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Inmates with mental illness neglected

Specializes in Peds(PICU, NICU float), PDN, ICU.

http://www.wral.com/news/story/10374729/

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 than this! And nobody got fired?!?!?! I understand the understaffing and the position it puts us nurses in. But we are also taught not to accept unsafe assignments. I blame whoever is managing this. Its unacceptable!

I'm sure once the comments open up on the news site that the nurses will be to blame :(

tothepointeLVN, LVN

Specializes in Hospice / Ambulatory Clinic.

It is sad how we essentially "throw" people away because their behavior doesn't fit within the realm of our acceptability. I think we easily become comfortably numb.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

Just as my patients who are told they will never walk and talk, learn to walk and talk, the inmates who people claim will never function in society could possibly be rehabilitated if they were worked with. Instead we "throw" them away. I don't think they have a chance because they are never given one. Somewhere either because of mental illness or parenting they were never given the tools to succeed. Some are doomed to failure. They still have to want to do better and want to work at it. Either way, none of them deserve to be treated in the way the article describes.

tothepointeLVN, LVN

Specializes in Hospice / Ambulatory Clinic.

Just before I landed on this thread I was reading a blog with a post by a Forensic Psychiatrist and this was quoted.

"Defendants who graduate from mental health courts demonstrate improved life circumstances with regard to housing, quality of life, symptoms and compliance. Some studies have shown mental health courts to result in improvement for as many as 78% of defendants."

http://en.wikipedia.org/wiki/Mental_health_court

"Mental health courts link offenders who would ordinarily be prison-bound to long-term community-based treatment. They rely on mental health assessments, individualized treatment plans, and ongoing judicial monitoring to address both the mental health needs of offenders and public safety concerns of communities. Like other problem-solving courts, such as drug courts, domestic violence courts, and community courts, mental health courts seek to address the underlying problems that contribute to criminal behavior"

Doesn't THAT sound like a much better solution?

Music in My Heart

Specializes in being a Credible Source.

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.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

I'd love to hear points of view from some of the correctional nurses. Its always different working in an environment compared to being on the outside.

I had a 13 week contract at a prison a couple of years ago. I was shocked and amazed at how many inmates not only were on psych meds, but were on the NAME BRAND meds. That means taxpayers are paying for these meds.

Most would try to cheek their meds and trade or sell them, and some reportedly would say that they were only on them so that they could sleep all day and night, and not have to think about anything.

I believe that there are many with true mental illness. However, inmates, in my opinion, have better healthcare in general than those of us not in prison or jail, and I find that sad.

Just as my patients who are told they will never walk and talk, learn to walk and talk, the inmates who people claim will never function in society could possibly be rehabilitated if they were worked with. Instead we "throw" them away. I don't think they have a chance because they are never given one. Somewhere either because of mental illness or parenting they were never given the tools to succeed. Some are doomed to failure. They still have to want to do better and want to work at it. Either way, none of them deserve to be treated in the way the article describes.

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.

And a lot of people who are mentally ill, don't even have a clue that they are. That's "normal" to them!

This is sad on so many levels.

How do you fix a system where there is more taking than giving? State Run Mental Health Facilities would be the answer to the more serious end of this dilemma. The seriously mentally ill belong in mental facilities not prisons.

Too often it seems the policy makers or people at the top who were trusted to do the right things, such as ensuring proper staffing ratios, are only interested in skimming money for themselves. They line their pockets with bonuses for cutting the budgets while leaving everyone at risk -the care givers and patients. Shame on whom ever is/was in charge of that facility.

When the Madoffs of this world are truly held responsible for their ruthlessness the world will get better.

Someone's head needs to roll. This is just plain laziness and cruelty. It's hard to believe people can be this ignorant, although custody personnel are not always cued in to mental illness, their focus being corrections. Still, anyone with a heart should know it's wrong to allow/force people to live in stool and urine, naked, and in solitary confinement. I'm glad officials are getting involved and demanding answers. That Jenny person in charge should be locked up and see how it feels.

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.

I agree that some people do run games. But not all. There's plenty of real mental illness.

I had a 13 week contract at a prison a couple of years ago. I was shocked and amazed at how many inmates not only were on psych meds, but were on the NAME BRAND meds. That means taxpayers are paying for these meds.

Most would try to cheek their meds and trade or sell them, and some reportedly would say that they were only on them so that they could sleep all day and night, and not have to think about anything.

I believe that there are many with true mental illness. However, inmates, in my opinion, have better healthcare in general than those of us not in prison or jail, and I find that sad.

The contract price for the meds is probably more favorable than generic - I hope so.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

Sweettart....those inmates don't have better healthcare. Living in human waste isn't healthy. Part of good healthcare is a healthy living environment.

I'm sure there are those who manipulate to get meds to sell, trade, or whatever. If they weren't liars and thiefs to begin with they wouldn't be there. None of us are that naive. But if they are on meds, you've never seen them without. So how do you know they don't need them for sure??

