The Latest Column
Questions are from the latest Standards Q&A column, posted in November 2019.
Mental Health Training for Detention Staff
Our jail wants to strengthen its mental health program. The health staff are well trained in mental health and coexisting disorders, but we need to increase the training for detention staff. Do you have any recommendations?
Congratulations on striving for excellence in your mental health program. In the Standards for Mental Health Services in Correctional Facilities, MH-C-04 Mental Health Training for Correctional Officers requires that all officers who work with inmates receive mental health-related training at least annually. At a minimum, this includes recognizing signs and symptoms of mental illness, substance abuse and intellectual and developmental disabilities; communicating with inmates who have signs of mental illness, substance abuse and intellectual and developmental disabilities; procedures for suicide prevention and intervention; and procedures for referral of inmates with mental health complaints or suicidal behaviors to mental health staff.
Officers assigned to receiving screening and mental health areas are to receive additional training from mental health staff in order to fulfill their specific roles. Where appropriate, correctional staff should receive training on the dynamics of sexual abuse and sexual harassment in confinement, psychological reactions to sexual abuse/harassment and how to detect and respond to the psychological signs of threatened and actual sexual abuse.
CO Shortage Effect on Patient Care
Our prison has a shortage of custody staff right now. As a result, inmates sometimes miss their on-site clinic appointments for annual assessments. Since we can document that the patients were scheduled for the assessment, would this meet the standard?
This problem could affect two standards. P-A-01 Access to Care requires that the responsible health authority identify and eliminate any unreasonable barriers, intentional and unintentional, to inmates receiving health care. P-D-06 Patient Escort states in compliance indicator #1 that patients are transported safely and in a timely manner for medical, dental and mental health clinic appointments inside and outside the facility. Compliance with these standards could be compromised if custody is not transporting patients to the clinic in a timely fashion. Custody staff shortage is not an acceptable justification for missing appointments.
Sharing Results From Off-Site Clinics
We understand the importance of informing patients of test results, but we are having difficulty receiving test results from off-site clinics, particularly the HIV clinic. We receive results only if something is abnormal. Is it acceptable to document this and note any abnormal findings that we receive back from the clinics?
In standard E-09 Continuity, Coordination, and Quality of Care During Incarceration, compliance indicator #6 requires that treatment plans, including test results, are shared with patients. Engaging patients in their treatment plans leads to better compliance to ordered care and better treatment results. Although it can be difficult to get results from outside providers, the lack of communication for normal and abnormal findings would not meet the intent of the standard. Facilities must find ways to share information with each other and with the patient.