NCJ Number
46812
Date Published
1977
Length
88 pages
Annotation
THIS SYMPOSIUM IDENTIFIED PROBLEMS AND ISSUES AFFECTING MEDICAL CARE AND HEALTH SERVICES IN CORRECTIONAL INSTITUTIONS AND DISCUSSED VARIOUS APPROACHES WHICH HAVE BEEN IMPLEMENTED TO IMPROVE DELIVERY.
Abstract
THESE PAPERS REVIEW THE MORE FLAGRANT CASES OF INATTENTION TO INMATE NEEDS WHICH HAVE LED COURTS TO ORDER IMPROVED MEDICAL TREATMENT IN PRISONS AND JAILS. THE PROBLEMS OF LOW PAY FOR DOCTORS, INSUFFICIENT NUMBER OF PARAMEDICAL PERSONNEL, AND DIFFICULTIES IN WORKING WITH INMATES WHICH PLAGUE PRISON MEDICAL CARE ARE DISCUSSED. AT THE LOCAL JAIL LEVEL THESE PROBLEMS ARE EVEN MORE ACUTE. MANY OFFENDERS ARE HELD FOR SHORT PERIODS OF TIME BY CORRECTIONS PERSONNEL WITH LITTLE MEDICAL BACKGROUND. COMMUNITY RESOURCES MUST BE MOBILIZED TO HANDLE PROBLEMS RANGING FROM DIABETIC COMA TO SUICIDE. A KENTUCKY TASK FORCE FOUND MAJOR MEDICAL DECISIONS BEING MADE BY UNTRAINED PERSONNEL; THEY ALSO FOUND POOR SANITATION, LITTLE PROVISION FOR TREATMENT OF DRUG PROBLEMS, ALCOHOLISM, AND ROUTINE MEDICAL MAINTENANCE PROBLEMS (SUCH AS THE HEART PATIENT WHO NEEDS MONITORING). THE SMALL POPULATION OF MOST PRISONS (USUALLY UNDER 500 PERSONS) COMBINED WITH THE GENERAL GOOD HEALTH OF PRISON POPULATIONS, SECURITY CONSIDERATIONS, AND THE FACT THAT MEDICAL CARE MUST BE INTERNALLY PROVIDED, HAS CONTRIBUTED TO TRADITIONALLY INEFFICIENT MEDICAL CARE. VARIOUS TYPES OF ONCALL SERVICES HAVE BEEN TRIED. MIAMI, FLORIDA, TRIED 'TELEMEDICINE' MONITORING WITH A NURSE-PRACTITIONER ONSITE WITH A TELEVISION HOOK-UP TO A HOSPITAL. IT WAS CONCLUDED THE NURSE-PRACTITIONER ALONE WAS JUST AS COST EFFECTIVE. SEVERAL STATES HAVE WORKED OUT ARRANGEMENTS WITH MEDICAL SCHOOLS. OTHER STATES HAVE GIVEN CORRECTIONS PERSONNEL PARAMEDICAL TRAINING. USE OF INMATES TO DELIVER MEDICAL SERVICES IS COMMON, BUT UNDESIRABLE BECAUSE OF TENSIONS WITHIN THE SYSTEM AND THE ABSENCE OF TRULY TRAINED PRISONERS. MENTAL HEALTH SERVICES ARE EVEN MORE CONTROVERSIAL. IN THE PAST, PSYCHIATRISTS HAVE CLAIMED THEY COULD DO MORE THAN WAS ACTUALLY POSSIBLE. THE FOLLOWING SHOULD BE RECOGNIZED: (1) PRISON CAUSES AS MANY MENTAL HEALTH PROBLEMS AS IT CURES AND THAT LESS-DANGEROUS OFFENDERS WOULD BE BETTER OFF NEVER ENTERING THE PENAL SYSTEM; (2) SERIOUSLY DISTURBED PATIENTS MUST BE TREATED FOR AT LEAST 1-2 YEARS AND THE PSYCHIATRIST CANNOT BE HELD RESPONSIBLE IF THE OFFENDER IS PAROLED SOONER; AND (3) VOLUNTEER GROUPS SUCH AS ALCOHOLICS ANONYMOUS ARE BETTER AT WORKING WITH SPECIFIC PROBLEMS THAN AN OVERWORKED PSYCHOLOGIST OR PSYCHIATRIST. GREATER USE OF VOLUNTEERS IS URGED. WIDER USE OF PREVENTIVE MEDICINE AND ROUTINE HEALTH MEASURES WILL ACTUALLY SAVE MONEY IN THE LONG RUN. A QUESTION AND ANSWER PERIOD THAT TOOK PLACE AT THE SOUTHERN HEALTH FOUNDATION SYMPOSIUM ON ALCOHOLISM AND SUICIDE IS REPRODUCED.