responsibility for other mental health programs. In the early 1990's Ohio's prison mental health services came under intense scrutiny. The 1993 Easter disturbance at the Southern Ohio Correctional Facility resulted in several reports by the Governor's Select Committee on Corrections, the OCSEA/AFSCME bargaining unit, and others regarding the need for expanded and improved services.

A federal lawsuit, Dunn v. Voinovich, accelerated these efforts to improve services. In a collaborative effort, DMH and DRC worked with the plaintiffs for a resolution to the lawsuit. Central to this approach was engaging a team of experts to conduct a detailed audit and inspection of mental health care in every state prison. The experts had unimpeded access to every facility and every document, with a guarantee that their findings would be available to the court. This audit resulted in recommendations for improving mental health care.

After thoughtful, joint planning, the Departments of Rehabilitation and Correction and Mental Health charged their respective staff with redefining their relationship. Effective July 1, 1995, DRC became responsible for providing prison mental health services and DMH became responsible for oversight by establishing standards of care and surveying service provision.

Changes in the Delivery of Mental Health Services in Prisons

The basic service system design has changed. DRC's approach to developing a service system is now consistent with a community mental health model. In response to the recommendations of the team of experts in Dunn, the prison system was subdivided into clusters. Each cluster is made up of one to five correctional institutions. Clusters are designed to operate like catchment areas in a community mental health model. The inter-disciplinary team assigned to the cluster provides a continuum of care ranging from outpatient to residential services. The cluster mental health team works jointly with medical, recovery services, and sex offender programming.

Cluster mental health teams utilize a multi-disciplinary approach to developing holistic interventions. Members of the team include psychiatrists, psychologists, nurses, social workers, activity therapists, corrections officers, unit managers, and case managers. All mental health services staff serve on the treatment team and will also provide consultation to other institutional departments and services.

Cluster mental health teams provide a variety of services:

• assessment
• evaluation
• treatment planning
• individual and group therapy and counseling
• activity therapy
• consultation to staff
• staff training
• medication prescription and monitoring
• behavior management
• case management
• crisis intervention

Mental health staff will also make regular rounds in all segregation areas to assure that inmates who need services receive them and to ensure that no inmate is placed in segregation solely because of mental illness. Each cluster provides short-term crisis care and a Residential Treatment Unit (RTU) in addition to out-patient care.

Measuring Improvement and Ensuring Cost Savings

To ensure the highest quality of care at the least expense to Ohio taxpayers, the Bureau of Mental Health Services is developing a comprehensive program evaluation and research component. The goal is to implement the most effective mental health interventions based upon the evaluation findings. A Quality Assurance program has been initiated to assure quality of care. A committee of experienced clinicians meet on a regular basis to review, evaluate, and make recommendations for improvement of mental health services.

Employment Opportunities in Mental Health Services

Mental Health Services is growing and developing rapidly. Our need is to find qualified and motivated clinicians who are willing to accept the challenge of providing quality care, seek solutions for challenging problems, and create a quality system of mental health care. Positions are available in psychiatry; social work; administration; psychiatric nursing; activity therapy; and psychology.

Employee Training

All mental health staff receive three weeks of pre-service training at the Corrections Training Academy prior to working in an institution. Additional specialized training focusing on mental health care in a prison setting is provided. A wide range of continuing education opportunities are available on an ongoing basis for all DRC staff through contracts with professional organizations and state universities and colleges.