By Michelle Gaseau, Managing Editor

A recent focus in corrections has been on offenders with mental illness, but a forgotten population -- disabled inmates -- is often mistakenly lumped into the mentally ill category. The result is that the special needs of mentally retarded inmates are often ignored.

Some corrections agencies have been at the forefront of managing this population by separately assessing for IQ and other indicators of disabilities
at the outset of incarceration. Yet other agencies opt to deal with the dilemma this population poses when an offender's presence forces them to - and then the responses are not ideal.

"Most people don't differentiate the developmentally disabled or mentally retarded from the mentally ill [but] there are almost no connections in their behavior," said Joan Petersilia, a Professor of Criminology, Law & Society at the University of California - Irvine. "Mental retardation refers to cognitive limitations. Mental illness describes a variety of disorders that result in disturbances in thinking, feeling or relating."

Often the most appropriate ways to manage developmentally disabled offenders is diversion away from prison or jail into a half-way house, Petersilia says, so a sentence can be served with support and coordination of community services. But this approach is expensive. 

Some researchers say this is part of the problem that corrections systems face. Because so few of these community programs exist -- due in part to the fact that the criminal justice system is often unable to use discretion in sentencing for diversion -- the population of developmentally disabled inmates is increasing in prisons and jails. 

As this trend develops, prison and jail officials should prepare by understanding the needs and having the appropriate housing and programs for them.

Understanding the Needs

Petersilia suggests that corrections officials first consider community corrections options where the developmentally disabled would be better
managed by service providers who understand the specific needs of this group.

"The mentally retarded need a lot of structure and a lot of routine. They follow directions well and want direction. The mentally retarded person is
frequently not violent whereas the mentally ill offender is frequently violent," she said.

Yet both groups are often treated the same in corrections, placed in the same programs or housed together, which inevitably means conflict between them and among others.

"When a mentally ill person is put in a program with a mentally retarded person there are much higher rates of violence toward the mentally retarded," Petersilia said. 

According to Eric Silver, Assistant Professor of Crime, Law and Justice at Pennsylvania State University, mentally disordered people are more likely
to be involved in conflict more often because their odd, unexpected or unusual behavior elicits negative responses from others. 

"These conflicted situations give rise to both victimization and opportunities for them to offend. It might be they think, 'If you are trying to control
my behavior, [then] I might be likely to lash out at you as well.' Studies tend to separate offenses and victimization [but] I see them as the same situational dynamic because one isn't behaving normally," said Silver.

Silver, who completed research on this population earlier this year, said that the results of his studies are easily extrapolated to the criminal justice system.

This could pose an added problem for corrections if staff do not fully understand the nuances of the population of mentally ill and developmentally
disabled offenders and put them together.

"The kinds of skills that are required to successfully negotiate interactions with mentally ill people, we can't assume they are out there and honed and well developed in people," he said.

But good work is being done by some corrections agencies in this area.

Petersilia said some corrections departments, such as Texas Department of Criminal Justice and New Jersey Department of Corrections, are partnering with community organizations that specialize in this population. The Association of Retarded Citizens (ARC) is one advocacy organization that has worked with a few corrections agencies nationwide.

"Many of those chapters have partnered with the criminal justice system to run group homes. There are partnership programs and everyone believes these are the most promising models. If you had a half way house that served domestic violence offenders or the drug addicted, you'd get the service provider that understands that population, so why wouldn't you do that for the mentally retarded," Petersilia said.

For those mentally retarded offenders who must be incarcerated, Petersilia suggests agencies follow some of the models that have already been developed. The Texas Department of Criminal Justice, for example, has a special prison for people with very low intellect. Others place this group of offenders with the general population, arguing that separating them prohibits equal access to programming.

"In my mind what works best is to have them in a separate wing where they can access some appropriate programs. There is some evidence they will be victimized more frequently [if left in the general population] and then what happens is it spirals out of control," she said.

Programs that Work with the Community

The New Jersey chapter of ARC has developed the Developmentally Disabled Offenders Program (DDOP) that works with the criminal justice system
to divert offenders whose crime does not require incarceration in a typical facility and ensures that offenders who are incarcerated receive appropriate services.

