1. 1 Inmate Mental Health Care Legislative Audit Bureau April 2009

2. 2 Background u 2001 LAB prison health care audit u 2002 and 2006 reviews by a professional standards organization u 2002 Supermax settlement agreement u 2008 Taycheedah settlement agreement

3. 3 Mental Health Care Expenditures u In FY 2007-08, mental health care expenditures totaled 59.8 million, including: –$27.0 million in DOC expenditures for mental health staffing and treatment –$32.8 million in DHS expenditures to house and treat inmates at the Wisconsin Resource Center

4. 4 Mental Health Care Staffing (FY 2007-08) u Department of Corrections: –127.35 FTE mental health positions – 21.51 LTE mental health positions – 96.00 FTE correctional officers at WRC u Wisconsin Resource Center: –226.60 FTE mental health positions – 72.20 FTE other direct service staff –105.30 FTE administrative and service staff

5. 5 DOC Mental Health Classifications

6. 6 Inmates by Mental Health Code (June 2008)

7. 7 Mental Health Screening u Inmates are to be screened for mental illnesses within two days of entering DOC custody u Files for inmates with mental illnesses are reviewed when they transfer between facilities u Most screenings and reviews occur on a timely basis

8. 8 Mental Health Services u 9 institutions operate specialized housing units for some mentally ill inmates u Psychologists and psychiatrists regularly monitor inmates on their caseloads u Individual and group therapy availability is limited

9. 9 Psychotropic Medications u 3,869 inmates were prescribed psychotropic medications in June 2008 u DOC expenditures for psychotropic medications totaled $6.1 million in FY 2007-08 u Most medications are delivered by correctional officers

10. 10 Safety and Discipline u Mentally ill inmates accounted for: –More than 90.0 percent of self-harm incidents –80.0 percent of inmate suicides –More than 40.0 percent of segregation placements

11. 11 Inmate Assaults on Staff (FY 2005-06 through FY 2007-08) u 79.2 percent of assaults on staff were committed by mentally ill inmates u 84.5 percent of assault-related worker’s compensation awards resulted from assaults by mentally ill inmates u $874,200 in awards resulted from assaults by mentally ill inmates

12. 12 Wisconsin Resource Center u Current operating capacity is 314 inmates u Over one-third of releases are to the community u We recommend improvements to admissions policies and procedures

13. 13 Release Planning u DOC is implementing a pre-release curriculum for all inmates u Inmates with mental illnesses receive assistance with: –medications –disability benefits applications –post-release treatment appointments

14. 14 Future Considerations u Assess the Conditional Release Program model u Build upon and fully implement recent improvements u Set priorities for future improvements u Report to the Joint Legislative Audit Committee in January 2010 to help ensure effective oversight

15. 15 Inmate Mental Health Care Legislative Audit Bureau April 2009