Health in prison

Now they tell us. Too bad New York just renewed Prison Health Service's contract for a third of a billion dollars:

Inmates' Medical Care Failing in Evaluation by Health Dept.

A recent evaluation of the company in charge of inmate health care at Rikers Island, coming months after it was awarded a new $300 million contract, has found that it has failed to meet a number of the most basic treatment goals. City records showed that the company, Prison Health Services Inc., did not meet standards on practices ranging from H.I.V. and diabetes therapy to the timely distribution of medication to adequately conducting mental health evaluations.

The city Department of Health and Mental Hygiene, which oversees the company's work at Rikers Island and at a jail in Lower Manhattan, found that during the first quarter of 2005, Prison Health failed to earn a passing grade on 12 of 39 performance standards the city sets for treating jail inmates. Some of the problems, like incomplete medical records or slipshod evaluations of mentally ill inmates, have been evident since 2004 but have not been corrected, according to health department reports.

Other problems identified in the department's review, involving things as serious as the oversight of inmates who have been placed on suicide watch, are more recent or had not been evaluated by city health auditors in the past.

As a result, the city is withholding $55,000 in payments to the company, the largest penalty for poor performance it has incurred since 2001, the first year of its work in New York City adult jails. [NYT]

Speaking of health care in prison, I've been meaning to recommend The New Asylums, Frontline's documentary about mental services in prison. The main focus is on Ohio's new prison-based psychiatric system. The Frontline crew got unprecedented access to film prison officials, health care providers, and inmates in Ohio's maximum security prisons.

Much of the footage is very disturbing. There's an incredibly poignant scene of a psychiatrist running a therapy group for ten guys in individual cells. The doc runs the group from rolling chair in the hall. The scene is especially poignant because he does such a good job, given the constraints of the setup. Everyone's really giving there all to this group, but you know that even if it works, it can't really help. These guys are deeply disturbed maximum security inmates whose mental health only matters to officials insofar as it improves their disciplinary records.

Comments

[Ol Cranky]

Jesus Lindsay,how naive can you be! They don't care about access to or quality of healthcare for the average American, you don't really expect them to care about it for those in [non white collar] prisons, do you?

[Lindsay Beyerstein]

Nope. Nobody cares about prisoners much. On the other hand New Yorkers don't like getting ripped off on general principle. So there's a wedge there.

The Frontline documentary is interesting because the people running the Ohio program do seem to care quite a bit--at any rate, much more than I'd expect of a psych staff in a supermax prison.

Ohio ended up with so many crazy people in their prisons that they had to create a separate psychiatric system within their maximum and supermax prisons. This goes beyond the state hospital for the criminally insane. It's an entire prison system for people with ongoing psychiatric disease. About 16% of the general population in Ohio has a major psychiatric illness (i.e. bipolar, schizophrenia, etc.).

[Lindsay Beyerstein]

What's so interesting about the group therapy scene is that the shrink is doing such a great job of delivering therapy whose core assumptions are inconsistent with prison (your feelings matter, we care about you as an individual, we're here to support each other...). Neither he nor the prisoners seem to realize the inconsistency. So, at least in the moment, the disconnect doesn't matter.

[Andrew Spark]

Health system is big problems in all over the world in my country the health department has declared the existing rate contract for the purchase of medicine five year ago but still yet we no receive any progress in this matters.