New System Designed to Better Monitor Patient Care

In December, Dr. Timothy Belavich answered San Quentin News questions about the delivery of health care services to prisoners. Belavich was formerly acting director of the Division of Health Care Services and deputy director of Statewide Mental Health Program. He is now employed by Los Angeles County. Dr. Belavich’s answers will be published as a series in the next several editions of the San Quentin News under the headings The Coleman Lawsuit, Custody and Prison Culture, Suicide and Use of Force, and Transgender Special Needs.

By Dr. Timothy Belavich
Contributing Writer

THE COLEMAN LAWSUIT:

Can you provide a brief history of the Coleman lawsuit?

In 1996, CDCR settled with Coleman plaintiffs regarding the delivery of care for inmates with mental illness. The original order required (1) proper

screening; (2) timely access to adequate mental health care; (3) competent staff in sufficient numbers; (4) an adequate medical record system; (5) proper administration of psychotropic medication; and (6) a basic suicide prevention program.

CDCR has continued to work with the Coleman monitors in a number of areas, including ensuring patients who require inpatient treatment are appropriately identified and referred, ensuring adequate treatment space and housing for patients with mental illness, and developing a system to monitor and ensure the quality of mental health services.

How can we know that the changes that have occurred as a result of the Coleman lawsuit can be sustainable?

The Mental Health Program, in conjunction with the Division of Adult Institutions (DAI) and the Coleman monitors, has developed a comprehensive system to monitor and evaluate the care provided to mental health patients and to ensure adherence to policies. This program is administered by the Quality Management Unit within the Mental Health Program and is implemented by the regional mental health teams. There are four regional mental health teams, each of which has a Regional Mental Health Administrator, several senior psychologists, support staff, and assigned lieutenants. The regional mental health teams ensure that both mental health and custodial components are compliant. In addition, the Quality Management Unit identifies areas that could be improved and ensures these areas area appropriately addressed.

Of the $10 billion CDCR budget, how much of it goes to Mental Health?

Approximately $400 million.

What other changes can we expect to see in the Mental Health Program in Corrections?

We are continuing to develop additional opportunities for patients at the EOP level of care to earn Milestone credits. Furthermore, we are planning toenhance and expand the substance-abuse treatment offered to patients at the Enhanced Outpatient Level of Care. The Mental Health Program is also

working to expand pre-release activities for patients at the EOP level of care. “Conflict Resolution” and “Coping with ASU” programs are currently in development.

What are the classifications of the various clinicians in the Mental Health Program and what are the requirements to obtain jobs in MHSDS?

The Statewide Mental Health Program employs psychiatrists, psychologists, and clinical social workers. All clinicians must meet credentialing guidelines established by California Correctional Health Care Services.

Do custody officers receive any training on how to intervene effectively with inmates who suffer from mental health conditions?

Yes, this is an ongoing process. First, all custody staff receive an eight-hour course at the cadet academy introducing the Mental Health Program.

This class covers issues such as:

Communicating with someone in crisis.

How to intervene with suicidal patients.

Understanding psychological disorders and how they are exacerbated in prison.

How to best communicate and work with individuals suffering from a mental illness.

Custody staff also receives annual training in crisis intervention and suicide prevention.

Additionally, we are in the process of developing a training specific to understanding and working with EOP patients. This training will be taught collaboratively by mental health and custody and will occur for custody and mental health staff at all EOP institutions.

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