Psychiatric consultation through continuing education in correctional institutions

Abstract

It is only recently that courts have seriously turned their attention to the constitutional rights of prison inmates for medical and psychiatric treatment. Reflecting this attention, there has been a significant increase in the number of mental health professionals working in correctional facilities, a development described by Nassi. 1 Many of these professionals encounter difficult conditions in their work environment: overcrowding in the institution; punitive rather than therapeutic attitudes; inadequate facilities for clinical work; and a shortage of other mental health personnel to help with the large amount of work. 2,3 Many of them also face perplexing and weighty decisions in their work: assessing whether an inmate is a danger to himself and/or others; assessing whether an inmate has the capacity to be law abiding if released on parole; deciding what is the most suitable treatment for a particular inmate; and advising custody personnel on how to manage inmates who are disruptive to others. Furthermore, working in correctional facilities presents the treaters with a special set of ethical and social concerns 4,5,6 that not only contribute to their need for help in making decisions but their need for support in facing the invevitable dilemmas of these settings. Help for the helpers in correctional institutions is clearly needed. In this paper, we will describe one approach to helping the helpers in correctional institutions through psychiatric consultation. This psychiatric consultation has an unusual format—it is provided indirectly through Continuing Education sessions with mental health personnel working in correctional facilities. This approach is well suited to meet the particular characteristics of the correctional work environment. Here we shall describe this approach, its multiple functions, and how it compares with other types of psychiatric consultation in other settings.