2005-2009 Statewide Comprehensive Plan for Mental Health Service Services
Chapter 7: Forensic Services

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Introduction

In New York State, a small yet significant group of individuals suffering from mental illness become involved with the criminal justice system. These individuals receive care in the forensic mental health system, where OMH provides care to New Yorkers pursuant to Mental Hygiene, Criminal Procedure or Correction Laws. OMH ensures that mental health services are available to members of this population at multiple points throughout the forensic system by providing statutorily mandated inpatient and corrections-based mental health services.

The forensic population was identified during the public planning process of 2004 as appropriate for special attention in this year’s Plan. This chapter describes two important components of the forensic mental health system: programs to avoid incarceration for certain individuals with serious mental illness, and services to more than 7,500 individuals with mental illness served in State correctional facilities (State Prison).

Goals for this population

For adults with mental illness, OMH’s overall goals are to:

• Foster the diversion from incarceration of adults with mental illness who come in contact with the criminal justice system into appropriate community-based services.
• Provide appropriate prison-based mental health services, and when necessary, provide inpatient services at the Central New York Psychiatric Center.
• Assist individuals with mental illness released from prison by facilitating access to aftercare services deemed essential for the safe and functional adjustment to community-based living.

New Trends in Diverting Offenders with Mental Illness from Incarceration

Mental Health Courts:
An Emerging Evidenced-Based Practice

In 1997, the nation’s first mental health court was created in Broward County, Florida to meet the needs of defendants with mental disorders charged with relatively minor offenses and who may have a history of frequent contact with the legal system. Criteria for admission to mental health court programs vary by jurisdiction. However, most require that the offender suffer from a serious mental illness, such as bipolar disorder, major depression or schizoaffective disorder, and that the crime committed is a misdemeanor or low-level felony. Sex offenders and other violent offenders are excluded from participation. According to the Survey of Mental Health Courts there are currently 110 mental health courts across the U.S.¹

Research has suggested that mental health courts are an emerging best practice. A study of the Akron, Ohio mental health court showed their services helped keep participants out of jail. The study tracked 40 program participants and found that their average number of incarcerations dropped from about 20 per person in 2000 to 0.54 per person in 2003. Evaluation of the Broward County mental health court revealed that, at least in comparison to a traditional misdemeanor court, the mental health court enhanced treatment access and involvement for a substantial number of defendants appearing before it. Statistically significant results from two mental health courts in Seattle suggest that participation in the court program had a positive impact on relevant criminal justice and mental health indicators, such as linkage to mental health services and increased communication between systems.

Brooklyn Mental Health Court

The Brooklyn Mental Health Court was one of the first courts in New York State dedicated to handling criminal cases of defendants with a major mental illness, and is designed to provide a more clinically appropriate response to these defendants in the criminal justice system. The Brooklyn Mental Health Court has been developed as a joint project of the New York State Unified Court System, OMH and the Center for Court Innovation (CCI). Other government and nonprofit partners involved in planning the Mental Health Court include the New York City Department of Health and Mental Hygiene, the Kings County District Attorney’s Office, the Legal Aid Society, the Brooklyn Defenders Service and numerous representatives of the mental health treatment community. The program uses the authority of the Court to link offenders with mental illness to treatment, stabilize their illness, and prevent their return to the criminal justice system.

The goals of the Brooklyn Mental Health Court are to:

• Improve the court system’s ability to identify, assess, evaluate and monitor offenders with mental illness.
• Use the authority of the Court to link offenders with mental illness to appropriate mental health treatment and supports.
• Ensure that participants receive high quality community-based services.
• Engage participants in treatment and hold them accountable for their actions.
• Create better understanding and effective linkages between the criminal justice and the mental health systems.
• Improve public safety by reducing recidivism of offenders with mental illness.

The Brooklyn Mental Health Court process emphasizes the use of good information, judicial monitoring, clear accountability and the coordination of services.

