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RSAT Forum > Monthly Discussion > May 2017: Screening and assessment for severe mental illness for RSAT programs serving individuals with co-occurring disorders. View modes: 
JCosta - 5/25/2017 1:22:21 PM
   
May 2017: Screening and assessment for severe mental illness for RSAT programs serving individuals with co-occurring disorders.
I was wondering if there were best practices with regard to screening and assessment of mental illness in jail? Not necessarily the tools but the process (e.g., must be assessed by mental health clinician, must be screened within the first 8 hours of booking, must be assessed within 24 hours of screening, etc.).
Any guidance would be appreciated!

From: Project Director, Criminal Justice/Mental Health

Answer: Some helpful sources:

1) FEDERAL BUREAU OF PRISONS, CLINICAL PRACTICE GUIDELINES FOR PSYCHIATRIC EVALUATIONS-March, 2002: http://www.neurosoup.com/pdf/boppsychEval.pdf

2) WASHINGTON State DOC Policy: http://www.doc.wa.gov/information/policies/default.aspx?show=600 Screened within 24 hours; Assessed within 14 days

3) NACo – Conducting Timely Screening and Assessment of MH Disorders in Jails (with CSG): http://www.naco.org/sites/default/files/event_attachments/Stepping%20Up%20April%20Webinar%20Slides.pdf

4) Report on Mentally Ill in CA Jails:
http://www.cdcr.ca.gov/COMIO/docs/MENTALLY_ILL_IN_JAILS_PAPER.pdf

While Title 15 and other regulations require screening, and everyone knows it is critical to determine who needs to be provided specialized housing or sent for 5150 evaluation as soon as possible, this can’t always happen at the point of intake / booking. There are several reasons screening is sometimes delayed:

• Some individuals are too agitated to be screened; jails cannot screen or assess people who are under the influence or acting out in ways that interfere with the booking process;

• There is no available staff person trained in mental health screening; many small county jails do not have nursing or other mental health staff available 24/7 and trained custody personnel may be involved in other duties;

• A large number of bookings occur at the same time; even large jails can sometimes (often?) be overwhelmed by the volume of bookings they have to deal with.

• In these instances, people who don’t meet the criteria for being sent to a hospital (or those the hospital won’t take) are placed in safety or administrative segregation cells, restraint chairs, or whatever is the safest place for the inmate and staff until a mental health person can get to the person for assessment to enable decisions about classification and appropriate housing. This is not ideal, but when it is the best that facilities can do, every effort must be made for screening and, when indicated, assessments to be conducted as soon as possible. A status assessment is required at least every eight (8) hours for people in safety cells or restraint chairs.

JCosta - 7/6/2017 10:36:40 AM
   
RE:May 2017: Screening and assessment for severe mental illness for RSAT programs serving individuals with co-occurring disorders.
Screening Tools for bipolar disorder

Composite International Diagnostic Interview (CIDI)-Based Screening Scale for Bipolar Spectrum Disorders

The CIDI-based screening scale consists of questions about symptom clusters and individual symptoms. Researchers have estimated that the CIDI-based screening scale identifies between 67 percent and 96 percent of bipolar disorder cases, depending in part on where the cut points for a positive result are set. The screening scale is available at https://www.integration.samhsa.gov/images/res/STABLE_toolkit.pdf.

For more information about general screening for mental disorders, see Treatment Improvement Protocol (TIP) 42, Substance Abuse Treatment for Persons With Co-Occurring Disorders.

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