Schizophrenia is overrepresented in the criminal justice system, particularly in correctional facilities, with prevalence estimated at 2% to 6.5% in state prison inmates vs. 1.1% in the U.S. adult population. Individuals with schizophrenia may be more resistant to medication as the delusions, hallucinations, and disturbed thinking make it difficult for them to realize that they have a mental illness. Unfortunately, these individuals have a hard time in corrections, ending up with longer sentences as they are unable to comply with instructions and rules. 

Join us for a discussion of treatment options that are long-lasting, easy to administer, and do not rely on daily compliance. Find solutions to help individuals establish control over their behaviors and have more success when they leave correctional facilities.

Learning Objectives

• Summarize relevant treatment guidelines for incarcerated individuals with schizophrenia
• Describe barriers to schizophrenia treatment 
• Discuss future directions in schizophrenia treatment

Level

Intermediate

For 10 years the speaker has worked with gender dysphoric patients and has conducted over 200 assessments of transgender people. This experience has provided a wealth of information, useful approaches, metrics, and phrasing for working with these patients. Attendees will learn how to assess, monitor, and provide a therapeutic experience for their gender dysphoric patients and participate in a lively Q&A session.

Learning Objectives 

• Review how to assess gender dysphoria
• Describe how to monitor symptoms of gender dysphoria
• Discuss how to determine the course of action for treatment

Level

Intermediate

A properly well-documented chart is one of the most critical aspects to a good defense of a correctional provider sued in a state law medical negligence or federal civil rights lawsuit. This presentation will address the dos and don'ts of medical records documentation, how smart charting assists in the defense of a lawsuit, and the potential legal consequences of improper charting.

Learning Objectives 

• Discuss the do's and don'ts of medical records documentation
• Explain how smart charting assists the defense of a lawsuit
• Examine potential consequences of improper charting

Level 

Basic

The impact of the COVID-19 pandemic has been massive, touching the lives of everyone worldwide. But what does recent data show about how it has affected our mental health and well-being? Preliminary statistics suggest that the pandemic has had a significant effect on suicide rates and violent incidents. This study examines available data to compare and contrast trends in the community to those within the Pennsylvania Department of Corrections.

Learning Objectives

• Describe the COVID-19 pandemic's far-reaching impact on many individuals' mental health, including neurotypical individuals with no prior mental health history
• Evaluate how the pandemic has influenced suicide and violence rates worldwide and within the population of the Pennsylvania Department of Corrections
• Discuss how clinicians can address some of the common symptoms, concerns, and struggles that people have been facing throughout this pandemic

Level

Basic

One of the 12 “Grand Challenges for Social Work” is promoting smart decarceration. This presentation discusses how we could better prepare juveniles for life in the community so that they don't recidivate or graduate to the adult system. It also speaks to the First Step Act for criminal justice reform and changes happening in the adult system to undo some of the laws that created mass incarceration.

Learning Objectives 

• Describe the juvenile justice system as it is run in the District of Columbia
• Discuss the Grand Challenges for Social Work with focus on smart decarceration
• Explore what changes we can make on the juvenile level as part of criminal justice reform

Level 

Basic

Development of individualized treatment plans is a key element of effective correctional mental health services. Although the NCCHC standards lay out the requirements for treatment plans, many mental health professionals and clinical supervisors struggle to develop strong plans that address the needs of the client population. This presentation reviews the NCCHC standards and presents recommendations for improved treatment plans.   

Learning Objectives

• Review key terms related to mental health treatment in carceral settings
• Identify common missteps and errors in treatment of mental health patients
• Explain the principles for developing effective treatment plans

Level

Intermediate

People with autism process information differently, so information needs to be conveyed in a way they can understand. Knowing the characteristics of people with autism and how to accommodate them will help to decrease problematic behavior. This discussion covers how to recognize autistic behaviors, how to de-escalate or preempt a meltdown, and how to communicate more effectively.