• An on-site clinical team performs detailed psycho-social assessments of each defendant referred to the Mental Health Court. This information allows the judge to make more informed decisions about defendants, enabling him to gauge the nature of defendants’ illnesses - and the risks they pose to public safety – in a much more nuanced way. Secondly, the information is used to craft individualized treatment plans for each defendant, matching them to appropriate counseling and service programs.
• Every defendant in the Mental Health Court is required to return to Court regularly to meet with case managers and appear before the judge to report on progress in treatment. This keeps the judge engaged with the defendant for the life of the case and underlines for the defendant the seriousness of the process.
• The Court has a range of graduated sanctions and rewards to respond to progress (and failure) in treatment. Regular monitoring of progress in treatment also holds service providers accountable to the judge. Where appropriate, changes in treatment plans are implemented to help defendants achieve stability. Defendants who complete all program requirements have their criminal charges dismissed or reduced.
• In addition to mental health issues, many defendants also confront homelessness, unemployment, substance abuse and serious health problems. Therefore, the Mental Health Court works with a broad network of government and not-for-profit service providers to address these inter-related issues.

Outcomes

Since its inception in 2002, 318 defendants have been referred to the Brooklyn Mental Health Court. One hundred and fourteen defendants met criteria for program participation (based on offense, mental illness, etc.) and were accepted. Thirty-six participants have graduated from the Brooklyn Mental Health Court after successful program compliance. Only 10 participants were terminated from the program and sentenced due to noncompliance. There are currently 91 active participants in the Mental Health Court program.

There are four other mental health courts in New York State. They are the Bronx TASC Mental Health Diversion Court, Buffalo City Mental Health Court, Niagara Falls Mental Health Court and the Monroe County Mental Health Court.

The Bronx TASC Mental Health Diversion Court

The Bronx TASC Mental Health Diversion Court is a collaborative project of the Bronx Supreme Court, The Bronx District Attorney’s Office and the Education Assistance Corporation’s (EAC) New York City TASC (Treatment Alternative to Street Crime).

The development of the Bronx TASC Mental Health Diversion Court was accomplished through a year long consensus building and planning process, supported by a Substance Abuse and Mental Health Services Administration (SAMHSA) Community Action Grant. Utilizing a best practices approach, exemplary practices were reviewed for specialized court models (including TASC models) and provided to the consensus building participants developing the Court.

The Bronx TASC Mental Health Diversion Court program works out of offices close to the Bronx Supreme Court and aims to divert felony-offenders with mental illness from the criminal justice system into treatment settings. The program staff conduct comprehensive psychiatric assessments, including risk assessments, and make treatment recommendations (including recommendations for risk management), placement into either outpatient or inpatient residential facilities, and continue to monitor the defendant with active engagement of the treatment provider on behalf of the court and the district attorney. This monitoring continues for 18 to 24 months until the defendant transitions to a permanent housing and treatment plan and is given a final legal disposition.

The Bronx TASC Mental Health Court continues to receive funding from SAMHSA, The Center for Substance Abuse Prevention, and The Center for Substance Abuse Treatment as well as the New York State Division of Probation and Correctional Alternatives (DPCA). In-kind contributions are provided through the Bronx Psychiatric Center. The program model and in-program client outcomes continue to be studied as appropriate for evidence based approaches.

Based on a SAMHSA study of the Court reported in March 2004, it was found that the findings were consistent with program goals: decreased substance use, psychiatric symptoms and criminal justice involvement (e.g. arrests and nights incarcerated) and involvement in an array of treatment services.

The positive results of the Brooklyn Mental Health Court and the four other mental health courts in New York State have encouraged further collaboration between the Office of Court Administration (OCA) and the OMH. Judith S. Kaye, Chief Judge of the State of New York selected Judy Harris Kluger, Deputy Chief Administrative Judge for Court Operations and Planning of the New York State Office of Court Administration, to oversee court-based mental health diversion, including the development of additional mental health courts. Commissioner Carpinello and Judge Kluger have established a collaborative relationship between organizations. One collaboration between OMH, OCA and CCI is the identification of key elements of successful mental health courts and the development of a technical assistance program to assist communities in their development of court-based mental health diversion.

Individuals with Mental Illness in the State Correctional System

Background

OMH and the Department of Correctional Services (DOCS) jointly provide mental health services and treatment to individuals incarcerated in DOCS facilities. Over the past three decades, this service delivery system has grown to become a nationally respected model. It is the only comprehensive system in the U.S. to be fully accredited by both the American Correctional Association and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).² Representatives from all over the U.S. and the world have come to New York to observe how our system is operated. The specifics on how these services are provided and how the interagency collaboration is designed is set forth in a formal Memorandum of Understanding (MOU) between the two agencies.

