Center on Sentencing and Corrections

Promising Practices

Diversion for people with SMI


Colorado Department of Corrections

Brief Summary

The Colorado Department of Corrections (CDOC) has excluded people with serious mental illnesses (SMI) from placement in administrative segregation. By using incentives to encourage people with SMI to leave their cells , today there are no people with SMI in long term segregation.

The Goal

The goal of CDOC’s reform is preventing people with serious mental illness (SMI) from contact with extended restrictive housing, including administrative segregation, to avoid further mental decompensation and other negative side effects.

The Process

In 2014, the CDOC partnered with the Colorado state legislature and local advocates to facilitate the first-ever legislation forbidding the placement of seriously mentally ill individuals in long-term isolation, absent exigent circumstances. The legislation solidifies and provides critical funding to implement reforms initiated by the CDOC to provide out-of-cell treatment for prisoners with serious mental illness.

The Solution

In order to implement this new policy change, a number of reforms were implemented including the development of a residential treatment program (RTP) for incarcerated people who are mentally ill. Before anyone is placed in long-term segregation, their mental health status must be assessed to ensure that individuals with serious mental illness are not placed there. Working as a team, clinical experts and correctional professionals determine whether an individual being considered for placement in long-term segregation has a serious mental illness. If so, the response is treatment, not isolation. The RTP model was designed to provide extra care and support for people with serious mental illness or an intellectual disability, and to ensure that these individuals are not placed in restrictive housing settings. The program’s success hinges on incarcerated people working together in group therapy and engaging in one-on-one sessions with mental health clinicians. Both clinical and line staff collaborate daily to provide individualized support.

For example, the CDOC designed and built restraint tables that accommodate up to four people restrained together to facilitate group and pro-social interactions with a therapist or clinician. This allows the safety of the environment, the incarcerated individuals, and the staff member, but also encourages individuals to get out of their cells in small groups. Another key component of the RTPs has been the implementation of a national consultant’s recommendation to introduce opportunities for individuals in the program to come out of their cells for a minimum of 10 hours for structured therapeutic interventions and 10 hours of non-structured recreational opportunities, per week. Recently, CDOC has expanded beyond the 10 and 10 model and instead offers a minimum of four hours out-of-cell per day for both therapy and recreational opportunities.

The Results

In 2012, 57 percent of individuals in administrative segregation had some form of mental illness. Since the reforms have been implemented, there are no people with a serious mental illness in long-term segregation. Since its inception, the program has facilitated successful outcomes for people with SMI. Individuals who had lived in administrative segregation for years have progressed through the program and excelled in group environments. Many of these people hold steady prison jobs and continue to make positive changes. In addition, incidents of assaults and uses of force in the RTPs have declined and stabilized over the past several years. In 2015 at the San Carlos Correctional Facility the number of forced cell entries declined by 77 percent and offender-on-staff assaults declined by 46 percent. During the same time frame, at the Centennial Correctional Facility (RTP) the number of forced cell entries declined by 81 percent and offender-on-staff assaults declined by 50 percent.

Lessons Learned

Due to the focused and ambitious efforts of the CDOC to embrace new philosophies and implement new policies to address this growing population, outside groups did not believe the successes of what they were accomplishing. Critics claimed that CDOC staff were calling administrative segregation something else. But CDOC has in fact opened their policies and practices to be reviewed and witnessed. They offer individuals in RTPs out-of-cell opportunities for both therapeutic and non-therapeutic time – they don’t force people to leave their cells if they don’t want to, but they do incentivize out-of-cell opportunities through a “token economy ” system. This has brought ridicule and critique , but CDOC believes they will reach these individuals through time, patience, and consistency when it comes to the dosage and frequency of treatment availability.

Related Documents

This Promising Practices section of the SAS Resource Center was developed as part of a collaborative effort with the Vera Institute of Justice, University of Michigan Law School, and Center for Prisoner Health and Human Rights. We are also deeply grateful to the many leaders across the country who created and implemented each of the reforms cited throughout this section for their efforts to reduce the use of restrictive housing in prisons and jails across the country.

Please note that Vera and our partners do not specifically endorse the practices and policies included in this section. The Promising Practices section features segregation reforms being implemented in prisons and jails around the country. Our goal is to serve as a resource to other jail and prison systems interested in implementing similar practices and policies by highlighting those jurisdictions that report successful reforms.