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NAMI California: Bridging Communication Between Prisons and Mental Health Advocates

Mark Gale discovered NAMI California in November of 2002. His son had been arrested after several months of homelessness. Mark believed that the families and friends of a person with a serious mental illness should be able to provide jail clinicians, essential psychiatric and medical information about their loved ones. He soon learned that there was no process for doing this at the Twin Towers Correctional Facility in Los Angeles. It took five days of calling the county jail repeatedly, asking to speak to a nurse or doctor regarding his son’s medications, before he was able to dictate an email to the secretary of the head of the Forensic Inpatient Unit. As a result of this unacceptable reality, Mark led a two-pronged collaborative effort with the support of the Los Angeles Sheriff’s Department (LASD) and the Department of Mental Health. Mark developed a new form he called the Inmate Medication Information Form which simply provided diagnosis, current medications, contact information for jail clinicians to reach out to family and recent providers of mental health services, and other vital information. Later, he collaborated with fellow NAMI colleagues Jim Randall and Carla Jacobs to co-author a local crisis guide titled My Family Member Has Been Arrested-What Do I Do?

The "Arrested Guide" acts as a roadmap in navigating the criminal justice system at the county level from arrest to arraignment, providing information about access to treatment, mental health courts and finding legal representation. The form and guide were posted in both English and Spanish on the LASD Web site, and made available in the county jail’s public visitors lobbies. NAMI California provided assistance in spreading the word of this advocacy across the state leading to a collaboration of NAMI members and system partners working together to adapt the form and guide for their individual counties. After joining the NAMI California Board of Directors and becoming Chair of the Criminal Justice Committee, Mark had the office contact every county jail in the state to encourage them to adopt these two important tools. To date, twelve California counties have done so. The adoption of a newly named “Inmate Mental Health Information Form” was included as a best practice in a recent report entitled Jails and the Mentally Ill: Issues and Analysis by the California Department of Corrections and Rehabilitation (CDCR) Council on Mentally Ill Offenders (COMIO)!

Many inmates arrive at prison reception centers without medical and psychiatric historical records. Mark knew that the form could fill this gap and was a good fit for California’s prison system - and there were no costs involved. He was introduced to the Chief Psychologist at North Kern State Prison, Dr. Greg Hirokawa, at a Criminal Justice, Mental Health Community Collaborative event hosted by NAMI California in 2007. Dr. Hirokawa had heard about the Inmate Mental Health Information Form used in the county jail system and wanted to implement it at the prison. This was a good idea and didn’t need a budget. This fortuitous introduction began a long process and a new collaboration between NAMI and the state’s prison system.

Dr. Hirokawa introduced the concept to his fellow clinicians at North Kern State Prison, who were positive about implementation and assisted with the adaptation of the original "jail form." Mark began to call CDCR mental health department heads to present the idea, which led to email exchanges, reviews by CDCR policy committees and conference calls with other clinicians and the Chiefs of Mental Health at the Reception Centers. After two years of advocacy, a six month pilot at North Kern State Prison and with the strong support of numerous prison clinicians, NAMI California obtained the support of the Department and the request was delivered to the Wardens of all Reception Centers to adapt the Inmate Mental Health Information Form for each location and post it on their individual websites. The forms will be made available in visitor areas as well. These prison Inmate Mental Health Information Forms should be available within the next 30 days.

When a person with a serious mental illness is faced with the challenges of the criminal justice system, it is critical that useful, practical information be made available to the consumer and his/her family in a user friendly manner. In addition, advocates require data and examples of best practices at their fingertips. Mark believes it is incumbent upon state NAMI organizations to organize and aggregate this information for its members by creating a "one-stop shopping" resource for information regarding how the criminal justice system interacts with persons living with serious mental illness and their families. "We should simplify the process of finding relevant material for advocates, families, and consumers organized on the NAMI California Web site for easy access. Our members should not have to troll the internet looking for help." The NAMI California Criminal Justice Web site Project is a continuous work in progress.

Members of the NAMI California Criminal Justice Committee Advisory Pool have volunteered to assist with this Website Project. The results of their hard work can be viewed on the NAMI California Web site under Criminal Justice Resources. All Arrested Guides and Inmate Mental Health Information Forms are listed by county (prison forms to be added soon).  In addition, links have been organized to assist NAMI advocates with useful information or to help families in crisis. They have also started writing practical guides for the prison and state hospital systems. These guides will be posted in the future upon completion.

A couple of months ago, Mark received a "crisis call" from a mother of a young man with mental illness who was incarcerated in Twin Towers. She said that one of the doctors from the jail had called her to clarify the diagnosis and previous treatment history.  This would never have happened years ago. Doctors practicing in an institution that had been an "iron curtain" to family members, now call out because contact information is available on the information form. Another doctor was using the form at the women’s jail to help identify participants for his program. Mark spoke to Dr. Hirokawa the other day and he claimed the usage of the form was having a very positive effect on patient care at North Kern State Prison. Mark believes that the implementation of the form had, at least in some small measure, helped these institutions to change for the better.

From: CIT in Action Newsletter - November 2009