Prior to 1976, mental health services to persons confined to New York State correctional facilities were provided by DOCS at Matteawan and Dannemora State Hospitals. In 1976 legislation was enacted which transferred the responsibility for mental health services to OMH. To fulfill the requirements of the legislative mandate, OMH opened Central New York Psychiatric Center (CNYPC), an inpatient facility along with a network of corrections-based satellite and mental health units which provide triage, crisis services referral and clinic services. In addition to the beds at CNYPC, OMH has 11 satellite and 11 mental health units in prisons throughout the State. With clinical staffing from OMH and security staffing from DOCS, satellite units provide a broad range of services to inmates.

The 2005-2006 Executive Budget continues to support collaboration between OMH and DOCS, and builds upon the range of treatment services jointly provided for prisoners with serious mental illness. A total of $7 million in new OMH appropriations were provided to significantly expand mental health treatment capacity and clinical staffing for this population. These funds will support a range of new and expanded treatment services based upon a statewide review of the forensic program, including two new Behavioral Health Units established in DOCS facilities; almost triple the number of beds for the Special Treatment Program; expanded bed capacity for the Intermediate Care Program; and improved access to clinical staff for mental health services that includes hiring additional psychiatrists and nurse practitioners.

The 2005-2006 Executive Budget appropriation to enhance corrections-based mental health services is the third such enhancement since 1995. In fiscal year 1997-1998 40 additional full time equivalent positions (FTEs) were added to OMH’s corrections-based mental health program to establish two new Satellite Units at Mid-State and Albion Correctional Facilities. In addition, in fiscal year 1999-2000, 82 additional FTEs were added to OMH’s corrections-based program to enhance aftercare planning services, mental health services to inmates confined to disciplinary housing units, and program oversight and administration. With full implementation of the 2004-2005 Executive Budget Initiatives, OMH will have expanded its corrections-based services by more than 80% (from 231 to 420 FTEs since 1997-1998).

System Overview

OMH provides appropriate corrections-based mental health services to individuals with mental illness in State correctional facilities who require mental health services on either an ambulatory or inpatient basis. When inpatient services are provided to these inmates by law, all admissions are involuntary and received at CNYPC.

Figure 7.2 depicts the typical paths individuals experience when accessing mental health services during their incarceration in DOCS. Inmates entering DOCS are processed into the system and classified at reception centers located at the Downstate, Elmira, Ulster, and Bedford Hills Correctional Facilities. Frequently, mental health providers who work in local correctional facilities refer individuals entering the State correctional system. At a minimum, each newly admitted inmate is accompanied by a discharge summary that describes his/her course of care in the local correctional facility. Newly admitted inmates receive a battery of assessments and evaluations including a mental health screening. The classification process enables DOCS to appropriately place inmates in the correctional system taking into account individual security, medical, and mental health needs.

At each of the reception centers, OMH staff is available to evaluate the mental health needs of inmates. Inmates can be referred by DOCS staff as possibly requiring mental health treatment or referred for additional assessment during the classification process. Once placed in a correctional facility, inmates receive mental health services through the inmate orientation plan, self-referral, or referral by corrections or medical staff. Should an inmate require more intensive services than are provided in prison, she/he can be transferred to a correctional facility where the needed level of mental health services is available, and if needed, committed to CNYPC for inpatient services. Discharge planning is provided to inmates with mental illness returning to the community, who may be offered services such as those provided through the Community Orientation and Re-entry Program (CORP). In addition, should inmates require continued inpatient mental health services after completing their sentence, they may be committed to a civil psychiatric center.

Figure 7.1
Services Delivered in State Correctional Facilities (Corrections-based Services)

Services Delivered in State Correctional Facilities (Corrections-based Services)

CNYPC’s corrections-based services component is responsible for planning and providing mental health services to sentenced inmates with mental illness within DOCS facilities, and for coordinating their reintegration into the community upon release from incarceration. As described earlier, since 1995, corrections-based mental health services provided to State prison inmates have improved due to a substantial increase in the number of mental health staff from 231 in 1997-1998 to 420 in 2004-2005. Today, OMH serves an inmate-patient caseload of approximately 7,500.

