DEPARTMENT OF CORRECTIONS
2017-19 Biennial Budget
Issue Paper
Topic: DIN 5303 - Mental Health Staffing in Restrictive Housing (RH)
Request
The Department of Corrections (DOC) requests $268,200 GPR and 4.80 GPR FTE in FY18 and $324,400
GPR and 4.80 GPR FTE in FY19 for psychological treatment in the RH units at Green Bay Correctional
Institution (GBCI) and Waupun Correctional Institution (WCI), and additional psychological service staff at
Columbia Correctional Institution (CCI). The positions requested would be Psychological Associates.
Problem Description
Treatment of mentally ill inmates in RH has become a national topic that is being addressed at a variety of
levels. More and more states have entered into settlement agreements limiting the use of RH for inmates
with serious mental illness (SMI) and/or providing the “10/10” model of treatment: at least 10 hours per
week of structured therapeutic out-of-cell programing and at least 10 hours per week of out-of-cell
unstructured recreation.
Fulfilling this request would constitute one step toward full implementation of the 10/10 model in DOC’s
male inmate population. In addition, a Psychological Services Unit (PSU) Clinician at CCI for weekend
coverage would assist in reducing acts of self-harm and other conduct issues among their disproportionately
high number of seriously mentally ill inmates.
Background
Mental Health professionals at DOC screen all inmates for the presence of serious mental illness (SMI) prior
to transfer to the Wisconsin Secure Program Facility (WSPF). A determination of SMI at any point makes
an inmate ineligible for transfer to WSPF.
Female inmates at the Taycheedah Correctional Institution (TCI) with serious mental health needs who are
in either Special Management Units (SMU) or restrictive housing are provided with at least ten hours per
week of structured, out-of-cell, therapeutic activities, also known as the “10/10 model”. Psychological staff
are utilized for individual therapy and crises management, while other classifications such as Teachers or
Recreation Leaders are able to provide the staff necessary for other structured out-of-cell time.
Across the state of Wisconsin, 4.2% of all adults in 2013-14 were diagnosed with a SMI2. SMI is defined as
having a current diagnosis of a mental health condition such as schizophrenia, delusional disorder, psychotic
disorder, major depressive disorder. Division of Adult Institutions (DAI) Policy 500.70.01 categorizes all
mental health conditions defined as SMI into MH-2a and MH-2b. (See Appendix I for all mental health
codes.)

2

Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: Wisconsin, 2015. HHS Publication No. SMA–16–Baro–2015–WI.
Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.

 As of May 6, 2016, 9% of DOC’s male inmate population have a serious mental illness; more than double
the general population. The distribution of the SMI population across institutions is not even, with the
Wisconsin Resource Center (WRC) having the highest percent (74.13%) and Prairie du Chien Correctional
Institution (PDCI) having the lowest with 0%. Table 1 below shows the SMI population for the three
institutions addressed in this request.
Table 1 % SMI of all inmates
11.99%
CCI
GBCI
12.99%
WCI
14.35%

The USDOJ published “Guiding Principles” for use of Restrictive Housing in January 2016. The principles
state:
•
•
•

Those inmates with serious mental illness in general should not be placed in Restrictive Housing.
If they are placed in RH, they should “receive enhanced opportunities for in-cell and out-of-cell
therapeutic activities and additional unstructured out-of-cell time”,
After 30 days in restrictive housing, the inmate should in most cases be transferred to alternative
housing.

In February 2016, the National Institute on Corrections (NIC) provided three-day technical assistance
training to DOC staff on the use of Restrictive Housing. Their recommendations to the Department are
consistent with USDOJ’s Guiding Principles.
The 10/10 model has been in place in the Wisconsin Women’s Correctional System (WWCS) for
approximately eight years. As a result of the changes made for females, inmates with serious mental health
needs at TCI are afforded better access to mental health treatment and a more proactive approach that
reduces rates of psychological deterioration, self-harm attempts, and need for use of force. DOC’s male
institutions do not currently have comparable mental health staff numbers to TCI.
The Department’s Restrictive Housing Committee began its work to review and revise RH policies and
practices in 2014. This work is ongoing, but concrete changes have already occurred. DAI Policy 500.70.04
“Psychological Input to Security Decision” was effective 5/27/2015; and requires written input from
psychological staff for any inmate diagnosed as MH-2a, MH-2b, Intellectually Disabled, or having had any
instance of self-harm. Policy setting disciplinary guidelines has also been altered to encourage alternative
sanctions and require monthly reviews of any disciplinary dispositions resulting in RH placements longer
than 120 days by DAI’s Administrator with the Department’s Secretary.
While these reforms are moving the Department’s use of RH in general and specifically for inmates with
SMI toward the national trend of the 10/10 model, additional staff is necessary for full implementation in
the men’s correctional institutions. Table 2 below shows the number of inmates in RH and in Administrative
Confinement at GBCI, CCI, and WCI who fall under SMI, as of April 30, 2016.

