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SAMHSA publishes guidelines for successful prison-to-community transition

The Substance Abuse and Mental Health Services Administration recently published guidelines for the successful transition of individuals with mental or substance use disorders from jail and prison.

“While it is estimated that approximately 5% of people living in the community have a serious mental illness, comparable figures in state prisons and jails are 16% and 17%, respectively,” David Morrissette, PhD, of SAMHSA, and colleagues wrote. “The prevalence of substance use disorder is notably more disparate, with estimates of 8.5% in the general public (aged 18 or older) but 53% in state prisons and 68% in jails. Similarly, the co-occurrence of mental and substance use disorders has been higher among people who are incarcerated in prisons or jails (33% to 60%) compared with people who are not incarcerated (14% to 25%).”

To provide successful strategies for transitioning individuals with mental or substance use disorders from institutional correctional settings into the community, SAMHSA established guidelines for behavioral health, correctional and community stakeholders to follow the Assess, Plan, Identify and Coordinate (APIC) framework. These guidelines serve as an update to the 2013 “Guidelines for the Successful Transition of People with Behavioral Health Disorders from Jail and Prison.”

To implement APIC, SAMHSA recommended:

• universal screening for mental and substance use disorders as early as possible in the booking/intake process and throughout the criminal justice continuum;
• follow-up on individuals with positive screens with comprehensive assessments to determine appropriate program placement and service delivery;
• develop individualized treatment and service plans based on information from risk and needs screening and assessment process;
• develop collaborative responses between behavioral health and criminal justice that address individuals’ risk levels and behavioral health need with appropriate supervision and treatment;
• recognize that the first hours, days and weeks following release are critical and establish appropriate interventions within transition planning practices;
• develop practices and policies that promote continuity of care through implementing strategies that facilitate direct linkages for postrelease treatment and supervision agencies;
• support treatment adherence and supervision conditions by providing incentive systems to promote treatment participation and establishing protocols across systems on how to handle technical violations of community supervision conditions;
• establish methods to share information across different points in the criminal justice system;
• encourage cross training to promote collaboration between workforces and agencies working with individuals with co-occurring mental and substance use disorders; and
• collect data to assess program performance, identify gaps in performance and prepare for long-term sustainability.

“People with mental and substance use disorder are disproportionately represented in jails and prisons,” the researchers wrote. “While an increasing number of jurisdictions have embraced the guidelines, practitioners have requested further assistance in the design of effective strategies, particularly in the area of discharge planning. This implementation guide provides specific examples of policies and practices that have been adopted at local and state levels to incorporate APIC model guidelines in cross-system responses to individuals with mental or substance use disorders and justice system involvement.” – by Amanda Oldt

Reference :

Substance Abuse and Mental Health Services Administration. Guidelines for successful transition of people with mental or substance use disorder from jail and prison: Implementation guide. Available at: http://www.samhsa.gov/data. Accessed April 6, 2017.