This curriculum on Carceral (Correctional) Psychiatry is designed to enhance the understanding and competency of general psychiatry residents in the field of jail and prison psychiatry. Through eight expertly crafted modules, it provides a comprehensive exploration of the intersection between mental health and the criminal justice system. Topics include the historical context, delivery of mental health services in carceral settings, psychopharmacology and substance use treatment, ethical dilemmas, and dual loyalty concerns. The curriculum also covers transitioning forensic populations to community settings and offers practical insights into working within jails and prisons, culminating in a firsthand perspective on the daily responsibilities of a jail psychiatrist. Delivered by leading experts, this program equips residents with the foundational knowledge and skills necessary to navigate the unique challenges of carceral psychiatry.

Format

Recorded lecture videos, asynchronous content.

Learning Objectives

• Understand the link between the social determinants of health and risk of incarceration.
• Discuss the unique aspects of providing mental health treatment within a correctional facility
• Review challenges to facets of standard care in the correctional setting including but not limited to informed consent, confidentiality, emergency treatment interventions, involuntary treatment over objection, suicide assessment and prevention.
• Review the challenges to quality assessment and improvement (research limitations)
• Describe the problem of misuse of prescription medications in jails and prisons
• Explain the purpose of Pharmacy & Therapeutics (P&T) Committees and how to navigate this process
• Review the range of mental health services that can be provided in incarcerated settings including mental health housing, specialized clinics, telepsychiatry, and hospitalization.
• Discuss treatment for special populations including female and transgender populations.
• Highlight the importance of risk assessment for suicide and self-harm in incarcerated patients

Curriculum Outline

1. History and Overview of Mental Health & Criminal Justice System
   • Jeffrey Metzner, MD
2. Mental Health Services in Jails and Prisons I: Facilities and Population
   
   • Debra Pinals, MD
3. Mental Health Services in Jails and Prisons II: Treatment
   
   • Debra Pinals, MD
4. Psychopharmacology & Substance Treatment in Jails and Prisons
   • Anthony Tamburello, MD, CCHP, DFAPA
5. Ethics & Dual Loyalty Concerns in Carceral Psychiatry
   • Elizabeth Ford, MD
6. Forensic Population in Community Settings
   • Reena Kapoor, MD
7. Working in Jail and Prisons
   • Cassandra Newkirk, MD, MBA, DLFAPA
8. A Day in the Life of a Forensic Psychiatrist
   • Danielle Kushner, MD

Target Audience

Medical Students, Residents/Fellows, Psychiatrists

Estimated Time to Complete

Estimated Duration: 8 hours
Begin Date: March 19, 2025
End Date: March 19, 2028

How to Earn Credit

Participants who wish to earn AMA PRA Category 1 Credit ™ or a certificate of participation may do so by completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the event date and hours earned.

Continuing Education Credit

In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians

In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

The APA designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Faculty and Planner Disclosures

The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Program Presenters

• Jeffrey Metzner, MD
• Debra Pinals, MD
• Anthony Tamburello, MD, CCHP, DFAPA
• Elizabeth Ford, MD
• Reena Kapoor, MD
• Cassandra Newkirk, MD, MBA, DLFAPA
• Danielle Kushner, MD

Program Planners

• Vishal Madaan, MD. Chief of Education and Deputy Medical Director, APA.
• Danielle Kushner, MD

Accessibility for Participants with Disabilities

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance.

Technical Requirements

This internet-based CME activity is best experienced using any of the following:

• The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
• Internet Explorer 11+

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:

• Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
• Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
• Internet Connection: 1 Mbps or higher

Minimum Requirements:

• Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
• Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content

For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance

APA Resources: 

• APA Edwin Valdiserri Correctional Psychiatry Fellowship - https://www.psychiatry.org/residents-medical-students/residents/fellowships/available-apa-apaf-fellowships/edwin-valdiserri-correctional-psychiatry-fellowship
• Why Should More Psychiatrists Participate in the Treatment of Patients in Jails and Prisons. APA Resource Document, October 2016. 

APA Resources: 

• Position Statement on Psychiatric Services in Adult Correctional Facilities. American Psychiatric Association, 2018. 
• Telepsychiatry for Adults in Jails and Prisons. APA Resource Document, February 2023. 
• Non Emergency Involuntary Medication for Mental Disorders in U.S. Jails. APA Resource Document, October 2020.
• Position Statement on Psychiatric Services in Adult Correctional Facilities. American Psychiatric Association, November 2021.  
• Position Statement on Restrictive Housing of Incarcerated Adults with Serious Mental Illness. American Psychiatric Association, July 2023.
• Position Statement on Treatment on Substance Use Disorder in the Criminal Justice System. American Psychiatric Association. December 2016. 

General Resources

• Prison Policy Initiative: Non profit, non partisan research and advocacy organization. https://www.prisonpolicy.org/
• Bureau of Justice Statistics: Primary source for statistics for the US Department of Justice. Collects, analyzes, publishes information on crime, offenders, victims, and operations of criminal legal systems. https://bjs.ojp.gov/
• Substance Abuse and Mental Health Services Association (SAMHSA): Criminal and Juvenile Justice - https://www.samhsa.gov/communities/criminal-juvenile-justice

Books

• People with Mental Illness in the Criminal Justice System. Answering a Cry for Help. Group for the Advancement of Psychiatry. Committee of Psychiatry and the Community. 2016
• Entangled: How People with Serious Mental Illness Get Caught in Misdemeanor Systems. Edited by: Pope L, et al. American Psychiatric Association Publishing. 2025. 
• Psychiatric Services in Correctional Facilities. 3rd Edition. American Psychiatric Association Publishing. 2016. 
• Oxford Textbook of Correctional Psychiatry, First Edition. Edited by: Trestman R, Metzner J, Appelbaum K: Oxford University Press, 2015. 
• Handbook of Mental Health Assessment and Treatment  in Jails. Edited by: Barber-Rioja V et. al: Oxford University Press, 2023. 
• National Commission on Correctional Health Care: Standards for health services in jails. Chicago, IL: NCCHC, 2018.
• Community-based interventions for criminal offenders with severe mental illness. Edited by: Fisher WH: Emerald Group Publishing Limited, 2002, pp. 199-220.