BOP Program Statement 5335.02 § 2

Inmate. An inmate is any person residing in the custody of the Bureau. This includes individuals

who are sentenced, state boarders, military and civilly committed persons. Inmates housed at

medical centers are commonly referred to as patients. For the purpose of this program statement,

pretrial forensic study inmates are not included in this definition.

Secure Mental Health Unit (SMHU). Any housing unit, to include those at MRCs, dedicated to

the treatment of inmates with a mental illness that offers mental health programming in the

context of removal from the general inmate population, whether voluntary or involuntary.

Inmates are secured in their cells for periods of time each day in support of safety. Typically, by

design of the unit, inmates are not permitted to leave their rooms independently.

■ Secure Psychology Treatment Program (Secure PTP). Secure PTPs are a specific type of

SMHU. They are intensive residential treatment programs designed around a specific mental

health need in which all program participants have volunteered to participate in mental health

treatment activities. These programs are managed securely as an SMHU. Examples of Secure

PTP units include Secure STAGES, Secure Mental Health Step-Down Program, and Secure

Skills.

 All of the Secure PTPs are voluntary, and all participants must consent to engage in a

residential treatment program with the exception of inmates who are committed via court

order for treatment. The Secure STAGES program targets inmates who engage in chronic

self-directed violence. The Secure Mental Health Step-Down Program is for inmates who

have an SMI diagnosis. The Secure Skills Program is a program for inmates who have

intellectual deficits or social adjustment concerns.

 Secure Psychology Treatment Unit (Secure PTU). Secure PTUs are residential treatment

units where intensive treatment services are offered but not required. Inmates have been

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assigned to the unit, regardless of their interest, and may or may not volunteer to participate

in mental health treatment activities. These units are managed securely as an SMHU.

Example of Secure PTUs include the Secure Administrative Unit and secure units at MRCs.

 Secure PTUs in MRCs are units that house inmates who require inpatient psychiatric

treatment in a secure setting for their safety or the safety of staff. Secure PTUs include

units where inmates are secured in cells for the majority of the day and do not have

access to departments who do not routinely work on the unit.

 The Secure Administrative Unit (SAU) is a Secure Mental Health Unit designed to house

inmates who have an SMI or history of SMI diagnosis and require a secure setting due to

significant security concerns and/or are awaiting placement in a secure Psychology

Treatment Program.

Mental illness. For the purposes of this program statement, mental illness is defined as a

syndrome characterized by clinically significant disturbance in an individual’s cognition,

emotional regulation, or behavior that reflects a dysfunction in the psychological, biological, or

developmental processes underlying mental functioning (Diagnostic and Statistical Manual of

Mental Disorders, 5th Edition, Text Revision). Mental disorders are usually associated with

significant distress or disability in social, occupational, or other important activities. Mental

illness can only be diagnosed by a qualified mental health or medical practitioner.

Serious Mental Illness (SMI). Serious mental illness is defined as a mental illness other than a

substance use disorder that results in serious functional impairment substantially limiting or

interfering with major life activities (Diagnostic and Statistical Manual of Mental Disorders, 5th

Edition, Text Revision). For the purposes of this program statement, please refer to the

considerations outlined in the Program Statement Treatment and Care of Inmates With Mental

Illness: Classification of an inmate as having an SMI requires consideration of diagnosis(es), the

severity and duration of symptoms, the degree of functional impairment associated with the

illness, treatment history, and current treatment needs.

Gravely disabled. Consistent with 28 CFR § 549.46(b)(1)(ii)(C), a grave disability is an extreme

deterioration in personal functioning due to a mental illness or disorder.

Therapeutic release. A clinical practice in which inmates are released from secure housing

conditions for brief periods that may increase in length and frequency over time. Therapeutic

release occurs under the direction, coordination, and supervision of a clinical treatment team and

in collaboration with Correctional Services. Its purpose is to increase an inmate’s participation in

meaningful activities with peers and staff and to provide the inmate with opportunities to

demonstrate readiness for less restrictive environments. Any correctional worker/department can

implement a therapeutic release once approved by the treatment team; it does not need to be a

psychologist.

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Token economy. A system for incentivizing desired behavior in which inmates earn points after

performing healthy, prosocial behaviors. These behaviors are closely tied to treatment plan goals.

Their points can be exchanged for tangible, meaningful items or privileges.

Mental health provider. This general title includes psychologists, psychiatrists, psychiatric

nurse practitioners, psychiatric physician’s assistants, psychology trainees, QMHPs, social

workers, and treatment specialists. All psychology trainees will be supervised by a licensed

psychologist. For the purposes of this program statement, please refer to the responsibilities and

positions outlined in the Program Statement Treatment and Care of Inmates With Mental

Illness for position specific duties.

Psychiatric provider. A healthcare provider specifically trained in the chronic management of

mental health conditions who additionally has prescriptive authority. This includes psychiatrists,

psychiatric nurse practitioners, and psychiatric physician’s assistants. In cases where a psychiatric

provider is not available, primary care providers can be utilized. Primary care providers are health care

providers who are credentialed and privileged or acting under the authority of a Clinical Practice

Agreement (CPA), to prescribe psychiatric medication.

Secure Treatment Team. All SMHUs are administratively managed by an interdisciplinary

Secure Treatment Team. Treatment team participants are similar to those involved in Care

Coordination and Reentry (CCARE) Teams described in the Program Statement Treatment and

Care of Inmates With Mental Illness. In the case of SMHUs, the Captain or designee, mental

health providers, and nursing staff will also be included. Correctional Services staff assigned to

the SMHU are encouraged to attend, when feasible. These teams meet briefly each weekday in

MRCs and at least weekly in PTPs/PTUs.

Difficult to Place Committee. This is a Central Office Committee composed of the Senior

Deputy Assistant Director of Reentry Services Division, the Senior Deputy Assistant Director of

Correctional Programs Division, a subject matter expert on designations from the Designation

and Sentence Computation Center (DSCC), a subject matter expert on mental health treatment

from the Psychology Services Branch (PSB), Reentry Services Division, Central Office, and an

attorney from the Office of General Counsel (OGC), or their designees.