STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
HEALTH CARE SERVICES REQUEST FORM
CDCR 7362 (Rev. 03/19)
PART I: TO BE COMPLETED BY THE PATIENT
If you believe this is an urgent/emergent health care need, contact the correctional officer on duty.
REQUEST FOR: MENTAL HEALTH
CDCR NUMBER: K77832
REASON YOU ARE REQUESTING HEALTH CARE SERVICES. (Describe your health problem and how long you have had the problem):
FINISHED THE ANGER MANAGEMENT (IN-CELC) COURSE AND NOW I'D LIKE TO DO THE IN-CELL COURSE FOR DEPRESSION - OR ANY OTHER IN-CELL COURSE OFFERED DURING THIS COVID CRISIS. I WANT A PERSONAL INTERVIEW ON THIS MATTER ASAP.
LIFE SUPPORT ALLIANCE & California Lifer Newsletter
P.O. Box 277 Rancho Cordova, CA. 95711
Will somebody please alert regarding the following documentation of two efforts to obtain/make available to general population, the courses listed below. Thank You. My own efforts are appearing counter-productive at this point, as "demanding" (LOL).
Recognizing the need for some programming that can be largely self-done during the current sequestered situation, CDCR's Mental Health Delivery System has made available to all prisoners in all prisons two multi-part in-cell study programs, one on Anger Management and the second on Depression - always relevant topics. These feature a substantial, evidence-based curriculum that provides a minimal contact with a mental health clinician and a certificate on completion. Those wishing to work the programs do not have to be a client in the mental health system, either CCCMS or EOP, but the program is offered by the mental health division.
To access the programs submit a Form 7362, asking for an appointment with a mental health clinician, let them know which module you'd like to work on. You'll be provided with the curriculum packet, including homework exercises, along with a 'cell front' visit by a clinician to collect your homework and answer any questions you might have. The topics and ideas that would normally be discussed in a group session are now done via answering questions and writing your thoughts.
Again, these programs are available to any inmate and you do not need to sign up for mental health services, therapy or treatment to participate in the in-cell learning. You are participating as a student, not a client or patient. Although these courses were sent to all institutions some time ago there seems to be a breakdown in communication, letting the prisoner population know of this opportunity (when was the last time CDCR offered anything for free, except possibly grief?), so we'd like to spread the word.
And if the mental health providers at your institution say they haven't heard of these programs, please let us know. There's nothing we enjoy more than providing a little reality check to CDCR's own. We'll be happy to make sure your institution not only knows about the two courses, but promotes them too.
Ask your counselor for Form 7362, submit it and begin taking advantage of one of the few things CDCR is, at their own instigation, making available to inmates that is free, helpful and timely. Wanting to continue your rehabilitative work and seeking those opportunities on your own, goes a long way to showing the board you're serious about your change and desire to become pro-social.
CALIFORNIA CORRECTIONAL HEALTH CARE SERVICES
MCSP - Mule Creek State Prison
4001 Highway 104
Ione, CA 95640-
Patient: GOEHLER, WILLIAM ROBERT
DOB/Age/Sex: 2/15/1963 57 years Male
CDCR #: K77832
Encounter Date: 5/22/2008
PID #: 11123924
Mental Health - Nursing
No data exists for this section
Mental Health Documentation
Document Type: MHPC Consult Routine Progress Note
Document Subject: MH Consult Note
Service Date/Time: 9/25/202 11:57 PDT
Result Status: Auth (Verified)
Perform Information: [REDACTED] Psychologist (9/25/2020 12:41 PDT)
Sign Information: [REDACTED] Psychologist (9/25/2020 12:41 PDT)
Authentication Information: [REDACTED] Psychologist (9/25/2020 12:41 PDT)
Inmate's Program and Level of Care [Bold, underlined title]
Non Mental health inmate MCSP B-Yard
New Issues/Complaints [Bold, underlined title]
No qualifying data available.
Mental Status [Bold, underlined title]
IP is a 57-year-old Caucasian male, large build, tall, above average height, appeared to be his stated age, long hair, medium trimmed beard. The IP presents with clean state blue clothes appropriate for the setting and for the weather. Overall the IP is well groomed and hygiene is adequate. Eye contact is consistent, good, and direct. Speech is conversational in regards to rate, prosody, tone and volume. The IP is oriented to all 4 spheres. The IP engaged and cooperative. Broad affect and congruent with euthymic mood. The IP denies s/i, h/i, plan, and intent. The IP does not appear to be distracted by internal stimuli. Thought process is linear and logical. Thought content is goal, future and present oriented. Insight and judgment are fair. The IP presents as properly nourished and does not appear to be sleep deprived. No psychomotor agitation/retardation observed. Short, and sensory memory appear to be intact.
Mental Health Assessments [Bold, underlined title]
Mental health seems to be stable at this time.
Assessment/Progress Towards Discharge [Bold, underlined title]
1. Chronic hepatitis C
3. Lumbar spinal stenosis
4. Health care maintenance
[this form spans pages 2-3 out of 5]
Plan/Disposition [Bold, underlined title]
Provided IP with information on the referral process including emergent, urgent, and routine mental health referral and prompted IP to seek help as needed. IP was informed if the materials he requested is available IP be contacted.
Active Consult Orders [Bold, underlined title]
MHPC Consult Routine - Completed
--09/10/20 9:30:00 PDT, 09/03/20 11:01:00
PDT, IP requests to see PC, 7 days, Schedule once with an A Yard MHPC.
188.8.131.52.20200904031656529792758433#1.00, 09/02/20, 09/10/20 23:59:00 PDT
MHPC Consult Routine - Completed
--09/24/20 10:45:00 PDT, 09/22/20 13:16:00 PDT, Other, 7 days, Schedule Ms. Amos on B yard, 184.108.40.206.202009022220010847543488926#1.00, 09/21/20, 09/29/2 23:59:00 PDT
Subjective/History of Present Illness [Bold, underlined title]
The author met with this IP, a GP inmate non mental health, in a confidential setting for a self referral for consult routine. When met with the IP, he reported that he has been down for 22 years with 12 years to go but he is going to be released for early elderly release in 2 years. IP said he has high anxiety which "it's a situation anxiety because uncertain of the parole." IP requested in a demanding manner [this text was highlighted, with note "NOTHING OF THE SORT!"] that writer provide him with materials on depression and anger management which that he believes it is online. It was discussed and informed IP that this writer will do some search yet not promising that is going to be provided if is is [if it is] not available. IP reported no current suicidal ideation, no homicidal ideation, not intent and or plan to harm himself and or to hurt others.
Problem List/Past Medical History [Bold, underlined title]
Ongoing [underlined title]
Acute low back pain
Chronic hepatitis C
Facial skin lesion
Lumbar spinal stenosis
Historical [underlined title]
No qualifying data
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