Satellite and Mental Health Units

Services are provided at DOCS facilities throughout New York State through a system of 11 Satellite Units and 11 Mental Health Units (Figure 7.2). Each Satellite Unit has a corresponding catchment area of correctional facilities. Services are aimed at providing continuity of care, enhancing safety within the prisons for staff and inmates, supporting inmates to better function within DOCS programs, and assisting them in accessing mental health services prior to their release back to the community.

Satellite Units are designed for inmates with serious mental illness. Their program components include Residential Crisis Treatment Programs, Clinic Services, Intermediate Care Programs, disciplinary Special Housing Unit Services, Consultative Services, and Pre-Release Planning. Special programs are also offered at select Satellite Units and include: Special Treatment Programs, Community Orientation and Reentry Programs and Creating Options to Manage Painful Emotions. Satellite Unit staff provide consultative mental health services on an as-needed basis to correctional facilities in the Satellite Unit’s catchment area that have no full or part time mental health staff. Approximately 35 of the 71 DOCS facilities offer on-site OMH services.

Mental Health Units provide similar services to those provided at Satellite Units with the exception of Residential Crisis Treatment and Intermediate Care Programs as well as special programs. Unit components are described below.

Residential Crisis Treatment Program

A Residential Crisis Treatment Program (RCTP) consists of two services: observation cells (56 beds statewide) and a dormitory area (93 beds statewide) where inmates experiencing a psychiatric crisis can be housed, observed, and treated. Patients housed in RCTP beds receive services from psychiatrists, other clinical staff and psychiatric nurses. Security is provided by DOCS correction officers. Once stabilized, RCTP patients are returned to their respective prison milieu or, if needed, committed to the inpatient unit of CNYPC.

Intermediate Care Program

An Intermediate Care Program (ICP) is similar to day treatment and community residence programs, and is jointly staffed by DOCS and OMH personnel. A distinguishing feature of the ICP is that services are provided in a housing area that is separate from the general prison population. There are 11 ICP units with 565 beds statewide serving inmates who are unable to function in the general prison population due to the effects of mental illness and its resulting functional impairment. The ICP’s goal is to provide each inmate with the support, treatment, and skill training necessary to return to the general prison population.

Increased funding has been secured through the 2004-2005 Budget to add a total of 87 new ICP beds at the Great Meadow, Sing Sing, and Fishkill Correctional Facilities. In 2003, nearly 500,000 hours of therapeutic programming were provided to ICP inmates. Evaluation of the program has revealed significant reductions in serious rule infractions, suicide attempts, correctional disciplinary sanctions, and admissions to inpatient and RCTP beds.

Clinic Treatment Services

Forensic clinic treatment services are similar to those provided by mental health clinics in the community. OMH staff provide screening and assessment of inmates in response to self-referrals and mental health referrals from DOCS staff and other sources. Patients are provided individual and group therapy and psychiatric services. In 2003, there were a total of 147,141 clinic treatment contacts with inmates. It is estimated there are 500,000 clinical contacts each year for all program types. In January 2004, CNYPC provided 12,460 treatment contacts in their walk-in corrections-based mental health clinics, an increase of 9% from the 11,454 receiving treatment in January 2002.

Screening and Evaluation

Outpatient services also include the evaluation of inmates for DOCS programs such as Work Release, Program Committee and Family Reunion Program, and the evaluation of inmates referred by the Division of Parole. There are 1,000 screenings per month, not including regular screenings of those conducted on inmates in disciplinary Special Housing Units.

Forensic Telepsychiatry Consultation

CNYPC provides case consultation to remote correctional facilities. Participating correctional facilities include Attica, Clinton, Elmira, Five Points and Sing Sing. To date, Satellite Units have participated in more than 40 consultations with clinicians at the NYS Psychiatric Institute. For the past 21/2 years, Great Meadow Correctional Facility has been providing telepsychiatry services to the Upstate Correctional Facility. Beginning in August 2004, OMH piloted a telepsychiatry program to provide direct services between CNYPC psychiatric staff and inmate-patients at Elmira Correctional Facility. Initial feedback has been positive. More information regarding telepsychiatry is included in Chapter 5.

