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

[A Hit With The Ladies]

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.

[ClaraRedheart, BSN, RN]

On 4/24/2020 at 11:36 AM, toomuchbaloney said:

Incarceration of the mentally ill is not a new phenomenon in this country.

Sure, but they commit crimes that land them in prison. I've met plenty of people who could be described as "mentally ill" without being violent, dangerous lawbreakers.

[toomuchbaloney]

8 minutes ago, ClaraRedheart said:

Sure, but they commit crimes that land them in prison. I've met plenty of people who could be described as "mentally ill" without being violent, dangerous lawbreakers.

Not always.

[Guest219794]

1 hour ago, ClaraRedheart said:

Sure, but they commit crimes that land them in prison. I've met plenty of people who could be described as "mentally ill" without being violent, dangerous lawbreakers.

Yup. The majority of those who suffer from mentally ill are not violent. But, if you take the cohort of mentally ill in this country, then look at the subset of mentally ill who are in prison, you will find dis proportionally high violence.

That is not judging or labeling- it's statistics.

[Orca, ADN, ASN, RN]

On 4/24/2020 at 9:17 AM, A Hit With The Ladies said:

The appropriate setting is a psych unit or psych care within the prisons themselves. The prisons have adequate armed, trained staff to manage their combative behaviors.

Having worked both inpatient mental health and mental health in a correctional setting, I can tell you that weapons have nothing to do with the programming, and in 20 years behind the fences, I have seen use of force one time on a mental health unit (this was to assist with forced medication on one uncooperative inmate). Correctional officers usually aren't even present when the programming is going on. They are observing the general area, but prisons aren't the combat zone that is portrayed on television. One thing that often happens is that we will get an inmate stabilized on medications, then when he leaves the system, he doesn't follow up with resources on the outside and he decompensates. this often leads to the same behaviors that put him in prison in the first place.

Mental health units have been the go-to for the homeless and others with few resources for decades. When I was working adult/chemical dependency inpatient, I had one patient who was supposedly homeless, but he had an awful lot of people to call for someone who lived on the streets. I overheard him tell someone over the phone, "I will tell them that I am suicidal for another two or three days, and by then, my welfare check should be in."

Having worked both, I prefer being behind the fences, where I have been for almost 20 years now. It is a much more controlled environment than a hospital unit, and inmates either comply or they are out of the program.

[lifelearningrn, BSN, RN]

In Harris County (TX), state jails and prisons are the largest providers of mental healthcare. I'm sure we are not alone. It stands to reason that if they're not getting their care in the jails, where else will they get it?

[A Hit With The Ladies, BSN, RN]

I'm also in Harris County!

[lifelearningrn, BSN, RN]

8 minutes ago, A Hit With The Ladies said:

I'm also in Harris County!

I don't doubt that at least some of your new patients are newly released inmates. I am also sure they have some serious mental health conditions. It's a shame they were released without anything in place to meet their needs.. the county and state are more worried about lawsuits and cost of medical care if the inmates get sick under their care, so they just released them into the 'wild' to fend for themselves.

[SarahMaria, MSN, RN]

On 4/28/2020 at 6:32 PM, ClaraRedheart said:

Sure, but they commit crimes that land them in prison. I've met plenty of people who could be described as "mentally ill" without being violent, dangerous lawbreakers.

Having worked in an acute psych facility and currently in a forensic psych facility, I have seen that most psych patients are not violent.

[ClaraRedheart, BSN, RN]

8 hours ago, SarahMaria said:

Having worked in an acute psych facility and currently in a forensic psych facility, I have seen that most psych patients are not violent.

I completely agree. I was referring only to the imprisoned psych patients, that are their because they committed a crime. Doesn't even mean it was a violent crime, but they are in prison not because they are mentally ill, but because they broke the law.