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UNMC, Sarpy County team for forensic psychiatry fellowship

Image with caption: Howard Liu, MD, chair, UNMC Department of Psychiatry

Howard Liu, MD, chair, UNMC Department of Psychiatry

Under a new partnership, Sarpy County and UNMC will create Nebraska's first forensic psychiatry fellowship to assess and treat inmates experiencing mental illness. The Sarpy County Board of Commissioners on Tuesday voted on a multi-year agreement to establish the program.

The agreement calls for UNMC to provide one psychiatrist a year to perform psychiatric services primarily for inmates with serious mental illness. The fellow would provide psychiatric treatment, prescribe medication, help with medication management, provide court testimony and reports, and potentially complete competency evaluations.

A 'groundbreaking' program

Sarpy County inmates currently have some access to mental health services, while competency evaluations and restorations are completed through the Lincoln Regional Center. Adding an on-site psychiatry fellow could more quickly address competency related needs, psychiatric medication management and other services for inmates.

"At least a quarter of our inmates would benefit from having a psychiatrist on site," said Jo Martin, interim Sarpy County Corrections director. "This is a groundbreaking program because it's filling in missing pieces that the system is lacking -- to bring better, more accessible psychiatric care to inmates."

Martin said inmates with serious mental illness have a 36% chance of committing another crime after they leave jail, and treating their psychiatric needs while in jail and connecting them with community resources upon release will set them up for more positive outcomes.

Sarpy County would pay UNMC $1.2 million over the course of the 5.25-year agreement. County funding would help develop a training site in the new Sarpy County Correctional Center and share the cost of faculty and a program director.

After approval, the program now begins the planning phase to ensure patients can be seen starting in 2023, shortly after the new Sarpy County Correctional Center is scheduled to open. The fellowship will support the correctional center's dedicated behavioral health care unit.

"The Sarpy County Board of Commissioners and leaders across county government have been spearheading several initiatives to help people who are dealing with mental illness, particularly those who have contact with the criminal justice system. A partnership with UNMC would be a game-changer for mental health treatment in Sarpy County," said Sarpy County Board Chairman Don Kelly. "This fellowship will assist inmates who are experiencing mental health crisis and those with serious mental illnesses, and hopefully get them on a path that doesn't lead back to jail."

Psychiatrists taking part in the program who complete the fellowship will then be eligible to become board certified in forensic psychiatry and give them experience and expertise working in a correctional center setting. UNMC plans to submit the fellowship program for national accreditation through the Accreditation Council on Graduate Medical Education.

"As the chair of the UNMC Department of Psychiatry and the former director of the Behavioral Health Education Center of Nebraska, I have long recognized the urgent need for forensic psychiatry expertise in our community," said Howard Liu, MD, who spoke before the board on Tuesday. "People with serious mental illness or addiction who are justice involved often present the most complex needs for law enforcement and health care providers. This is a truly innovative partnership between Sarpy County and UNMC to develop that pipeline of experts. Nationally, there are fewer than 50 forensic psychiatry fellowships and there has never been one in Nebraska. We plan to matriculate our first fellow in 2023 and they will train at the new 400-bed Sarpy County Jail and other sites around the state."

The program's primary focus will be on the county's adult inmate population, though the fellow also will assist the Sarpy County Sheriff's Mental Health Unit, the newly-established Sarpy County Wellness Court and see youth at the county's Juvenile Justice Center, as necessary.

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