Mentally Disordered Offenders

Mentally disordered offenders (MDO) is a term most applicable in a correctional setting, because it implies someone who has been convicted of a crime and has also been diagnosed as having a mental illness (i.e., insane). Some individuals diagnosed with a mental illness may commit a crime but are not legally considered incompetent or insane. It must be noted that legal standards of psychological impairment differ from psychiatric standards. MDOs are likely to be processed through the criminal justice system and, if appropriate, spend time incarcerated in prisons or jails. MDOs also include those who did not suffer from a mental illness when they committed their crime but later developed one during their incarceration.

MDOs receive mental health services during their incarceration when services are available, for example, psychotropic medication, individual or group psychotherapy, medication monitoring, psychological assessments, substance abuse treatment, and/or self help groups such as a 12-Step program. These services are provided within the correctional facilities, and inmates who participate remain within these facilities until their release or transfer.

MDO also refers to individuals convicted of a crime but sentenced to a correctional psychiatric facility—a hospital within a prison or a prison within a hospital. These facilities are numerous throughout America and are reserved for the most disturbed: offenders suffering from severe forms of mental illness, such as psychotic disorders, or an illness that is unresponsive to treatment. [Page 310]Thus, an MDO receives treatment in a therapeutic milieu, although it is likely to evidence adaptations that are not evident in psychiatric in-patient units. These mental health facilities remain correctional institutions and despite their specialized ability to treat mental illness are designed with appropriate security measures.

In addition to providing mental health treatment, facilities are equipped to provide forensic evaluations that pertain to legal questions regarding competency and insanity. Each state establishes its own policies and procedures for admitting offenders into the facilities. The federal government also maintains mental health treatment services for federal offenders diagnosed with mental illness. Admissions include transfers from prisons or jails, court-ordered individuals not yet convicted but judged insane or incompetent, and individuals whose competency is in question.