Mental Health Services are staffed by 12 FTE RIDOC employees: four psychologists and eight social workers. Additionally, there are a number of psychiatrists under contract with the Department to provide 100 hours per week of psychiatric care. One psychiatrist provides 30 hours per week of services at our Intake Services Center, the State’s jail. Another psychiatrist provides crisis management services on weekends. Our sentenced facilities are covered through a contract with Rhode Island Hospital/Lifespan Department of Psychiatry Rhode Island Hospital also provides neuropsychological testing services to our inmates.
Mental Health is tasked with a variety of duties, including evaluation and monitoring of inmates on crisis management status (CMS) and psychiatric observation (Psych Obs); on-going evaluation and counseling; and medication management by the psychiatrists. Treatment is provided via a number of methods including individual, group, psycho-educational, behavioral, and milieu therapy. Follow-up and discharge planning is also provided for all patients with mental health problems, but especially those who are Community Support Program eligible. The mental health staff also provides consultation to custody staff for inmates with significant institutional behavioral problems and provides training through the Academy on Suicide Prevention, Mental Health, and Personality Issues.
Psychotropic medications account for one-third of the RIDOC’s overall pharmacy budget. In consultation with Contract Pharmacy Services via a Pharmacy and Therapeutics Committee including pharmacists, the Medical Program Director and consulting psychiatrists, we have developed a psychotropic medication formulary representing the best balance of clinical efficacy and cost. Clinicians are encouraged to use formulary drugs wherever possible. Use of non-formulary drugs is possible when there is clinical justification. Non-formulary requests for psychiatric drugs require the approval of the Medical Program Director.
The Clinical Director has recommended that a specialized unit be established for sentenced inmates who, because of their mental illness, are difficult to manage in general population. This new unit, to be called the Observation and Stabilization Unit (OSU) will serve the sentenced male population exhibiting difficulty in functioning in general population who could benefit from more intensified behavioral health treatment. As with our current practice, when, and if, any inmate requires hospital level care, that inmate is transferred to the forensic services of the State’s hospital which is on the same campus as our correctional facilities.
It is the vision of both our Department and Rhode Island Hospital Psychiatry that we attempt to model our affiliation after the successful Miriam Hospital/Brown University Immunology Program which has gained an international reputation for collaboration with the RIDOC. The goal for this behavioral health initiative is to be a major cornerstone in the development of a Forensic Psychiatry “Center of Excellence” at the Brown University Medical School and to insure the continued growth and “cutting edge” treatment of inmates with behavioral health problems.