To help correctional mental healthcare providers manage patients withschizophrenia, NCCHC has devel-oped new clinical guidelines that arebased, in part, on the AmericanPsychiatric Association’s PracticeGuideline for the Treatment of Patients with Schizophrenia.The need has never been greater.On any given day in the UnitedStates, 2% to 4% of state prisonersand about 1% of jail detainees haveschizophrenia or another psychoticdisorder, compared with 0.8% of theU.S. population as a whole. Providingadequate treatment to inmates withschizophrenia not only helps theindividual by reducing bizarre anddisruptive behaviors but also may make the environment safer forother inmates and for staff.
The high prevalence of mentally illinmates is believed to be related tothe deinstitutionalization of patientsin mental health facilities and thedismantling of mental health pro-grams across the country.Left to their own devices on thestreet, these former patients oftenengage in behavior that leads totheir incarceration. Many of theseinmates also have other risk factorsassociated with a higher incidence of violent behavior (e.g., substanceabuse, neurological impairment,poor impulse control) that may beexacerbated by psychotic symptoms.Because of their idiosyncratic andsometimes provocative behaviors,people with schizophrenia may be athigher risk of being victimized incorrectional settings, and often theirclinical conditions are intensified by overcrowding, hostility and loss of basic freedoms.
NCCHC’s Clinical Guidelines on theTreatment of Schizophrenia inCorrectional Institutions are intend-ed to supplement the APA’s guide-line by focusing on treatment issuesthat are unique to a correctional set-ting. (For useful principles andguidelines on providing psychiatricservices in these settings, consultthe APA publication “PsychiatricServices in Jails and Prisons,” whichcan be purchased at the NCCHC Website or by calling our headquarters.)The schizophrenia guidelinesaddress the following areas:•background•diagnosis•management overview (includingtreatment goals)•assessment on entry to the system•frequency of follow-up visits•content of follow-up visits (includingassessment and levels of function)•use of the assessment to guidetreatment efforts (including conti-nuity of care, treatment strategiesand environmental controls)•correctional barriers•quality improvement monitors
Free Guidance Online
The seventh in a series of clinicalguidelines geared toward health careproviders working in correctionalsettings, the schizophrenia treat-ment guidelines are the first devel-oped by NCCHCthat deal with men-tal illness. The others offered to datedeal with the following chronic dis-eases: asthma, diabetes, epilepsy,high blood pressure, high blood cho-lesterol and HIV. All of the guidelines can be down-loaded for free at the NCCHC Website. Go to www.ncchc.org, select theResources and Link page, and thenclick on Clinical Guidelines.2SPRING 2004 • CorrectCarewww.ncchc.org
CCHP proctored examination, multiple sites(see www.ncchc.org for locations)
Best Practices in Transitional Planning essaycompetition deadline (see page 7)
Application deadline for the November 14CCHP and CCHP-A examinations
Accreditation Committee meetings: HealthServices and Opioid Treatment Program
National Conference on Correctional HealthCare, New Orleans
CCHP and CCHP-A proctored examinations,New Orleans
Odds & Ends
Catalog keeps growing.
The large number of registrants for NCCHC’s mentalhealth conference demonstrates the pressing need for more resources gearedtoward mental health assessment and treatment in correctional settings. Tohelp, we’ve added three valuable new titles from the well-regarded publishingarm of the American Psychological Association. For product descriptions andordering information, visit the Publications section of our Web site.
Treating Adult and Juvenile Offenders With Special Needs
, edited by JoseB. Ashford, Bruce D. Sales, and William H. Reid. 2001, 518 pages, hard-cover; $49.95
Acting Out: Maladaptive Behavior in Confinement
, written by Hans Tochand Kenneth Adams, with J. Douglas Grant and Elaine Lord. 2002, 446pages, softcover; $29.95
Treating Chronic Juvenile Offenders: Advances Made Through the Oregon Multidimensional Treatment Foster Care Model
; written by PatriciaChamberlain. 2003, 186 pages, hardcover; $39.95
Spring 2004Vol. 18 No. 2
is published quarterly by the NationalCommission on Correctional Health Care, a not-for-profitorganization whose mission is to improve the quality of healthcare in our nation’s jails, prisons and juvenile confinementfacilities. NCCHC is supported by 36 leading national organi-zations representing the fields of health, law and corrections.
