Magazine article Corrections Forum

Money Isn't the Solution to Correctional Health Care Issues

Magazine article Corrections Forum

Money Isn't the Solution to Correctional Health Care Issues

Article excerpt

"People who come to prison have much greater health care needs," said Kevin Wright, professor of criminal justice at Binghamton University, SUNY, Vestal, NY. "Many of those who end up in prison have grown up in poverty. Many also live wild lives ... so they arrive in prison with many health care problems."

Younger Inmates More Seriously Ill Today

Because of their "wild lives" and excessive alcohol and drug use, prisons today are getting younger people with diseases that older people used to get, according to Timothy Revell, MD, Clements Unit, Amarillo, TX. Inmates are arriving with diabetes, asthma, COPD, hepatitis and AIDS, along with impaired cognitive functioning, as a result of their life choices.

"Almost all DOC inmates have a history of recent methamphetamine use when they arrive at Washington Corrections Center Receiving and most demonstrate impaired cognitive function as measured by entry IQ and academic testing," explained Patrick A. Shannon, Health Care Manager II, Washington Corrections Center, Shelton WA. "Subsequent recidivism usually reveals a further lowered function at each return."

Identifying the Most Serious Problems

Drug abuse leads to a wide variety of health care problems, from physical and mental to dental.

"We believe that methamphetamine use causes the great bulk of current crime, with crack cocaine and heroin to a lesser degree," said Shannon. "The prison system is currently overwhelmed by meth freaks with long sentences and usually mentally and physically ill from their drug adventure. Teeth and brains are almost universally badly damaged. Its [meth] use continues to grow and prisons increasingly bulge with users. It creates a mass of chemically caused psychopaths without any conscience or morality. Incarceration under our present circumstances seems totally ineffective. Drug use recidivism is unbelievably high."

A typical antipsychotic drugs and SSRIs, or antidepressants, are also a significant cost for DOCs.

"Whether inmates can afford these treatment regimes once released will factor into their recidivism and return to prison. It will take significant community coordination to place and maintain these chronically mentally ill individuals. Discharge planning is a must with these inmates," explained Robert D. Jones, MD, deputy director, Arizona Department of Corrections, Phoenix, AZ. "It is time that state community mental health programs worked with Corrections in meeting the needs of these individuals."

More seriously ill inmates means that more health care staff members are needed to care for them. Low pay, lack of knowledge about opportunities in correctional health care, and high turnover rates have all contributed to a shortage in correctional health care staffing, particularly in nursing.

States have taken steps to rectify this situation, by raising salaries to match those at other health care facilities, participating in job fairs and offering internships in correctional health care facilities.

"Another method of addressing the nursing crunch was to identify other categories of health care workers which could perform some of the tasks which the nurses have done," said Catherine McVey, Director for the Bureau of Healthcare, PA Department of Corrections, Camp Hill, PA. "We are currently considering expanding our staffing to include medical assistants, increased use of certified nursing assistants, and ward clerks. Their use would result in using the nurses for those functions, in accordance with the Nurse Practices Act, which only they may perform."

Florida continues to try to meet the needs for correctional nurses at a time when there is a growing shortage of nurses, according to Larry Purintun, program administrator at the Florida Department of Corrections, Office of Health Services in Tallahassee.

"Nothing we have done has resolved the issue. We have a dedicated individual with previous correctional healthcare nursing experience performing recruitment functions. …

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