Mental Health Treatment in Correctional Facilities

Lissette Santiago 

February 28th, 20230

MET CJ 752 O1 Forensic Behavior Analysis.

Blog Post.

I will be discussing the need for Mental Health services within a correctional setting, whether that be a jail, prison, or any level of security. As a counselor working inside a prison, Mental Health is not taken as seriously as it should be. A little bit about my job, I work as a Counselor/Facilitator for the Secure Adjustment Unit in a prison. For those of you who do not know what the Secure Adjustment Unit is, per the Massachusetts Department of Corrections, “SAU is defined as a highly structured unit that is not Restrictive Housing which provides access to cognitive behavioral treatment, education, programs, structured recreation, leisure time activities, and mental health services for those inmates assessed as needing a specific structured program intervention to support positive adjustment”(M.ADOC policy, 4). Incarcerated individuals will be placed in this unit after they are assessed on the pattern of behavior that has been displayed. 

Based on the assessments, these incarcerated individuals will be placed on 1 of the three tracks. The first track is Recovery Skills, specific toward Substance Use. The second track is Rational Thinking, specific towards Criminal Thinking, and lastly, track 3 is Interpersonal Effectiveness, specific towards adjustment concerns and conflict management. Through these tracks, as counselors we’re able to create individual program objectives, to measure their progress toward their treatment. The incarcerated individuals that get placed in this unit, have high levels of substance use issues, violence, and SMI, which stands for Serious Mental Illness. Due to the number of SMI participants residing within this unit, there is an imperative to be trauma-informed training for security staff. 

Depending on the incarcerated individual’s mental health status, they will not be seen by the mental health clinicians, and they submit a “sick slip”. Depending on the severity level of the sick slip, mental health clinicians can take up to 1 month to check in with a participant.  If these individuals are in a Mental Health crisis, a certain protocol must be followed. When I read, “The Role of Adult Correctional Officers in Preventing Suicide” I was able to relate my first-hand experience with incarcerated individuals who are in what’s called “crisis”, meaning serious mental distress. In this reading I found the protocol questions to be similar, on page 3 of the reading under “ Responding to a suicidal inmate” number 2 states “ Ask if the inmate is thinking about suicide… this will not encourage him or her to attempt but will let the inmate know it is okay to share how he or she is feeling”( Pg, 3). The protocol for different facilities is different, but ultimately should be addressed because even so, lots of incarcerated individuals do not feel safe telling the officers how they feel mentally. 

The sad reality of prison is that 9 times out of 10  offenders are taunted by their peers and security staff for being in a mental health crisis. Imagine having a panic attack in the middle of the night due to PTSD, and having to tell a correctional officer you need to speak with mental health. While being called a “p***y”, “f***ing idiot”, and much more. These are just a small portion of the informal and underreported actions from Correctional Officers that cause lots of climate issues. Not having enough trauma-informed line staff can cause a person to be re-traumatized and can cause a violent outbreak. According to the National Alliance of Mental Illness, “ Despite constitutional rights for individuals who are incarcerated to receive medical and mental health care, nearly two-thirds of people with mental illness in jails and prisons do not receive mental health treatment”(NAMI,8). Incarcerated individuals do not feel safe expressing their emotions due to the decreasing number of mental health clinicians, and security staff that are not trauma-informed. 

Mental health can be improved in correctional facilities with more trauma-informed care for all staff. However, it also requires a change in perspective. According to “ Implementing Trauma-Informed Care in Correctional Treatment and Supervision” it states “  Viewing criminal behavior through the lens of early trauma does not excuse crime or victimization; rather, it enriches our understanding of how criminal behavior develops and informs intervention strategies. In this way, we can improve desired outcomes such as reduced recidivism and successful reintegration”(Levenson and Willis, 2). Being trauma-informed is not about making excuses for a person’s behavior, it’s about understanding the root issue of a person’s actions to prevent mental health crises and rehabilitate negative behavior. As a society, if we want incarcerated individuals to be rehabilitated, we need to strengthen our Mental Health services in correctional facilities. 


Jill S. Levenson & Gwenda M. Willis (2018): Implementing Trauma-Informed Care in Correctional Treatment and Supervision, Journal of Aggression, Maltreatment & Trauma, DOI: 10.1080/10926771.2018.1531959 

Massachusetts Department of Corrections. (2023, January 25). Policy – 103 DOC 427 Behavioral Assessment Units and Secure Adjustment Units. Retrieved February 28, 2023, from 

NAMI. (n.d.). Mental health treatment while incarcerated. NAMI. Retrieved February 28, 2023, from 

Suicide Prevention Resource Center. (2014). The Role of corrections Professionals in preventing suicide. U.S Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). 


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