MENTAL HEALTH SERVICES CONTINUUM PROGRAM (CA)

Program Description
In July 2000, the California Department of Corrections (CDC) and Parole and Community Services Division began implementation of the Mental Health Services Continuum Program (Continuum Program). The program is an expansion and enhancement of mental health treatment services delivered by the Parole Division's existing Parole Outpatient Clinics throughout the state, designed to ensure continuity of care between prison and the community. In January 2001, the Parole Division created the central administration unit responsible for monitoring, reviewing, and coordinating the various mental health programs the Parole Division operates.

The target populations for the Continuum Program are inmates and parolees who received in-prison mental health treatment and were diagnosed with one or more serious mental health disorders (such as schizophrenia, delusional disorder, major depressive disorders, and bipolar disorder). The program provides the following services to eligible inmates and parolees: 1) comprehensive, computerized, pre-release needs assessments, benefits eligibility, and application assistance; 2) expanded and enhanced post-release mental health services such as medication management, psychological testing, and individual/ group therapy; and 3) reintegration assistance via connections with community-based programs for long-term care.

Services for the pre-release component, called the Transitional Case Management Program, are provided by private independent contractors who employ social workers to cover all 33 of the state's correctional institutions. The pre-release services are provided at 90-and 30-day intervals prior to release. One unique feature of the Continuum Program is the development of an automated case management system. The information collected during the pre-release phase is entered into laptop computers and ultimately transferred into a comprehensive statewide database that is utilized by both the pre-and post-release components of the program. The database is the crux of the program, offering nearly 1,800 fields of data collection that range from arrest, alcohol and drug history, to community reentry planning. In addition, the database offers a built in appointment scheduler, a comprehensive case notes section, and intensive sections on the parolee's mental health diagnosis, medication management, and benefits eligibility updates.

After the pre-release process is complete and the parolee is released to the community, as a condition of his/ her parole, the parolee receives post-release care from the Parole Division's Parole Outpatient Clinics (POC). The POC uses a treatment team approach to ensure quality and continuity of care. POC clinical staff includes psychiatrists, psychologists, and psychiatric social workers who provide the parolee with medication maintenance, psychological testing, and individual and group therapy, respectively. POC psychiatric social workers finalize parolees' applications for benefits that were initiated during the pre-release phase. This process completes the continuum of care and prepares the parolee for the transition to long-term community-based care.

Program Goals
The Mental Health Continuum Program's goal is to prepare inmates with mental illness for release back to the community by ensuring they have made connections to health care providers in the community and have access to health benefits upon release. These efforts are aimed at facilitating the reintegration process and reducing the likelihood of rearrest and reincarceration.

Networking, Partnering & Collaboration
Implementation of the Continuum Program has fostered a number of collaborations and partnerships between the Parole Division and other organizations. For example, the Parole Division has:

• Worked with the Social Security Administration in developing a presumptive eligibility for the state's severest mentally ill population within 30 days of release from prison.
• Developed a relationship with the Department of Corrections' Office of Substance Abuse Programs to network and share information among programs.
• Created an ongoing working relationship with the University of California, Davis, Telehealth Division, which set up, installed, and provides technical support to the Parole Division's Telemedicine services utilized by the POC's and its parolee population.
• Established a process with the Board of Prison Terms that alerts the Parole Division when a mentally disordered offender/ parolee is being released from a state hospital. This early notification allows the program to prepare and establish a service plan with the POC so the parolee is adequately treated.
• Received federal funding from the Going Home Re-entry grant initiative that expands collaborative efforts for treatment to a portion of the parolee population in Los Angeles.
  

Outcomes
Since the continuum program is so new, no formal evaluation has been completed. However, the parole division recently contracted with the University of California, Los Angeles to provide a comprehensive independent evaluation of the program. UCLA will provide monthly, quarterly, and year-end reports that will thoroughly detail program activity. In addition, through the reporting capabilities of its automated database, the continuum program can provide interim statistics and reports to monitor program activity.

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