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When a professional knows of and disregards an excessive risk to an inmate's health or safety |
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Classroom setting withfeet shackled to desk |
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Community Orientation and Re-entry Program 90-day pre-release program Develops skills essential for success |
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Levels of the Correctional System |
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Criminal Justice Involvement: Community Supervision |
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Criminal Justice Involvement: Incarceration |
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Houses of Detention Jails Prisons |
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Prison Language: Inmate Handbook |
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Issued by security to distinguish tolerable and intolerable inmate behavior |
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Prison Language: Inmate Code |
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Oral tradition developed over generations of inmates to limit accidental violence and maximize inmate power |
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87% nono-violent Many drug-related crimes Less rigid inmate codes Greater need for privacy, relatedness, and alliances 19%: schizophrenic, bipolar, major depressive (vs 9% males) 34% PTSD 75% substance abuse / addiction |
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Detainee Competency Restoration (730) |
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Two Prongs: Psychiatric stabilization, education Agent of the court |
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Provider's role: treatment, advocacy |
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Special Treatment Program Daily rounds and private interviews for inmate-patients |
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Training for DOCS employees, record keeping, and evauluation for all inmates within 24 hours |
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OMH input into disciplinary hearings Joint Case Management Committee (DOCS and OMH) |
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Disability Advocates, In v. OMH, et al (2002) |
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Federal action against OMH and DOCS - agreement signed April 2007 Alleged that SHU confinement of inmates with a mental illness was inadequate: violation of the U.S. Constitution - cruel and unusual punishment |
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Private Settlement Agreement (PSA) terms Joint case management oversight committee 2 hours daily of out-of-cell treatment |
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Corrections-Based Operations Central New York Psychiatric Center (CYNPC) provides mental health treatment to inates; NYS Office of Mental Health |
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Department of Corrections and Community Supervision |
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Office of Mental Health Provides advocacy, evaulations, treatment, and pre-release planning for mentally ill inmates Does NOT provide security, medical treatment, educational services, rehabilitative servises, or pastoral counseling |
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Mental Health in Corrections |
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58,000 people in NYS prison 7800 on MH caseload 2500 seriously mentally ill 1200 in special programs 3000 released each year (out of 25,000 overall) 1200 mental health contacts annually |
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Mental Health Process in Corrections |
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1. Screen 2. Active cases transfer to the right facility 3. Inactive cases may have referrals made at any time 4. Active cases refusing services will not be terminated if in NEED of mental health care. |
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Residential Mental Health Units |
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Intermediate Care Program (ICP) Intensive Intermediate Care Program (IICP) Transitional Intermediate Care Program (Tr-ICP) Bheavioral Health Unit (BHU) Therapeutic Behavioral Unit (TBU) Residential Mental Health Unit (RMHU) Group Therapy Program (GTP) |
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"S" Designation: Specific Diagnoses |
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Delusional Disorder; Schizophrenia, Schizophreniform Disorder, Schizoaffective Disorder, Brief Psychotic Disorder, Substance Induced Psychotic Disorder (excluding intoxiation and withdrawal), Major Depressive Disorders |
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Schizophreniform Disorder |
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Possibly schizophrenia, but not confirmed yet |
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Mood disorder mixed with thought disorder |
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Psychotic Disorder - not bipolar disorder or otherwise specified Actively suicidal or recent suicide attempted Organic Brain Syndrom that results in significant functional impairments Severe Personlity Disorder that causes significant functional impairment, self harm, or behaviors that seriously adversely effect mental or physical health |
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Physically separate residental program Inmates are unable to function in group settings |
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Serves inmate patients who have at least 60 days of keeplock time for non-assaultive behaviors |
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Mental Health Programs: Disciplinary Sanctions |
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Chronic management difficulties & lengthy keeplock sentences Must have an "S" designation Residential Programs - Behavioral Health Unit, Therapeutic Behavioral Unit, Residential Mental Health Unit |
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Therapeutic Behavioral Unit Assist in developing skills to successfully complete their disciplinary sanctions Transition into general population or a specialized program |
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Residential Crisis Treatment Program Crisis services for inmate-patients whoe mental health status has deteriorated Observation Cells (OBS) and Residential Crisis Dorms 10 day out count |
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Pre-release coordination services Assistence with community entitlements, medications, mental health providers, and housing upon release |
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Mentally Disordered Offenders Issues |
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Culture, Consent to Treatment, Confidentiality, Privilege, Duty to Protect, Dual Agency Issues |
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Cognitive and emotional understanding of impact of treatment, side effects, refusal Ability to anticipate the future |
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Tarassoff v. Regents of the University of California |
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Duty to Protect in a Prison System Tarasoff Assessment: - Attidues which support or facilitate violence - Capacity or means to carry out the violence - Thresholds crossed (plan & implementation) - Intent (ideas v fantasies; commitments) - Other's reactions & responses - Noncompliance with risk reduction |
