16. PERSONS WITH MENTAL IMPAIRMENTS

1. 16. PERSONS WITH MENTAL IMPAIRMENTS

2. Note to Instructor: Commission Course, “Mental Health Officer” (#4001) can be used as a supplement.

3. Unit Goal 16.1: The student will be able to summarize the issues involving persons with mental impairments at a jail facility.

4. 16.1.1 The student will be able to discuss the jail’s responsibility for persons with mental impairments.

5. A. Americans with Disabilities Act

6. 1. The National Institute of Justice examined the implications of the Americans With Disabilities Act (ADA) for criminal justice agencies at the state and local levels. Under the ADA, corrections facilities must do more than just identify inmates and employees with mental disabilities. Now they must also provide mental health screening, evaluation, and treatment.

7. 2. Approximately 10 million individuals are confined in jails in the United States each year. • An estimated 6.4% of these detainees have a severe mental disability. • Some experts believe this percentage is even higher, around 8%, and that the percentage of female detainees with a severe mental disability may be as high as 13%. • This means that jails across the United States are dealing with 640-800 thousand detainees with mental disabilities each year.

8. B. Case law and deliberate indifference

9. 1. The courts now consider a facility’s deliberate indifference to an inmate’s mental disability the same as that facility’s indifference to an inmate’s medical condition. This standard, “deliberate indifference,” has evolved from a series of federal court rulings on the adequacy of health care and mental health care in prisons (Cohen, 1985, 1988).

10. Simply stated, federal courts have generally found in favor of prison systems in suits filed on the basis of inadequate health care, as long as prison administrators and staff have not demonstrated a deliberate indifference to the mental or physical health care needs of the inmate.

11. 2. A correctional facility should avoid practices that screen out or eliminate eligible inmates from programs and services solely on the basis of a mental (or physical) disability.

12. C. Jail standards

13. 1. Correctional facilities, including local jails, should screen all inmates to identify those with mental or physical disabilities. Inmates with mental disabilities should be evaluated by a qualified mental health professional. Health personnel should have access to crisis intervention, treatment, and discharge planning services. It is simply not enough to provide separate services to those with mental disabilities since mainstreaming is a major intent of the ADA.

14. 2. Inmates with mental disabilities, particularly those in local jails, are the responsibility of the community, not of just law enforcement personnel.

15. 3. The integration of jail services and community health services is critical to the success of an inmate’s treatment and reintegration into the community and the continuity of care requirements of the HSC 614.016.

16. 4. In accordance with the TCJS 273.1, entitled “Health Services”: The owner/operator of each facility shall provide medical, mental, and dental services in accordance with the approved health services plan. These services may include, but shall not be limited to, the services of a licensed physician, professional and allied health personnel, hospital, or similar services. In addition, TCJS 273.5 requires that a mental disabilities/suicide prevention plan be implemented.

17. 16.1.2 The student will be able to define mental impairment.

18. A. Definition of “offender with mental impairment” - a person with mental retardation, mental illness, or a developmental disability who is arrested or charged with a criminal offense. (HSC 614.001(7))

19. 16.1.3 The student will be able to define mental retardation.

20. A. Definition of “offender with mental retardation” - significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behavior and originates during the developmental period. (HSC 591.003(13))

21. 16.1.4 The student will be able to identify the characteristics of a person who is mentally retarded.

22. A. General information and statistics

23. 1. Approximately 3% of the American population is considered retarded. Although a large percentage of the jail population (up to 10%) can be classified as having mental retardation.

24. 2. To determine with certainty whether a person is mentally retarded requires comprehensive examinations and tests by qualified individuals. When officers first encounter a citizen, they must rely on their own perceptions and minimal information to determine whether referral or other actions are appropriate.

25. B. Possible characteristics

26. 1. Physical appearance

27. a. Physical signs rarely indicate that a person is mildly or moderately retarded, but they may provide an initial clue to look further

28. b. Does the person have any obvious physical disabilities?

29. c. Does the person move awkwardly or have poor motor coordination?

30. d. Does the person have a slow reaction time?

31. 2. Task performance deficiencies - inability to successfully perform relatively simple tasks such as the following may indicate the person is mentally retarded:

32. a. Reading and writing

33. b. Identifying oneself

34. c. Telling time

35. d. Counting or making change

36. e. Using the telephone

37. f. Giving directions to their home

38. g. Understanding directions or instructions

39. 3. Ask yourself the following questions:

40. a. Does the person have any speech defects?

41. b. Does the person have a difficult time understanding your questions?

42. c. Is the person unable to use abstract reasoning concepts?

43. d. Does the person have difficulty staying on the subject you are trying to discuss?

44. e. Does the person become distracted easily?

45. f. Do the person’s eyes maintain normal contact with yours, or do they wander?

46. g. Does the person have someone who speaks for them in certain situations or transactions?

47. h. Is the person easily led or persuaded by others?

48. i. Does the person display an inappropriate “social distance” during conversation?

49. j. Does the person use hostility and anger to compensate for intellectual deficits?

50. 16.1.5 The student will be able to identify effective communication and interaction skills for dealing with persons with mental retardation.