Monitoring a correctional mental health care system: the role of the mental health expert

2009 ◽  
Vol 27 (5) ◽  
pp. 727-741 ◽  
Author(s):  
Jeffrey L. Metzner
Laws ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 22
Author(s):  
Sebastian von Peter ◽  
Martin Zinkler

In August 2019, a manuscript was published in this journal that aimed at imagining a mental health care system that renounces the judicial control to better focus on the will and preferences of those who require support. Alternative scenarios for dealing with risk, inpatient care, and police custody were presented that elicited strong and emotionally laden reactions. This article adds further reflections to this debate, aiming at contributing explanations for this unsettlement. A productive notion of criticism is discussed, and ways to achieve change toward a more human rights-oriented psychiatric practice are outlined.


2020 ◽  
pp. 002076402094678
Author(s):  
Dana Alonzo ◽  
Dafne Aida Zapata Pratto

Background: Mental Health professionals often have to deal with at-risk individuals in crises and lack specialized training on suicide risk assessment and intervention. This study examined mental health professionals’ attitudes toward at-risk individuals and their perceptions of the quality of training and treatment available for assessing and intervening with this population. Methods: A total of 32 mental health professionals (13 psychiatrists, 16 psychologists, 2 psychiatric nurses; 1 social assistant) from highly vulnerable communities in Lima, Peru discussed their perceptions in four focus groups conducted by the authors. Results: Participants reported glaring deficiencies in all areas explored including training, knowledge and skills regarding suicide assessment and management. In addition, using ground theory analysis, three domains of findings emerged representing barriers and facilitators of treatment engagement, risk and protective factors of suicide and pros and cons of the current mental health care system including micro-, mezzo- and macro-level factors. The most frequently identified barrier was the perception that suicide is illegal; facilitator was family involvement; risk factor was poor parenting; protective factor was religious beliefs; pro of mental health care system was establishment of community-based services and con of mental health care system was lack of access to psychiatrists. Conclusion: The lack of specialized training available in the institutions that are designed to prepare mental health professionals for working with at-risk individuals is notable and has a direct and known impact self-identified by helping professionals. The need and desire for targeted training is palpable and essential to address growing rates of suicide, particularly among youth, in Peru.


Author(s):  
Jeffrey L. Metzner

Class action litigation that includes a focus on constitutionally inadequate correctional mental health care systems has been a major and effective force in jail and prison reform during the past four decades. Benefits to correctional mental health systems resulting from such litigation have included increased resources needed to implement basic policies and procedures that are necessary for a constitutionally adequate system. Following the passage of the Prison Litigation Reform Act of 1995, newly initiated consent decrees related to class action litigation involving correctional mental health services significantly decreased. The reduction in litigation related to this act followed from limiting the discretion of judges in approving such decrees that were previously allowed. Private settlement agreements and/or memoranda of agreement or their equivalents (the “Agreement”) have been substituted for the consent decree process. Although the judicial enforcement specific to implementation of these Agreements is weak, the monitoring process of such Agreements is very similar to those previously used with consent decrees. This chapter will summarize the monitoring process frequently involved in an Agreement resulting from a class action lawsuit specific to a correctional mental health care system using a single prison mental health system as an illustrative example. Emphasis will be placed on the importance of developing a quality improvement process that should ultimately eliminate the need for a monitor external to the mental health care system.


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