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Adults with Behavioral Health Needs under Correctional Supervision

addiction services that emphasizes continuity and quality is in the best interest of consumers, providers, programs, funders, and systems.75 Although integrated treatment is a demonstrated EBP for individuals with serious mental illnesses and co-occurring substance use disorders,76 the availability of integrated services remains limited in most communities.77 As such, individuals with co-occurring disorders may not get access to interventions associated with positive outcomes—both in terms of their recovery and public safety. Because having co-occurring disorders is associated with increased criminal justice contact,78 it is not surprising that the rates of co-occurring disorders in jails and prisons are high. Therefore, at booking and throughout criminal justice processing, personnel can use evidence-based screening and assessment practices to identify the possible contribution of both mental illness and substance use to disorders in mood, thinking, and behavior associated with criminal conduct. The presence of co-occurring disorders has a significant impact on treatment interventions in which effective responses require integration and coordination between mental health and addiction systems.

Corrections: Custody, Control, and Supervision Corrections officials often conduct assessments both for custodial classifications and for treatment and programming. It is important to distinguish between these uses. Custody and security placement decisions are often determined by an assessment of individuals’ level of institutional risk (escape risk, gang affiliations, and other day-today management concerns), which directs inmates’ facility placement, security level, and work assignments during incarceration. While these concerns are essential to operating safe and secure facilities, it is also critically important that prisons and jails use objective assessments to determine placement in programs that can affect individuals’ criminogenic risk—that is, likelihood of reoffending. The same holds true in using assessments for assigning people to community supervision. Institutional officials have understandably focused on the important functions related to the safe management of inmates. However, as the science of risk assessment has become more widely accepted, officials have recognized the need to broaden their practices. This represents a major cultural and systems change that many institutions are still in the early stages of addressing. Not all correctional facility authorities at present effectively screen for risk or need, in part because of problems associated with choosing, tailoring, and applying instruments. Those that do use screening and assessment tools sometimes lack resources or guidance on how to ensure that personnel use the results consistently to identify and prioritize people for their programs. Inmates also may simply refuse treatment, complicating the prioritization process, or they may sign up for substance abuse or other treatment programs (independent of need) to reduce time served when that option is available. Taken together, these factors may result in individuals participating in programming who are not at the greatest risk for committing future crimes.

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