DSH - Salinas Valley: Treatment Programs

In-Patient Mental Health Treatment

The Department of State Hospitals (DSH) - Salinas Valley) Intermediate Inpatient Treatment Program is committed to the pursuit of quality in providing assessment and treatment services to the mentally ill inmates in the California Department of Corrections and Rehabilitation (CDCR).

The program is a 370 bed inpatient Intermediate Care Facility (ICF). DSH - Salinas Valley serves male inmate-patients from CDCR who are 18 years of age or older, ambulatory, and behaviorally appropriate for housing in the treatment milieu.

Inmate-patients at the ICF level of care typically require highly structured inpatient hospitalization with constant supervision due to their major mental disorder. They often experience limited functioning ability in most life areas and have a substantial history of substance abuse and suicidal behavior. As such, these individuals generally require symptom stabilization and diagnostic clarification to enhance their prognosis for treatment.

Effective treatment is based upon both an experiential and an empirical understanding of the inmate population. Treatment approaches are designed with the recognition of shared psychiatric, social and psychological characteristics of the patient population. Sufficient flexibility will be maintained to accommodate a wide range of special needs and functioning levels. Implementation of the clinical program is accomplished through interdisciplinary treatment planning and decision-making structure. The professional disciplines of:

  • Psychiatry
  • Psychology
  • Psychiatric Social Work
  • Nursing
  • Dietetics
  • Rehabilitation Therapy
These constitute a multidisciplinary approach to inmate-patient evaluation and treatment.

DSH - Salinas Valley, as an integral part of the continuum of care, recognizes the importance of preadmission status as the starting point for treatment planning. Inmate-patients are admitted from Salinas Valley State Prison (SVSP) crisis beds, and through the Mental Health Services Delivery System (MHDS) institutions throughout California. DSH - Salinas Valley strives to maintain effective continuity of care with the above referral sources. Inmate-patients generally will have had some level of preliminary introductory therapy consistent with that provided in the program. The emphasis is on providing the most appropriate treatment plan consistent with individual inmate-patient needs.

Discharge planning will continue to address adaptive skill development, environmental contingency management and symptom reduction. The majority of the inmate-patients treated will continue their incarceration within the CDCR and maintenance of therapeutic benefits and maximization of functioning must occur within that unique environmental context to enhance their chances for success once released to the community. Therefore, emphasis is on developing skills which are aimed at maximizing the adaptation of mentally ill individuals living in prison. The program also provides treatment modalities to accommodate the needs of the minority of inmate-patients who will likely reenter the community upon, or shortly after, discharge.

Upon successful completion of the treatment program, inmate-patients should be psychiatrically stable, have at least a basic understanding of their mental illness, and be capable of assuming a meaningful role in managing their mental illness with use of available supportive resources relevant to their specific living circumstances, and thereby maintain their optimal functioning level. In addition, they will have acquired and refined a functional repertoire of adaptive coping skills, including:

  • Emotional Management
  • Behavioral Control Strategies
  • Problem-solving Skills
  • Social Skills
All of which will facilitate successful adaptation to their long-term living environment. The typical inmate-patient's clinical picture is poor coping skills, inability to delay gratification and subsequently he will act before thinking. His social skills and social adaptation behaviors are generally underdeveloped. Chronic impairment in areas of reasoning, decision-making, accurate reality perception and volition are common in this population as is susceptibility toward stress and environmental change. Based on these characteristics, the DSH - Salinas Valley Inpatient Mental Health Treatment facility provides treatment with the following foci:
  • A highly structured environment with adequate clinical staffing levels consistent with a CTC licensing status
  • Psychotropic medication adjustment and maintenance
  • Psycho-educational therapy modalities including Coping Skill Development. These include facilitating development of an understanding of mental illness and the symptoms of decompensation, including precursors and warning signs specific to the individual inmate-patients. It also includes modalities aimed at developing and supervising implementation of adaptive patterns of social behavior.
  • Psycho-educational modalities focusing on the inmate-patient's capabilities in maintaining psychiatric stabilization and maximizing functioning. This includes understanding the need for medication and possible side effects, and effective use of clinical resources and supportive services available outside an inpatient setting. Therapy focuses on understanding and modifying substance abuse behaviors. Ideally these incorporate psycho-educational, mutually-supportive/directive, and relapse-prevention approaches.