Working in correctional mental health can be an enriching and fulfilling experience, you get to provide care for an underserved population that truly needs services and gain valuable clinical experience treating a wide range of mental disorders.
If you’re new to correctional healthcare, the idea of working in a jail or prison may sound intimidating. However, there are certain basic skills that once you master, will not only boost your confidence but make you a more effective correctional clinician.
- Safety Skills
When I started working as a mental health clinician, I kept hearing the same question from my family and friends, “is it safe?” The truth is that I felt safer than I did working in a community health center because correctional facilities are highly structured and have comprehensive safety protocols and security staff. If I ever felt unsafe, I knew how to ask for immediate help and was aware that correctional officers were always only a few steps away. In order to keep yourself and others safe you need to have the right clinical tools, know the facility’s safety policies and procedures and work closely with your team.
As a correctional mental health clinician, you’ll need to be vigilant and assertive. Newer clinicians are sometimes less alert to cues of anger and violence and may not see the need to set so many limits thinking that may help establish rapport with the inmate. However, these mistakes can quickly increase the risk of experiencing violence when working in a correctional setting. It is imperative that you get the necessary training prior to starting your new job in corrections. You must be well versed in de-escalation and anger management techniques as well as violence prevention
Other basic tips include positioning yourself so you’re closest to the door and can quickly exit if needed. If you or your team determines an inmate is at high risk of becoming violent, the facility will have special procedures outlined that you’ll need to learn and follow carefully. When in doubt, consult with your clinical supervisor.
- Diagnostic Skills
It is estimated that at least 20% of jail inmates and at least 15% of prison inmates have a serious mental illness (Treatment Advocacy Center & Office of Research & Public Affairs, 2016).
In correctional settings, you’ll likely to see a wide range of mental disorders and various degrees of severity. Becoming acquainted with mental illness in correctional populations is essential.
Some diagnoses may also be more relevant in corrections including:
- Disorders defined as serious mental illness (SMI) according to the federal definition (Department of Health and Human Services, 1999). These include but are not limited to major depression, schizophrenia, and bipolar disorder.
- Malingering [hyperlink Malingering: Understanding the Legal Implications of the Term]
- Substance abuse intoxication and withdrawal symptoms
- Posttraumatic stress disorder (PTSD)
Additionally, you should become proficient in differential diagnosis [hyperlink Differential Diagnosis – Most Common Challenging Diagnosis in Corrections link] as often times it is challenging to provide an accurate diagnosis, particularly when substance abuse is in the picture.
- Suicide Risk Assessment Skills
Incarcerated individuals are at greater risk of suicide compared to the general population. Suicide is the leading cause of death in jails across the country; between 2000 and 2014, suicide accounted for 31% of all jail inmate deaths (Bureau of Justice Statistics [BJA], 2016). Accurately assessing suicide risk and taking the necessary measures to prevent self-injurious behavior is key in correctional mental health and this is something you will need to do on a daily basis. Taking comprehensive suicide prevention training not once, but every year, is recommended for all correctional healthcare staff.
- Self-care Skills
Correctional healthcare is fast-paced and can often be intense. The most experienced correctional mental health clinicians know that self-care is key in preventing burnout and ensuring their well-being. Whether it is a hobby, talking to a friend, spending time with loved ones, or something else you enjoy, make time for yourself each day. To learn more about preventing burnout and correctional employee wellness click here
- Teamwork Skills
Teamwork in the pillar of correctional healthcare and is the basis for providing effective care and maintaining safety for yourself and others. Take the time to get to know your interdisciplinary team and maintain an open communication channel. In order to maintain a safe environment and ensure that things run smoothly, you’ll need to learn all relevant policies and procedures including documentation, referrals to psychiatry [insert hyperlink], and segregation policies to name a few.
Carefully following the facility’s policies and procedures from paperwork to safety, helps everyone else perform their duties efficiently. Failing to do so will slow down your team and create unnecessary stress for everyone involved.
Bureau of Justice Statistics. (2016). Mortality in local jails, 2000-2014- Statistical tables.
Retrieved from https://www.bjs.gov/content/pub/pdf/mlj0014st.pdf
Department of Health and Human Services (1999). Substance Abuse and Mental Health Services
Administration. Estimation methodology for adults with serious mental illness (SMI). United States Government Publishing Office. Retrieved from https://www.gpo.gov/fdsys/pkg/FR-1999-06-24/html/99-15377.htm
Treatment Advocacy Center & Office of Research and Public Affairs (2016). Serious mental illness (SMI) prevalence in jails and prisons. Retrieved from https://www.treatmentadvocacycenter.org/storage/documents/backgrounders/smi-in-jails-and-prisons.pdf