Skip to main content

Main menu

  • Home
  • Current Issue
  • Ahead of Print
  • Past Issues
  • Info for
    • Authors
    • Print Subscriptions
  • About
    • About the Journal
    • About the Academy
    • Editorial Board
  • Feedback
  • Alerts
  • AAPL

User menu

  • Alerts

Search

  • Advanced search
Journal of the American Academy of Psychiatry and the Law
  • AAPL
  • Alerts
Journal of the American Academy of Psychiatry and the Law

Advanced Search

  • Home
  • Current Issue
  • Ahead of Print
  • Past Issues
  • Info for
    • Authors
    • Print Subscriptions
  • About
    • About the Journal
    • About the Academy
    • Editorial Board
  • Feedback
  • Alerts
Research ArticlePractice Resource

The American Academy of Psychiatry and the Law Practice Resource for Prescribing in Corrections

Anthony Tamburello, Jeffrey Metzner, Elizabeth Fergusen, Michael Champion, Elizabeth Ford, Graham Glancy, Kenneth Appelbaum, Joseph Penn, Kathryn Burns and Jason Ourada
Journal of the American Academy of Psychiatry and the Law Online June 2018, 46 (2) 242-243; DOI: https://doi.org/10.29158/JAAPL.003762-18
Anthony Tamburello
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeffrey Metzner
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elizabeth Fergusen
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael Champion
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elizabeth Ford
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Graham Glancy
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kenneth Appelbaum
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joseph Penn
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kathryn Burns
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jason Ourada
Reviewed by: Jeffrey S. Janofsky, MD, Medical Director, American Academy of Psychiatry and the Law.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site

Abstract

The practice of prescribing in jails and prisons is often different from that in the community. Serious mental illness is common among inmates, and so are co-morbidities such as substance use, impulse-control, attention-deficit/hyperactivity, and personality disorders. Operational requirements, staffing, and the physical plant of the institution may complicate the provision of treatment according to community standards. Problems related to medication nonadherence, as well as the pursuit of medications for nonmedical reasons, are often seen in these settings and may be managed differently than they are elsewhere. Existing practice resources rarely account for these challenges. Pursuant to a recommendation by the Correctional Committee of the American Academy of Psychiatry and the Law (AAPL), the AAPL Council in May 2015 approved the creation of a task force charged with producing a document on prescribing in correctional facilities.

Full Document: Tamburello A, Metzner J, Ferguson E, et al: AAPL practice resource for prescribing in corrections. Journal of the American Academy of Psychiatry and the Law Online Supplement 2018, 46 (2). Available at: http://www.jaapl.org/content/46/2_Supplement

This document is intended as a review of the literature and expert opinion to give guidance and assistance for providing psychiatric treatment, with a focus on psychopharmacology, to adults in correctional facilities. The process of developing this document incorporated a thorough review that integrated feedback and revisions from AAPL members into the final draft. The final draft was reviewed and approved by the Council of the American Academy of Psychiatry and the Law on May 21, 2017. It reflects a consensus among members and experts about the principles and practice of prescribing psychiatric medications in correctional settings. Although recommendations are sometimes articulated when backed by research evidence, ethics standards, or expert opinion, this document should not be construed as a practice guideline, or as dictating the standard of care. Rather, it is intended to inform practice in this area.

The AAPL Practice Resource for Prescribing in Corrections is organized as follows: Section 1 states the intent and limitations of the document. Section 2 describes the legal framework for prescribing in jails and prisons. Section 3 focuses on operational matters, such as medication administration and systems-level oversight of prescribing practices. Section 4 covers general prescribing matters including continuity and coordination of care, assessment, the role of education and nonpharmacologic treatment, and informed consent. Section 5 describes evidence-based practices related to specific mental health diagnoses or problems. Section 6 examines topics that are not addressed elsewhere but may have an impact on prescribing decisions, such as special settings within correctional institutions; adverse effects of medications; medication nonadherence; treatment over objection; misuse, abuse, and diversion of psychotropic medications; and electroconvulsive therapy. Finally, Section 7 discusses gaps in the existing literature that present opportunities to influence the quality of care in jails and prisons.

We encourage the use of this document for the education of students and trainees, as an orientation for those professionals new to practicing in jails and prisons, and as a resource for those currently providing psychiatric care for inmate patients.

Acknowledgments

The American Academy of Psychiatry and the Law acknowledges contributions to this document by Steven Berger, MD, Nickolas Culpepper, MD, Jose Hidalgo, MD, Jerry McKee, PharmD, BCPP, and Hal S. Wortzel, MD.

  • © 2018 American Academy of Psychiatry and the Law

Site Navigation

  • Home
  • Current Issue
  • Ahead of Print
  • Archive
  • Information for Authors
  • About the Journal
  • Editorial Board
  • Feedback
  • Alerts

Other Resources

  • Academy Website
  • AAPL Meetings
  • AAPL Annual Review Course

Reviewers

  • Peer Reviewers

Other Publications

  • AAPL Practice Guidelines
  • AAPL Newsletter
  • AAPL Ethics Guidelines
  • AAPL Amicus Briefs
  • Landmark Cases

Customer Service

  • Cookie Policy
  • Reprints and Permissions
  • Order Physical Copy

Copyright © 2022 by The American Academy of Psychiatry and the Law