Sunday, March 30, 2014

Progress Report: Improved Mental Health Services At HRRJ

Harrisonburg/Rockingham Regional Jail
Thursday I had the privilege of meeting with two representatives of the Community Services Board, Executive Director Lacy Whitmore and Acute Services Director Ellen Harrison, and with Sheriff Bryan Hutcheson and Jail Director Captain Steven Shortell to discuss ways of improving mental health services for inmates at our local jail.

Here are four areas of concern we covered:

1. As state funds become available for more community-based mental health services in Virginia, what might be the best possible ways of using such funds to expand and improve mental health treatment at the jail?

Captain Shortell's ultimate dream would be to have a separate fully staffed mental health unit added to the facility. This would decrease the number of inmates needing to be transferred to the forensic unit at Western State Hospital and could greatly improve the quality of services at HRRJ. Such a unit may only be a pipe dream, of course, under present budget constraints, but it would represent a far cry from currently having only one CSB Nurse Practitioner available for one three-hour block of time per week (plus other CSB case workers as called on for emergency needs). Meanwhile any increase in the number of trained counselors could help improve mental health treatment.

2. Could inmates already under a doctor or psychiatrist's care when they are incarcerated continue that care while at HRRJ, with the patient or patient's family billed for any prescriptions and/or phone consults involved and with nursing staff continuing to dispense medications as provided?

We were told that if an inmate brings prescriptions from home that these may be continued at the discretion of medical personnel if it is clear that they are have been taken on a consistent basis prior to their coming. However if, for example, full bottles of meds are brought without evidence that the inmate has been taking them as prescribed they may not be given. More time and staff available to do more coordination with outside providers would clearly be a plus in making required medication management more efficient and effective.

3. Could a community-based advisory board be created for the purpose of hearing the Jail's challenges in providing mental services and brainstorm potential solutions? 

It was encouraging to have Sheriff Hutcheson assure us that if the Community Services Board were to get such a group together that the Sheriff and staff would be willing to give their recommendations every reasonable consideration. This is potentially a great step in collaborating with concerned community members to help provide for better mental health services within current budget restraints--as well as perhaps working at ways of increasing necessary funding to provide at least the level of care available at state prisons.

4. Subject to the recommendations of such a group, could a select team of volunteer professionals be granted access to inmates in need of counseling similar to what volunteer chaplains now have?

Sheriff Hutcheson is open to having outside clinicians help provide services if clear credentialing guidelines can be established by the CSB for those allowed access to inmates, perhaps on the same basis as attorneys are presently. The proposed advisory board could be useful in establishing such guidelines.

Meanwhile, here's some really good news: I was encouraged to hear that all sheriff's deputies and corrections officers are set to receive a mandated 40-hour Crisis Intervention Team training initiated by the CSB and funded by a special grant. CIT is a program designed to improve the way law enforcement and the community respond to people experiencing mental health crises. The first persons enrolled in the program just completed their training last week, and three other classes are planned for this year. More details will be posted on the HRRJ website by the end of this week.

Please feel free to offer your comments or suggestions for working collaboratively with the Sheriff and the CSB to do an ever better job of rehabilitating offenders.

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