Mind(Full) Series: Ep. 10: Nilda – Mental Health Services in Correctional Facilities

Mind(Full) Series: Ep. 10: Nilda – Mental Health Services in Correctional Facilities

[Music] hello and welcome to mindful I’m too light you have the opportunity today to speak with dr. new little boy today we’re going to have the opportunity to talk about mental health services offered in prisons or correctional psychology and I want to say that you’re very well suited to this task and I want to spend a minute for our viewers to describe your experience you’ve been an expert witness in clinical and forensic psychology and courts in both Virginia and Massachusetts specializing in states which are Commonwealth’s yes and also in the federal immigration court you’ve been a court psychologists in both adult and juvenile court clinics and in this state in Massachusetts you have a private practice in forensic evaluations and among the issues you have expertise in and experience are competency to stand trial criminal responsibilities competency to waive Miranda rights riska seven assessments eight 8/2 sentencings and sex offender evaluations and finally I want to mention that you supervise students delivering clinical services during their internships at the Department of Corrections and at the Department of Youth Services for the past eight years that’s wonderful when we talk about underserved populations one of the populations and particularly sticks out is incarcerated individuals you have considerable experience in this area and it’s a very different environment deliver health services and mental health services so could you leave by painting a little bit of picture about what it’s like to be a provider in a setting like this well one thing to consider before we get into that is that it is said now that most of the mental health services in this country I’ve provided in prison or in correctional settings the Los Angeles County Jail for example is considered to be the largest psychiatric hospital in the whole nation that’s partly because of the institutionalization when people were when psychiatric hospitals were reduced in capacity and people what is charged many of them want those three standing and have resources to fend for themselves or have gainful employment and some of them committed crimes for getting food or getting a place to stay or trespassing and they were arrested and that has continued happening to this day so many people who get arrested for even for petty crimes they end up in jail what prompts that situation is their mental illness providing services in that type of environment is very challenging for many reasons one is that the main purpose of place of incarceration is to provide security right so security is paramount and it doesn’t matter what’s happening if there’s a security issue everything else has to stop so you could be in the middle of a session you could be in the middle of a crisis intervention and if there’s a problem they go on lockdown and you may not be able to see the person again for the rest of the day on the other hand they’re the political reality is that people who are incarcerated are not a priority for anyone so you’re gonna run a successful political campaign by saying I’m gonna provide more services to those incarcerated and every time that there’s budget cuts one of the things that goes first our services for people who are incarcerated forgetting that if you don’t provide necessary services to those individuals when they are released they’re going to go back to the community and they’re not going to have a chance to to do well there has been an effort in the Department of Corrections to provide services for inmates every TLC facility here has a mental health team many of our students over the years have served as interns in those themes they do assessments they do individual therapy depending on the facility they may do group therapy as well you mentioned how a session may have to be interrupted because of a lockdown I’m also thinking about something that correctional psychologists must think about frequently which is about privacy yes could you comment on privacy issues in a correctional setting if I mean make these clothes as something that will impact the security in the facility you have to make you have to stop the session and make a report immediately I would say it’s it’s non-existent and that’s something that you have to explain to the inmate at the outset of your interactions with them and they’re very well aware of that yet psychotherapy in general we talked about the importance of building treatment alliance of building trust these are often men and women that have good reason to be careful about whom they trust can you say something about the trust building process in offering psychotherapy with this population a couple of things you can see there is that there’s a lot of turnover sometimes in facilities and when there’s not a lot of turnover the interns turnover every year so you can be a sign if you’re an inmate you can be in turn work with them for 10 months and then you have another one next year so the nature of psychotherapy is also different in that you don’t go into very deep themes for example many of the individuals who are incarcerated have a history of trauma or complex trauma and it is not the purpose of therapy to go into that and to heal that trauma because the environment is not conducive the focus is on helping the individuals with coping skills to adapt to the environment or for example if they have it’s more like targeting the symptoms for example if someone has insomnia then you deal with them and teach them how to have better sleep hygiene if someone gets angry very often then you teach them coping skills how to deal with anger how to perhaps use breathing techniques meditation and other things like that but it’s not you cannot engage in profound psychotherapy in a setting like that because there’s no support to to deal with all the things that people go through when they engage in that process and you had mentioned the issue for someone that has a life term yes could we chat about that so in some facilities there are prisoners inmates who have been sentenced to life and of course life means different things in different places right some people who have sentient life sentences may be able to get out in 25 years depending on the situation depending on if they’re parallel eligible or not but some people know also depending on their age that most likely they’re never gonna go out there is work to be done with them to help them adjust that reality and to try to find purpose in their life even when they’re