Due to the Coronavirus, are freed prison inmates going to malinger their way into psychiatric hospitals?

Nurses COVID

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I work inpatient psych and I noticed over the past two weeks the acuity level of the patients on my unit has dramatically increased. So many are incredibly violent, combative, mean, demanding - far more so than what is normal on my unit. I genuinely felt overwhelmed and largely defenseless, despite having techs on my unit.

The nurse I got report from says it's because a lot of these freed inmates will simply say "Oh I'm suicidal" and get transferred from a county hospital to the psych hospital. I find it quite plausible really.

Specializes in Psych, Addictions, SOL (Student of Life).

I have noticed the Acuity of our in-patient crises units had gotten really high. Most are faces we see fairly often so I doubt we are getting a lot of freed in-mates. What I do see is sharp increase in unmanageable anxiety, sexual acting out, spousal/partner and child abuse due to the stress of the current situation. Also a fair number of medically critical detox patients who do not have their usual source of product and go into withdrawal. Make no mistake by believing that people don't die in detox so they do need our help. Among my Adolescent Pop biggest problems and fear, anxiety, increased exposure to damaging social media and fake news, Not graduating on time, not knowing if they will get into college, fighting with parents etc.... Running away from home and more.

Everybody is on edge these days and even though we still have no covid patients in our facility our workload has increased with higher acuity.

I know that the rate of violent crime has gone up especially home Invasion, sexual assault burglary etc... and this may or may not be attributable to freed in-mates but only time will tell.

Hppy

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Specializes in NICU, PICU, Transport, L&D, Hospice.
31 minutes ago, hppygr8ful said:

I have noticed the Acuity of our in-patient crises units had gotten really high. Most are faces we see fairly often so I doubt we are getting a lot of freed in-mates. What I do see is sharp increase in unmanageable anxiety, sexual acting out, spousal/partner and child abuse due to the stress of the current situation. Also a fair number of medically critical detox patients who do not have their usual source of product and go into withdrawal. Make no mistake by believing that people don't die in detox so they do need our help. Among my Adolescent Pop biggest problems and fear, anxiety, increased exposure to damaging social media and fake news, Not graduating on time, not knowing if they will get into college, fighting with parents etc.... Running away from home and more.

Everybody is on edge these days and even though we still have no covid patients in our facility our workload has increased with higher acuity.

I know that the rate of violent crime has gone up especially home Invasion, sexual assault burglary etc... and this may or may not be attributable to freed in-mates but only time will tell.

Hppy

This is definitely playing out here in Alaska. We've had a sad number of personal violence deaths recently.

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Specializes in Psych.

The acuity is through the roof where I work.

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15 hours ago, hppygr8ful said:

I have noticed the Acuity of our in-patient crises units had gotten really high. Most are faces we see fairly often so I doubt we are getting a lot of freed in-mates. What I do see is sharp increase in unmanageable anxiety, sexual acting out, spousal/partner and child abuse due to the stress of the current situation. Also a fair number of medically critical detox patients who do not have their usual source of product and go into withdrawal. Make no mistake by believing that people don't die in detox so they do need our help. Among my Adolescent Pop biggest problems and fear, anxiety, increased exposure to damaging social media and fake news, Not graduating on time, not knowing if they will get into college, fighting with parents etc.... Running away from home and more.

Everybody is on edge these days and even though we still have no covid patients in our facility our workload has increased with higher acuity.

I know that the rate of violent crime has gone up especially home Invasion, sexual assault burglary etc... and this may or may not be attributable to freed in-mates but only time will tell.

Hppy

The criminals in New York who were released were somehow expected to not be criminals.

https://nypost.com/2020/04/20/unconscionable-for-released-inmates-to-commit-crimes-de-blasio/

How can anyone think it's a good idea.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

Does anyone know if they are releasing the immigrants and refugees from the detention camps too?

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Specializes in Psych, Addictions, SOL (Student of Life).

+I don't know if they are releasing detained immigrants into the US but I read somewhere that the US will pay to repatriate them to their home country

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2 hours ago, juniper222 said:

The criminals in New York who were released were somehow expected to not be criminals.

https://nypost.com/2020/04/20/unconscionable-for-released-inmates-to-commit-crimes-de-blasio/

How can anyone think it's a good idea.

Let's not act like America doesn't has the biggest jail population on this planet for a huge margin and a huge chunk of it isn't because of non-violent drug offenses. There is no reason why someone who deals weed should be in a prison right now ( or at all but that is a discussion for a different time). Most prisoners in America aren't animals who are going to "malinger" their way into psych hospitals.

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1 hour ago, carti said:

Let's not act like America doesn't has the biggest jail population on this planet for a huge margin and a huge chunk of it isn't because of non-violent drug offenses. There is no reason why someone who deals weed should be in a prison right now ( or at all but that is a discussion for a different time). Most prisoners in America aren't animals who are going to "malinger" their way into psych hospitals.

I respectfully ask how I am acting like we don't have "the biggest jail population on the planet?" The post was to show how those inmates were released and expected not to commit any crimes and yet they did.