 Table 2. Restrictive Housing & Administrative Confinement Population
with Serious Mental Illness
CCI
14
WCI
30
GBCI
25
There have been reductions in the number of inmates placed in RH with SMI, for example, CCI had 35 in
2014 and 22 in 2015. Even with the reductions, the need for additional mental health services for this
population is persistent. WCI and GBCI house the largest number of inmates with SMI in RH; a total of 97
male inmates in RH on April 30, 2016 had a serious mental illness.
Since 2004, 11.00 FTE mental health staff positions have been added to male institutions within the
Division of Adult Institutions (DAI), including 5.50 FTE added in 2013 Act 20 (the 2013-15 Biennial
Budget). Currently, staffing levels do not allow for providing programming as called for in this request.
The 5.50 FTE added in the 2013-15 budget are providing mental health staffing at: CCI, GBCI, and WCI.
These staff works in RH units to provide crises management, regular rounds, and assist the multidisciplinary teams who determine if an inmate should be placed in RH. All of these functions provide
critical support to the RH unit. Because of the number of RH inmates with SMI, there is not enough staff
time to provide 10/10 programming.
Analysis
This request assumes the creation of a special diversion unit for SMI inmates in RH is created at OSCI.
(DOC’s request for a diversion unit at OSCI is addressed through the issue paper DIN 5304 – OSCI Mental
Illness Treatment and Diversion Units). The diversion unit would allow for inmates to be transferred to
OSCI and receive mental health treatment. If no unit is created, DOC estimates that the staffing needed at
CCI, GBCI, and WCI would increase, bringing the total to 8.60 Psychological Associate FTE.
Table 3 shows the number of inmates, hours of 10/10 programming needed, current and requested mental
health staffing if the diversion unit at OSCI is created and if it is not created.

 Table. 3. Number of SMI inmates in RH and AC by Location and Staffing Needed for Programming
OSCI Diversion Unit
CCI GBCI
WCI
# of Inmates
8
12
18
10/10 Programming Hours Needed
N/A** 3,328
4,992
9.5
Currently Allocated Mental Health FTE*** 8.5
7.5
1.6
2.6
Requested Psychological Associates FTE 0.6

No OSCI Diversion Unit*
CCI GBCI
WCI
25
30
8
6,933
8,320
8.5
7.5
9.5
0.6
4.0
4.0

FTE needed calculations account for individual and group treatment and administrative time. *Number of inmates as
of 4/30/2016 in each institution's RH & AC population with SMI. **This request is not for implementation of 10/10
programming at CCI. ***As of May 31, 2016, PMIS PP12.

System-wide implementation of the 10/10 model would require 14.60 FTE, using both Psychological
Associate FTE and Teacher FTE. This does not account for any additional security staff necessary to
accommodate treatment in the RH unit. Appendix 2 lists the entire male RH population with SMI by
location on April 30, 2016.
If fulfilled, this request would not require construction at WCI or GBCI. Based on current population
numbers and need, sufficient space for programming and staff already exists. Construction of additional
program space and office space at other institutions may be necessary.
New construction would take at least six years to be approved by the Building Commission and completed.
Remodeling current space may be possible depending on the institution. The need for construction,
including remodeling or creating new space, will vary by location and the cost has not been estimated.
Some states, such as Colorado, California, Ohio, Pennsylvania, and New York have eliminated the use of
RH for inmates with SMI and are instead using focused mental health treatment units. These units are
similar to those in place at TCI. Such units allow inmates to be secured away from the general population
and receive mental health treatment necessary for stabilization.
Staff has observed several improvements as a result of the 10/10 model at TCI such as fewer conduct
reports, fewer uses of force and fewer mental health crises. If this request is fulfilled, these improvements
may realize at WCI and GBCI and improvements may be seen at CCI.
Summary
GPR
TOTAL
Prepared by:

FY 18
Funding
FTE
$268,200
4.80
$268,200
4.80

Emily Lindsey, Budget and Policy Analyst- Advanced
240-5413

FY 19
Funding
FTE
$324,400
4.80
$324,400
4.80