Mental Health Services (MHS) is a division of the Michigan Department of Corrections' Bureau of Health Care Services (BHCS), and is responsible for the provision of mental health care for any eligible prisoner incarcerated in a Michigan Department of Corrections (MDOC) correctional facility. Approximately 20% of Michigan's prisoner population is enrolled in a mental health program operated by MHS, with services ranging from brief counseling to inpatient residential placements.
Programs offered through MHS reflect the following guiding principles:
Mission
The mission of Mental Health Services is to provide mental health services to MDOC prisoners that are efficient, effective, accessible, timely, and of quality equal to or exceeding community standards.
Vision
The vision of Mental Health Services is to provide treatment to prisoners with mental illness, which will empower them to function more independently, responsibly, and with self-control, thereby increasing the safety and security of the prisoners and the facility, and with the skills and abilities to prepare them for successful re-entry into the community.
Additional information on each specialized level of care is below.
The Adaptive Skills Residential Program (ASRP) is designed to serve prisoners with moderate to serious adaptive problems due to a developmental disability or other cognitive impairment. These prisoners may or may not have a co-existing serious mental illness diagnosis. The ASRP is based on a bio-psychosocial rehabilitation model, whose goal is to improve the functioning and self-management of prisoners with developmental disabilities/cognitive limitations so they can adapt to the prison setting, decrease the likelihood of being victimized, becoming disruptive, or engaging in behavior which could result in a reclassification to administrative segregation, or to prepare them for community re-entry. Most prisoners admitted to the program will have moderate to serious functioning limitations in three or more of the following areas of major life activity: self-care, receptive and/or expressive language, learning, mobility, self-direction, capacity for independent living or economic self-sufficiency.
The ASRP utilizes a range of behavioral techniques including behavior reinforcement schedules, visually enhanced communications, and an enriched schedule of prisoner reinforcement and social skills training. Program activities designed to enhance independent living can include, but are not limited to, psychosocial skills, leisure skills, academic skills, stress management, self-management, anger management and problem solving. Treatment is conducted in clear, simple language, giving the prisoner additional time to learn and incorporate behavior changes and responses.
The Counseling Services and Interventions (CSI) program is provided to prisoners who exhibit psychological signs or symptoms that negatively affect ordinary demands of life. The program includes, but is not limited to:
Prisoners are admitted and discharged from the counseling program on a short-term basis by a qualified mental health professional. The prisoners participating in this programming are housed in general population units and do not require psychiatric services.
The Institutional Program provides mental health services to all prisoners within the Department of Corrections. Prisoners receive services by Qualified Mental Health Professionals in a timely manner with reasonable access and continuity of care, including aftercare planning and follow-up as indicated. Institutional Programming includes, but is not limited to:
The Crisis Stabilization Program (CSP) services are provided 24 hours/7 days a week for prisoners whose symptoms and behavior demonstrate a mental health crisis with an immediate need for intervention and further evaluation. The crisis may be an urgent or potentially emergent mental illness and/or a potentially high risk of suicide. CSP uses solution-focused treatment to allow quick re-establishment of more stabilized coping behavior so the prisoner can be reintegrated into the prison general population. These services intend to achieve the following outcome:
Acute Care (AC) is an inpatient program providing 24-hour access to psychiatric, psychiatric nursing, and correctional services 7 days a week. The program provides intensive assessment and treatment, as well as rapid disposition for prisoners with acute mental illness, severe emotional disorders and possible co-existing disorders. It is the preferred level of care for prisoners with serious mental illness and co-existing disorders and prisoners who are exhibiting symptoms of psychosis or high suicide risk. A multidisciplinary team comprised of mental health and correctional professionals provides mental health and programmatic intervention.
The AC program follows a bio-psychosocial model, emphasizing intensive diagnostic assessment, stabilization with psychotropic medications and brief psychotherapy. It offers a protective environment that facilitates stabilization of acute psychiatric disorders and rapid triage to other levels of care. Integrated services emphasize coordination with other service providers and organizations.
The primary mission of the Rehabilitation Treatment Services (RTS) program is to provide inpatient treatment programs for prisoners with chronic serious mental illness/severe emotional disorders within a prison who have received maximum benefit from acute psychiatric services but who, nevertheless, continue to require continued intensive support. The RTS program utilizes an interdisciplinary treatment team consisting of a Unit Chief, psychiatrist, nurse, social worker, psychologist, and activity therapists with additional 24/7 coverage provided by correctional staff, on-site nurses, and on-call psychiatrists, whose goal is to enable prisoners to function in a less intensive level of care within the CMHP.
The RTS program follows a bio-psychosocial rehabilitation model of mental illness and treatment and is an appropriate level of care for seriously mentally ill prisoners with symptoms and functional deficits that are chronic, resistant to treatment, or disabling. The mental health needs of this population render them unsuitable for treatment in a less restrictive level of care. Often they have prominent negative symptoms of mental illness, severe difficulties with social skills, and difficulty in negotiating the activities of daily living without frequent supervision and assistance.
The Residential Treatment Program (RTP) is the recommended level of care for seriously mentally ill prisoners who continue to demonstrate significant impairments in social skills as well as a limited ability to participate independently in activities of daily living. These individuals cannot function adequately in the general population without significant support and modified behavioral expectations. Prisoners participating in the RTP program are housed in specialized units that provide on-site care from a multidisciplinary team consisting of a psychiatrist, psychologists, social workers, nurses, and a variety of specialized therapists.
The RTP is based on a bio-psychosocial rehabilitation model. Central to this model is the expectation that seriously mentally ill individuals cannot be successfully treated solely with psychotropic medications. Therefore, the primary treatment focus of the RTP is a provision of those skills necessary to enable prisoners to function independently within the general prison population or in the community following parole release or discharge. Group therapy is the primary focus of treatment, providing RTP prisoners with a wide range of groups including, but not limited to: physical activity groups, Dual Diagnosis, Dialectical Based Training and cognitive restructuring.
The Outpatient Services (OPT) program is an integral component of the mental health continuum of care, as it provides psychiatric services to prisoners residing in general population who have a serious mental illness/disability, as well as ensuring continuity, quality, and accessibility of services for prisoners discharged from more intensive levels of care.
Outpatient therapy is designed to help prisoners deal with chronic mental illness by compensating for any deficiencies attributed to their diagnoses, and by developing and implementing relapse prevention plans. Outpatient services are provided by interdisciplinary treatment teams that typically consist of a Unit Chief, Psychiatrist, at least two Qualified Mental Health Professionals (psychologist, clinical social worker, registered nurse, or clinical nurse specialist), and a unit secretary. Members of the treatment team work with prisoners to design and implement an individualized plan of services, which may consist of any combination of group therapy, individual therapy, or psychiatric intervention.