Learning Objectives

• Define autism spectrum disorder
• Summarize the five keys to de-escalation of problem behavior
• Identify at least two coping strategies to offer someone on the autism spectrum in a crisis

Level

Basic

The COVID-19 global pandemic disrupted nearly all aspects of mental health services delivery for patients and staff in correctional settings. This presentation will describe the use of evidence-based, data-driven strategies for suicide prevention among patients in a large metropolitan detention center during the pandemic. Relevant NCCHC mental health standards will be used to highlight key messages from the pandemic.

Learning Objectives

• Discuss the challenges to the delivery of correctional mental health services posed by the global pandemic.
• Describe the elevated risk for correctional mental health problems posed by the global pandemic
• Review evidence-based strategies to mitigate the risk for suicide in the correctional setting during a global pandemic

Level

Intermediate

To curb the spread of COVID-19 inside the San Luis Obispo County Jail, staff followed measures recommended by the CDC and the National Commission on Correctional Health Care. The resulting increased isolation and decreased programming led to more mental health symptoms, causing the team to rethink the balance between infection control and wellness. This talk will take participants through that journey, using data, anecdotes, and best practices.

Learning Objectives

• Describe the mental health effects of the COVID pandemic in congregate settings
• Examine techniques to mitigate the mental health effects of infectious disease protocols
• Discuss how following data in real time can assist with timely interventions to prevent poor outcomes

Level

Intermediate

The designation of “serious mental illness” often obligates correctional health care departments to provide certain protections under professional and legal standards. The result is often a blanket policy that aims to protect a vulnerable population, but which ignores the dynamic functional aspects of human psychology. This talk explores the clinical implications of SMI designation and presents the importance of levels of functional need to assign resources and provide treatment in a proactive, effective manner.

Learning Objectives 

• Discuss the ramifications of having various definitions of “serious mental illness”
• Describe clinical and ethical ramifications of the categorical approach to defining SMI
• Explore the dynamic levels of acuity and functional impairments within an SMI designation

Level 

Intermediate

The speakers will present an overview of legal protections afforded to incarcerated mental health patients, and will delve deeper into the topics of involuntary medication and hospitalization, security of mental health records and other information, capacity v. competency, and the proper use and role of legal guardians. The aim is to expand participants’ understanding of the risks and best practices for correctional mental health care.

Learning Objectives

• Review federal and state laws governing involuntary medication and hospitalization
• Compare the role of physicians in determining capacity to the court's function of ruling on competency
• Explore when a healthcare guardian is needed and how to obtain one when no family members volunteer

Level

Intermediate

Problem-solving courts, adult detention centers, and community medical services have partnered to support opioid use disorder patients at the intersection of arraignment, incarceration, and reentry to society. This talk describes evidence-based efforts to reduce justice, health care, and supervised probation costs. Provision of medication and trauma-informed treatment, as well as psychosocial, educational, physiological, and emotional support, companied with human connection, have lowered recidivism, relapse, overdose, and deaths.

Learning Objectives

• Discuss how Arizona problem-solving courts and adult detention centers are using measures to support people struggling with substance dependence during the COVID pandemic
• Examine the process of targeted intersectionality implementing MAT into treatment courts and adult detention centers
• Assess an in-depth analysis of outcomes associated with treatment courts and adult detention centers MAT programs during COVID restrictions

Level

Advanced

Nurses and mental health workers both desire quality care for our patients, so why do we sometimes seem to be at odds with each other? This group will discuss case scenarios, perceived responsibilities, and the minds of both disciplines to illustrate how and why individual disciplines approach the same issues differently. It aims to share new and modified approaches between these critical patient care disciplines in order to achieve shared patient care goals in a cohesive, harmonious, team-oriented environment.

Learning Objectives

• Verbalize at least four common issues that create disharmony between nurses and mental health workers
• Analyze four case studies involving conflicts between nurses and mental health workers
• Discuss how to apply learned skills and knowledge to change workplace approaches or practices

Level 

Basic

A peer support program helps decrease day-to-day stress and can countercheck the emotional strain of critical incidents and prevent the accumulation of emotions that can lead to alcohol abuse, depression, domestic violence, and suicide, often working in tandem with the services provided by chaplains and mental health professionals. Attend this group to discuss how to implement a program and the many benefits a peer support program can bring.