Special Housing Unit Services

Beginning in May 2004, a joint CNYPC and DOCS Case Management Committee was implemented in all maximum security prisons for the purpose of reviewing, monitoring, and coordinating treatment and behavior plans for inmates assigned to a disciplinary Special Housing Unit (SHU). Inmates are transferred into SHU disciplinary cells for only the most serious infractions of prison rules such as fighting or assault. Every inmate in SHU in New York State receives mental health screening, and if referred, receives evaluation and/or screening by CNYPC.

Each Case Management Committee has co-chairs-one from DOCS and the other from OMH. The purpose of the Committee is to review and monitor SHU inmates on the OMH caseload and any other SHU inmates who are referred to the committee. The Committee will also review the status of all inmates newly assigned to SHU following a disciplinary hearing in which the inmate’s mental health or intellectual capacity is at issue. The Case Management Committee meets every two weeks. After reviewing an inmate’s status, the Committee may do one of the following: (1) recommend restoration of privileges, suspension or reduction of SHU sentences, or a housing reassignment; or (2) recommend to the OMH Satellite Unit Chief that the inmate’s medication be reevaluated or that the inmate be examined by two physicians for possible commitment to CNYPC.

Recent data suggests that there has been statistically significant improvement in the number of mental health contact hours and cell-side contact hours among SHU inmates. There has also been a significant reduction in the percentage of SHU inmates who are classified as having a serious mental illness. Services to SHU inmate-patients include:

Behavioral Health Unit

OMH will be expanding its services in 2005-2006 to inmates diagnosed with serious mental illness, who, due to their disciplinary status, are serving time in SHU, and require mental health treatment beyond which has been previously available in a SHU environment. This new program model, Behavioral Health Units (BHU) will be located at Great Meadow and Sullivan Correctional Facilities and will include the addition of 102 beds offering evaluation, intervention, and supportive mental health services. BHUs provide psychiatric and behavioral interventions that enable inmate to adjust to environmental demands, and, if successful, ultimately allow for reintegration into a prison placement. The inmate population targeted for this program includes individuals who have not benefited from traditional corrections based mental health services and have demonstrated a marked inability to conform their behaviors to societal or institutional expectations. The BHU program is designed to meet the mental health needs of these individuals while taking into consideration safety and security needs of the prison system.

Bedford Therapeutic Behavioral Unit

The number of female inmate-patients on OMH rolls who demonstrate disruptive, aggressive, and self-injurious behaviors resulting in extended SHU or Keep Lock placement has prompted OMH to reconfigure its existing services to address the needs of these individuals to avoid placement in disciplinary housing. For this reason, OMH, within existing resources, will expand the Bedford Therapeutic Behavioral Unit (TBU) from 16 to 32 beds. The program will continue to offer psychotherapeutic and behavioral treatment interventions that will enable inmate-patients to adjust to and function effectively in a specialized, alternative program. The ultimate goal for inmate-patients is the achievement of behavioral adjustment that will allow for reintegration into the general population.

Special Treatment Program

The Special Treatment Program (STP) is designed for seriously mentally ill patients in SHU who require extended services. STP group and individual interventions are provided in the SHU for two hours per day, five days a week for those patients who meet admission criteria. STPs have been in operation at Attica since 2000 and Five Points since 2001. Program evaluation studies report positive outcomes including reductions in disciplinary consequences for participants, reduction in use of crisis mental health services, and greater treatment adherence including medication compliance and improved mental health functioning. The 2004-2005 Budget includes appropriations to expand STP capacity (currently 43 slots) by 75 additional slots.

Inpatient Services

When services provided within a prison do not meet the needs of an inmate-patient, hospital services are made available. OMH provides inpatient services for persons serving sentences within the DOCS and local correctional facilities at CNYPC, a 189 bed maximum security forensic hospital serving an inmate population of over 65,000. CNYPC is the only State facility where inmate-patients who are serving sentences (either in prison or in jail) may be involuntarily hospitalized as psychiatric inpatients.

Continuity of Care between Inpatient and Corrections-based Services

To ensure continuity of care between inpatient and corrections-based services, a new mechanism is being piloted at CNYPC. Pursuant to a court order, an inmate-patient may be treated with psychiatric medication over his objection at CNYPC’s inpatient unit, and that order may follow the patient after discharge to one of its corrections-based Satellite Units. As of November 2004, orders have been obtained for 32 individuals.

