Mental Health Screening & Evaluation

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If the psychiatrist trains the nurses who do health assessments to do mental health screenings, would this be an acceptable way to meet standard E-05 Mental Health Screening and Evaluation?

This standard is essential for both jails and prisons and its intent is to “ensure that the inmate’s serious mental health needs, including those related to developmental disability and/or addictions, are identified.” To answer your question, we must distinguish between the “screening” portion of the standard and the “evaluation” portion.

Mental health screening: Within 14 days, all inmates must receive the initial mental health screening that addresses the issues listed in compliance indicator 2. This screening may be done by qualified mental health professionals or by mental health staff, defined as qualified health care professionals who have received instruction and supervision in identifying and interacting with individuals in need of mental health services. The training you describe by the psychiatrist would meet the intent of this part of the standard.

Mental health evaluation: Regardless of who does the initial screening, when the results are positive for mental health problems, the inmate must be referred to qualified mental health professionals (e.g., psychiatrist, psychologist, psychiatric nurse, psychiatric social worker) for further evaluation as stated in Compliance Indicator 4.

— From CorrectCare Volume 32, Issue 1, Winter 2018

 
 

In standard J-E-05 Mental Health Screening and Evaluation, compliance indicator #1 says that within 14 days qualified health professionals or mental health staff conduct initial mental health screening. On intake our nursing staff do an initial screening, and will refer to mental health for a positive screen, but do all inmates need an additional mental health evaluation by the mental health staff?

To clarify, the mental health questions described in standard E-02 for receiving screening are not part of the initial mental health screening. Specially trained nursing staff may, during intake, include each inquiry noted in the E-05 mental health screening standard in order to fulfill the “initial mental health screening within 14 days” requirement. If all elements of the E-05 screening are completed at that time by health staff trained in identifying and interacting with individuals in need of mental health services, the screening does not need to be repeated.

The mental health evaluation, which is performed by qualified mental health professionals such as psychiatrists, psychologists, psychiatric social workers, etc., is completed only for inmates who screen positive on aspects of the initial mental health screening.
— From CorrectCare Volume 26, Issue 2, Spring 2012

 
 

Our facility is trying to make better use of staff time by reassigning job duties. One idea was to have correctional officers perform the mental health screening for new inmates. Is this OK under the standards?

No. To be clear, let’s distinguish between receiving screening and mental health screening. Standard E-02 Receiving Screening states that the screening done at intake includes questions related to mental health and these may be asked by a health-trained correctional officer. However, these questions alone do not constitute the mental health screening. Within 14 days of admission, an initial mental health screening needs to be conducted by qualified mental health professionals or mental health staff (see E-05 Mental Health Screening and Evaluation). “Mental health staff” includes qualified health care professionals who have been trained and are supervised in identifying and interacting with people in need of mental health services.
— From CorrectCare Volume 25, Issue 1, Winter 2011

 
 

Regarding standard J-E-05 Mental Health Screening and Evaluation: Do we need to screen every admission? For example, if an inmate was seen just 30 days ago and is booked into our county jail again, would the inmate need another screen?

The intent of J-E-05 is to identify people with mental health problems, to determine whether there’s a clinical need for further evaluation or treatment, and, if so, to provide it in a timely manner.

To deal with frequently readmitted inmates, the responsible health/mental health authority can establish a protocol that permits modification of the mental health screening interview, but the protocol should not eliminate inquiry into mental health status. Patients well-known to staff and for whom previous incarceration health records are available may simply need a brief interview to ascertain whether anything has changed since the last discharge that would impact mental health treatment. This interview can be combined with the physical review and assessment, provided the staff are trained and the results are documented.

Since mental health problems can and often do change with time or circumstances, this must remain an area of inquiry for all readmissions.
— From CorrectCare Volume 19, Issue 2, Spring 2005