A Prerelease Program for Mentally Ill Inmates

The transition between incarceration and return to the community is a difficult and stressful process, especially for mentally ill inmates. In 1999 a new prerelease program, the mental health transitional unit, was implemented within the Maryland Department of Public Safety and Correctional Services at the Patuxent Institution. The forces prompting development of this program included poor linkage with community programs for mentally ill inmates before their release, inadequate access to prompt and receptive mental health care for newly released inmates, and minimal preparation of mentally ill inmates for the stress of release.

The program is designed to accept all inmates with known mental illness, including those with dual diagnoses, approximately six months before their scheduled release date. During the inmate's stay in the mental health transitional unit, a variety of treatment modules are offered, targeted to issues that are likely to cause difficulty in the community for newly released mentally ill inmates. The modules include medication compliance, budgeting, decision making, assertiveness and social skills training, drug education, relapse prevention, 12-step groups, and AIDS education.

In addition, a comprehensive reassessment of the inmate's psychiatric diagnosis and treatment needs is made, and the inmate's medication regimen is adjusted as needed. As the inmate's date of release approaches, the transitional unit's social worker invites the appropriate community-based providers to the unit. This team of institutional and community providers attempts to forge a coordinated and comprehensive plan that includes, as needed, living arrangements; community mental health, addiction treatment, and medical services; psychosocial or vocational rehabilitation services; application for available benefits such as Supplemental Security Income, medical or pharmacy assistance, and veterans' benefits; and confirmation of required parole supervision.

The staff of the mental health transitional unit plans to follow up former inmates at 14, 30, and 90 days after their release to document the degree of linkage to the needed services. We hope to be able to present preliminary data soon. We also hope others in the correctional system will develop programs like ours.