CrimeSolutions.gov

Additional Resources:

Program Profile: Mental Health Services Continuum Program (Calif.)

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on January 26, 2016

Program Summary

The program targets parolees with mental health problems and provides services to enhance their level of individual functioning in the community. The overall goal is to reduce recidivism of mentally ill parolees and improve public safety. The program is rated Promising. Parolees who participated in the program and received a pre-release assessment or who had one or more contacts with the Parole Outpatient Clinic showed a significant reduction in the odds of being returned to custody.

Program Description

Program Goals
The Mental Health Services Continuum Program (MHSCP) was designed to reduce the symptoms of mental illness among parolees, by providing timely, cost-effective mental health services that enhance parolees’ level of individual functioning in the community. The program targets inmates with mental health problems who are under the jurisdiction of the California Department of Corrections and Rehabilitation (CDCR) and are expected to be paroled in the next few months. The overall goal is to reduce recidivism of mentally ill parolees and improve public safety.
 
Target Population
The MHSCP was designed for parolees who received mental health treatment while in prison under the Mental Health Services Delivery System of the CDCR. The program also targets parolees who have been in a Mental Health Crisis Bed as well as those being released from any Department of Mental Health facility.
 
To be eligible for the MHSCP, parolees must have a diagnosis of one or more of the following Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) psychiatric disorders: schizophrenia (all subtypes); delusional disorder; schizophreniform disorder; schizoaffective disorder; substance-induced psychotic disorder (excluding intoxication and withdrawal); psychotic disorder due to a general medical condition; psychotic disorder not otherwise specified; major depressive disorders; bipolar disorders I and II; and medical necessity (any other major mental illness diagnosis that requires treatment due to the acuity of the illness).
 
Mental health designations are used to determine the level of treatment need for parolees upon release. Parolees receive one of two designations: 1) Correctional Clinical Case Management System (CCCMS), which requires one or more of the DSM-IV diagnoses and a stable functioning in the community as well as a Global Assessment of Functioning (GAF) Score above 50; or 2) Enhanced Outpatient Program (EOP), which also requires one or more of the DSM-IV diagnoses and an acute onset or significant deterioration of a serious mental disorder, hallucinatory experience, dysfunctional or disruptive social interaction, impairment of Activities of Daily Living, and a GAF Score of 50 or less.
 
Program Components
The MHSCP includes
  • Pre-release assessment of mentally ill inmates who are close to being paroled
  • Pre-release benefits eligibility and application assistance
  • Expanded and enhanced post-release mental health treatment for mentally ill parolees
  • Improved continuity of care from the Mental Health Services Delivery System to the community-based Parole Outpatient Clinic (POC)
  • Increased assistance for reintegration into the community upon discharge from parole
Within 90 days of an inmate’s estimated parole release date, a social worker from the regional Transitional Case Management Program–Mental Illness (TCMP-MI) conducts a face-to-face assessment with the inmate. That assessment is updated within 30 days of the inmate’s release. The social worker merges the assessment information into the Parole Automated Tracking System database. The TCMP-MI liaison verifies the information and sends it to the appropriate POC. The POC liaison for the MHSCP consults with the inmate’s parole agent of record and schedules an initial appointment with the parolee. The appointment is scheduled to occur within 3 working days of release for EOP parolees and within 7 working days for CCCMS parolees.

Once parolees are released from prison, they return to one of four parole regions in California. EOP parolees are required to receive at least eight consecutive weekly POC appointments within the first 60 days following release. CCCMS parolees are required to receive at least four consecutive weekly POC visits within the first 30 days of the initial appointment. Treatment that may be provided to parolees includes medication management, group therapy, individual therapy, and case management.

Evaluation Outcomes

top border
Study 1
Return to Custody: Pre-Release Assessment
Farabee and colleagues (2008) found that parolees who received a pre-release assessment through the Mental Health Services Continuum Program (MHSCP) had a significant, 7 percent reduction in the odds of being returned to custody within 12 months of release, compared with parolees who were not assessed.
 
