Treating prison inmates with co-occurring disorders: an integrative review of existing programs

Abstract

The tremendous growth in state and federal correctional populations has focused greater attention on the needs of mentally ill and substance abusing inmates. Although an estimated 3–11% of prison inmates have co‐occurring mental health (psychotic and major mood) disorders and substance abuse disorders, few treatment programs are described in the literature and there is little available information regarding effective treatment strategies for this population. The current study provides an integrative review of seven ‘dual diagnosis’ treatment programs that recently have been developed in state and federal prisons. Many of these have evolved from existing substance abuse treatment programs and approaches. Key program components include an extended assessment period, orientation/motivational activities, psychoeducational groups, cognitive–behavioral interventions such as restructuring of ‘criminal thinking errors’, self‐help groups, medication monitoring, relapse prevention, and transition into institution or community‐based aftercare facilities. Many programs use therapeutic community approaches that are modified to provide (a) greater individual counseling and support, (b) less confrontation, (c) smaller staff caseloads, and (d) cross‐training of staff. Research is underway in three of the seven sites to examine the effectiveness of these new programs. © 1997 John Wiley & Sons, Ltd.

Specialized 12-Step Programs and 12-Step Facilitation for the Dually Diagnosed

“…The efficacy of 12-step programs and 12-step-oriented treatments in the treatment of dually diagnosed individuals (DDI) is less clear, in spite of the fact that they have been included in many programs and models described in the literature (Chatlos, 1989;Chiauzzi, 1994;Edens, Peters, et al, 1997;Franco, Galanter, et al, 1995;Galanter, 2000;Katz, 1999;Minkoff, 1989;Minkoff, 2001;Mowbray, Solomon, et al, 1995;RachBeisel, Scott, et al, 1999).…”

Findings of a Formative Evaluation of a Transitional Housing Program for Forensic Patients Discharged into the Community

“…While some programs have provided linkages for their clients to new service providers as they transition to the community, either postprison (Hartwell & Orr, 1999;Edens, Peters, & Hills, 1997) or posthospital (Dimmek, 1994), there is a paucity of descriptions of transitional housing programs with extensive support for forensic patients transitioning from the hospital to the community. Cimino and Jennings (2001) described a progressive treatment model for forensic clients discharged from the hospital; however, the interim accommodation between the hospital and community was described as a secure, residential treatment facility, rather than transitional supportive housing.…”

“…Those programs that offer services to individuals with mental health and justice system involvement often provide support (Dimmek, 1994;Edens et al, 1997;Hartwell & Orr, 1999), while some provide some housing options (Campanelli et al, 2005;Cimino & Jennings, 2001;Lamberti et al, 2001). TRHP provides a comprehensive program initially based around limited-term supportive housing, with access to staff 24-hours a day, and the option of group programming or individual support targeted to address client needs.…”

Public Sector Responses to Jail Mental Health: A Review with Recommendations for Future Research

“…A critical concern in treating inmates who are dually diagnosed is that service providers are often confronted with the problem of which symptoms to treat first as one often precipitates the other. As documented by Edens, Peters, and Hills (1997), this detainee population often has more significant psychosocial problems, more difficulty adjusting to institutional arrangements, and more pronounced cognitive and functional deficits when compared to other jail detainees. Alcohol and drug detoxification must preclude treating any form or mental disorder, and generally is not effectively addressed in a punitive environment.…”