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• Special
• Needs
• Inmates

Instructors Aid
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• Program Objectives

• Definition of Special Needs
• How to Identify and Manage Inmates with Mental
  Disabilities

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• How to Identify and Manage Inmates with
  Personality Disorders
• How to Manage Inmates with Physical Disabilities

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• Special Needs Inmates is designed to instruct
  corrections and detention officers in the basics
  concepts of identifying and managing special
  needs inmates.

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• A Definition

What is a Special Needs Inmate?
A Special Needs Inmate has a physical or mental
disability that limits his or her capacity to
function in the normal inmate population.
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• Notice the definition does not say special
  inmates.

It does say, inmates with special needs.
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• Never forget the fact that these are people who
  are incarcerated for a reason.

Inmates are suspected or convicted criminals.
They have physical or mental limitations that
require special attention and consideration.
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• Mental Disabilities

You will encounter some special needs inmates
with mental disabilities.
They will behave differently than other inmates,
sometimes in strange and unpredictable ways.
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• Mental disabilities can be subdivided into three
  general categories
• Developmental Disabilities
• Learning Disabilities
• Mental Illness

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• Individuals with developmental disabilities are
  often referred to as mentally retarded.

This means their measured intelligence quotient,
or IQ, is significantly below the norm of 100.
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• Levels of mental retardation are

Mild IQ 51-69 Moderate IQ 35-50 Severe IQ 20-
35 Profound IQ lt 20
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• An individual is considered Mildly retarded if
  their IQ is measured between 51 and 69,
  Moderately retarded if their IQ is between 35 and
  50, Severely retarded between 20 and 35, and
  Profoundly below 20.

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• Courts most usually place Moderately, Severely,
  or Profoundly retarded offenders in institutions
  that have the resources to care for them.

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• You are most likely to encounter the
  developmentally disabled offenders who are mildly
  retarded.

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• Mental Retardation

At first the behavior of the offender who is
mildly retarded may seem almost normal, or
described by others as a little slow.
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• But there are ways to recognize mental
  retardation. Some signs are

• Lack of judgment in personal hygiene. They may
  forget to shower or comb their hair or brush
  their teeth.

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• Difficulty Communicating

Retarded offenders may not be able to make
themselves understood by officers or other
inmates because their thinking is not logical.
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• Unusual or inappropriate social behavior

Retarded offenders may think some things are
funny when no one else does, or make
inappropriate comments during someones
conversation.
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• Lacking in basic life skills

They will have trouble with things such as
balancing their commissary account, or knowing
how to make a collect call.
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• These are only signs of mental retardation, none
  is conclusive proof.

If you suspect an inmate is mentally retarded and
has not been identified during intake or booking,
refer them to a mental health professional for
evaluation.
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• Managing Mentally Retarded Inmates

Retarded people have difficulty functioning in a
variety of situations, especially ones that are
new to them.
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• They may seem confused about what to do and how
  to act.

Have difficulty learning new things to the point
where you may think they are being defiant or
non-compliant.
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• It is your job to be alert. This kind of
  behavior is easy to misread in a corrections
  setting.

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• It is important to remember the difficulty the
  retarded inmate is experiencing is not something
  he or she can control.

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• It is a result of deficits in adaptive behavior.

To overcome these deficits, use straightforward
communication techniques.
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• Communicating With Mildly Retarded Inmates

• Give specific and concrete directions.
• Use simple, direct language.

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• Use small, sequential steps.
• Check to see that directions are followed.

Be specific with your directions.
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• Do not give abstract directions like Clean this
  place up.

Be specific Fill this bucket with water and use
this mop to wash the floor.
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• Be specific and patient. Continue to use
  specific, concrete instructions.

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• Protecting Retarded Inmates

Mentally retarded offenders may be easily
manipulated or abused by other inmates because
they are sometimes highly impressionable and
eager to please.
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• Its not only your job to protect the retarded
  inmate from physical, sexual, and emotional abuse

but to make sure other inmates dont talk them
into hiding contraband, assaulting officers, or
engaging in illegal behavior.
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• Learning Disabilities

These inmates may have normal or above average
intelligence, but have difficulty understanding
or using language, either written or spoken.
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• They will most likely have problems with
  listening, speaking, reading, writing,
  mathematics, or logical thinking.

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• Many people with learning disabilities try to
  compensate with excuses or other behavior that
  may make detection difficult.

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• Learning disabilities cover a wide spectrum of
  symptoms and severity.

Some individuals may appear very bright, while
others may seem very slow.
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• Helping Inmates with Learning Disabilities

If you should encounter inmates with learning
disabilities you can help them by
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• Making sure they get the information they need.

Make sure the learning disabled inmate gets the
information they need to succeed in the
institution.
This may mean helping them read documents
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• Give directions slowly and clearly demonstrate.

