Mental Health and Corrections:

[WCSU1987]

Hi, I work in the ER of a local hospital in my state. Over probably 3-4 month's 2-3 patients have come in just recently released from prison, minus 1 about 6 month's.

The 2 recently released came in for depression and relapsed. Now while serving in prison they never received any psychiatric medication.

Do prisons only treat for health related issue's and not mental health issue's? If so that's a walking disaster there.

Curious on feedback.

P.S. Outside of depression/relapse many leave no place to go turn to substances/alcohol on the street's. That was the case of one patient. I see a lot of people out of prison system come in all mostly homeless.

[SarahMaria, MSN, RN]

yes, DOC does treat psychiatric disorders

[Neats, BSN]

Both Jails and prisons must offer both Health Care and Mental Health, now it is up to the patient (offender) to obtain the services that are evidenced based, current and medically necessary. All offenders must go through a medical and mental health evaluation upon the incarceration episode. Some offenders are mandated by a judge to obtain mental health services. On the average (ball park figure) the mental health need is almost 100 percent. The care received in the prison setting is the same care one would expect on the outside. I treat anyone the same in or out, I am a professional and take my job seriously. Correctional healthcare professionals really have two jobs the first provide healthcare services, the second is security for we all want to go home after work to our families.

[CryssyD]

The sad truth of the matter is, jail and prison are often the only places to provide mental health services to poor and/or unemployed people. Community mental health centers are almost invariable stretched to the max, often with a handful of doctors, nurses, social workers, and psychologists trying to provide care, counseling, medication management, case management, referral, and placement for residents of maybe 9 counties (where I am, in a mostly rural/small-town area). People with untreated or inadequately treated mental illnesses can certainly decompensate, become depressed or aggressive, have trouble managing their emotions, make poor decisions, and--as you noted--often resort to alcohol or street drugs to self-medicate; it is sad but true that illegal drugs are quite likely easier to get hold of than appropriate psychiatric medication.

I don't know if you've heard of him, but there is a comedian named John Oliver who has done a series of shows focusing on the state of the criminal justice system, covering everything from the death penalty and the privatization of prisons to the inadequacy of many public defenders and the enormous difficulties of being released from prison (re-entry). I'll see if I can manage a link, but if I'm not successful, his shows are usually posted on YouTube. Check him out--extremely informative, if maddening.

The prison I work at has an excellent mental health department. Most prisons provide mental health care and medications, they pretty much have to, as I said before; being incarcerated may lead to a person getting mental health care for the very first time. Part of helping prisoners prepare for release is addressing problems that may impede their successful re-entry--like mental illness.

[vintagemother, BSN, CNA, LVN, RN]

I didn't work in a prison or jail. I did work in a forensic psych unit. Pretty much without fail, when the clients left us to go to jail, they often decompensated and ended back with us.

I think, keep in mind, just think, and have no real knowledge, that in jail, the meds aren't really forced/encouraged.

I just assume that the pt has the right to refuse in prison.

Versus, in our controlled facility, a client would be counseled about meds and the psychiatrist would be consulted ASAP. You can't just refuse psych meds in our facility, in the same way you can refuse your colace.

If you refuse, you would get counseled by your social services person, by a nurse, by the psychiatrist and often by your county appointed guardian.

I assume that jails/prisons do not have the same supports available.

[Orca, ADN, ASN, RN]

I didn't work in a prison or jail. I did work in a forensic psych unit. Pretty much without fail, when the clients left us to go to jail, they often decompensated and ended back with us.

I think, keep in mind, just think, and have no real knowledge, that in jail, the meds aren't really forced/encouraged.

In a prison setting, medications can only be forced with a court order or forced medication panel recommendation. This is only considered when an inmate is a danger to self or others and he refuses treatment on his own. Psychiatric services are available, but inmates are not compelled to use them. Inmates are free to do as they please in terms of treatment - much like on the outside.

[elkpark]

Shoot, the state and federal prisons and local jails have been the de facto public mental health system for many years now. Yes, they treat psychiatric conditions, but, same as anywhere else, people need to identify that they need/want help. Depression is widely overlooked and undertreated in the general public, also.

The local jail in my medium-sized city not only treats mental health disorders, it has its own inpatient psychiatric unit.