Learning Objectives

• Explain the purpose and benefits of a peer support program for one's public safety agency
• Describe best practices for designing and implementing a peer support program
• Discuss how to organize a program for long-term success

Level

Basic

The moderators will share how they reduced the gap between the overwhelming differences between treatment and security cultures in a correctional treatment facility. They share their experiences of implementing a trauma treatment program in a prison using evidence-based guidelines, and will engage group participants to explore how to best connect these two opposing worlds.

Learning Objectives

• Discuss the challenges in implementing a trauma-informed treatment program in a correctional facility
• Describe conflicts between DOC trainings and trauma-informed treatment standards
• Explore methods that support both a secure and safe environment while providing effective treatment

Level

Intermediate

This presentation will review the historical concept of pseudoseizures and their connotations in the institutional environment. It will review recent research and the emergence of our understanding of psychogenic nonepileptic seizures as nonfeigned seizures that are distinct from malingering. It will then outline the steps in an appropriate diagnostic process when psychogenic seizures may be present, as well as appropriate interventions for those determined to be experiencing pseudoseizures.

Learning Objectives

• Define and differentiate among the terms pseudoseizures, PNES, malingering, and factitious disorder
• Articulate strategies for working with multidisciplinary team to create and implement treatment plans for PNES
• Summarize talking points for educating patients, custody, medical staff, and families

Level

Basic

This workshop aims to inspire, support, and offer guidance to others seeking innovative, effective treatments targeting incarcerated adolescents. It will describe how the Music/Arts Initiative Program is transforming the lives of incarcerated youth in one Midwestern juvenile correctional facility and will cover the background history, program development steps, programmatic challenges and successes, and program data and outcomes.

Learning Objectives

• Describe positive outcomes of introducing and engaging incarcerated adolescents in music and the arts
• Outline steps to take in developing a music and arts program
• Discuss how music and arts provide culturally appropriate experiences that foster prosocial life skills

Level

Basic

Prescribing psychotropic medications to incarcerated women requires both the ability to distinguish certain differences specific to this gender population and to recognize the additional contextual challenges of clinical practice in a correctional environment. This presentation will address such considerations and provide the prescriber with a practical overview of key concepts of women's psychiatric and behavioral health care.

Learning Objectives

• Examine the inherent challenges in the provision of care for unique women's health needs in corrections
• Summarize clinical aspects of women's psychiatric principles across the maternal life cycle
• Discuss women-specific disorders and related concerns

Level

Advanced

Individuals with substance use disorders are more susceptible to HIV because of needle sharing, sex work to earn money for drugs, and ultimately, entrance into a correctional facility. Prisons are a high-risk environment for HIV transmission with drug use and needle sharing, tattooing with homemade and unsterile equipment, and high-risk sex and rape. HIV affects approximately 1.3% of inmates in correctional facilities, which is more than 4x the prevalence found in the general United States population. Treating individuals at risk for HIV for substance use disorder is especially important to help them avoid HIV infection and further time in the judicial system after release. Making sure individuals with HIV get treated for substance use disorder is critical to help them live a healthier lifestyle and avoid further health complications – in and after incarceration.

This session will highlight how and why HIV and SUD co-occur, current treatments, and where the science is headed.

Educational Objectives

• Identify the risks, symptoms and treatments for SUD in patients being treated for HIV
• Review a treatment overview for patients receiving therapy for HIV
• Discuss newly approved HIV treatments, including long-acting injectables

Level

Intermediate

The correctional environment presents a tempting opportunity for treating the opioid addicted in the U.S. Potential benefits include a monitored, controlled environment, adjunctive services such as behavioral health, and ties with community health and social services. Challenges include medication availability, diversion potential, the regulatory environment, and lack of willingness to act on the part of both health care and custody leadership. Still, the potential number of patients to be treated is high enough in essentially any community to warrant a careful look by state and local officials and decision makers. In this panel, experts will offer a brief refresher on the principles of addition medicine, risks and benefits of treatment of opioid disorder in a correctional environment, and will discuss recent events and innovations.

