Mental Health Services

North Carolina Department of Public Safety

DIVISION OF PRISONS
MENTAL HEALTH SERVICES

OUR SERVICE PLAN

A. MISSION STATEMENT
The North Carolina Division of Prisons has the responsibility to deliver comprehensive mental health services which provide for the care and treatment of inmates with mental disorders. Treatment programs will contain multi-disciplinary services designed to prevent, control, reduce or eliminate those conditions which contribute to the inmate's mental impairment. These services will include, but are not limited to:
(1) patient identification and diagnosis
(2) services for the acutely ill
(3) outpatient services
(4) residential services
(5) special programs for selected diagnostic categories (e.g., passive Inadequate, mentally
retarded, borderline personality, serious and persistently mentally ill, sexually disordered), and
(6) preventive services.

There will also be quality assurance and staff development components as a part of the mental health program.

B. RESPONSIBILITY
1. The Director of the Division of Prisons is charged by the North Carolina General Statutes to provide "Preventive, diagnostic and therapeutic measures on both an outpatient and a hospital basis for all types of patients." This applies to those requiring mental health intervention, as well as other types of health care.

2. The Director of Mental Health Services is responsible for the coordination, development and implementation of the Mental Health Program for the Division of Prisons.

3. It is the responsibility of the Division of Prisons employees to refer to mental health services those inmates who show behavior suggesting the need for such services or who request such care.

C. INPATIENT TREATMENT FACILITIES

1. Central Mental Health Facility
This unit is located at Central Prison and consists of 144 beds, designated for acute mental health treatment and stabilization. There are six 24-bed single-cell treatment units that provide hospital levels of mental health care. The unit is adjacent to one of the medical facilities that serve prison inmates and provides needed consultation.

2. Hoke Mental Health Unit
This is a 72-bed unit for medium and minimum custody felons. The unit is all single-cell and provides long-term care for inmates with mental illness and mental retardation. Efforts are made to identify vocational and life-skill deficits and to provide treatment programs that facilitate reintegration to the regular prison units, day treatment programs, or the community.

3. Eastern Mental Health Unit
This unit has a total of 48 single-cells and is located at Eastern Correctional Institution in Maury. This program is designed for close and medium custody felons who are mentally ill or mentally retarded. The program is designed to provide living skills needed to reintegrate into the regular prison population where feasible. Twenty-four transition beds are available for inmates who are preparing for return to the regular prison population or day treatment programs.

4. Foothills Mental Health Unit
A 96 bed mental health unit is located at Foothills Correctional Institution in Morganton. This unit provides services to adult and youth male felons who have a history of significant mental disorders and require residential mental health treatment. Inmates completing this program are likely to be transferred to day treatment programs or to regular prison units.

5. Mental Health Unit For Females
This 26-bed unit is located at North Carolina Correctional Institution for Women in Raleigh and provides inpatient/residential services for the female population in the Division. A day treatment program that teaches life skills is also available at this correctional institution.

D. DAY TREATMENT/SOCIAL SKILLS TRAINING
A major component of transition services are the two day treatment/social skills training programs located at Brown Creek and Pender Correctional Institutions. These programs are full-time activities usually requiring a minimum of six hours of program participation per day. The primary focus is vocational skill building and social skills training essential to successful integration into the regular prison population and greater likelihood of successful living in the community upon release. Structured psychoeducational modules focus on conversational skills, medication management, leisure activities and developing marketable work skills. Housing is in dormitories and the level of mental health treatment is consistent with outpatient standards. Brown Creek has 78 beds and focuses primarily on the persons with severe and persistent mental illness. Pender has 66 beds primarily aimed at offenders with borderline intellectual functioning and mental retardation.

E. SEXUAL OFFENDER ACCOUNTABILITY AND RESPONSIBILITY
A 36 bed program to treat inmates convicted of sexual crimes has been established at Harnett Correctional Institution. This full-time program is an intensive group oriented process that lasts 20 weeks. The program objectives are to increase responsibility and accountability through various cognitive, behavioral, and psycho-educational methodologies. Relapse prevention is the overall strategy. The program is available to medium custody adult felons, preferably within reasonable proximity to promotion to minimum custody, and minimum custody felons. Mental Health Program Directors are responsible for primary case finding and referral.

F. OUTPATIENT SERVICES
Each area and major institution operates an outpatient clinic that consists of psychological, social work and part-time psychiatric services. Inmates receiving outpatient mental health services usually represent about 15 percent of the total prison population. The general philosophy is to provide outpatient services so that the inmate can continue to be housed at a regularly assigned unit. Some inmates are transported to a central location for appointments and, in other cases, the service provider travels to the unit.

G. MENTALLY RETARDED Mentally retarded male felons upon entering prison are initially transferred to the day treatment program at Pender Correctional Institution. Most of these inmates will be transferred to regular prison units upon completion of the program. Specialized programs for the mentally retarded have been established at selected medium and minimum custody field units. These programs typically include hortitherapy, grounds maintenance, and basic education activities.

H. CASE FINDING
Inmates who are in need of mental health intervention are identified either upon admission or at some later point during incarceration. In the former case, the inmates are referred to a psychologist during the reception process when:

(1) they are referred by the committing court,
(2) the mental health screening inventory indicates
the possible presence of a mental disorder,
(3) behavioral abnormalities are observed by staff,
(4) there is a prior history of mental illness.

During incarceration, inmates are evaluated by mental health staff when they are:

(1) referred by medical personnel,
(2) referred by non-medical staff due to observed
behavioral abnormalities,
(3) self-referred.

It is the obligation of the Mental Health Program Directors to monitor case finding in their program area and ensure referral to the appropriate treatment service and facility.

I. PATIENT FLOW: MALES
The Area/Institution Mental Health Program Director is responsible for accomplishing routine referrals to the inpatient/residential and day treatment units. Emergency referrals may be made by the Officer-in-Charge at each unit or institution. Routine referrals from non-mental health staff will be routed from the unit to the mental health staff for evaluation and disposition. The Mental Health Program Director may elect to treat a case on an outpatient basis or refer to inpatient or other services as needed. A single portal entry system is generally followed with referrals to inpatient services being initially received at Central Mental Health Unit for male inmates.

All female inmates in need of inpatient mental health services are referred to the mental health unit at the North Carolina Correctional Institution for Women.

MENTAL HEALTH UNIT TYPE OF CASES

1. Central MH Unit
Acute mental illness.
Suicide risks.
Emergency cases.
Males - all ages, all custody levels.
Requires single cell housing.

2. Hoke MH Unit
Long term treatment requiring removal from the
regular population.
Males - ages 18 and above.
Felons, medium and minimum custody.
Requires single cell housing.

3. Eastern MH Unit
Long term treatment requiring removal from the
regular population.
Males - age 22 and above.
Mentally retarded inmate.
Felons, close, medium, or minimum custody.
Requires single cell housing.

4. Foothills MH Unit
Long term treatment for mental illness and mental retardation.
Males - youth and adults.
Felons, close, medium, or minimum custody.
Requires single cell housing.
Special treatment populations.

5. Brown Creek - Day Treatment
Persistent mental illness.
Stable, able to live in dormitory.
Compliant with treatment.
Social and vocational skill deficits.
Felons, adults, medium custody.

6. Pender - Day Treatment
Low intellectual functioning (i.e., MR or borderline).
Stable, able to live in dormitory.
Social and vocational skill deficits.
Felons, adults, medium, or minimum custody.
Focus on new admissions.