Mental Health in New Hampshire Correctional Facilities

In response to increased awareness, both nationally and in New Hampshire, of the mental health needs of prison inmates this report aims to provide New Hampshire policymakers with a better understanding of the status, challenges, and policy options New Hampshire faces with regard to mental health care.

The information presented here follows two tracks: cost and quality. With regard to cost, this report covers the current costs, potential areas of improvement, and available policy options particularly regarding opportunities for cost reduction.

The current costs of providing mental health care to inmates are high due to recidivism, the loss of Medicaid for inmates while in prison, expensive psychotropic drugs, an expensive contract with Dartmouth Medical School (DMS), and a growing elderly population in prisons.

Policy options to help reduce costs of mental health care for inmates include:

• Create diversion programs
• Continue and broaden use of mental health courts
• Consider using telemedicine
• Consider changing to generic psychotropic medications

With regard to quality, this report addresses the less empirical - though equally and possibly more important - aspect of services to the patient upon entering prison, care and treatment while within the correctional system, and transitional services upon the community.

Policy options to improve the quality of mental health care for inmates include:

• Improve patients' needs assessment
• Make greater use of outside services, specifically DMS
• Focus on and improve corrections officer training
• Create a "fast track" program to facilitate the application/re-application process for Medicaid before an inmate's release date