Today my ever trusty search bots on the look out for topics like this of interest to me, and to you the reader I hope as well, learned the the Federal Dept. of Justice is seeking to take over supervision or operations of the Los Angeles County Jails one of the largest county jail systems in the county. For more detail on this use this link http://bit.ly/1CNElNT.
As an nudge from this writer, it is really worthwhile if you have an interest in this kind of legal action which sort of had its heyday in the Civil Rights Era of the 1960-2 and 1970’s in desegregation issues ranging from busing of school children across school districts to taking over entire states’ university systems and electoral processes. But the present tidbit that makes for interesting reading is a link contained at the end of the above link that reprints that DOJ letter of notice to the LA County Jail system.
This is just another example of what may have to be done in many correctional venues to force state legislatures to face up the funding “on the other end” the unavoidable costs of public mental health costs and essential treatments and good enough system. On a personal aside, I am “old enough” to recall as many of my senior mentors in this state in which I practice, to recall the age of mental health center treatment on a county by county basis that actually worked. And while the jails still had their share so to speak of mentally ill inmates, I recall when the local county MHC psychiatrists and professionally trained, well qualified mental health professionals regularly and routinely “made rounds” as we say in America, or held “clinic” as the British would term it. We saw, treated and followed the mentally ill inmates and they received good quality care. And my adopted state in which I still practice was not unique. It was the way it was and we all took it for granted that it would continue. In fact all the medical schools in this state and in most of the state had training rotations that took psychiatric residents in training on prison/jail rounds, exposing them to these environments, desensitizing them to them, and imparting the ethos that this should be part of every community psychiatrist’s monthly duties and obligations.
Nowadays psychiatrists are spread very thinly over the state’s correctional facility. I have a sense of this as three years ago when I was finishing my several year wonderful stint on an Indian reservation health service that in itself was incredibly progressive and realized the need for its own substance abuse/mental health full service,helping them supervise staff, see patients, etc., I took a one month “locum tenens” ‘rent-a-doc’ job for a state’s prison system which was a good as I knew a colleague who had worked in that system for almost two decades. But i was deployed as a telepsychiatrist in order to cover several facilities working long days, sometime till past 8 or 9 p.m. to get all the work done. The telepsychiatric method I had utilized some before in work on the spread out Native American reservation with distant clinics etc., and found that state’s prison system’s use of telepsychiatry to be well deployed and the wisest method under the conditions of what appeared to be a real shortage of “bodies,” real live MD psychiatric practitioners.
But as they say on tv, that is a story for another time, the national shortage of psychiatrists.