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1 hour ago, carti said:

Let's not act like America doesn't has the biggest jail population on this planet for a huge margin and a huge chunk of it isn't because of non-violent drug offenses. There is no reason why someone who deals weed should be in a prison right now ( or at all but that is a discussion for a different time). Most prisoners in America aren't animals who are going to "malinger" their way into psych hospitals.

Somebody who just deals weed isn't going to end up in a psych unit.

And you are right that most prisoners won't end up in psych units.

But- in your accurate criticism of the prison system, you missed a few points.

1- Many prisoners are mentally ill. This is well known, and a frequent and correct criticism that our justice system deals inadequately with this population imprisoning the mentally ill when what they really need treatment. Obviously if these people are released, many of them will end up in a psych unit. and, many of them are violent, particularly so when outside of a the system after being released without taking needed meds.

2- Many people with mental illness are extremely manipulative, and know the system well. Manipulating the system for three hots and a cot is common. There is a reason psych complaints increase during cold snaps.

3- The prison population is more violent than the general population.

So yes- if you release a lot of prisoners a number of them will end up in psych units. And, a number of them will be violent.

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19 minutes ago, hherrn said:

Somebody who just deals weed isn't going to end up in a psych unit.

And you are right that most prisoners won't end up in psych units.

But- in your accurate criticism of the prison system, you missed a few points.

1- Many prisoners are mentally ill. This is well known, and a frequent and correct criticism that our justice system deals inadequately with this population imprisoning the mentally ill when what they really need treatment. Obviously if these people are released, many of them will end up in a psych unit. and, many of them are violent, particularly so when outside of a the system after being released without taking needed meds.

2- Many people with mental illness are extremely manipulative, and know the system well. Manipulating the system for three hots and a cot is common. There is a reason psych complaints increase during cold snaps.

3- The prison population is more violent than the general population.

So yes- if you release a lot of prisoners a number of them will end up in psych units. And, a number of them will be violent.

I see what your saying but inmates being freed right now aren't murders or child rapists. Those people are still locked up. People being freed right now are small drug dealers as well as other menial misdemeanors. Free people who are mentally ill just don't automatically become violent animals after they spend time in the pen.

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10 hours ago, carti said:

I see what your saying but inmates being freed right now aren't murders or child rapists. Those people are still locked up. People being freed right now are small drug dealers as well as other menial misdemeanors. Free people who are mentally ill just don't automatically become violent animals after they spend time in the pen.

I am quite sure that everybody can agree that Free people who are mentally ill just don't automatically become violent animals after they spend time in the pen.

Nonetheless, If you suddenly reduced psych unit capacity, jails census would increase, and visa-versa. There are people so entrenched n our sub-par system that they are generally in one or the other. Ask any psych nurse about the relationship between these two institutions.

And, if you look at the hospitalized psych population, and looked more specifically at the sub group that also spends time in prison, you will see a lot more violence in that group.

Lately, there is huge polarization in this forum. I can tell you that having read the OP's other posts, we see things very differently. But, what he said in his OP is simply accurate. You don't have to be a murderer or child rapist to be prone to violence. And, there are many people with violent tendencies locked up for non-violent crimes.

Prisoners with mental illness often lack the executive functioning skills to access needed resources, and even if they did, those resources are scarce. Anything that creates a shift from prisons to hospitals is going to increase workload and decrease safety for nurses.

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10 hours ago, hherrn said:

Prisoners with mental illness often lack the executive functioning skills to access needed resources, and even if they did, those resources are scarce. Anything that creates a shift from prisons to hospitals is going to increase workload and decrease safety for nurses.

That's honestly why I thought a discussion among docs and nurses on wards experiencing an issue with extremely combative pts about "chemical restraint" protocol would be a potential option, at least with pts who are there because of early release.

Discharge may just result in having them back soon, without their regular meds and with street drugs in their system to boot.

I admit my experience in a psych facility was not in acute care or as a licensed professional (residential care facility for chronically mentally ill adults, I was assisting the licensed professional who was on the 72-hour live-in weekend shift while working on my bachelors).

Even there I had a pt hand me a 90-day supply of diazepam (all meds, especially PRNs, in that facility were locked up, he was not supposed to have any others) and ask if I could get them weed for it. I said "I'll see what I can do", he handed it over, I handed it over to the owner of the facility -- it was exactly what I could do, so I didn't lie. I know pts can be extremely manipulative -- he was to even get a bed there.

But in acute care, one thing that you do have access to that we didn't is medication that, at least in non-schizophrenic pts who are simply acting out for 3 hots and a cot, will make them unable to BE combative. And those meds really don't get them high, at least in a way that's pleasant.

If I felt it was going to be an issue, or especially if a pt/set of pts had already had one conflict that resulted in getting emergency chemical restraint administered out of necessity, I would want to have a discussion about whether potent 3rd gen antipsychotics should be added to those pts med lists.

Nothing lately in medical practice has been "normal", and I would not otherwise advocate for sedating pts to make nurses lives easier, but continued vs emergency chemical restraint would be safer for both pts and staff IMHO for extremely combative pts.

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