10.3 Careers in Behavioral Health
There are a variety of career paths for people interested in mental health-related aspects of the criminal justice field. Careers in mental health or behavioral health can include work that relates to mental health, substance abuse, trauma, or related challenges. Many professionals may enjoy working in the behavioral health field and also like the overlap of working with people also involved in the criminal justice system. Hospitals that house a forensic population, jails, prisons and residential reentry centers are all examples of controlled environments that hire behavioral health professionals to assist in treatment of and successful community reentry for incarcerated people.
Community environments such as non-profit organizations, government agencies, and private practices also hire behavioral health professionals. As mentioned in the previous section, in considering career options in this area, you will want to consider the level of schooling that you intend to complete, as well as the work environment you prefer and the tasks you find meaningful. People who work in social work have varying educational backgrounds from no advanced degree, bachelor’s degree, master’s degree, and doctoral degrees.
Like those in criminal justice, careers in behavioral health have a wide range of educational and licensing requirements. Most positions require some form of certification, which is generally obtained through a combination of supervised experience and testing. Some professions require a bachelor’s degree, others require a master’s degree, still others a doctorate or medical degree. Lastly, there is generally a component of continuing education to ensure professionals stay knowledgeable on the most recent developments in their field of practice.
10.3.1 Counselors
A mental health counselor is a professional providing treatment to someone with a mental disorder. Counselors may provide individual and group therapy along with skill building. Most common court-mandated treatment services provided by counselors include: mental health counseling, substance use counseling, DUI diversion, gambling addiction services, sex-offense specific treatment, domestic violence intervention programming, and anger management.
Mental health counselors have a master’s degree or doctorate degree and are often licensed by their state licensing board. Generally, counselors with their master’s degree and with specialized training and/or licensing can diagnose mental disorders, including substance use disorders. Counselors without their master’s degree can diagnose substance use disorders, only after they have completed specific course work, training, and certification specific to treating people with substance use disorders. Mental health counselors can provide therapy prior to being licensed as they are working under someone else’s license.
A counselor’s education level ranges based on state requirements, and on the focus of their work. A certified drug and alcohol counselor (CADC), for example, is an Oregon state board-certified professional who provides substance use counseling only. Gambling addiction services are generally CADCs with additional training and certification to treat gambling disorders.
Domestic violence intervention programming usually does not require formal education like a bachelor’s degree, however it does require that certain training has been completed. Sex offense specific treatment does require formal and advanced education along with specific certification to treat paraphilic disorders.
Watch this short video sharing the work and experience of a drug and alcohol counselor at the Oregon State Hospital. Listen for the information he provides about what makes him successful in this role, and consider what qualities you have that will help you succeed in your career:
Figure 10.3. Drug and Alcohol Counselor : Careers in Mental Health [YouTube Video]. This is a four-minute video on the benefits Michael Kemp sees in working in the field of treating substance use disorders. In this video, he describes what keeps him motivated to “keep showing up.”
10.3.2 Peer Wellness Specialist and Recovery Mentor
A Peer Wellness Specialist (PWS) is a state board certified professional who has lived-experience accessing mental health services. A Recovery Mentor is similar to a PWS, however a Recovery Mentor has been previously diagnosed with a substance use disorder and is in recovery from this substance. A Recovery Mentor generally works in a substance use program to provide support in achieving and maintaining sobriety. Both PWS and Recovery Mentors provide a variety of direct services to clients who benefit from connecting with someone who has a similar background. PWS and Recovery Mentors generally have more flexibility in their role to support clients and have a unique way they can assist clients that clinical staff could not. For instance, a Recovery Mentor and/or PWS may assist with transporting a client to a court hearing, parent-child supervised visit, or accompany someone to a recovery meeting (i.e. alcoholics anonymous, narcotics anonymous, etc). There are no education requirements to work as a peer wellness specialist or recovery mentor, however specialized training is required.
Watch this short video sharing the experience of a peer recovery mentor working with people housed in the Oregon State Hospital.
Figure 10.4. Peer Recovery Specialist : Careers in Mental Health [YouTube Video]. This is a six-minute video describing the impact a peer can have working with people who are currently housed in a controlled environment. Malcolm Aquinas describes the impact it can have on a person when a professional can validate and identify with the person because they have experienced similar situations. In this clip, Aquinas describes how he too has been physically restrained.
10.3.3 Forensic Psychologist
A forensic psychologist can have many roles, but one of them involves completing psychological assessments for the Court. Forensic psychologists are utilized when an entity of the Court is requesting additional information and conceptualization of a person involved in the criminal justice system. Psychological assessments, such as those discussed in Chapter 6 related to competency or insanity, will include psychological testing, review of collateral information, and interviews with the person of interest. After completing a comprehensive assessment, the forensic psychologist provides a clinical recommendation that is reviewed by all parties in the court system.