Giving meds doesn't help this population. It makes their prison stay easier on the people working there. These people need more than that or they are going to end up back in prison or in an institution.

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.

canoehead, BSN, RN

Specializes in ER.

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.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

Canoehead, understandable that this is reality. But something needs to be done about this. Its hazardous for the nurses and the inmates. And once these inmates return to the streets, they'll go off their meds that they can't afford. Then society will be dealing with them again. :-(

apocatastasis

Specializes in Psychiatry, ICU, ER.

There is also discussion taking place about prisons as generators of mental illness. I watched a documentary a couple of nights ago, where prisoners stayed on solitary for years at a time... up until the day of release. YEARS at a TIME.

And the prison wardens and staff were wondering why the patients were PSYCHOTIC! And why they had trouble reintegrating into society! Really!?

Between that and the fact that we'll jail a monkey for looking funny, truly, a bunch of retards running this system we have here in the States.

Here's the deal.

After a news expose on the Willowbrook State School on Staten Island, NY showed just how horrible conditions in "mental hospitals" were/could be there was this huge rush to move the mentally ill into community based care.

Institutions by the scores were closed and patients were supposed to be placed into group homes and or other supportive settings where their needs could be managed with therapy and or medications in the hopes many would lead some sort of productive lives or at least were free from the horrors of a psychiatric hospital.

It all sounded good on paper and in some places it worked for awhile. However it seems no one really planned on how much this would all cost and soon state/local governments began cutting back on services. The result is the vast population of homeless persons living on the street suffering from mental illness. Without meds and theraphy and often in stress inducing situations it is no surprise they often act out in a violent manner towards themselves and or others. When this happens they are often put through the criminal justice system and often end up incarcerated.

Prisons and jails are *not* set up nor designed to act as mental hospitals but yet that is what they are becoming by default and the poor souls confined there often are living in conditions not that much better than the old state schools.

The other sad thing is that contact between LE and those suffering with mental illness often does not go well for the latter. Persons not in their right mind often do not understand what is being demanded of them by LE and that is something the po-po does not take kindly to. There was a recent event in California that broke my heart. A young homeless man suffering from mental illness was beaten so badly by the local police he died of his injuries in hospital. His last words as the police were beating him down were "I'm sorry" and "Dad' (calling for his father).

subee, MSN, CRNA

Specializes in CRNA, Finally retired.

The list of people in our society who are underserved and uncared for is long and varied; institutionalized criminals' date=' mentally ill or not, are a fairly low priority for me given the insufficient resources available to governments at all levels.[/quote']

What is this thing spinning?

The list of people in our society who are underserved and uncared for is long and varied; institutionalized criminals' date=' mentally ill or not, are a fairly low priority for me given the insufficient resources available to governments at all levels.[/quote']

Not everyone in a jail has been convicted yet. Not everyone who is convicted is guilty. some have had terrible and ineffective assistance of counsel and been otherwise mistreated by police and prosecutors.

I don't like to see that you look down upon those in lock-up. You could find yourself there some day! Then what?

I know we have budget limitations, I know we have to prioritize. Maybe I am misreading your words. If so, I'm sorry. I just don't have any easy answers except for individuals to start lobbying those in charge of prisons and jails and who are able to change the care of inmates, especially the mentally ill.

I am a EMT and worked for the jail system for 4 years and I had to leave as things I saw that made me mad as hell were NOT being addressed even though I brought them to my supervisor and higher up's in the system.

There would be inmates there that had to be given pysch shots due to behavior that had to be held down to give shots, I would tell them as soon as they get their shot you HAVE to get off the inmate, as studies show people can die after getting said meds and being held down for ANY length of time.

I have seen officers scream and be aggresive towards inmates that were "acting out" in truth these inmates were having pysch episodes. I would try to explain to the officers that in may seem as they are acting out, but they are scared, thinking people are out to harm them, etc...You coming in like the goon squad screaming and yelling will NOT help the patient calm down, you are making the situation worse!

Speaking of Lithium levels, there was one inmate that was on this with phenobarb, he was highly combative and he was a very hard stick due to years of drug use. I would see the lab book that had dates that labs were ordered and see his name, and the days pass with no one doing the lab, I would get the guards to bring inmate down in full shackles so he could not hurt me and draw his labs, never once had a problem with him...

A patient had a suicide attempt and bleed out very quickly, the LPN with me (I am holding direct pressure) I tell her to start IV as he has lost so much blood, she looks at me and says I don't know how.....

These are just some of many things I saw or experienced and while i felt MOST of my complaints fell on deaf ears, it was to much for me and I got out and I am so glad I did and now I hear there are SEVERAL changes being implemented including firing the supervisor over the nursing dept and some protocals being tweeked and guards being educated on pysch patients. I hope it is better there, for the inmates sake. I feel like I let them down, honestly I do....Because I chose to leave, to get out.

NOTE: Most guards did the right thing I will say, but the small bunch that didn't made life much harder than it had to be for the medical staff and the inmates!!

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