Formulary management

Abstract As with any patient population, clinicians must consider the risks and benefits when prescribing psychiatric medications to incarcerated patients. At the broader systems level, jail and prison authorities must also weigh competing pressures, including potential therapeutic benefits, safety risks, financial costs, staff availability, and legal obligations, when determining the availability of each medication for patient care. The development of a psychiatric medication formulary, including a list of available medications and guidelines for their use, is an essential process for evaluating, balancing, and addressing these concerns. This chapter examines psychiatric medication formulary management in jails and prisons, including how pharmacy and therapeutic committees can contribute to the development, implementation, monitoring, and refinement of such formularies and associated prescribing practices. In addition, this chapter highlights how formularies should not just limit clinician use of and patient access to psychiatric medications but instead serve as a guiding framework that supports safety, efficiency, and evidence-based practices in psychiatric medication prescribing in jails and prisons.