BOP Program Statement 5324.07 § 13

transfers to and from Medical Centers will have a PSY ALERT

assignment if substantial mental health concerns are present that

require extra care, and/or the inmate has special psychological

needs that pose management concerns. Each case will be reviewed

individually to determine if the assignment is warranted.

When necessary, the Regional Psychology Services Administrator

must ensure the PSY ALERT assignment is entered for mentally ill

inmates housed in contract facilities.

/s/

Harley G. Lappin

Director

P5324.07

3/13/2007

Attachment A, Page 1

GUIDELINES FOR USING THE SENTRY PSYCHOLOGY ALERT ASSIGNMENT

Generally, the SENTRY PSY ALERT assignment is to be applied in

special mental health cases that will likely pose management and

security concerns for the institution when an inmate’s housing is

changed or when a transfer occurs. The guiding principle is that

the continuum of care must be maintained.

Application of the SENTRY PSY ALERT assignment requires sound

clinical judgment. The intent of this assignment is to ensure, if

movement occurs, that all staff consider the special

psychological and management-related risks associated with the

inmate.

Examples of when Psychology Services Staff should apply the PSY

ALERT assignment:

Example 1 - The inmate requires psychotropic medication for the

management of psychotic symptoms, and has a recent history of

being non-compliant with treatment.

Example 2 - The inmate is at risk for self-harm when distressed.

Example 3 - The inmate has a history of sexually predatory

behavior that is recent and occurred in an institution

environment. Psychology Services staff have identified the

offender to be a risk to staff and others.

Examples of when not to apply PSY ALERT assignment:

Example 1 - The inmate is involved in a psycho-educational group

or individual counseling, and a transfer would result in mild or

moderate adjustment problems.

Example 2 - The inmate is receiving medication from a chronic

care clinic for a moderate mental health disorder (e.g., anxiety

or mild depression), and is compliant with medication orders.

Example 3 - The inmate has a previous suicide attempt that is not

recent and he or she is not currently dangerous to self or

others.

P5324.07

3/13/2007

Attachment B, Page 1

Frequently Asked Questions (FAQs)

1. Is the PSY ALERT assignment intended to replace the MDS

assignment of Mentally Ill?

No - The MDS assignment of MEN ILL was intended for a

different purpose and has a specific definition. Although

some inmates with the MDS assignment of MEN ILL are

candidates for the PSY ALERT assignment, the focus of the

PSY ALERT assignment is different. Accordingly, staff should

not add a PSY ALERT assignment automatically for an inmate

who has the MDS assignment of MEN ILL.

2. Can you provide an example of an inmate who would have had an

MDS MEN ILL assignment but not a PSY ALERT assignment?

Yes - An inmate is diagnosed with Schizophrenia, is on

medication for this disorder, and has complied with all

treatment recommendations when transferred (no signs of

disruptive behavior at all). He may have a MEN ILL

assignment but not a PSY ALERT assignment.

3. One of the examples of when to add a PSY ALERT assignment

includes a sex offender. Are all inmates that are sex offenders

the target of the PSY ALERT assignment?

No - We are targeting only a small segment of the sex

offender population. SENTRY PSY ALERT is intended for staff

to better track sex offenders whose predatory sexual

behavior occurred during incarceration and who pose a risk

to staff and inmates. Tracking mechanisms are already in

place for other types of sex offenders (see the Public

Safety Factor definition for Sex Offender).

4. The definition and examples for Psychology Alert seem to give

a psychologist discretion on when to apply or not apply the PSY

ALERT assignment? Why?

This policy provides guidelines (only) for psychologists on

when to apply PSY ALERT. It was intentional that the PSY

ALERT assignment was not defined by AXIS level disorders

contained in the Diagnostic Statistical Manual. It is

expected that sound clinical judgment will be used for this

assignment.

P5324.07

3/13/2007

Attachment B, Page 2

5. What is meant by “continuity of care?”

For this Program Statement, “continuity of care” is a

generic term. It is much more than simply having BOP

psychologists communicate mental health information.

“Continuity of Care” also means ensuring that those staff

outside psychology services are aware that an inmate has

special psychological needs, and that his or her movement

requires special precautions.

6. If the inmate has a PSY ALERT assignment when he or she

leaves Bureau custody, will it remain in SENTRY?

Yes - The SENTRY PSY ALERT assignment will remain with the

inmate on SENTRY after he or she leaves Bureau custody. This

approach will allow U.S. Probation Officials to identify

these inmates while on Supervised Release. Additionally, the

assignment remains with the inmate if he or she returns to

Bureau custody.

7. Can an inmate be placed in a minimum security facility with a

PSY ALERT assignment?

Yes - However, when an inmate is being considered for

transfer to a camp, a psychologist should evaluate very

carefully whether the SENTRY PSY ALERT is still needed. This

is because the local jail may be used as the Special Housing

Unit, and additionally, there are resource limitations

consistent with a mission of lesser security.

8. When an inmate is scheduled for transfer, should a

psychologist make comments on the In-Transit Data form that the

unit team prepares, or the Medical Summary of Federal

Prisoner/Alien In Transit Form, or both?

The unit team may want to include comments on the In-Transit

Data form since the PSY ALERT will be conveyed on the form.

The psychologist should provide them with any helpful

information when requested. However, in all PSY ALERT cases,

information from psychology services must be included on the

Medical Summary of Federal Prisoner/Alien In-Transit Form.

Health Services and Psychology should develop systems of

control so that this can be accomplished before an inmate

with a SENTRY PSY ALERT transfers.

P5324.07

3/13/2007

Attachment B, Page 3

9. Is the Psychology Data System important to the PSY ALERT

assignment?

Yes - Justifications for inclusion or removal of this

assignment should always be made in PDS. Psychologists are

to make the entry in the category “PSYCH ALERT”. More

specifically, the body of the PDS notation must include:

1) justification for addition or deletion of PSY ALERT;

2) Concerns or precautions regarding housing and movement

(if any); and,

3) Recommendations for follow-up (if necessary).

However, OMDT staff who designate study cases are not

required to make an entry in PDS.

10. The policy states that a psychologist must conduct a face to

face interview before clearance of the inmate to a general

population unit. What happens when an inmate arrives on a bus

after-hours?

Inmates with a SENTRY PSY ALERT assignment must always have

a face to face interview with a psychologist before release

to a general population unit.

11. What happens if an inmate is housed in holdover short-term

(e.g., overnight) and has a PSY ALERT assignment?

Inmates with a SENTRY PSY ALERT assignment must always have

a face to face interview with a psychologist before release

from Receiving and Discharge (R&D).

12. Should Psychology Services staff develop local systems of

control to know when inmates are arriving and departing their

facility?

Yes - If not already in place, Psychology Services staff

should develop local systems of control with the CMC, and/or

unit team staff to ensure they are notified when a busload

is arriving or leaving.

P5324.07

3/13/2007

Attachment C, Page 1

MEMORANDUM TO UNIT TEAM REGARDING MOVEMENT OF INMATE WITH

PSYCHOLOGY ALERT ASSIGNMENT

(Include the following in memorandum)

I. Reason for SENTRY PSY ALERT assignment

(diagnosis or presenting problem)

II. Current mental health treatment

III. Suitability for transfer

IV. Treatment recommendations that might be relevant to the

designation process