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Psych Doc Talks Prison Treatment Changes


When Dr. Randall Nero first joined the Maryland prison system, psychologists focused on an inmate’s childhood experiences and parental relationships as the source of their criminality, preached by famous psychoanalyst Sigmund Freud.

Not anymore.

Next month, Nero will celebrate 35 years in correctional psychiatry, now focused on cognitive behavior, teaching inmates to address emotions such as anger management.

“A lot of these folks are going to be released at some point so it plays a huge role in public safety for everybody,” Nero said.

The Maryland Department of Public Safety and Correctional Services is making huge strides in the treatment of mentally ill inmates due to the explosion of that population entering its facilities.

About 25 percent of Maryland’s 19,500 inmates and detainees are being treated for mental illness, Nero said. That’s a 10 percent rise since he started in 1984.

In addition, 10 percent are considered seriously mentally ill with ailments such as schizophrenia.

National changes in mental health treatment has spurred the mentally ill inmate population rise. Three decades ago, troubled patients were admitted to psychiatric hospitals before the providers began sending them to community sites.

Many of those smaller units were unable to handle the rising numbers.

“A lot of them fell into the cracks and ended up in the legal system,” Nero said. “We’re experiencing the ramifications of that.”

Last year, the Department’s new mental health provider brought 100 additional staff to the battle. And on Wednesday, the state Board of Public Works recently voted to demolish the former Baltimore City Detention Center to build a mental health and substance abuse therapeutic treatment center ordered by Gov. Larry Hogan.

“That’s a huge plus,” Nero said. “Many of the mentally ill in our system are coming in right off the streets and pose a huge challenge.”

The 63-year-old Nero grew up in Chicago and gained an interest in psychology attending Loyola University. He earned his master’s degree at the University of Eastern Kentucky and doctorate from the University of Mississippi.

After an internship at the state’s Spring Grove Hospital Center in Catonsville, Nero found his way into corrections after doing an internship with the Baltimore Circuit Court where he evaluated those arrested.

In 2003, he became director of the Patuxent Institution in Jessup, the correctional department’s treatment center, and three years ago rose to be the department’s mental health director, appreciating his Patuxent experience.

“It gives me a better understanding of what the boots on the ground are facing,” Nero said.