A Publication of the National Commission on Correctional Health Care
BOARD OF DIRECTORS
Thomas J. Fagan, PhD (Chair)American Psychological AssociationEugene A. Migliaccio, DrPH, CCHP (Chair-Elect)American College of Healthcare ExecutivesDouglas A. Mack, MD, CCHP (Immediate Past Chair)American Association of Public Health PhysiciansKenneth J. Kuipers, PhD (Treasurer)National Association of CountiesNancy B. White, LPC (Secretary)American Counseling AssociationEdward A. Harrison, CCHP (President)National Commission on Correctional Health CareCarl C. Bell, MD, CCHPNational Medical AssociationH. Blair Carlson, MDAmerican Society of Addiction MedicineKleanthe Caruso, MSN, CCHPAmerican Nurses AssociationRobert Cohen, MDAmerican Public Health AssociationHon. Richard A. Devine, JDNational District Attorneys AssociationCapt. Nina Dozoretz, RHIA, CCHPAmerican Health Information Management AssociationCharles A. FasanoJohn Howard AssociationBernard H. Feigelman, DOAmerican College of NeuropsychiatristsWilliam T. Haeck, MD, CCHPAmerican College of Emergency PhysiciansRobert L. Hilton, RPh, CCHPAmerican Pharmacists AssociationJoRene Kerns, BSN, CCHPAmerican Correctional Health Services AssociationDaniel Lorber, MDAmerican Diabetes AssociationEdwin I. Megargee, PhD, CCHPAmerican Association for Correctional PsychologyCharles A. Meyer, Jr., MD, CCHP-AAmerican Academy of Psychiatry & the LawRobert E. Morris, MDSociety for Adolescent MedicinePeter C. Ober, PA-C, CCHPAmerican Academy of Physician AssistantsJoseph V. Penn, MD, CCHPAmerican Academy of Child & Adolescent PsychiatryPeter Perroncello, CJMAmerican Jail AssociationGeorge J. Pramstaller, DO, CCHPAmerican Osteopathic AssociationPatricia N. Reams, MD, CCHPAmerican Academy of PediatricsSheriff B.J. RobertsNational Sheriffs’ AssociationJohn M. Robertson, MDAmerican College of PhysiciansWilliam J. Rold, JD, CCHP-AAmerican Bar AssociationDavid W. Roush, PhDNational Juvenile Detention AssociationRonald M. Shansky, MDSociety of Correctional PhysiciansThomas E. Shields II, DDSAmerican Dental AssociationJere G. Sutton, DO, CCHPAmerican Association of Physician SpecialistsAlvin J. Thompson, MDAmerican Medical AssociationBarbara A. Wakeen, RDAmerican Dietetic AssociationHenry C. Weinstein, MD, CCHPAmerican Psychiatric AssociationJonathan B. Weisbuch, MDNational Association of County & City Health Officials
NCCHC’S NEW ADDRESS
1145 W. Diversey Parkway, Chicago, Illinois 60614
New Guidelines Aid in Schizophrenia Treatment
Standards for Opioid TreatmentPrograms in Correctional Settings
With the recent launch of its accredi-tation program for opioid treatmentprograms based in correctional facili-ties, NCCHC has published a set of standards that represent the require-ments for opioid treatment servicesin such facilities. In developing thestandards, we used federal regula-tions and community standards as aguide and modified them to take intoaccount the issues unique to provid-ing services in a correctional facility.Conforming with NCCHC’s
Standards for Health Services
are divided into ninegeneral areas: A – Governance and AdministrationB – Managing a Safe and Healthy EnvironmentC – Personnel and TrainingD – Health Care Services andSupportE – Inmate Care and TreatmentF – Health Promotion and DiseasePreventionG – Special Needs and ServicesH – Health RecordsI – Medical-Legal Issues All of the standards are linked tospecific federal regulations andtherefore are essential for achievingNCCHC accreditation. However,some may not apply, in whole or inpart, to a given facility’s program. Accreditation by NCCHC allowsOTPs to obtain legally required certi-fication from the federal Substance Abuse and Mental Health Services Administration. OTPs seeking accredi-tation are eligible for technical assis-tance consultation, funded by SAMHSA, that assesses what may beneeded to comply with the standards. An OTP seeking accreditation neednot be in a facility whose health ser- vices are accredited by NCCHC.To learn more or to order the stan-dards (which cost $29.95) callNCCHC at (773) 880-1460, or visitthe Web at www.ncchc.org.
Copyright 2004 National Commission on Correctional Health Care.Statements of fact and opinion are the responsibility of the authorsalone and do not necessarily reflect the opinions of this publication,NCCHC or its supporting organizations. NCCHC assumes no respon-sibility for products or services advertised. We invite letters of supportor criticism or correction of facts, which will be printed as spaceallows. Articles without designated authorship may be reprinted inwhole or in part provided attribution is given to NCCHC.Send change of address, advertising inquiries and othercorrespondence to Jaime Shimkus, publications editor,NCCHC, 1145 W. Diversey Parkway, Chicago, IL 60614.Phone: (773) 880-1460. Fax: (773) 880-2424.E-mail: firstname.lastname@example.org. Web: www.ncchc.org.