Give all directions slow and clear.
Demonstrate the behavior or activity. Ask the
inmate questions until you are sure they
understand.
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• Offer assistance but promote independence.

An example, you might help them solve a math
problem rather than doing it for them.
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• Protect learning disabled inmates.

Protect them from other inmates who may take
advantage of their limitations.
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• Be understanding.

The most important thing you can do for anyone
with a learning disability is to be understanding
and supportive.
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• Encourage the inmates efforts at independence.

Offer them help of specially trained staff
members who know how to assist them.
Above all, TREAT them with the same dignity and
respect you would give anyone else.
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• Mental Illness Emotional Disturbances.

You may encounter an inmate with mental illness.
There are many classifications of mental illness.
We will discuss two major categories.
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• Emotional Disturbances
• and
• Personality Disorders

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• Emotional Disturbances

People with emotional disturbances often suffer
from defects in their brain chemistry that can
cause unpredictable, sometimes bizarre behavior.
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• The inmate can appear to function normally, often
  for great lengths of time.

Be alert to indications of emotional disturbances.
Emotional disturbances usually reveal themselves
relatively slowly.
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• The following are a few signs of emotional
  disturbance.

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• Mood Changes

Prolonged mood shifts result in major changes in
behavior.
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• Behavior Changes

When behaviors become aggressive, violent, or
strange, the inmate is often referred to as
acting out.
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• Changes in eating or sleeping pattern

Mental illness can affect the bodys physiology.
The mentally ill inmate can begin skipping meals
and losing weight.
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• Many inmates will exhibit some of these behaviors
  some of the time.

What you need to look for are significant,
prolonged changes in behavior patterns that are
unrelated to other events.
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• While there are many kinds of mental illness,
  ones you are most likely to encounter are
  Schizophrenia, Anxiety Disorders, Paranoia,
  Hypochondria, and Depression.

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• Schizophrenia

People with schizophrenia are usually out of
touch with reality.
Schizophrenics may exhibit some of the following
symptoms
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• They may have irrational thoughts, speak in
  bizarre and disorganized ways making up words
  or talking to themselves incoherently.

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• Schizophrenics may also experience delusions,
  like they are being spied upon.

exhibit bizarre actions, such as strange
rituals, like starring at their own hands, or
wearing their clothing inappropriately.
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• Finally, they may have hallucinations hearing
  voices, or seeing things that are not there.

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• Medication can often control schizophrenia,
  making it possible to join the general population
  when they behave normally.

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• Inmates with active schizophrenia can be
  dangerous because they are out of touch with
  reality.

You must be alert to these symptoms, and, if
necessary isolate the inmate and get help from
mental professionals immediately.
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• Anxiety Disorders

The next mental illness you may encounter is
likely to be anxiety disorders.
People who suffer from this disorder are
excessively anxious for long periods of time.
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• They may exhibit symptoms of excitability, muscle
  tension, sweating, rapid heart beat, and
  sometimes dizziness.

Severe anxiety can usually be treated with
tranquilizers. Remember, these medications can
become addictive, use should be tightly
controlled.
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• Another illness you may encounter is paranoia.

People with paranoid personality disorder are
excessively distrustful and suspicious of others.
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• Paranoid people read hidden threats into normal
  remarks or incidents.

They bear grudges and are unforgiving of insults
or injuries.
They fear others will share information about
them, and worry about the loyalty of friends.
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• One thing to remember, in a prison or jail
  setting, paranoid behavior is not uncommon.

If an inmate complains that other inmates are
threatening him or her, dont deny the inmates
feelings or reject the claim.
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• Always ask questions to get more facts

and then report the threat to your supervisor.
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• Hypochondria

Hypochondria is an exaggerated concern over ones
physical health.
Simply stated, hypochondriacs believe they are
sick most of the time.
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• You must always take every inmates medical
  complaints seriously.

This may be difficult because hypochondriacs
often complain constantly and insist on visiting
the medical unit almost every day.
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• Denying access to medical care may put you at
  risk of being sued for jeopardizing an inmates
  well-being.

So, if you feel there is no justification for it,
you should refer all medical complaints to the
medical staff for evaluation.
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• Depression

The final, and probably the most common illness
you are likely to encounter is depression.
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• More than just sadness, depression is also a
  chronic feeling of hopelessness, or
  self-loathing.

Symptoms include apathy, loss of appetite,
changes in sleep patterns and anti-social
behavior.
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• Depression can usually be treated with medication
  and counseling. However, left untreated, it is a
  real danger to the inmate and can lead to suicide
  attempts.

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• Suicidal inmates may have other symptoms like
  extreme self pity.

They may talk about suicide, leave suicide notes,
give away their possessions, followed by a period
of calmness that suggests they have decide to
commit suicide.
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• Some suicide threats are trial runs for the real
  thing.