Return to Custody: Parole Outpatient Clinic (POC) Attendance
In addition, parolees who had one or more POC contacts under the MHSCP had a significant, 52 percent reduction in the odds of being returned to custody within 12 months of release.
bottom border

Evaluation Methodology

top border
Study 1
Farabee and colleagues (2008) assessed the effectiveness of the Mental Health Services Continuum Program (MHSCP) to reduce recidivism of parolees with mental health problems. A comparison was conducted between inmates who received pre-release assessments by Transitional Case Management Program (TMCP) social workers and non-assessed inmates. The sample (N=106,667) included inmates released between January 1, 2003, and December 31, 2007. The assessed treatment group included 45,764 inmates. The assessed group was 84 percent male, with an average age of 38.6 years. The race/ethnicity breakdown was 34.2 percent African American, 20.8 percent Hispanic, 41.7 percent white, and 3.3 percent other. The non-assessed comparison group included 60,903 inmates. The non-assessed group was 85.9 percent male, with an average age of 38.1 years. The race/ethnicity breakdown was 33.2 percent African American, 23 percent Hispanic, 40.4 percent white, and 3.5 percent other. There were significant differences between the groups on background characteristics, which were controlled for in the analysis.
 
The primary outcome of interest was recidivism, which was based on parolees’ return to custody, regardless of the reason. Recidivism was based on release cohorts, rather than on individuals, which means that one parolee could have accounted for multiple returns to custody.
 
A multivariate logistic regression was conducted to predict the likelihood that assessed parolees would be returned to custody within 12 months of release. For this analysis, a cohort of offenders who were released between January 1, 2003, and December 31, 2006 (N=74,015) were used, because a policy change to the MHSCP in early 2007 may have affected the results. The analysis included six control variables (age, gender, race/ethnicity, commitment offense, parole region, and severity of mental health problems) and two primary variables of interest related to the MHSCP transitional process: 1) whether inmates were assessed by a TMCP social worker prior to release; and 2) whether inmates had at least one Parole Outpatient Clinic contact following release.
bottom border

Cost

top border
Farabee and colleagues (2008) conducted a cost analysis of the Mental Health Services Continuum Program (MHSCP) by estimating the incremental cost savings associated with avoided incarceration costs with the receipt of the transitional services under the program. The study authors found that pre-release assessments were associated with annual savings of $2,357 for each Enhanced Outpatient Program (EOP) parolee and $1,049 for each Correctional Clinical Case Management System (CCCMS) parolee, compared with non-assessed parolees. In addition, it was found that having one or more Parole Outpatient Clinic (POC) contacts following release was associated with an annual savings of $4,881 for EOP parolees and $2,861 for CCCMS parolees, compared with parolees who had no POC contact.
bottom border

Evidence-Base (Studies Reviewed)

top border
These sources were used in the development of the program profile:

Study 1
Farabee, David, Joy Yang, Dan Sikangwan, Dave Bennett, and Umme Warda. 2008. Final Report on the Mental Health Services Continuum Program of the California Department of Corrections and Rehabilitation–Parole Division. Los Angeles, Calif.: David Geffen School of Medicine at UCLA, Semel Institute for Neuroscience and Human Behavior, UCLA Integrated Substance Abuse Programs.
http://www.academia.edu/26157858/Final_Report_on_the_Mental_Health_Services_Continuum_Program_of_the_California_Department_of_Corrections_and_Rehabilitation_Parole_Division?auto=download
bottom border

Additional References

top border
These sources were used in the development of the program profile:

California Department of Corrections & Rehabiliation. 2015.”Mental Health Services Continuum Program.” Accessed December 22, 2015.
http://www.cdcr.ca.gov/Parole/Mental-Health-Services-Continuum-Program.html
bottom border

Related Practices

top border
Following are CrimeSolutions.gov-rated practices that are related to this program:

Adult Reentry Programs
This practice involves correctional programs that focus on the transition of individuals from prison into the community. Reentry programs involve treatment or services that have been initiated while the individual is in custody and a follow-up component after the individual is released. The practice is rated Promising for reducing recidivism.

Evidence Ratings for Outcomes:
Promising - One Meta-Analysis Crime & Delinquency - Multiple crime/offense types
bottom border


Program Snapshot

Age: 30 - 45

Gender: Both

Race/Ethnicity: Black, Hispanic, White, Other

Setting (Delivery): Correctional, Other Community Setting

Program Type: Aftercare/Reentry, Group Therapy, Individual Therapy, Probation/Parole Services, Wraparound/Case Management

Targeted Population: Mentally Ill Offenders, Prisoners

Current Program Status: Active

Listed by Other Directories: National Reentry Resource Center

Program Director:
California Department of Corrections and Rehabilitation, Division of Adult Parole Operations, Division Headquarters
Phone: 916.445.6200
Website