Mahoning mental-health board makes better meds available to inmates

By William K. Alcorn


The Mahoning County Mental Health Board has allocated $30,000 through June 30 to pay for psychotropic medications to maintain continuity of care for inmates at the Mahoning County Justice Center with mental-health diagnoses.

Psychotropic medications are prescribed by psychiatrists for the treatment of mental and emotional problems.

Continuity of care is not always possible because the jail’s formulary — the list of medications it uses — may not be an exact match to those prescribed for the inmates before incarceration, said Duane Piccirilli, Mahoning County Mental Health Board executive director.

“Treatment works, and being able to maintain inmates on the same formulary during incarceration helps maintain their mental health while in jail and when they are released and restored to the community,” Piccirilli said.

About 25 percent of the justice center’s average population of 500 to 600 inmates have major mental-health diagnoses and are seen by a psychiatrist while incarcerated, said Maj. Alki Santamas, justice center administrator.

Piccirilli and William Carbonell, director of clinical programs and evaluation at the county mental-health board, said the use of atypical drugs, newer more-expensive, high-end medications, is important for continuity of care for inmates.

From an inside perspective, Santamas said he believes continuity of care is beneficial to the inmates while they are in jail and when they transition back to the community.

“When a mental-health patient comes into our care, we examine their mental-health history and get them back on or maintain a regulated medication protocol to keep them stabilized during their incarceration,” Santamas said.

But sometimes, he said, the justice center’s formulary doesn’t have the exact medications they were using before incarceration, which interrupts their continuity of care, he said.

The justice center will be able to draw down on the money made available through the mental-health board to purchase the high-end medications that it doesn’t have from a central pharmacy to better keep inmates who need them stabilized and functional, Santamas said. The central pharmacy is operated by the Ohio Department of Mental Health & Addiction Services to provide medications for the poor and indigent.

“If they are put on a different medication than they were taking before incarceration, they may become behavioral problems and harm themselves or others,” he said.

If the justice center has access to atypical medications, they will follow inmates when they are released, creating a continuity of care from pre-incarceration, to incarceration and back to the community, Santamas said.

Continuity-of-care has several advantages, as do atypical medications, Carbonell said.

Atypical medications, while generally more expensive, have fewer side-effects such as shaking, and they are longer-lasting, he said.

“Using the best medications, even though they are more expensive, provides more patient stability over time, increases the likelihood of compliance with treatment after discharge, which leads to less recidivism, making the atypical medications overall cost-effective for the justice center and Mahoning County and its taxpayers,” Carbonell said.

“We want to provide the jail population with the same mental-health medications as we do to the general population. The mental-health board has the responsibility to provide appropriate treatment for the safety and welfare of our community, including people in jail,” Piccirilli said.

“We are able to provide this service this year because of Medicaid expansion,” he said.

In the past, the mental-health board’s allocation from Ohio Department of Mental Health & Addiction Services was used up by the board’s contract service agencies by the end of the fiscal year.

Now, with more consumers having access to treatment through Medicaid, dollars are freed up to provide more services to consumers in the justice center, Piccirilli said.