Take all threats or gestures seriously.
Report them to the mental health professionals on
staff.
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• Managing Mentally Ill Inmates

There are specific things to keep in mind to
effectively manage inmates with all types of
mental illness.
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• To remember, think S-S-P

• Sick, not bad
• Symptoms are real
• Positive professional

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• First, remember the mentally ill person is a sick
  person, not a bad person.

You may become frustrated with the inmates
behavior and angry that they wont just shape
up.
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• Treat the mentally ill inmate with the same
  patience you would have for someone with a
  physical illness.

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• Second, you should recognize to the mentally ill,
  their symptoms are very real, even if they may
  seem preposterous to you.

Do not support the delusion, but understand the
inmates feelings are genuine.
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• Third, you should stay positive and professional.

Emotionally disturbed people take cues from those
around them.
So it pays to be calm and upbeat.
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• Do not take bizarre behavior personally.

Your own emotional well-being should remain
professionally detached, refer mentally ill
inmates to the mental health staff.
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• Mental Illness Personality Disorders

People with personality disorders do not play by
the rules, but want their own rules.
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• They are impulsive, usually without regard to the
  consequences of their behavior.

Often they are compulsive liars, and do it with
sincerity and without guilt.
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• They do not learn from experience, have disregard
  or even contempt for authority.

Often they have trouble with relationships, are
irresponsible, and unreliable, insisting on
immediate gratification, rather than long-term
goals or commitments.
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• People with personality disorders are prime
  candidates for run-ins with the law, so it is not
  unusual to find them in a correctional setting.

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• Because they do not have a conscience, they can
  be very dangerous.

Dealing with inmates with personality disorders
means you must be straightforward and factual.
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• Enforce the rules consistently.

Get help from mental health professionals when
needed.
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• Physical Disabilities
• What You Should Do

These will include people who are deaf or blind,
diabetes, paraplegia, and epilepsy.
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• Most corrections professionals are not experts in
  American Sign Language.

Therefore, to communicate with the deaf inmate it
is usually done in writing.
Always have pen and paper on hand.
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• To get a deaf persons attention, tap them on
  their shoulder, but do so with caution, not to
  startle the inmate.

If the deaf person can read lips, speak slowly,
clear, and in a normal tone of voice.
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• Blind inmates are becoming more common.

You must familiarize the blind inmate with the
living area to prevent injuries.
Consider posting a sign on the inmates cell
alerting staff members to the disability.
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• When offering assistance, allow the inmate to
  take your arm for guidance.

To greet a blind person, identify yourself and
others, let the blind person know the
conversation is over and you are moving away.
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• With diabetes, the pancreas does not produce
  enough insulin needed for normal blood sugar
  metabolism.

Controlling diabetes usually includes insulin
doses and a regulated diet.
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• Diabetics are subject to two life threatening
  conditions that you should be aware of

• Diabetic Coma
• Insulin Shock

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• Diabetic Coma

Diabetic coma, or hyperglycemia is a result of
not enough insulin in the bloodstream.
Caused by an overdose of medicine, not eating
enough, or over-exercising.
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• Symptoms include lightheadedness, sweating,
  trembling, hunger, and weakness.

This condition can develop very quickly and the
person needs sugar immediately in any form, along
with medical attention.
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• Word of caution

Symptoms of both diabetic coma and insulin shock
are similar to alcoholic intoxication.
If the diabetic does not get immediate medical
attention, brain damage or death could result.
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• Paraplegia

When you encounter an inmate who is
wheelchair-bound, do not make an issue out of the
disability.
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• Treat them as you would any other inmate,
  especially with regard to rules, regulations and
  privileges.

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• Leaning on a persons wheelchair is similar to
  hanging or leaning on their body.

The chair is part of the inmates body space, so
treat it as such.
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• If you have to speak at length to someone in a
  wheelchair, position yourself to the disabled
  persons level.

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• Epilepsy

Epilepsy is a malfunction of the electrical
system of the brain that results in seizures.
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• The most severe type of seizures, the victim
  suddenly loses consciousness, becomes rigid and
  falls.

They may have convulsions, foam at the mouth,
jerk uncontrollably, or even stop breathing
temporarily.
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• These are called grand mall seizures and usually
  last two to three minutes.

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• When you encounter an inmate having a seizure,
  you should

Remove all nearby objects that could cause injury.
Remove eyeglasses, loosen tight clothing.
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• Turn the person to the side keeping airway open.

And, put a pillow or folded blanket under the
inmates head.
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• Do not attempt to restrain the inmate unless he
  is in a dangerous place that could cause injury.

Do not put objects in the inmates mouth.
Contrary to belief, people cannot swallow their
tongue.
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• Call for medical assistance immediately, call for
  backup to keep the area secure.

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• Remember

In all cases of disabilities, the important thing
is to remain professional.
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• Always document any unusual occurrence.

These are not special inmates
but inmates with special needs.
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• QUESTIONS

Instructors Aid