16. PERSONS WITH MENTAL IMPAIRMENTS . Note to Instructor: Commission Course, “Mental Health Officer” (#4001) can be used as a supplement. Unit Goal 16.1: The student will be able to summarize the issues involving persons with mental impairments at a jail facility. .
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1. The National Institute of Justice examined the implications of the Americans With Disabilities Act (ADA) for criminal justice agencies at the state and local levels. Under the ADA, corrections facilities must do more than just identify inmates and employees with mental disabilities. Now they must also provide mental health screening, evaluation, and treatment.
1. The courts now consider a facility’s deliberate indifference to an inmate’s mental disability the same as that facility’s indifference to an inmate’s medical condition. This standard, “deliberate indifference,” has evolved from a series of federal court rulings on the adequacy of health care and mental health care in prisons (Cohen, 1985, 1988).
Simply stated, federal courts have generally found in favor of prison systems in suits filed on the basis of inadequate health care, as long as prison administrators and staff have not demonstrated a deliberate indifference to the mental or physical health care needs of the inmate.
2. A correctional facility should avoid practices that screen out or eliminate eligible inmates from programs and services solely on the basis of a mental (or physical) disability.
1. Correctional facilities, including local jails, should screen all inmates to identify those with mental or physical disabilities. Inmates with mental disabilities should be evaluated by a qualified mental health professional. Health personnel should have access to crisis intervention, treatment, and discharge planning services. It is simply not enough to provide separate services to those with mental disabilities since mainstreaming is a major intent of the ADA.
2. Inmates with mental disabilities, particularly those in local jails, are the responsibility of the community, not of just law enforcement personnel.
3. The integration of jail services and community health services is critical to the success of an inmate’s treatment and reintegration into the community and the continuity of care requirements of the HSC 614.016.
4. In accordance with the TCJS 273.1, entitled “Health Services”: The owner/operator of each facility shall provide medical, mental, and dental services in accordance with the approved health services plan. These services may include, but shall not be limited to, the services of a licensed physician, professional and allied health personnel, hospital, or similar services. In addition, TCJS 273.5 requires that a mental disabilities/suicide prevention plan be implemented.
A. Definition of “offender with mental impairment” - a person with mental retardation, mental illness, or a developmental disability who is arrested or charged with a criminal offense. (HSC 614.001(7))
A. Definition of “offender with mental retardation” - significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behavior and originates during the developmental period. (HSC 591.003(13))
1. Approximately 3% of the American population is considered retarded. Although a large percentage of the jail population (up to 10%) can be classified as having mental retardation.
2. To determine with certainty whether a person is mentally retarded requires comprehensive examinations and tests by qualified individuals. When officers first encounter a citizen, they must rely on their own perceptions and minimal information to determine whether referral or other actions are appropriate.
2. Task performance deficiencies - inability to successfully perform relatively simple tasks such as the following may indicate the person is mentally retarded:
16.1.5 The student will be able to identify effective communication and interaction skills for dealing with persons with mental retardation.
2. When asking questions, be patient for a reply. The thought process of certain individuals takes longer. Repeat the question or information if needed.
3. Ask open-ended rather than "yes/no" questions. A person with limited understanding may answer yes/no questions without full comprehension.
7. Referral to the appropriate agency in the community will depend upon your agency’s practice in accommodating the offender with mental retardation.
10. Even though several signs may point to an offender as having mental retardation there may be other explanations. People with other developmental disorders, mental disorders, certain health problems and handicaps, drug and alcohol abuse problems, and people who are trying to “beat the system” are sometimes mistakenly identified as having mental retardation.
A. The mentally retarded inmate needs empathy, support, and understanding. The following tips on supervising the mentally retarded should assist the officer in successfully meeting the inmate’s needs and the jail’s needs.
2. Do not assume understanding. Just because the mentally retarded inmate agrees with you or even because he repeats information back to you, do not assume understanding. Some retarded persons are very adept at hiding their handicap and one common method used is to parrot information and pretend to understand.
3. Use repetition is an effective way to get information and expectations across in a manner that will assist retention. Try saying it again in a slightly different manner.
4. Take one thing at a time. Assign one task at a time or deal with one concept at a time. A retarded person can be easily overwhelmed by more than one concept or instruction at any one time.
5. Use plain language. Use simple, plain language that is not easily misinterpreted. Do not assume that just because a person uses a word he understands its meaning.
E. Any interruptions of a disturbed inmate’s medication may result in violent behavior, hallucinations, suicide attempts, and/or various other symptoms specific to an inmate’s psychiatric disability.
The instructor is not expected to comprehensively cover all of these statutes, but to briefly convey the purpose of these statutes and indicate where information may be found if the need arises.