"Having a disability is not an excuse for criminal behavior. We don't want to [ignore] their behavior, but you have to deal with this population in a different way," said Denise Goobic, Assistant Director of the DDOP. 

Certain offenders are referred to the program by prosecutors and others involved in a case. From there, the offender's records are reviewed to
determine if they have a developmental disability. The program, which serves as a liaison between the criminal justice system and the community,
seeks to determine whether those developmentally disabled offenders charged with crimes could qualify for alternatives to incarceration. This is accomplished through a Personalized Justice Plan.

The PJP, which is completed after an offender is referred to the program, identifies community supports and emphasizes the importance of utilizing
the least restrictive community-based alternatives, while also holding offenders accountable for their actions. This plan is then provided to the court hearing the offender's case.

"If they [have committed] a serious crime and/or this is not their first offense, [then an alternative may not suit them] and the court may not entertain it. Most times, the court will entertain an alternative because it is less expensive and with this population, there are not a lot of options," said Goobic.

The plan typically maps out where an offender will reside, who will supervise them, where they will work, what counseling services will be provided,
how they will pay restitution and how the ARC will be involved.

"If the client agrees to participate - and they typically do - we will fax over the contract to the attorney for the client to sign. We review these plans about once a week and work with the probation department so the person can function as on probation, but not get violated in a way [traditional probationers] would," said Goobic.

She explained that difficulties may arise, for example, with an offender with a PJP who does not understand time. Instead of an officer saying "Come and see me at 8 a.m. or a certain time, the probation officer may say "Come see me tomorrow." The officer may have to wait, but eventually the client gets there. If the probation officer has trouble with a client, then ARC can intervene, Goobic said.

For some offenders, alternatives in the community are not an option. Then ARC works with the prison or jail to ensure that officials understand the
needs of the developmentally disabled offender.

"Most of the time, we alert the prison or jail that a person has a developmental disability and raise the red flag and make that known [to those at the facility]. A portion of our clients are currently in the prison system and should be there, but we want the system to know that this person has different needs and requires different services," Goobic said.

ARC may ask the prison or jail to put a client in protective custody or in a medical area until sentencing. Or, if a client of ARC takes medication and
has a dual diagnosis involving mental illness, ARC will alert the facility to that as well. 

"The last thing our [clients] will tell [people in corrections] is 'I have mental retardation.' That won't happen unless someone alerts the staff to that," she added.

Goobic said that typically mentally retarded offenders know they will receive ridicule and be called "stupid," so they hide it. They can play the quiet role and be shy and "yes everyone to death," even with questions they don't understand, she said. 

The challenge for ARC is to increase understanding of this population and coordinate services between the community that already exist and the offenders while they are incarcerated and after.

"This is a population that needs help and people are starting to see that. I know that there are others that want to do something, but there are budget issues and other [obstacles]. There are people trying," she said.

Programs that Work in Prison

The Oregon Department of Corrections has had special programming in place for the developmentally disabled since 1979. At that time the program
was run by the staff at the Oregon State Hospital, but as the structure of these services changed within the department, officials decided in 1996 to provide services for these offenders by staff at the facility level.

The Connections program is located primarily at the Oregon State Penitentiary with satellite programs in some institutions in the Salem area,
including the women's prison. The reasoning behind this is to provide a strong network of case management for developmentally disabled offenders who participate in the program and to prepare them for release.

"It only lasts six to eight months, so after they have gone through the program and are out in general population, we are seeing them on a regular basis to protect them from harm. The goal is to get those inmates to a level where they can access education and workforce skills," said Gary Field, Administrator of Counseling and Treatment Services for the Oregon Department of Corrections.

Entrance to the program starts with screening of the developmentally disabled at intake. They are screened through testing instruments such as
the BASIS exam and WAIS-R. Any offender scoring below the fourth grade reading level is individually interviewed by a case manager. All inmates
with IQs below 70 or between 70 and 79 with significant adaptive behavior issues are included in the program. 

In addition, other inmates can be referred to the program for testing and interviews with case managers at any time.

