Blog
Managing Mental Health in Prison
May 18, 2016

Every year, more than 1.1 million people diagnosed with mental illnesses are arrested and booked into jails in the United States.* Poverty, homelessness and substance abuse are common among people with serious mental illnesses who come in contact with the justice system. The CUCS Institute recognized the need to help these inmates learn to cope with their issues to better navigate the prison system. We sat down with Mike Golub, a long time CUCS trainer, who shed some light into the program and his experience as a trainer at Fishkill Correctional Facility.

Tell us about the prison training.

Essentially, the CUCS Institute has conducted two types of prison trainings: one for the greater community on the culture of incarceration called ‘From the Incarceration to the Community’ and the other for inmates in the prison called ‘Wellness Self-Management’ (WSM).

WSM is an evidence-based practice, 40 week curriculum-based program that helps individuals living with a serious mental illness such as schizophrenia, bi-polar disorder, and major depression to manage their health issues, reduce hospitalizations, and move towards living in recovery. The concept for recovery, which is geared towards having a meaningful and healthy life while living with a serious mental illness, is core for each of the classes.

The WSM training we did in the prisons spanned 22 weeks and integrated five mental health interventions: psychoeducation, behavioral tailoring, relapse prevention training, coping skills training, and social skills training. The classes worked with prisoners on mental health, stress, building social support, managing negative thinking, and coping with substance abuse. We trained both inmates and staff in the prison who would then take over the classes after us.

How did CUCS get involved with this type of training?

Looking at how many people with mental health problems are incarcerated every year, we saw that there was definitely a need for it. Correctional facilities have turned into primary settings for provision of mental health services, even though they are largely designed for detention, not therapeutic purposes. CUCS worked with the New York State Office of Mental Health and the Department of Corrections and Community Supervision on planning the WSM project, which took place at Sing Sing, Bedford Hills, and Fishkill correctional facilities.

The classes were all voluntary, which was not easy given the setting. But we explained that this was something new that they were not going to get out in the community, and that this was a class, not group therapy. It was all about managing their own lives and helping themselves.

How long were you training for?

The program lasted for over three years. We had one group that would meet in the morning and one in the afternoon every Tuesday and Thursday.

What did you find?

Prisons are highly disciplined environments where inmates are expected to abide by the rules at all times. Whenever an inmate breaks one of these rules, they are given a disciplinary ticket. The biggest finding was that people had a substantial reduction in disciplinary tickets. This was a big deal for both the Department of Corrections, because they keep the prison safe, and the individual because the more tickets they get, the less privileges they have.

The data we gathered from the control group, which consisted of 99 inmates, shows that there was a significant reduction in the frequency of disciplinary actions and crisis care placement. Most of those who took these classes did not get ticketed for disciplinary problems and that goes to show that instead of violence, they started using their words. They also did much better out in the community after the classes.

What impact did the training have on the inmates?

Anecdotally, people told me they learned a lot about themselves and how to manage their mental health. I could tell that the inmates in my class were getting better and they would come up to me after class saying “Mike, if I had taken this class 20 years ago, I’d probably never be in prison in the first place” or “I’ve been told all this stuff before but it never really sunk in. Now I get it.” We had great conversations and it was a lot of fun.

In fact, I tell everyone that it kind of turned into America’s Got Talent because we would have these serious conversations that were very heavy, as you can imagine, and people would read poetry, sing and rap about their experiences. They had the most tragic lives you could hear, it was just unbelievable. Many started drinking and drugging at 7 or 8 and just came from just awful places. But they were able to open up about it and learn how to cope with their issues.

They were also able to identify meaningful goals in the classes, while focusing on setting and pursuing personal goals. One of the inmates, Mr. Brewer, said to me “my goal was to be able to speak up for myself, especially to deal with my doctors here and because of these classes, I’m getting what I need now from my doctor here and things are going well for me.”

There were many others who were looking forward to putting the classes to use. One of them, Mr. Haniff, said to me “I’ve been dealing with anger problems my whole life, that’s why I’ve ended up in here a bunch of times. But taking these classes, now I know how to manage my stress, deal with my anger and I know I need the support of my family and my religion to make it out there.  I’m going to make it now.”

I think one of the reasons why it also worked was because there aren’t a lot of places or spaces in prison where you are able to just share and be yourself and not have retribution with people all the time. It taught them things that they might have known but just drove it home somehow because it is a lot of self-guiding work.

What did you get out of it?

For one, it was clinically intense. The stories from these guys were heart-breaking. I’ve been in the field for 24 years now working with many different populations in a variety of settings and teaching those classes to those guys was, without a doubt, the most rewarding experience of my life. I really saw the transformation in those guys.

What is a client success story that has stayed with you?

It would probably have to be Mr. Collins who I often talk about. His parents died while he was in prison in a horrific way. He was in the hole for a couple of days before he came to the class. The others had already been in the class for a few days and already identified and set their goals. When Mr. Collins joined, I asked him “what do you want to do when you get out?” and he said to me, “I just wanted to be a son to my parents” and then told me that awful story. I had to think fast and so I asked, “well, what did you want to do or be when you were 12?” and he said “you know, I wanted to be an anthropologist.” I said to him, “that’s what you’re going to do! Put that down, you’re going to become an anthropologist when you get out of here.”

I talk about what he gave himself was a dream and a reason to get better; a reason to live and goals to look forward to once back out there.

* National Leadership Forum on Behavioral Health/Criminal Justice Services, Ending an American Tragedy: Addressing the Needs of Justice-Involved People with Mental Illnesses and Co-Occurring Disorders (http://gainscenter.samhsa.gov/pdfs/nlf/AmericanTragedy.pdf)