The Solution: Mental Health Assistants: Bridging the Gap to Effective Treatment

By Craigen Armstrong and Adrian Berumen

Two alleged murderers in LA County jail take on one of the biggest problems to date: incarceration of people with mental illness. Not only is this a pressing issue within jails and prisons, the lack of treatment and support for people with mental illness is contributing to our homeless issues throughout Los Angeles and the rest of the country.

"The Solution" details effective strategies and successful methods for treating and caring for the mentally challenged. It is presented as a three part-analysis on how patients (inmates) are treated, the structure under which treatment is delivered and the goal of the Mental Health Assistants who deliver the treatment. It also highlights the effort and teamwork necessary to make this treatment a success in the incarcerated environment. Finally, "The Solution" is a demonstrative guide for those who desire a successful treatment program of their own.

This book is written, researched and published by two inmates at Los Angeles County Twin Towers Correctional Facility (TTCF); young men who underwent a rigorous preparation to transfer from other county facilities into the towers that hold mentally ill inmates. One author has spent 12 years on death row and the other is a juvenile offender who has been awaiting trial for the past seven years. These two committed men have become the solution through their work as Mental Health Assistants at TTCF.

The authors live 24/7 with acutely ill patients in a specialized setting which provides more intensive treatment and encouragement to prevent isolation, decompensation, and re-hospitalization. They have taken the initiative to develop a curriculum that address life skills, communication, court competency and planning for the future. With no direct access to computers or email, they cobbled together educational modules, quizzes, incentives and rewards to provide a much-needed structure to the men with whom they are embedded. This entire book was written out long-hand with a pencil and they had to exercise great patience and diligence to see it through to publication.

Their hope is that others will find this program inspiring and useful. They themselves have benefitted from the opportunity to be of service to the inmates. Further, the inmates who participate in this program are better prepared to understand the legal proceedings they will experience, and they are better prepared for life on the outside.

• Language: English
• Publisher: BookBaby
• Release date: Oct 1, 2020
• ISBN: 9781098334185

Book preview

Copyright © 2020

Craigen Armstrong & Adrian Berumen

Los Angeles

Published in the USA

No form of this book may be copied without authors’ written consent through email

@[e-mail]

@[e-mail]

Cover illustration by

Adrian Berumen

@adriangreatstuff

All rights reserved

ISBN: 9781098334185

TABLE OF CONTENTS

Contents

Praise for The Solution

Dedication

Acknowledgments

FOREWORD

Part One: The Patients

Part Two:  The Structure

Part Three:  The Goal

AFTERWORD

Introduction to Appendices

Appendix 1:

RAA Motto and Disability Information

Appendix 2:

FIP Stepdown Program and Quizzes

Appendix 3:

Process for Certifying MHA’s

Appendix 4:

Program Tri-Fold printouts

Appendix 5:

Founders of MHA Certification Program

Appendix 6:

Methods for Observing Patients

True Stories by the Authors

ONE OF A KIND: A DAY IN F POD, THE FORENSIC IN-PATIENT PROGRAM

THE STATE OF PANIC:  A REAL LIFE SAVER

About the Authors

EPILOGUE

Praise for The Solution

Bruce C. Gage, M.D., Forensic and Correctional Psychiatrist, Clinical Associate Professor, University of Washington. Puget Sound Mental Health, General and Forensic Psychiatry

I

first met Mr. Armstrong and Mr. Berumen when I was on a tour of the Twin Towers Correctional Facility, the Los Angeles County jail that houses men, most all suffering from mental illness.  This jail is arguably the largest mental health facility in the U.S.  These two men, who were there as prisoners, were working as Mental Health Assistants on one of the units with the most seriously ill, unfortunate men most of whom had schizophrenia and other psychotic illnesses.

