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Ira K Packer

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Full-Text Articles in Medicine and Health Sciences

The Role Of Correctional Officers In Multidisciplinary Mental Health Care In Prisons, Kenneth Appelbaum, James Hickey, Ira Packer Oct 2014

The Role Of Correctional Officers In Multidisciplinary Mental Health Care In Prisons, Kenneth Appelbaum, James Hickey, Ira Packer

Ira K Packer

Prisons have become the homes of thousands of inmates who have mental disorders. The stress of incarceration can cause morbidity among these individuals, resulting in more severe symptoms and more disruptive behavior. Effective treatment for such inmates often involves services provided by a multidisciplinary treatment team that includes correctional officers. Correctional officers can assist in observations and interventions, and they play a unique role on specialized housing units. Successful collaboration between correctional officers and treatment teams requires a foundation of mutual respect, shared training, and ongoing communication and cooperation. With these elements in place, correctional officers can assist the treatment …


Relationship Between Race And Ethnicity And Forensic Clinical Triage Dispositions, Debra Pinals, Ira Packer, William Fisher, Kristen Roy-Bujnowski Oct 2014

Relationship Between Race And Ethnicity And Forensic Clinical Triage Dispositions, Debra Pinals, Ira Packer, William Fisher, Kristen Roy-Bujnowski

Ira K Packer

OBJECTIVE: Racial and ethnic disparities in the criminal justice system have been widely reported, as have racial and ethnic disparities in diagnoses and certain aspects of clinical management. This study examined the association between race and ethnicity and dispositions for pretrial defendants who were referred for forensic mental health evaluations. METHODS: Available data were reviewed for all defendants in Massachusetts who were referred to a Massachusetts court clinic from 1994 to 2001 for a screening evaluation of their competence to stand trial, their criminal responsibility, or both. Logistic regression models were developed to assess the relationship between defendants' race and …


From Case Management To Court Clinic: Examining Forensic System Involvement Of Persons With Severe Mental Illness, William Fisher, Ira Packer, Thomas Grisso, Melissa Mcdermeit, Julie-Marie Brown Oct 2014

From Case Management To Court Clinic: Examining Forensic System Involvement Of Persons With Severe Mental Illness, William Fisher, Ira Packer, Thomas Grisso, Melissa Mcdermeit, Julie-Marie Brown

Ira K Packer

The study examined the flow of a state mental health agency's case-managed clients into its forensic mental health court clinic systems for evaluation of competency to stand trial (CST) for a criminal offense. An analysis of merged encounter data from the case management and court clinic systems revealed that roughly 2% of the case-managed population were referred to court clinics for evaluation of CST during a 1-year period, but that these 2% represented roughly one eighth of that year's court clinic evaluees. The likelihood of this involvement was higher for males, African-Americans, and Latinos, and for persons with a history …


Use Of A State Inpatient Forensic System Under Managed Mental Health Care, William Fisher, Barbara Dickey, Sharon-Lise Normand, Ira Packer, Albert Grudzinskas, Hocine Azeni Oct 2014

Use Of A State Inpatient Forensic System Under Managed Mental Health Care, William Fisher, Barbara Dickey, Sharon-Lise Normand, Ira Packer, Albert Grudzinskas, Hocine Azeni

Ira K Packer

OBJECTIVES: One of the goals of managed mental health care has been to lower the use of inpatient psychiatric treatment. In the past, interventions that have limited hospitalization for persons with severe mental illness have led to greater involvement of these individuals with the criminal justice and forensic mental health systems. The authors examined associations between Medicaid managed mental health care in Massachusetts and rates of admission to the inpatient forensic mental health service maintained by the state's mental health department. METHODS: A total of 7,996 persons who were receiving services from the department before and after the introduction of …