The practice of forensic psychology requires an extensive education – you can study forensic psychology at the bachelor’s or master’s level, but a certified psychologist must have a doctorate degree, either a Ph.D or Psy.D, which takes several years of schooling to obtain. Forensic psychologists are licensed by their state licensing board.
Watch this five minute video (figure 10.5) to hear Dr. Franz Kubak, a licensed psychologist at the Oregon State Hospital, share his experience and work in this interesting role. What stands out to you in his description; is this work that would appeal to you?
Figure 10.5. Clinical Psychologist : Careers in Mental Health [YouTube Video]. This video describes the day-to-day duties of a clinical psychologist who works at the Oregon State Hospital.
There are many interesting occupations in the field of mental health, with varying responsibility and opportunity based on education level. Take a look at this interactive tool by the American Psychological Association (APA) to see what occupation professionals have held with a doctoral degree, masters degree, and bachelors degree in psychology, and how that has changed over time: APA Careers Data
10.3.4 Licensed Nurse Practitioner
A licensed nurse practitioner (LNP) is someone who holds a degree in nursing and has completed additional advanced training. A LNP is under the direct supervision of a physician. Additional roles of a LNP can include prescribing certain medications. LNPs work in hospitals, community-based mental health programs, residential settings, and controlled environments (i.e. hospitals, prisons and jails). Specialized psychiatric mental-health nurse practitioners (PMHNP) are trained in administration and prescribing of psychotropic medications. https://www.ohsu.edu/school-of-nursing/psych-mental-health-nurse-practitioner
Watch this five minute video (figure 10.6) of a psychiatric nurse practitioner explaining the work she does at the Oregon State Hospital.
Figure 10.6. Psychiatric Nurse : Careers in Mental Health [YouTube Video]
10.3.5 Psychiatrist
A psychiatrist holds a medical degree and is able to prescribe medications to improve a mental disorder. A psychiatrist is licensed and governed by their state licensing boards. A psychiatrist generally prescribes psychotropic medication, monitors the success of this medication, and provides therapy to their patient. Psychiatrists, like other mental health professionals, may experience conflict where the patient they are supporting discloses intent to harm others. See spotlight below on the Tarasoff case.
10.3.6 SPOTLIGHT: Tarasoff v. Regents of University of California (1976)
In the summer of 1969, Dr. Lawrence Moore, serving as Staff Psychologist at University of California’s Cowell Hospital, was faced with a predicament. Having earned many degrees, one being a doctorate in psychology at the University of Oregon, he knew very well that it was his duty to keep the trust of his patients. Unfortunately, one of his patients had confided in him that he planned to commit a murder. Dr. Moore knew that this patient was dangerous and fully believed he was planning to carry out this murder, so the doctor wrote a letter and hand delivered it to campus security. Dr. Moore urged them to take this student into custody and have him committed to a psychiatric hospital. Unfortunately, campus security didn’t see him as a risk and let him go, doing nothing more about it.
The student was Prosenjit Poddar. It was the fall of 1968 when he met Tatiana Tarasoff. On New Year’s Eve, Tatiana kissed Poddar. Misinterpreting the meaning behind the gesture, Poddar believed that he and Tatiana were now in a serious relationship.
In the summer of 1969, It was while she was away that Poddar told Dr. Moore of his plan to murder her when she returned. And then, in October of 1969, he did just that. Poddar showed up at Tatiana’s home with a weapon and wanted to speak to her, but she began to scream when she realized her life was in danger.
Upon learning that Poddar had told a mental health professional of his plan to commit this murder, Tatiana’s parents took legal action against the psychologist, his superior, the campus police, and the University of California itself. The Tarasoffs asserted that the defendants had acted negligently when they failed to warn them or Tatiana of the danger.
This case took years of litigation, including appeals. Ultimately, in 1976 it was decided by the Supreme Court that if a therapist believes their client to be a danger to a third party, the therapist “bears a duty to exercise reasonable care to protect the foreseeable victim of that danger….” Furthermore, the majority of the Court held: “…our current crowded and computerized society compels the interdependence of its members. In this risk-infested society we can hardly tolerate the further exposure to danger that would result from a concealed knowledge to the therapist that his patient was lethal” (Tarasoff v. Regents of the U. California, 551 P. 2d 334, 1976).
Legislation followed in many states to clarify this duty to protect and warn third parties. Oregon: ORS 179.505 allows but does not require a duty to warn by health care professionals of serious threat.
10.3.7 Licenses and Attributions for Careers in Behavioral Health
“SPOTLIGHT: Tarasoff v. Regents of University of California (1976)” by Monica McKirdy is licensed under CC BY 4.0.
Used Under Fair Use:
American Psychological Association. (2021). Careers in psychology [Interactive data tool]. https://www.apa.org/workforce/data-tools/careers-psychology
Figure 10.3 video of Clinical Alcohol and Drug Counselor is licensed under standard youtube license.
Figure 10.5 video of forensic psychologist is licensed under standard youtube license.
Figure 10.6 video of nurse practitioner is licensed under standard youtube license.