NaphCare Perspective: Mental Health Stabilization Units: A Novel Approach to Mental Health Care in Jails

Across the United States, there are more individuals with severe mental illness (SMI) in jails than public and private psychiatric hospitals, though treatment resources are far more scarce in correctional than clinical settings. With well-intentioned motivation, correctional facilities attempt to protect this vulnerable – often traumatized – population by separating them from the general population. Unfortunately, we have learned the harmful consequences that can occur with social isolation and segregated housing.

Because inmates with untreated SMI are at increased risk for adverse outcomes (e.g., harm to self, harm to others, reoffending), NaphCare – in conjunction with our correctional partners at Hillsborough County Jail in Tampa, Florida – developed a new model for providing mental health care in a correctional environment.

NaphCare’s Mental Health Stabilization Unit (MHSU)

An innovative concept, the NaphCare MHSU in Hillsborough County is an open-bay, self-governed community that creates space for mental health patients to receive treatment without confinement while remaining separated from the general population.

In the MHSU, patients experiencing symptoms of SMI are incentivized to participate in therapeutic programming rather than ‘punished’ by being placed in lockdown or other segregated housing. The dedicated unit creates a setting where individuals can strive for overall wellness and functioning to eventually transition to general population and/or a more stable setting within the jail.

Our interdisciplinary approach to facilitate mental health stabilization includes medication management, treatment planning and programming, and monitoring throughout the detention process, with discharge planning as the primary focus and goal of mental health services. MHSU program staff are trained professionals who practice with integrity and professionalism and are able to acknowledge and respect the multiple needs of patients who experience symptoms of mental illness.

Operating from a recovery-based framework, we aim to help individuals navigate the aftermath of experiencing symptoms of and/or being diagnosed with SMI while learning to manage/cope with their symptoms. In some cases, this means redefining and attaining basic life goals that may be challenging for individuals with SMI (e.g., developing/maintaining meaningful relationships, stable and safe housing, adequate income, life satisfaction).

In addition to individual interventions provided by advanced and intermediate mental health professionals, patients participate in evidence-based treatment curriculum to gain insight about their mental health functioning and develop coping skills.

Since the Hillsborough County MHSU’s inception, the jail has seen a 55% reduction in the use of force, 25% reduction in mental health segregation, 20% reduction in emergency treatment orders and no suicide attempts. To date, the program has graduated more than 200 individuals to general population or less restrictive community placements.

The success of the MHSU is largely contingent on our close partnership with the Hillsborough County Jail correctional officers. Through their participation in specialized training (e.g., working with mentally ill inmates, non-violent de-escalation), reconsideration of disciplinary strategies, and collaboration with mental health professionals, officers have pivoted the pendulum of jail culture toward rehabilitation and recovery.

As we continue to monitor the success of this program and the impacted patients, we are committed to continuing to refine the work we do to better serve our patients, our correctional partners and their communities.

As NaphCare’s Chief Psychologist, Dr. Simpler collaborates with mental health providers to improve clinical and operational processes within correctional settings and evaluates sites to assist with new initiatives such as mental health crisis stabilization units and jail based competency restoration programs.