The Virginia Department of Corrections (VADOC) carries out its public safety mission by operating safe and secure facilities and probation/parole supervision and by providing programs and services to prepare individuals to lead crime-free lives after release. The VADOC’s mental health and wellness services are a critical part of the mission, providing evidenceinformed assessment, evaluation and treatment to restore individuals with mental health issues to their highest level of functioning. These services also contribute to safer facilities and safer communities during probation/parole supervision and after individuals are release from VADOC care.

VADOC mental health services are integrated within a complex system of graduated levels of care, purposefully structured within prison security levels to meet the varying levels of treatment needs. Levels of care within the prisons range from civil commitment in VADOC’s licensed and accredited treatment prisons, to specialized residential housing units for those needing focused care, to outpatient group counseling and to those who require regular monitoring or crisis management. A very important role of mental health staff is providing initial assessments, screenings and monitoring of inmate adjustment in addition to brief, solution-focused individual treatment. Staff also engage in regular consultation with multidisciplinary treatment teams and administrators, and they provide expert training to Correctional Officers to equip them to identify and refer for evaluation inmates who show signs of mental health needs.

Since 2010 the percentage of inmates with mental health issues in the prison system has grown astonishingly from 17% to 36% of the incarcerated population. As the mental health needs of the inmate population have increased, concurrently the professional standards of care and legal mandates and expectations for VADOC mental health treatment have increased.

The International Association for Correctional and Forensic Psychology sets standards for psychological services in jails, prisons, correctional facilities, and agencies. The standards for staffing are:

Standard (a): There will be a sufficient number of qualified mental health professionals (e.g., psychologists, counselors, social workers) to meet the mental health needs of the facility’s inmate population. Standard (b): Qualified mental health professionals are credentialed for independent practice and qualified to provide testing, assessment, diagnosis, and treatment services in keeping with professional, legal, and community standards of practice.

The following psychological staff-to-inmate ratios are presented as guidelines: Prisons: The minimum ratio of a full-time qualified mental health care professional (licensed psychologist or other mental health care professional practitioner credentialed for independent practice) to adult inmates is 1 for every 150 – 160 general population inmates.

For specialized units (e.g., drug treatment and special management units for mentally ill inmates), the minimally acceptable ratio is 1 full-time qualified mental health care professional for every 50-75 adult inmates.

The correctional system has increasingly become the de facto point of care for many persons needing mental health treatment, exceeding existing VADOC professional staffing levels. To address this issue, in the 2022 General Assembly the VADOC requested additional positions needed to bring the mental health staff to inmate ratio more in line with the published recommended ratio. In response to the VADOC’s request, the 2022 Virginia Acts of Assembly provided the VADOC with 33 FTE and included funding to fill 28 of these positions. An update on the VADOC’s implementation of these positions is the basis of this report.