Being curious about what they were doing on this unit, I struck up a conversation with them.  They were eager to tell me about the program they had been developing to train peers to assist with caring for the mentally ill prisoners in the facility.  They showed me some of their materials and manuals.  It was raw, but right on target – exactly the kind of thing that they should have been doing.  I suggested they try to publish their work and the next time I visited, they showed me the beginnings of this monograph, now come to fruition.  I am deeply grateful for their efforts. 

But what is even more important to emphasize was the atmosphere on the unit.  It was worlds apart from similar units in the jail.  There were decorations and artwork done by the men on the unit, it was quiet and calm, and it was clean.  It was clear that there was order here, order that Mr. Armstrong and Mr. Berumen helped achieve and keep; it was not a disciplinary order, but an order that comes from building the kind of environment that truly serves the needs of this mentally ill population.  I spoke with the men on the unit who were uniformly, if sometimes oddly, complimentary towards these two men, who lived there on the unit with them.  It is very difficult to bring this kind of program into a correctional setting, especially a jail, and do it safely and well.  But these kinds of approaches are desperately needed, especially in these times of limited mental health resources.  When done well, peer assistance like this can often bridge the gap between staff and the mentally ill correctional population in a remarkable way.  It is also incredibly valuable for the peer assistants themselves.  Not only does it give them something to do, and a useful work skill, but it brings real meaning into their own lives instead of just doing time. 

Every jail administrator and jail mental health leader should look at this work and see the possibilities it opens – and the heart that comes from a true spirit of helping.v

Philippe Bourgois, PhD.  Professor of Medical Anthropology and Director of the Center for Social Medicine, Department of Psychiatry & Biobehavioral Sciences/Semel Institute of Neuroscience (UCLA)

M

r. Armstrong and Mr. Berumen are an inspiration of human redemption and generosity at the tragic intersection of mass incarceration and the failure of the United States to meet the needs of people with serious mental illness—especially those with psychosis. They are also miracle survivors themselves of childhoods of poverty, exposure to gang violence and the traumatic irrationality of the US criminal justice system. Without any formal education and only the most minimal vocational training through a helpful but small program for inmate education and rehabilitation run by the Los Angeles County Sheriff’s Department, Armstrong and Berumen have emerged as brilliant organic intellectuals.

They developed a new model of commonsensical humane solidarity for people with serious mental illness who have tragically been incarcerated rather than offered services, support and therapy by our frayed Public Health safety net. Offered the opportunity to volunteer as peer caregivers for inmates in the mental health unit of the world’s largest County jail system that has also tragically emerged de facto as the largest psychiatric facility in the globe, they created a slightly safer, more humane space for some of the jail’s most vulnerable detainees—who never should have been locked up in the first place.

Having grown up in devastated neighborhoods overrun by gangs and dysfunctional public schools, they were both swept up into the carceral dragnet as youth. Armstrong was sentenced to an absurdly long prison sentence that is now on appeal and Berumen has been trapped in the jail awaiting trial for over a third of his life by an unconscionably dysfunctional court following his arrest as a teenager. They developed a rewards-based curriculum through the charisma of their social solidarity and empathetic conversational accompaniment therapy. They have dramatically improved outcomes among the handful of lucky inmates with serious mental illness transferred into their unit for special care.

Without any access to the internet, simply through reading whatever limited psychiatric textbooks and photocopied handouts manage to reach them within the county jail system, Armstrong and Berumen invented what can be thought of as an applied psychoanalysis. They soothe their most distressed peers trapped in a crucible of institutional suffering and overcrowded dysfunction. Through a system of rewards, collectively distributed chores and genuinely empathetic social engagement, they reduce the suffering of hundreds of the mentally ill individuals abandoned by society to homelessness and chronic incarceration. With the support of sympathetic psychiatrists, social workers, religious services volunteers, health techs, and Sheriff’s deputies they have developed an innovative structured curriculum using an effective harm reduction model that genuinely meets fragile suffering individuals at rock bottom and gently, respectfully engages with them on terms of human equality and reciprocal sharing.

These two men serve as an