Mental Healthcare In The BOP – Is This Your Client?

Mental Healthcare In The BOP – Is This Your Client?

Serious Mental Illness In The BOP P5310.16

The BOP provides Medical and Mental Healthcare (MH), through their 4 CARE LEVELS.

The BOP’s Psychology Data System (Page 2) Is Filled Out For All MH Levels.

The Designation and Sentence Computation Center places inmates into Care Levels 1 and 2

CARE LEVEL 1 MH

  • No Significant Need.
  • No history of serious functional impairment due to mental illness
  • No need for regular mental health visits
  • No hospitalization in the last 5 years
  • Defendant on their own has sought help
  • Controlled with 2 psychotropic meds (Not MH I if taking antipsychotic)
  1. Psychotropic medications:
    • anti-anxiety agents
    • mood stabilizers
    • stimulants
  2. Antipsychotic medicines, 
    • delusions (false, fixed beliefs) or
    • hallucinations (hearing or seeing things that are not really there).
    • schizophrenia, bipolar disorder, or
    • very severe depression (also known as “psychotic depression”).
  • Clinical visits q 6 mo

CARE LEVEL 2 MH

  • He/she has a mental illness requiring:
  • Routine Ongoing Outpatient visits
    • Medication controlled,
    • Medical visits q 1-6 months
    • Group Therapy, interventions every other week
  • Crisis Oriented, BRIEF MH Care, g., placement on suicide watch
  • Psychiatric Hospitalizations within the last 5 yrs
  • On Antipsychotic or 2 psychotropic meds

CARE LEVEL III & IV designation is made by the BOP’s Office of Medical Designations and Transportation

 CARE LEVEL 3 MH

  • Not In-patient
  • Enhanced Outpatient (Requires outpatient contacts with a prescribing doc > than monthly [at least weekly]); or
  • Housed in A Residential Treatment Program.
  • 2+ Psychiatric Hospitalizations within the last 3 yrs
  • 3+ anti-psychotic meds [Or > 5 meds for multiple Dx]

If you have a client with an MH CARE LEVEL of III, and a Medical CARE LEVEL of II,
The MH placement takes precedence.

Care Level 4 MH

  • Inpatient
    • gravely disabled and
    • cannot function in the general population, as in CARE3-MH
    • medical care 24/7/365
  • Tx plan reviewed every 90 days
Dr. Marc Blatstein

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