Inmates with mental illness neglected - page 3

They are out begging for nurses. I always wondered why none of the nurses I know would work for them. Also wondered why they needed nurses so bad with the state benefits and all. This is absolutely horrible. Dogs live better... Read More

  1. 0
    The Dept of Justice needs to step in. That sure fixed our hospital.

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  2. 2
    Quote from SweettartRN
    I disagree. I feel that many patients use or hide behind mental illness so that they don't have to take responsibility for their actions. In fact, I have seen it first hand.
    If you're speaking of people who commit murder or even mass killings then suddenly claim they have "mental" issues then I *might* agree with you. However given how many suffering from genuine physiatric illnesses are treated in this country can't see any real benefit from gaming the system.

    The real sad thing is that many of these person in jail or prison wouldn't have come into contact with the legal system if they had access to proper treatments/meds and supportive housing. That was how things were supposed to happen when the new era of drugs came on the market allowing mental illness to be treated and thus prompting the emptying out and closure of facilities.

    Now with a shortage of treatment options along with federal, state and local governments unable or unwilling to properly fund, these persons are falling through the cracks and end up incarcerated; which by the way costs more than providing initial treatment in the first place.
    PrisonPsychRN and tabbysrn like this.
  3. 2
    Quote from canoehead
    It sounds horrible, but given the staffing described...I don't think I'd be in a hurry to clean out a cell of urine and feces, if the inmate was mentally ill and assaultive, and especially if he consistently dirties it up again 5 minutes after you've cleaned it. If it takes 4-5 people to safely enter the cell he might get it hosed out daily (twice a day if we've got tons of staff.)

    If an inmate is going to escalate, and fire up everyone waiting in cells, once I let them out in the day room, I might find a reason to let them stay in their cell for the hour of "recreation." Especially if the other prisoners are having a calm day for once.

    I would especially be tempted if I was covering two nursing jobs, and the officers had double coverage too. We'd be lucky to complete the shift safely, without poking a few bears out of hibernation. Sounds like they didn't have much support from above, which may mean not a lot of review from above either. Even good prison nurses would need to prioritize, and the bad ones could very quickly learn to not care.

    Yes, I know it's wrong. I agree that it's wrong, but we don't live in Wonderland.
    Correctional nurses do not have control over the inmates' environment unless the inmate happens to physically be in the medical office or infirmary (prison med-surg type unit). Correctional nurses do not clean cells, and they do not clean body fluids out of cells. Officers do that, if it's ever done. It would be rare. The description in the article sounds like the inmates are cell-based, not in an infirmary.

    Correctional nurses do not have any involvement with controlling inmates' movement on prison grounds related to recreation time, etc. Officers control all of this. I suspect a lot (not all) of the problems in the article are related to officer shortages and poor training and supervision of officers.
    Last edit by Multicollinearity on Nov 18, '11
    PrisonPsychRN and VickyRN like this.
  4. 1
    Quote from SDALPN
    Some meds are only name brand. I wonder how many of those had generics and how many were too new for a generic to be available.
    How many of those inmates went on generic psych meds, only to end up back on name brand meds when the generic didn't work? It happens, especially with psych meds.
    PrisonPsychRN likes this.
  5. 1
    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.
    Last edit by Multicollinearity on Nov 19, '11
    PrisonPsychRN likes this.

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