Learning Objectives

• Describe the driving principle, from a medical perspective, behind the use of medications to treat OUD
• List three common pitfalls and risks that can occur when operating an MAT program within a jail or prison
• List at least one recent significant development that affects the treatment of patients with OUD in a jail

Level

Intermediate

COVID-19 increased awareness of how telehealth can serve as an essential safety net when access to on-site care is restricted. This talk reviews what was done in several California jail systems to keep essential mental health services running during the pandemic, including successes and barriers.

Learning Objectives

• Review how telehealth for mental health services was implemented in jails during the COVID-19 pandemic
• Describe the factors that made some jails successful while others failed to maintain essential services
• Explore possible future emergencies that might result in an interruption of services and how systems should prepare for it

Level

Basic

Correctional environments can have powerful effects on everyone within the walls. This talk will present the findings of a recent study on the effects of the correctional environment on mental health professionals with a focus on interdisciplinary relationships, trauma, countertransference, and supervision. Recommendations on how to improve the experience of correctional mental health staff will be offered, as well as suggestions for future research.

Learning Objectives

• Review key theoretical explanations related to the experience of correctional mental health professionals
• Explore ways in which the study findings relate to the experiences of correctional mental health professionals
• Describe concrete suggestions for enhancing the professional experiences of correctional mental health professionals

Level

Basic

Due to concern about how mental health watches are handled in the Massachusetts Department of Correction, the DOC and its health care vendor sought to examine the practice in the state’s prisons, particularly around self-injurious behavior. In addition, in November 2020 the DOJ Civil Rights Division found the MA DOC in violation of the Eight Amendment. This presentation will share the many changes implemented, measured outcomes, and lessons learned.

Learning Objectives

• Review the concerns surrounding mental health watch for self-injurious patients in the MA DOC
• Describe the changes implemented, both operational and cultural
• Analyze the lessons learned from incorporating the "therapeutic supervision" approach

Level

Basic

Individuals receiving mental health services are referred to by an array of labels by staff and other inmates. Some of these terms are intended to be functional or supportive while others may be less so and tend to stigmatize. This interactive workshop explores the clinical and ethical implications of common labels in correctional settings as well as the potentially transformative power of language when providing services and discussing patients.

Learning Objectives

• Review commonly used labels and nomenclature
• Describe clinical and ethical ramifications of labeling
• Explore the creation of a personal plan to address stigma of labeling in one's practice setting

Level

Basic

A detailed review of suicides in Pennsylvania state prisons revealed that more than 97% of suicides occurred among individuals who were housed alone in a cell. Research findings identified three main circumstances in which individuals were able to be housed alone. Operational solutions implemented will be discussed.

Learning Objectives

• Analyze historical Pennsylvania Department of Corrections suicide data
• Discuss the three main categories of how and why individuals are celled alone in Pennsylvania state prisons
• Examine operational solutions to mitigate the unintended consequences of suicide due to housing alone in a cell

Level

Intermediate

Jails and prisons are the largest mental health facilities in the nation. No matter how hard we try to defer entry, those with mental illness find their way through our doors. Implementing mental health service standards in correctional facilities can remove barriers to assisting individuals with mental illness, while also helping achieve peak organizational performance. Firsthand experiences from the presenters and the audience will shape the conversation and develop potential avenues for advocacy.

The Michigan Department of Corrections transformed how it assesses and treats sexual offenders. The presenters will discuss what was not working, what was changed (e.g., evidence-based assessment and treatment), the results arising from these changes, and next steps.

Learning Objectives

• Describe the need for external and internal expertise, training, quality assurance, and inclusion of stakeholders in a treatment program for sexual offenders
• Review empirically validated risk and needs assessments for individuals with a history of sexual offending
• Summmarize manualized therapy and The Good Lives Model positive psychology

Level

Intermediate

The Kansas Department of Corrections Office of Victim Services has created a facility-based Batterer Intervention Program that fosters an environment of behavior change without the use of shame and punishment. Group members gain understanding of how their own trauma has impacted their behaviors and beliefs, which in turn helps to build their empathy for others and change abusive behaviors.

