Core Process: reflection on mental health

Core Process: reflection on mental healthBy: Tashima Ricks, Senior Correctional Nurse Specialist

Throughout the month of May, organizations across the country have been raising awareness of the importance of mental health. In line with this increased awareness, the Nursing Services Healthcare Support Team challenges each site to re-visit the Intake Core Process: Behavioral Health, and initiate dialogue with their site interdisciplinary team members to review the behaviors that increase the risk or exacerbate mental illness in the correctional setting.

More than half of all inmates at prisons (54 percent) and jails (64 percent) have a behavioral health disorder or condition (Bureau of Justice Statistics, 2006). When patients present to the correctional facility, it is the responsibility of the receiving medical and behavioral health team to screen these patients for mental health conditions and take the necessary steps to identify these conditions in a timely manner and refer to the required services. Identifying mental health conditions at the time of intake can prove challenging, as patients often present in distress and/or under the influence of drugs or other substances. It is through awareness, education, training, judgement, intuition and expedient referral to the behavioral health team that our patients’ needs are met without undue delay.

Our patients have regular encounters with many members of the nursing team on a daily basis. It is often a member of the nursing team who collects vital signs, administers medications and provides other medical therapies and treatments. The members of the nursing team are in a prime position to readily identify subtle changes in behavior and daily routines that may indicate changes in the mental health status of our patients. However, this prime position also carries the responsibility to communicate and collaborate with the behavioral health team and custody partners to ensure that the patient is protected from harm, including harm to self and harm to others.

Nursing team members serve as a conduit to connect the patient to the needed mental health services and resources that begin the process of restoring and/or improving the mental health of our patients. While the process generally begins at the time of intake into the correctional facility, it is through advocacy, support and education that we facilitate mental health and wellness throughout the incarceration period, and beyond.