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Journal of Correctional Health Care
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A Mental Health Clinician Model of Care in a Jail System

Earl H. Goldstein, MD

San Diego County Sheriff’s Department, Medical and Inmate Services Division, San Diego, California, earl.goldstein{at}sdsheriff.org

Vicky Felizardo, RN, BSN

San Diego County Sheriff’s Department, Medical and Inmate Services Division, San Diego, California

Richard M. Conklin, LCSW

San Diego County Sheriff’s Department, Medical and Inmate Services Division, San Diego, California

Royanne Schissel, RN, CCHP

San Diego County Sheriff’s Department, Medical and Inmate Services Division, San Diego, California

This study sought to measure the value of a mental health clinician (MHC) model of assessment and care in the San Diego County jail system. It describes implementation of the model, by which inmates requesting psychiatric care are screened for possible referral to an MHC clinic. Patients who meet certain criteria receive initial evaluation by an MHC rather than direct referral to a psychiatrist. If the clinician determines that further psychiatric evaluation and treatment are not required, holistic treatment is used to address problems such as sleep disturbance, anxiety, depression, and drug withdrawal. Analysis of clinical use and referral data found several positive outcomes. The model identified patients who do not need to see a psychiatrist and can be treated with holistic approaches. Holistic treatment resulted in marked reduction in patient symptoms and in usage of sleep and antianxiety medications. Psychiatric evaluation time and waiting time for new psychiatric patients decreased, thereby increasing overall access to psychiatric care.

Key Words: correctional heath care • correctional mental health • jail mental health • jail psychiatric care • holistic mental health

Journal of Correctional Health Care, Vol. 12, No. 3, 189-202 (2006)
DOI: 10.1177/1078345806292720
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