Magazine article Corrections Today

Brief Mental Health Screening for Corrections Intake

Magazine article Corrections Today

Brief Mental Health Screening for Corrections Intake

Article excerpt

Authors' note: Points of view expressed in this article do not represent the official position or policies of the U.S. Department of Justice.

Correctional administrators need brief, cost-effective, easy-to-administer and reliable mental health screens to initially identify mentally ill detainees, who can become disruptive and a threat to themselves and others. Current mental health screening at corrections intake varies greatly--from one or two questions to a full-scale clinical analysis. Available instruments are often costly and time-consuming, making them impractical for daily screening of a large number of inmates at intake. As a result, even though most prisons and jails screen inmates for mental illness during booking, (1) research has shown that they miss the majority of inmates with mental health problems, particularly those with less obvious symptoms. (2)

Researchers, through funding by the National Institute of Justice (NIJ), have now developed and validated two brief, free mental health screening tools that proved effective in identifying various levels of mentally ill detainees at intake: the Correctional Mental Health Screen (CMHS) (3) and the Brief Jail Mental Health Screen (BJMHS). (4) The screens use standard one-page questionnaires that correctional officers with modest training can administer in three to five minutes and score simply by adding up "yes" answers.

Both screens proved valid when compared with far longer and more detailed screens administered by trained clinical assessors. The CMHS screens were effective in identifying nine categories of mental disorder in both male and female inmates. The BJMHS was effective in identifying male inmates with mental disorders and is being refined to increase its effectiveness in identifying female detainees with anxiety- and stress-related mental illness.

Using the Screening Instruments

CMHS. The CMHS uses separate questionnaires for men and women: the Correctional Mental Health Screen-Male (CMHS-M) asks 12 yes/no questions, and the Correctional Mental Health Screen-Female (CMHS-F) asks eight yes/no questions about current and lifetime indications of serious mental disorder. Both screens take about three to five minutes to administer. Six questions regarding symptoms and history of mental illness appear on both questionnaires, including whether the inmate ever has been hospitalized for nonmedical, including psychiatric, reasons. The remaining questions on each test focus on types of mental disorders more prevalent in that gender. It is recommended that male inmates who answer five or more questions "yes" and female inmates who answer four or more questions "yes" be referred for further evaluation.

BJMHS. The BJMHS is an eight-item yes/no questionnaire that takes about two to three minutes and requires minimal training to administer; it asks six questions about current mental disorders and two about any history of hospitalization or medication for mental or emotional problems. Inmates who answer "yes" to two or more questions about current mental disorders or acknowledge having been hospitalized or taking medication for mental or emotional problems are referred for further evaluation. Instructions for administering the screen appear on the back of the form. Correctional classification officers, intake staff or nursing staff can administer the screen without specialized mental health training, but may receive brief informal training before administration.

The Correctional Mental Health Screen

First phase. The researchers combined into one composite interview questions from five screening modules for a range of mental disorders. (5) The resulting Composite Mental Health Screen consisted of 53 items and took about 25 minutes to administer.

Researchers then administered the composite screen to randomly selected adult detainees in Connecticut's five jails (four for men and one for women) within 24 to 76 hours after admission. …

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