You asked a number of questions about inmates and mental health.

SUMMARY

This report answers a number of your questions on this topic. We are waiting for additional information from the Department of Correction (DOC) and will answer your remaining questions in a separate report. Anne Cournoyer, DOC liaison, provided the following information.

How many inmates are treated with psychoactive medications?

According to DOC, this requires extensive research. Many inmates brought to intake facilities are put on medication and discharged or released on bond within a week. According to DOC, about 15% of the incarcerated population has mental health issues requiring intervention and about half of that group is prescribed psychotropic medication. The incarcerated population on November 1, 2004 was 18,763. Based on this figure and DOC’s estimation, about 2,814 inmates would require intervention and 1,407 would be prescribed psychotropic medication.

Have lawsuits required staffing ratios for mental health services in correction facilities?

DOC recently negotiated a settlement with the Office of Protection and Advocacy regarding inmates at the Northern Correctional Institution. This requires the equivalent of one full-time psychiatrist for every 150 inmates on psychotropic medication at Northern and Garner Correctional Institutions (Office of Protection and Advocacy v. Choinski, D. Conn. , No. 3: 03CV1352).

A consent decree also requires the equivalent of one full-time psychiatrist at the Bridgeport Correctional Institution to handle mentally ill inmates in the infirmary.

What are the training requirements for staff providing mental health services?

Correctional managed health care staff must attend a training academy and must receive 40 hours of refresher training each year about custody topics (such as fire safety) and health services (such as suicide prevention and blood-borne pathogens). Facilities also conduct training specifically related to the facility’s mission. For example, staff at Garner Correctional Institution receive more mental health training and this year received one week of training from a Texas correctional psychologist on programs and managing mentally ill inmates.

How soon must an inmate have a mental health evaluation after entering a facility? Are there delays in conducting the evaluations? Are inmates evaluated each time they are transferred?

Inmates receive a mental health screening if (1) they are first time offenders, (2) the court order suggests mental health problems, or (3) medical staff at the inmate’s medical evaluation on arrival identify a mental health issue. Most inmates requiring a screening receive one the same day. Inmates who are processed on the third shift are screened within 12 hours. Inmates are prioritized and there is no waiting list. DOC uses on-call psychiatry or placement in an infirmary setting if there are placement questions or observation is required.

Before an inmate is moved to another facility, the staff prepares a transfer summary. Inmates with serious mental health issues are “flagged” on intake at the new facility. All inmates transferred to Garner Correctional Institution are evaluated by mental health staff.

Have inmates awaiting mental health treatment assaulted themselves, other inmates, or staff?

Inmates are evaluated on intake and those that may be a danger to themselves or others are placed in an infirmary setting for observation. Inmates are also classified for housing needs and inmates with serious or persistent mental illnesses are placed in special housing.

Assaults have occurred and it is often attributed to poor medication compliance and serious personality disorders. We do not yet have data on the number of these assaults.

How many inmates committed or attempted suicide, and in which facilities, during the last seven years?

The table below shows the number of suicides in the last seven years in each facility.

Table 1: Number of Suicides by Facility in the Last Seven Years.

DOC states that it will take more research to determine the number of suicide attempts. As with the number of completed suicides, the number of attempts would be higher in the intake facilities (Hartford, New Haven, Bridgeport, Corrigan, and York Correctional Institutions).

Is there a system to track inmates with mental health needs from arrest to discharge that is available to the courts, law enforcement, and corrections?

There is no database that the courts or law enforcement shares that tracks these individuals. In addition, DOC states that legislation prevents DOC health service staff from accessing the Department of Mental Health and Addiction Services (DMHAS) database. But DMHAS jail diversion staff notifies intake facilities if they know the court is sending a mentally ill person to DOC.

Communication with the court is done through procedures that require written or phone notification.

DOC states that agencies try to work together to transmit information.

CR: ts