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    Document Summary
    - Report Published -

    House Document No. 5
    PUBLICATION YEAR 1994

    Document Title
    Evaluation of Inmate Mental Health Care

    Author
    Joint Legislative Audit and Review Commission

    Enabling Authority
    Appropriation Act - Item 15. (Regular Session, 1992)

    Executive Summary
    The U.S. Supreme Court determined in the 1970s that inmates have a Constitutional right to mental health treatment but the court has not provided direction on what constitutes adequate treatment. Therefore, the level and quality of mental health care must be determined by treatment professionals within the corrections system.

    JLARC staff estimate that the Virginia Department of Corrections (DOC) expended almost $4.9 million in FY 1993 to fund mental health treatment. The department employs 76.5 classified employees, 15 contract employees, and two temporary employees to provide mental health treatment in the institutions. One staff member within the central office is dedicated to mental health treatment and serves in an advisory capacity to the institutional staff.

    DOC provides three levels of mental health treatment. Acute care for male inmates who are severely mentally ill and present a danger to self or others is provided at Marion Correctional Treatment Center. Acute care for female inmates is provided by the Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) at Central State Hospital. Sheltered care units at five facilities provide treatment and housing for inmates who are so mentally ill that they cannot function in the general population. Outpatient treatment is provided at 15 facilities for inmates who need periodic mental health treatment but are able to function within the general inmate population.

    There are two major findings of this report. First, the department has not fully developed a system of comprehensive mental health care. Several problems with mental health service delivery appear to result from the lack of such a system. Second, the department has not developed adequate cost control mechanisms, in part because it lacks data on the costs of the mental health services it is providing. The department, which is planning to add new mental health staffing and beds during FY 1994, could also utilize its existing resources in a more cost-effective manner. While the new resources the department is adding should help it improve its mental health services, it is also important that DOC implement cost control mechanisms and operate more efficiently, in order to use its existing and new staff to their full potential.