Levels of care

Jeffrey L. Metzner and Kenneth L. Appelbaum

in Oxford Textbook of Correctional Psychiatry

Published on behalf of Oxford University Press

Published in print March 2015 | ISBN: 9780199360574
Published online September 2017 | e-ISBN: 9780190224042 | DOI:

Series: Oxford Textbooks in Psychiatry

Levels of care

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  • Psychiatry
  • Forensic Psychiatry


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Just as in community settings, there is a continuum of care for mentally ill inmates in correctional settings. This continuum progresses from ambulatory care through supported residential housing to inpatient or infirmary care. The continuum of care for inmates with mental illness includes outpatient care, emergency services, day treatment, supported residential housing, infirmary care, and inpatient psychiatric hospitalization services. Outpatient treatment is the least intensive level of care. In some systems this may include a day treatment program, which provides enhanced mental health services similar to a residential program as described below. In the case of outpatient treatment, participating inmates live in a general population housing unit with other inmates, many of whom are not in need of mental health services. A residential program (i.e., housing unit) within the correctional setting is provided for inmates with chronic mental illness who do not require inpatient treatment but do require enhanced mental health services. Such a designated housing unit can provide a safe and therapeutic environment for those unable to function adequately within the general inmate population. Crisis intervention services include both brief counseling and supervised stabilization. The latter, often provided in an infirmary setting, serve short-term stabilization and/or diagnostic purposes. A psychiatric inpatient program is the most intensive level of care and is often provided by the state psychiatric hospital system. This chapter describes each level and how they may be adapted successfully to function in correctional settings to meet the needs of individuals with mental illness.

Chapter.  4624 words. 

Subjects: Psychiatry ; Forensic Psychiatry

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