Behavioral Health Services

The primary function of this unit is to provide mental health treatment services to inmates who have been remanded to our custody and care. The Behavioral Health Unit is staffed by sixteen RIDOC employees, including the Clinical Director, the Supervising Clinical Psychologist and thirteen (13) Clinical Social Workers. Each facility is assigned a team of clinical staff that is proportionate to the population being served. Staff provide services on-grounds between the hours of 8:30am - 8:30pm, with 24-hour, 7 days per week on-call coverage provided by the Clinical Director and Supervising Clinical Psychologist.

Behavioral Health Services is tasked with a variety of duties, including the ongoing evaluation and monitoring of all inmates who present with a level of risk for suicidal behavior. RIDOC utilizes a three-tier system of observational statuses for inmates who present with a potential risk to harm themselves or others. All inmates are assessed for suicide risk and need for mental health services upon commitment to the Department, and on an ongoing basis throughout their time served.

Mental Health treatment is provided via a variety of methods including individual and group therapy; medication-based treatment; psychoeducational interventions and evidenced-based behavioral interventions including cognitive-behavioral therapy (CBT); Dialectical Behavioral Therapy (DBT); Motivational Interviewing and Anger Management. A psychiatric Occupational Therapist provides 28 hours per week of individual and group occupational therapy to inmates at the High Security Center. Discharge planning services are provided to all inmates receiving mental health and psychiatric treatment to ensure continuity of care. A specialized mental health discharge planner is assigned to work with all sentenced inmates who are designated as Community Support Program (CSP) eligible and/or designated severely and persistently mentally ill.

Psychiatric services are provided through contracts with Rhode Island Hospital/Lifespan Department of Psychiatry for both the sentenced and awaiting-trial facilities. Approximately 40% of our population is prescribed psychotropic medication. There are a number of psychiatrists under contract with the Department to provide approximately 44 to 48 hours per week of psychiatric care for the sentenced facilities, and 40 hours per week for the Intake Service Center. On-call coverage is also provided by Rhode Island Hospital during weekend and evening hours. Psychiatric staff work closely with the clinical and supervisory staff as part of a treatment team for the highest possible level of coordinated mental health care services. For patients who lack the capacity to understand the benefits of treatment or the risks of refusal, psychiatric staff work closely with the Office of Legal Counsel and Supervisory staff to obtain court-mandated treatment services (Petition for Instructions, Specialized Service Transfers to Eleanor Slater Hospital), ensuring that the patients receive the treatment necessary to maintain their safety and the safety of the institution.

In the past 5 years, RIDOC has seen an increase in the number of severe and persistently mentally ill (SPMI) inmates entering our facilities, with the number in the RIDOC being approximately 5-10% at any given time. In February 2018, a Residential Treatment Unit was established at the High Security Center. The mission of this 12-bed unit is to provide inmates with programming, treatment and structure as an alternative to placement in a Disciplinary Confinement Unit or an Administrative Confinement Unit, or when deemed clinically appropriate. The goal of the placement in the RTU is to assist inmates to achieve their highest level of functioning by developing alternative coping skills that result in behavioral stability sufficient to return to general population. The RTU is designed to assist inmates with achieving their highest level of functioning using an incentive-based system. The Phase System is the basis for this program. When an inmate is admitted into the RTU, the treatment team will determine the phase that is most appropriate for the inmate's clinical presentation and recent behavior. The treatment team will develop individualized time frames to allow the inmate to progress through all phases when clinically indicated.

It is estimated that 70-90% of the RIDOC population has a significant history of substance use disorders. It is further estimated that 20% of this population has issues with opioid use. The provision of community health focused recovery services for individuals with substance use disorders is a high priority for the RIDOC. As a matter of public safety, the Department endeavors to treat all individuals with substance use disorders while they are incarcerated with a focus on recovery. Linkage to follow-up care and recovery support is also deemed to be an essential aspect of the Department's treatment approach. The Department's goal is to be an integral part of statewide efforts to develop a community health response to substance use disorder, the opioid crisis, and the behavioral health needs of offenders.

The RIDOC's substance use disorder treatment programs have been ongoing since 1989. During this time, utilizing both Federal and State dollars, the RIDOC has contracted with external vendors for the provision of treatment, recovery, and more recently Medication Assisted Treatment (MAT) services. The earliest programs emphasized group counseling in an outpatient format. In 1992, the RIDOC refocused its treatment programs to include a residential treatment model. Currently RIDOC utilizes a four-tier model, the highest being a modified residential therapeutic community, the second is a day-treatment model, the third is counseling groups, and the fourth is recovery services and peer support.

The RIDOC is aware that the field of substance use disorder treatment has advanced and treatment for addiction is evolving. In keeping with best practices and evidenced-based treatment, substance use disorder treatment and recovery services within the RIDOC are comprehensive, stressing behavioral change to promote public safety and reduce recidivism. Treatment is individualized and directed at individuals accepting responsibility for both their crimes and their recovery, with the dual goal of relapse prevention and the reduction of criminal recidivism.

If you or someone you know needs help with an opiate use problem call (401) 942-STOP or visit http://preventoverdoseri.org/get-help/.

Lauranne Howard, MA, LCDP, Interdepartmental Project Manager

18 Wilma Schesler Road

Dix Building

Cranston, RI 02920