Mental Health in a county jail

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I am a recent graduate RN working at the sedgwick county jail in wichita ks. I have been there for two years working as a LPN in the medical clinic. I am wanting ideas to help improve the mental health department. I am the only RN, there is a PA and a LMSW. We have 1500-1700 inmates at the jail. I am a very open minded person and i dont judge any of the patients by their charges. I get mad at some but I never act nastily towards them. I'm wanting to be able to distinguish the different types of mental disorders and learn more about them. I also need to get my bull**** detector to work better. I am wanting ideas for ways to improve compliance with meds. if any one has any suggestions or questions please respond. I work for conmed,inc.

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I have found that the best way to assist with medication compliance is to ask them what is the barrier that they are experiencing. Sometimes it is as simple as not wanting to get up in the morning for med line - other times it has to do with upset stomach - then occassionally it is to do with strong arming.

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Specializes in Infectious Disease, Neuro, Research.

Hey, brooke, you're in my old AO (I was an EMT in ICT from '91-'96). ;)

Corrections is a big transition. Aside from actually having the day-to-day interactions, I would suggest the following books:

Stanton Samenow, PhD. (Criminal psych)

http://www.amazon.com/Myth-Out-Character-Crime-ebook/dp/B0026L7A5Y/ref=sr_1_2?ie=UTF8&qid=1314977705&sr=8-2

http://www.amazon.com/Inside-Criminal-Mind-Revised-Updated/dp/140004619X/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1314977766&sr=1-1

Katherine Ramsland, PhD. (Criminal psych. Haven't personally read this, but was told its good)

http://www.amazon.com/The-Measure-of-Madness-ebook/dp/B003IYI7P0/ref=pd_sim_kinc_1?ie=UTF8&m=AG56TWVU5XWC2

Dan Ariely, PhD. (Psychology of economics. Cons are all about arousal-motivation, wants-gratification, exaggerated valuation, and so forth.)

http://www.amazon.com/Predictably-Irrational-Revised-Expanded-ebook/dp/B002C949KE/ref=sr_1_3?s=digital-text&ie=UTF8&qid=1314977846&sr=1-3

Samenow reinforces my own bias, which is why I recommend him.:D IME, personally and professionally, criminal behavior is not created/motivated/defined/caused by society, but by personal choice. Many, of far higher educational attainment, will disagree, but if you couple Ariely's social-economic theory with Samenow's individual behavioral patterns, I've found good reliability.

Ramsland is a new find for me, but not new to the field. She's not big on the sociological model either, and gives similar info, with slightly different analytical paths, as compared to Samenow.

Remeber: criminals are entirely motivated by gratification and power, and they have retarded risk-benefit models, and those largely overwritten by exaggerated stimulation needs..

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Specializes in Infectious Disease, Neuro, Research.

cont. Be careful with "mental disorders". Remember the DSM is a concensus, with little empiricle basis, and is influenced by political motions in the APA and billing considerations. Not saying there isn't validity, it just needs to be carefully evaluated.

For instance, "compulsive-defiance disorder" is reeeaaaly hard to accept as a disorder, as the people are generally able to function, until presented with a gratification conflict. It doesn't (in most cases)present in every instance of compliance-demand, only in those where there is significant gratificatuion at stake.

If you ask, "How is this behavior being used to gain power/pleasure/deferral?", this will tell you what you need; the DSM will let you put a name (of variable accuracy) on the behavior.

Anyhow, my own rant.

For med-compliance, Ariely would be a help, in identifying ways to manipulate the inmates into compliance, i.e., identifying which buttons to push.

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