Violence and Mental Health Opportunities for Prevention and Early Detection: Proceedings of a Workshop (2018) / Chapter Skim
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5 Prevention, Intervention, and Treatment
5 Prevention, Intervention, and Treatment
Pages 51-66
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Colleen Barry cited 1 This section summarizes information presented by Colleen Barry, Johns Hopkins B loomberg School of Public Health.
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This context, Barry argued, is important for considering the connection between public attitudes and broader support for mental health services. Many people experience mental illness, and seeking care is common; one in five seeks care yearly, and one in three over the lifetime.
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While the state health insurance exchanges account for some of the expansion, the bulk of it is a result of Medicaid expansion, particularly the new Medicaid Health Home option, which allows for different types of services that have not been traditionally financed but are important for coordinating care. The new health care provisions also have implications for criminal justice.
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The community partnership offers schools the ability to provide a broad continuum of care beyond what school staff provides. Community partners also reduce necessary and expensive services, such as emergency room visits, by facilitating pathways, providing preventive care, and assisting with transition from inpatient psychiatric care back to schools.
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for community-based services. Dévora Kestel remarked that in LAC, there are on average 2 psychiatrists, 3 This section summarizes information presented by Dévora Kestel, Pan American Health Organization.
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The Pan American Health Organization's work in the region is focused on two aspects: leadership and governance, and mental health and social care services. Greater investment in both aspects is needed, Kestel felt, because the mental health burden in LAC cannot be addressed solely by mental health professionals, but should be integrated with primary care and community care.
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4 This section summarizes information presented by Madelon Baranoski, Yale University. 5 This section summarizes information presented by Sheldon Greenberg, Johns Hopkins University School of Education.
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For example, about 70 percent of police work does not involve law enforcement, and much of a police officer's interaction with the public is not recorded. Many police officers would like to do more to serve people with mental illness, but barriers of time and resources stand in the way (Cooper et al., 2004)
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Greenberg raised several additional concerns at the intersection of law enforcement and mental health. There are an estimated 1.2 million people with mental illness currently incarcerated, but it is not clear how many have already been sentenced and how many are in jail awaiting trial.
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Skyland Trail also incorporates educational programs for law enforcement. Kotwicki and his colleagues studied the impact of a 2-day training for police officers involving mental health professionals, including doctors and nurses.
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In exploring how such elements might be included in criminal justice, Wexler noted that he and his colleagues examined which practices are in place already, which are not, why they are not, and how they could be 7 This section summarizes information presented by David Wexler, International Network of Therapeutic Jurisprudence.
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He concluded by citing important research areas: relapse prevention planning, reasoning and rehabilitation, desistance from crime, treatment adherence, behavioral contracting, active listening, and restorative justice. Behavioral Health Care in Correctional Facilities8 Patrick Fox described the shift of population, cost, and burden from community-based and state-hospital-based mental health systems to the correctional system as trans-institutionalization.
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When there is a behavioral health emergency, correctional officers are usually first responders in a correctional facility. However, mental health staff who manage such events in psychiatric hospitals have a greater understanding of trauma informed care and recovery.
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The increased decompensation and limited access to mental health professionals could result in prolonged confinement, as well. Despite the challenges and limitations of addressing mental health in the current incarceration system, there are shifts occurring.
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2001. Mental health treatment in state prisons, 2000.
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