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Levels of care 

Levels of care
Chapter:
Levels of care
Author(s):

Jeffrey L. Metzner

and Kenneth L. Appelbaum

DOI:
10.1093/med/9780199360574.003.0022_update_001

Update:

Minor updates throughout

Added one new reference.

Updated on 28 September 2017. The previous version of this content can be found here.
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date: 17 January 2020

Just as in community settings, there is a continuum of care for mentally ill inmates in correctional settings. This continuum progresses from ambulatory care through supported residential housing to inpatient or infirmary care. The continuum of care for inmates with mental illness includes outpatient care, emergency services, day treatment, supported residential housing, infirmary care, and inpatient psychiatric hospitalization services. Outpatient treatment is the least intensive level of care. In some systems this may include a day treatment program, which provides enhanced mental health services similar to a residential program as described below. In the case of outpatient treatment, participating inmates live in a general population housing unit with other inmates, many of whom are not in need of mental health services. A residential program (i.e., housing unit) within the correctional setting is provided for inmates with chronic mental illness who do not require inpatient treatment but do require enhanced mental health services. Such a designated housing unit can provide a safe and therapeutic environment for those unable to function adequately within the general inmate population. Crisis intervention services include both brief counseling and supervised stabilization. The latter, often provided in an infirmary setting, serve short-term stabilization and/or diagnostic purposes. A psychiatric inpatient program is the most intensive level of care and is often provided by the state psychiatric hospital system. This chapter describes each level and how they may be adapted successfully to function in correctional settings to meet the needs of individuals with mental illness.

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