The ongoing physician shortage poses a challenge for mental healthcare in the U.S., and this crisis extends to our national network correctional facilities. According to the National Alliance on Mental Illness (NAMI), inmates showing symptoms of “serious mental illness” comprise a shockingly high percentage of the average prison or jail’s population. Approximately 64 percent of inmates in local jails show signs, along with 56 percent of inmates in state prisons.
This has led to a worrisome situation we’ve all seen on the evening news or an outraged friend’s social media feed: Overworked, underpaid private- and government-run facility staff, many of whom lack adequate mental health training, struggle to effectively handle the population they are tasked with watching and keeping safe.
Of course, this is not to criticize the beleaguered correctional staff (or even the facilities that house them), many of whom are simply left to do what they can with the resources they have. Better, it would be fair to same some progress has been made on the corrections mental health front in recent years. In California, for instance, improved screening capability is one factor contributing to an uptick in psychiatric drugs prescribed throughout state, county, and local systems.
Still, progress is still needed. And for correctional facilities in the wake of their own hyperlocal mental health crises, locum tenens may provide just the conduit to relieve the burden.
When Budgets Are Short, Temporary Help Is Better Than No Help
Consider the average public (or, as is frequently the case in corrections, privately-run, government-contracted) institution. Like most any government-run or government-funded organization, budgets in jails and prisons are tight, responsibility is high, and the idea of doing more with less permeates largely every facet of the service provided. These aren’t the kind of places with money for extensive mental health services — but provide it they must, with prison systems in several large cities becoming the largest mental health entities in the country and “the nation’s de facto mental health providers,” per one article from The Guardian.
Obviously, nothing short of sweeping regulatory change will resolve this problem wholly. Locum tenens services, however, can be an invaluable stopgap in the interim, helping facilities with the capacity to hire full-time staff deal with certain mental health issues as needed.
Take a facility large enough to contain its own mental health ward, as is common in large cities around the country. Because state departments of corrections (and the private facilities that often contract with them) aren’t always alerted to the conditions inmates face before they receive and process them, a locum professional might represent an affordable way to screen and diagnose perceived “bad cases”: situations where an inmate who doesn’t receive some manner of care likely poses an inordinate amount of danger to themselves or others.
The same idea applies in smaller local facilities, which may be utterly unprepared in terms of staffing or available space to house mentally ill intakes. A town with a sub-10,000 population may not have the resources (or need) for full-time psychiatric help, making short-term access to help for anomalous cases an important resource.
Alternative Modes of Treatment
Furthermore, innovative care models like telepsychiatry — already used to great effect in states like Texas — can further broaden access to care. Consider now a corrections facility that houses a large mentally ill population and, due to extreme budget cuts, needs an affordable way to ensure ongoing treatment and prescribing are available. A telepsych program could cut costs related to prisoner transport or professional travel, ensuring inmates have access to a broader selection of care without putting too much financial strain on the system housing them.
A telepsychiatry program may also serve to keep attending professionals safer in certain situations. The same attending provider who may not feel comfortable sharing a room with a violent inmate could feel perfectly comfortable treating the same person via a computer screen.
In any event, it’s clear that mental health treatment, as it pertains to corrections, needs some level of improvement. This much is in near universal agreement both within and outside the criminal justice system. When or however these changes are implemented, the current-day role of locum tenens is vital — a service that, at minimum, reduces the strain on a vastly overtaxed system.
