BOP Mental Healthcare: Levels I-IV

Medical Healthcare Mental Healthcare

Prison Design Affect Inmates’ Mental Health

Before any initial designation decision is made, DSCC staff assess a provisional CARE LEVEL from I – IV for each inmate. BOP institutions also have a Mental Healthcare (MH) CARE LEVEL assignment which reflects the mental healthcare resources available at that facility.

The Designation and Sentencing Computation Center (DSCC) designates those inmates with Medical and Mental Healthcare CARE LEVEL I-II.

For those inmates with Mental Healthcare, CARE LEVELS III-IV, the designation decision will be made by The Office of Medical Determinations and Transportation (OMDT).

Unfortunately, the BOP is not equipped to provide any meaningful treatment for the following underlying disorders (just to mention a few) – for example:

  • Post-traumatic stress
  • Major depressive
  • Bipolar

As medical staffing differs from one facility to another, and if the care is available within the BOP; this may necessitate a transfer to a facility further away from their home.

If your client is approaching Dementia or is currently being treated,

  • Published by the ABA, Fay Spence, Esq., and I am proud to have contributed two chapters regarding, REPRESENTING PEOPLE WITH DEMENTIA
    • CHAPTER 1. What Is Dementia? Page 1, Dr. Marc Blatstein, and Faye Spence, Esq.
    • CHAPTER 13. Jail and Prison Conditions, Page 155, Dr. Marc Blatstein, and Faye Spence, Esq.
  • there is only 1 BOP location,
  • with 1 wing, and if I recall what I read last, they had only 35 beds.

For a personal, one-on-one call with me to discuss your current issue, or that of a loved one,  give me a call (240.888.7778). If I am unable to answer, please leave me your name, number, and a brief message, as I personally make every effort to return all of my calls – that same day. Marc

We are not Attorneys, you need legal representation.


Mental Health CARE LEVEL I

  • No Remarkable Issues.
  • No history of regular Mental Illness Interventions, seeking help should there be a returning episode.

Mental Health CARE LEVEL II

  • ‘Routine and/or Crisis Oriented Outpatient’ Care.
  • Outpatient or brief crisis-oriented care.
  • Controlled with medication.
  • May require a suicide watch or brief observation.

Mental Health CARE LEVEL III

  • ‘More Severe Outpatient’ or Residential Mental Healthcare.
  • May require weekly mental healthcare visits or Residential Psychology Treatment.

Mental Health CARE LEVEL IV

  • ‘Inpatient’ Psychiatrist Monitored, include those who are:
    • Gravely disabled and cannot function in the general population as in MH III.
    • Have a current or recent historical need for inpatient psychiatric care?
    • 24/7/365 nursing.

The First Step Act

It appears that the BOP has created an “in-between” First Step Act Mental Healthcare Model where some of their mental health programs are run by trained [Contractors, Education, Health Services, Psychology, RAC, Social Workers, SPPC, Unit Team, and Volunteers] providing mental health care services. Should your client have a unique need, it is recommended that this should be professionally addressed long before the Presentence Interview.

A separate challenge that I have come across is that due to severe staffing shortages, qualified inmates that need access to some of these psychology-oriented programs may wind up on waiting lists.

As the FSA is still undergoing changes, and if my assumption is anywhere near accurate, it is incumbent upon the legal defense team in preparation for their PSR, to work with the court in order to get their client designated appropriately should there be an accurate ICD MH diagnosis that would require greater care.


If You Suspect You’re The Target of a Federal Investigation | Before The Presentence Interview (PSI) | After The PSI – But Before The Sentencing Hearing | or After Sentencing or You’re Already Incarcerated – There Are Still Things – At All Levels, We Can Do