Pre-Release Planning and Transitional Services and Programs

Pre-Release planning services are provided to inmate-patients, who have serious mental illness and require follow-up treatment in the community. Eligible patients are enrolled in the Medication Grant Program and have Social Security applications submitted. Pre-Release Coordinators may refer patients approaching release date to CNYPC for consideration for inpatient treatment and coordination to the inpatient Discharge Ward, or to Assisted Outpatient Treatment (AOT) for determination if court-ordered treatment should be in place prior to release from prison. An AOT Committee reviews all referrals and coordinates information with county court systems to assure public safety.

The number of inmate-patients on the OMH caseload for whom aftercare linkages were made upon release has quadrupled since 1995. This increase is due in part to OMH hiring seven new pre-release coordinators, and is also a result of improved reporting and case finding. It is projected that in 2004, 1,800 individuals will have received aftercare linkages.

Community Orientation and Re-entry Program

OMH, DOCS and the Division of Parole (DOP) have collaborated with community-based service providers to develop and implement a program designed to meet the needs of inmates returning to the community whose mental health issues go beyond that which the pre-release coordinators can effectively manage. This innovative Community Orientation and Re-entry Program (CORP) is housed in a 30-bed unit within the ICP at Sing Sing Correctional Facility. The mission of this program is the safe and successful return of these inmate-patients to the community. Inmate-patients identified as seriously mentally ill and returning to the greater New York Metropolitan Area may be transferred to the CORP unit approximately four months before their scheduled release to the community.

In designing the program, planning staff sought to utilize a Best Practices approach and incorporate the following elements into the final program components: Peer Support, Peer Bridging, Cognitive Behavioral Programming, Reach-In Services, On-Site Interviews, Risk Assessment and Risk Management Plans, Dedicated Mental Health Parole Officers, Benefit Applications and Coordinated Programming through DOCS, DOP and OMH.

CORP inmate-patients are housed in a segregated gallery where corrections officers who are specially trained in working with inmates with mental illness supervise their activities. Five days a week, CORP patients participate in a variety of modules comprising a specialized psychiatric rehabilitation day treatment program. Modules focus on areas such as symptom and medication management, substance abuse and relapse prevention, anger management and alternatives to violence, working with DOP and community providers, community resource awareness and community survival skills.

Major goals of the program are to improve community living skills, minimize criminal recidivism and psychiatric deterioration, and increase the successful length of stay in the community. Each year the program is expected to serve 100-125 male inmates with serious mental illness who are released to New York City.

Community Integration

Case Management

The New York State LINK program has been the anchor of New York City-based release programs. It is a transition case management program which services individuals with serious mental illness being released from state prison. The program has grown to include seven case managers who use best practice approaches in engaging participants, including: pre-release telephone interview and day-of-entry contact and coordination with the Division of Parole. The focus of this program is to buffer re-entry for individuals and transition individuals to long-term care providers.

Most releases to the community from CORP are coordinated with the State LINK team. Service plans may include day treatment programs, MICA programs, referral to self-help programs or clinic services. When individuals do not have a residence, referrals are made to housing providers. LINK expanded its services to provide “reach-in engagement,” during which staff visit the CORP unit on a regular basis to meet with patients and participate in community preparation groups.

Parole Supported Treatment Program

In 2000, New York State developed a housing program for individuals with serious mental illness being released from prison. OMH and the Division of Parole jointly funded a parole supported treatment program (PSTP) which provides 50 supported housing beds coordinated with an Assertive Community Treatment team for individuals with serious mental illness and substance abuse, who will be under parole supervision.

The PSTP provides “reach-in” services for CORP patients. Professional staff provide on-site interviews and community preparation groups while peer staff provide self-help groups. Referrals are also made to other housing providers and CORP staff actively cultivate housing resources. Since the program opened, there have been over 50 housing agencies which have visited the CORP unit and have been impressed with the thoroughness of the clinical documentation, comprehensiveness of the program and engagement of the patients. Providers who previously had not accepted referrals of prison releasees have since agreed to accept referrals from CORP.