Learning Objectives

• Describe the Kansas Department of Correction's facility-based Batterer Intervention Programming
• Outline the River of Cruelty model and how it provides trauma-informed accountability
• Explore the practice of tailored accountability based on a group member's motivation for using violence

Level

Intermediate

Correctional health and mental health professionals must provide effective, efficient care to a high-need, high-acuity population while navigating strict security regulations, crowded facilities and unique legal and public health considerations. To meet these challenges, continual professional growth is essential. CCHP recognizes the special skills and knowledge necessary to provide care in the complex world of corrections. CCHP-MH specialty certification goes one step further for QMHPs in providing formal recognition for practitioners who have engaged in ongoing, focused and targeted professional development and is validation of one’s dedication to continuing competence and quality service delivery.

Learning Objectives:

• Outline the eligibility criteria and application process for CCHP and CCHP-MH certifications
• Discuss how to prepare for CCHP and CCHP-MH exams
• Review the recertification process and continuing education requirements

Level:

Basic

The antipsychotic medication clozapine has been shown to reduce self-injurious behavior, suicide, and aggression in heterogeneous populations. This presentation will provide an overview of clozapine, its indications, and routine monitoring. It will review evidence from the North Carolina prison system showing reductions in self-injurious episodes, assaults on custody staff, disciplinary infractions, and time assigned to restrictive housing among clozapine-treated patients refractory to other medications and therapies.

Learning Objectives

• Review the general benefits and risks of clozapine therapy
• List three potential benefits of clozapine use in a correctional system
• Describe nuances of clozapine prescribing in a prison setting

Level

Intermediate

Stress, burnout, and trauma among correctional workers lead to mental health disorders, employee turnover, and poor patient care. This presentation highlights the magnitude of the problem and how it has only been exacerbated by the COVID-19 pandemic. The authors provide a holistic analysis of the impact of the problem and offer examples of institution-based programs and activities that can help prevent stress and burnout or mitigate their effects.

Learning Objectives

• Describe the costs of stress and burnout on correctional workers and organizations
• Review the return on investment with wellness programs in health care organizations
• Discuss wellness initiatives implemented in secure facilities

Level

Basic

Yoga can yield positive effects as an integrative intervention to address emotional and behavioral dysregulation, symptoms of complex trauma, and mental illnesses and disorders common in detained youth. The presenter will outline systems of care, intervention models, time constraints, and why providers in the juvenile facilities need to adopt more integrative treatment modalities.

Learning Objectives

• Demonstrate a basic understanding of trauma and how it disrupts the development of children
• Review effects trauma and manifestations of emotion and behavioral dysregulation
• Discuss the positive effects of yoga on mental and emotional heath

Level

Intermediate

Many people entering correctional facilities have multiple risk factors that place them at higher risk for life-threatening illnesses. It is imperative that health care professionals who conduct mental health intake screenings receive the proper training so that they ask the right questions to gain clinically relevant information. This will aid in continuity of care and lead to more positive clinical outcomes.

Learning Objectives

• Identify the components of the mental health intake screening
• Demonstrate how to complete an intake mental health screening
• Discuss follow-up interventions when a patient reports a history of mental illness

Level

Basic

Suicide is an enormous problem in the corrections, with significant economic and social impacts. This presentation will review current strategies for accurate suicide risk assessment and discuss innovative approaches that have the potential to significantly reduce suicide rates. Ways to mitigate legal risks and to care for inmates and staff who have witnessed or been affected by suicide-related adverse advents will be offered.

Learning Objectives

• Review options for suicide risk assessment
• Examine technological advances in the field of suicide risk assessment
• Discuss successful staff and inmate intervention strategies for adverse events

Level

Basic

Join us for a virtual get together to meet the Foundation’s scholarship award winners and hear what’s new with the NCCHC Foundation. The Foundation has had a stellar year since its launch at the 2020 Mental Health Conference. Find out how we are making progress on our mission to champion the correctional health care field and serve the public by supporting research, professional education, scholarships, and patient reentry into the community. 

Zoom info:

Zoom.com

Meeting ID: 992 3554 0325 

Dial any number:  
+1 312 626 6799 
+1 301 715 8592   
+1 669 900 6833