"We talk about this as being for the developmentally disabled but in reality it is [about] intellectual potential. [Some], by past head trauma, have lost some of their ability [and] because of that you have some who score above 70 but are low functioning in some areas. Some of those have 70 to 80 IQs; that's where case management comes in," said Field.

Case managers in the Connections program conduct ongoing assessments of offenders to ensure the right inmates are receiving services from the program.

Once in the program, the offenders receive special training to help them develop social skills and help them understand the services they can access after release. The goal is to transition these offenders back into the general population so they can participate in regular education and work programs, but with new skills that will help them negotiate the typical prison day.

"There is the mainstreaming dilemma where if you keep them separate, then you keep them from harm, but it may stunt their growth and they can't access other programs in the department. We have tried to blend some skills training with a mainstreaming approach," Field said.

Field said that the case managers develop a strong relationship with developmentally disabled inmates so that they will report when feel pressured
by others.

"In any prison you have a certain number of predatory offenders and when this population is at high risk, we are trying to be very careful and intervene quickly. We take action to ensure those things don't happen," he added.

Another strength of the program is the involvement the case managers have with community services. According to Field, each month the case managers hold a meeting with representatives from the state's developmental disabilities office and some of the local county services to evaluate which inmates within a year of release will qualify for community developmental disability services.

"For those who qualify, we do well at getting them into those services. The bad part is a high percentage of our people score too high [on IQ tests] and we don't have anything to send them to in the community," Field said.

The difference, Field explained, between the DOC's programs and state and county services for this population is that the IQ score is considered as a cutoff for services. 

Field said the program is successful for a variety of reasons but one that stands out is the desire by staff to do the right thing and protect the developmentally disabled when they need it.

"The assistance and support from our classification and transfer unit is critical. When we want to move inmates and if someone is being threatened, it happens fast. These people know where everyone is. I'm not sure what other states are like, but it's incredible. It amazes me how often they know the inmate's name," said Field.

That level of commitment by all involved is what makes the program successful, he said.

It's the Law

While a few corrections agencies are working to be prepared when a developmentally disabled inmate comes through their door, some have not yet
seen the importance of addressing the problem and may not realize what the Americans with Disabilities Act requires.

According to former jail administrator and corrections consultant Susan McCampbell of McCampbell and Associates, Inc., some jails are still at a
loss about how to manage a developmentally disabled inmate.

"I was in large urban jail where they had kid whose IQ was at 71 and they had him locked down 23 hours a day because they didn't know what to do with him. That was a large urban jail that should have known better," she said. "I think developmentally disabled [inmates] get lumped in the category of vulnerable inmates. If a jail is smart enough to do something with them, then they do something with other disabled inmates."

As fewer services are available for this population in the community, they inevitably will end up in jail. The it is incumbent upon the jail to make
some bridges back to the community and act quickly to get people out who would benefit from community services, McCampbell said.

"Those with IQs between 90 and 70 are the biggest problems [for jails]. With those in that middle range, [jail staff] don't know if they are looking
at drugs, alcohol or [the] developmentally disabled," McCampbell said.

The burden should not fall completely on corrections, however, as McCampbell points out that police departments also need to be cognizant of the
needs of the developmentally disabled and the services that are available to them.

McCampbell said a larger problem is whether jails and other facilities are designed to accommodate offenders with physical disabilities.

She has noticed several newly constructed jails that have not dealt with creating access for disabled visitors or cells for disabled inmates.

"When a jail hires a designer, they think an architect will build according to ADA requirements for inmates and staff, [but] I've worked with a couple
of jails recently where they didn't meet it," she said. "It's like the early days of HIV where you take them all and stick them in the same unit. We're
sort of past that."

She said an assumption still exists in some corrections facilities where inmates who are either developmentally or physically disabled are all considered to be either high risk or low risk and are not considered individually.

But one size does not fit all. Unfortunately, McCampbell said, changes aren't usually made until someone brings it to their attention.

"I don't believe for one minute that a jail administrator wants to get sued. The jail administrators who are doing the best job are the people with
members of their family with disabilities. If they have personal experience with it, then they are sensitive to it. [Nevertheless] it's one of those things where it is the right thing to do," she said.