Outcomes

Since opening in January 2003, CORP has averaged 15 new enrollments per month. Early evaluation results indicate that the program is performing well by improving mental health functioning and community skills. Seventy-seven percent of enrollees have been released to the community and another 10% to a community psychiatric hospital. After 90 days, 66% of patients released to the community were still living there. Most were participating in programs and learning new community survival skills. Participant comments from the program include:

“This is my third bid (prison sentence). When I was released before I had nothing like this. When they came to me and told me they were transferring me to Sing Sing because they had a program for me, I’m thinking, yeah right, a program for me, like last time. They gave me lawn mower repair. Lawn mower repair? What are you going to do with lawn mower repair in New York City? So I wasn’t expecting much. But I’ll tell you what. This program is great. I have a chance this time. I have people that will help. I have hope.”

Osborne Association Safe Landing

Funded by the Robert Woods Johnson Foundation, the Osborne Association operates a re-entry program for persons with mental illness who are being released from Sing Sing and Bayview Correctional Facilities. Safe Landing staff provide reach-in assessment and re-entry preparation for individuals returning to New York City. Upon release, the Osborne Association also provides case management and linkage services. Program participants are identified by a CNYPC pre-release coordinator who arranges mental health follow-up, while Safe Landing staff provide linkage to other services including employment, education and entitlements.

Project Caring Community

Project Caring Community is a re-entry initiative for women with serious mental illness being released from the Bedford Hills and Taconic Correctional Facilities. The program’s target population includes women who will be regaining custody of their children upon release. In this program, OMH, DOCS, and the Division of Parole, have partnered with Goodwill Industries and the Bridge Inc. for planning, coordination and sharing of resources to develop an integrated pre-release, transition and aftercare program.

The Medication Grant Program

As part of New York State’s Kendra’s Law, the Medication Grant Program (MGP) provides the ability to file Medicaid applications for inmates with mental illness prior to their release from prison to the community. To qualify for MGP, an individual must have received mental health services in a correctional facility, have a mental illness, be prescribed psychiatric medications, and apply for Medicaid prior to or within one week of release from a correctional facility. The program covers screening visits with a mental health professional, medication evaluation and diagnostic visits with a physician, provision of injectable medications, follow-up visits to monitor for medication side effects and/or to adjust dosages and laboratory tests. Enrollees are given a MGP card which is valid for use at over 3,700 pharmacies statewide.

OMH-LINK Case Management

Through a staff-sharing agreement with the Federation Employment and Guidance Service, Inc. (FEGS), OMH’s LINK Case Management Program in New York City provides short-term intensive case management to individuals with serious mental illness who are returning to the City from State correctional facilities. The LINK program provides intensive case management services for approximately five months until the client is stable and placed with other case management providers. LINK also attempts to find housing and treatment programs for these hard-to-place individuals. Typical program participants have serious mental illness, extremely violent criminal justice histories, and are homeless. When a LINK participant is released from prison, the assigned intensive case manager meets the inmate at the Port Authority Bus Station in New York City and assists in all aspects of contacting Parole, housing and other community supports. This program was recognized in 2000 by the Governor’s Office of Employee Relations and an Achievement Award was given to State work teams for substantially contributing to the public good. Since 1996, OMH LINK has served 909 clients.

Conclusion

The delivery of effective mental health care, treatment and services to inmates with serious mental illness requires a careful balancing of overall safety and security issues with the individual treatment needs.

OMH recognizes that collaborative planning, program overview and use of evaluation information are crucial for the continued overall effectiveness and success of our forensic mental health programs and services. OMH is committed to providing a comprehensive array of mental health services to persons across the criminal justice spectrum in settings consistent with the public safety, as well as supporting access to services deemed essential to successful adjustment to both institutional and community living.

More information about OMH forensic facilities and the populations they serve is available on the OMH Web page at http://www.omh.state.ny.us/omhweb/forensic/index.htm.

Criteria for Participation in the Brooklyn Mental Health Court

The offender must have a major mental illness such as schizophrenia, bipolar disorder, major depression or schizoaffective disorder.

The mental health evaluation must indicate that the offender's mental illness contributed to criminal activity, and that the offender is willing to enter into treatment and that the treatment may help the offender lead a crime-free life in the community.

Notes

1. http://www.mentalhealthcourtsurvey.com/default.asp
2. The American Correctional Association develops and promulgates new national standards, revises existing standards, and coordinates the accreditation process for all correctional components of the criminal justice system in the U.S. The Joint Commission evaluates and accredits more than 15,000 health care organizations and programs in the U.S., including medical centers and teaching hospitals, nursing homes, etc.

Comments or questions about the information on this page can be directed to the Office of Planning.