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Malpractice Failure to: perform adequate risk assesment, take adequate precautions, observe & monitor, medicate properly, take an adequate history, or use adequate supervision |
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Police Probation / Parole Correction Officers |
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Supervise people arrested for, charged with, or convicted of criminal offenses Small percentage of people (20%) are institutionalized Majority supervised in the community |
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Factors Responsible for the Growth in Correctional Psychology |
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Increase in US prison population - presently more than 2.25 million in institutions and 5 million are supervised in the community on a given day - more attendance to offender REHABILITATION |
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Protect public safety, retribution, individaul / general deterence |
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Hazard that is incompletely understood Its occurence can be foreast only with uncertainty |
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A correlation that also precedes occurence of a hazard, and, therefore, may play a casual role |
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Risk Factor: Fixed Risk Markers |
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Risk Factor: Variable Risk Markers |
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Change status over time, but changes do not influence outcome |
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Risk Factors: Casual Risk Markers |
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Change status over time, and changes influence outcome |
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1. Characterize the risk that they will commit crime in the future 2. Develop interventions to manage or reduce risks Uses interviews, observations, direct psychological/medical testing, record review, collateral interviews Ultimate Goal: crime prevention |
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Offender Risk Assesment: Professional Judgement |
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Definition
Evaluator exercises some degree of discretion in the decision-making process Wide discretion about gathering / consideration of assessment information |
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Actuarial Decision Making |
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Available info Evaulators make ultimate decision according to fixed and explicit rules Based on specific assessment data |
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Professional Judgement Approach: Unstructured Professional Judgement |
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Decision making in absence of structure Historically most commonly used Strengths: Highly adaptable & efficient Problems: Little empirical data to prove consistent, helpful decisions; decisions are unimpeachable - broad in scope and dispositional vs. speculative |
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Professional Judgement Approach: Anamestic Risk Assessment |
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Limited degree of structure Evaluator must identify personal & situational factors that resulted in crime & identify ways to break behavioral cains No empiracal evidence supporting consistency or utility. Assumption that hisotry will repeat itself. |
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Professional Judgement Approach: Structured Professional Judgement |
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Decision making assisted by guidelines that reflect state of discipline, scientific knowledge, and professional practice Define risk & identify core set of risk factors Strenghts: Improved cosnistency, utility, and transparency Problems: may require considerable time & resources to develop / implement; Lack of intuitive freedom/objectivity of actuarial approach; Disliked by some |
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Actuarial Decision Making: Actuarial Use of Psychological Tests |
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Identify cutoff scores on a test that maximize predicitive accuracy Strengths: transparecy, consistency, utility of decisions made using tests Problems: test selection, judgement for scoring, one test is inefficient, prediction vs. prevention |
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Actuarial Decision Making: Actuarial Risk Assessment Instruments |
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Predict future / specific outcome over period of time Strengths: transparency, direct empiracle support Problems: significant time / effort to construct & validate; trade-off between precision and generalizability, easy to accord too much weight to estimates of risk |
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Actuarial Decision Making: Level of Service-Case Management Inventory |
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Guidelines to assist in assessment and management of risk for general criminality (male & female offenders 16+) Evaluators make ratings based on interview with offender & review of relevant records Document opioninos, recommendations, decisions Gold-standard for offender assessment: correlation betwee total scores & general recidivism in offenders is r=.25 and r=.15 for institutional infractions |
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Risk Assessment Instruments: LS-CMI |
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Simplistic definition of risk Ignores important risk factors for specific forms of antisocial behavior Structure is limiting, best suited for assessing adult males in urban North American correction centers |
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Risk Assessment Instruments: Hare Psychopathy Checklist-Revised |
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Definition
PCL-R Assess symptoms of psychopathic personality disorder |
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Risk-Needs-Responsivity Risk: Level of Services commensurate with risks Need: Assessment & management focuses on criminogenic needs Responsivity: servises should be delivered to maximize effectiveness |
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High risk factors only Concrete goals only Too structured / skill-focussed Delivered to groups rather than individuals Too much focus on reducing recidivism |
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Focus on promoting personal goals while simultaneously reducing & managing risk Acheive primary goods to naturally minimize crime involvement Expansion of RNR, with greater emphasis on constructing meaning in life |
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Reasoning and Rehabilitation - Revised Program |
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Group-based cognitive-behavioral treatment for adult male offenders at moderate risk Limitations: high dropout rate, recidivism remains too high, quasi-experimentally designed evaluations, targeted at general criminality, unclear mechanism of change |
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