incarcerated because many of them say well what’s the point of being here if I’m never gonna go out again what do I have to look forward to so there’s a lot of work with those individuals in terms of trying to find purpose along those lines we were talking a few minutes ago about that the targets in psychotherapy are different in this setting how is suicidality managed it seems that the higher the security level the most likely people have more either suicide our ideas or attempts there are protocols established to monitor people who expresses a ideation that include constant eyes on them they are placed in in a different cell sometimes their garments are different they are given paper gowns instead of their regular clothing and they’re not allowed to have anything that can be used so it’s not unlike psychiatric hospitals but in a more secure environment so let’s shift our conversation to the issue of families you know many incarcerated individuals have minor children at home they have a long-term partnership of marriage that they hope to sustain what are some of the themes that the counselors psychologists deals with around maintaining family relationships we have to also make a difference between people who are in a jail or a house of Corrections versus people who are in prison so people who are in jails or house of Corrections are there because they’re either detained while awaiting trial or they have sentences that are less than one year and one day when you have a sentence that’s more than that then usually you end up in a Department of Corrections Facility in a prison State Prison in terms of services for women Massachusetts as one state prison for women which is the facility in Framingham there’s many women who go to Framingham who have very small children some of them even give birth while they’re in prison and then the child has to be relocated to somebody family member or foster care I remember going to Framingham to do an evaluation of an inmate seeing all these social workers outside in the waiting area with very small kids one-year-old two-year-olds who are there to see their moms I think they’re more thorough but not facility than any other facility I’ve visited before in terms of checking you for contraband the other thing is it’s not only difficult for the person who’s incarcerated but for the people who are left behind at home that don’t have many families lose a breadwinner their financial situation changes drastically by that person be incarcerated so the kids of those individuals then experience the privation in other ways so they’re not only missing their father or their whatever relationship they have with the incarcerated person but they also face poverty and other problems in addition to that people get incarcerated that doesn’t mean that they are in a facility that’s close to where the family lives so for some people it’s prohibitive to go visit because they don’t have transportation or they don’t have the money to go so that puts a strain in the family in the family relations the reality is that a lot of their relationships are strained or are broken because people stop visiting they stop calling they stop you know showing interest writing and so many of the incarcerated people also feel that they don’t count anymore they’re not part of the family life anymore there’s a issue of so many inmates that receive the divorce papers but they’re in prison and they have to deal with that I’m aware because we get inquiries from psychologists who are Chiefs at either a prison or throughout a state system and they say they’d have a very difficult time hiring professionals to join their team and I I contrast that to the fact that the forensic program and the counseling department is very popular in part you have a very talented faculty but students are really attracted to careers on the forensic side of the spectrum us less so on the Correctional side what what’s your thoughts about how we might further build teams within prisons well I my experience has been during the years that I’ve been here in the beginning there were a lot of people interested in what I call the CSI effect right they watched CSI on TV and they think that studying forensic psychology or forensic counseling that that’s what they’re gonna be doing solving crimes and dealing with serial killers and things like that which is the case but lately I would say within the last five years we’ve received a lot of candidates and a lot of people who end up coming to the program who are really committed to serving people who are incarcerated because they have identified them as an underserved population and either they have had experience with either relatives or neighbors or people they’ve known who have been incarcerated and they see the need that exists in the system and they’re very committed to providing these services so I am glad that we have the opportunity to send our students to both adult facilities and juvenile facilities to work with these individuals and many of them end up being hired so early at the beat of our interview you commented at the in the in LA County this is the largest psychiatric hospital so there’s the thought and the conviction that many of these people have mental health challenges and this is really in my thinking the original community mental health system I am really grateful to have this chance to chat with you about these important topics we’re gonna wrap up in just a moment a summary comment or final reflection sometimes it’s disheartening to see that people who have significant problems in there too young are unable to get the help that they need and then continue on a path that they get in trouble with the law because of those issues that were not propagated I’m not gonna say not attended to because they were but not properly attended to so I think that there’s a lot of work to do I think that we are committed to training dividuals to provide these services I think that the next step would be also to be more proactive in influencing legislature to make funds available to do the treatment that we know how to provide but that we need the the funds and the mandate do it an excellent final point thanks so much for talking to thank you for doper to me [Music]

Dr. Nilda Laboy joins Dr. Stanley Berman to discuss the provision of mental health services in correctional facilities. Dr. Laboy emphasizes the critical importance of delivering effective treatment to incarcerated populations. She describes the challenges associated with providing psychotherapy and psychiatric care to inmates. The experiences of families who have a family member incarcerated are also discussed.