Quote from ♪♫ in my ♥
The list of people in our society who are underserved and uncared for is long and varied; institutionalized criminals, mentally ill or not, are a fairly low priority for me given the insufficient resources available to governments at all levels.
Our politicians who establish and vote for agency funding agree. City, county, state, and federal correctional institutions who must allocate their paltry funding pretty much agree. Inmates do not receive the same level of healthcare the general public does. They just don't. Here's an example. I have knowledge of an inmate who was raped while in custody, developed a rectal abscess, and it turned into a rectal fistula. His surgery has been rescheduled for almost a year due to various government agencies running out of money and delaying necessary surgery. His crime? He's been caught with marijuana a few times. Let's say this inmate had this condition and was uninsured and showed up in an ER without insurance: the typical under-served, uninsured patient. He'd get his surgery and get out of the hospital quickly due to lack of insurance. He cannot even get to an emergency room because he's been in various correctional facilities continuously, transferred back and forth, and he lacks control.
I have been covered in hep C+ blood after an inmate was stabbed (due to shortage of officers to keep the environment safe) and did not have soap in the building because we ran out and the unit was out of money. These are examples of the severe short-shrift correctional healthcare facilities operate under.
Thing is, most of these inmates WILL get out and return to society at some point. They will be next to your child in the grocery store. They might deliver your pizza and stand at your doorstep late at night. They need to have a minimum level of healthcare and be treated in the manner a civilized society treats its most desolate. Not just because it's ethically correct, but because most will walk amongst us in society post-release, and we do not want them socialized in prison to be violent animals upon release. We do not want their severe mental illnesses to become amplified without treatment, if only because they will be more likely to re-offend. Some will be violent animals anyway. But certainly not all. The US already has the highest percentage of its' population in prison of any nation in the world. We cannot afford to warehouse people like animals and perpetuate the downward spiral of our society and the resulting increase in our (expensive) dysfunctional underclass.
Back to the original article. A monitor needs to be appointed within the prison to monitor the interface between medical and nursing staffs' special needs orders related to medical and psychiatric conditions and the officers' implementation of these orders. In correctional facilities medical and nursing staff issue forms related to special needs that the officers must implement. For example, if an inmate needs ice a few times a day related to an injury, nursing would issue a form for that, and officers would issue the ice to the inmate. If an inmate has a sz disorder, a nurse would issue a lower bunk order, and officers would implement that.
The only way nursing or medical staff knows it's not being done is if the inmate protests to the medical department in the form of a letter. The inmates in the original article are severely mentally ill and may not be able to do this. So a monitor needs to perform this action of auditing for compliance due to the population's vulnerable state.
Medical and nursing staff do not have any control or knowledge of inmates' daily environmental conditions or movement within the prison facility (recreation, day-room activity). Sometimes it can be as simple as having CNAs round daily or weekly, and ask the inmate if they have needs. Still, the prison must have a higher-level person who interfaces between the officers' security chain of command and the medical department to ensure compliance with medical orders.
Correctional facilities are at risk for being sued for deliberate indifference with their treatment of inmates. The state of California's prison healthcare system is currently run by a US federal receiver because of an outrageous number of preventable inmate deaths and deliberate indifference in the treatment of inmate's medical conditions. The State of California is paying billions of dollars to remediate all of their prison healthcare facilities over many years due to being found guilty of deliberate indifference. So, besides ethical treatment being the morally right thing to do, it also saves a government institution money in the long-term as it keeps them out of class-action lawsuits with devastating financial consequences.