The Changing Role of Correctional Health Care Professionals

Written By: Beth Boone

It seems that there are almost daily reports of encounters between law enforcement and mentally ill individuals, some with devastatingly fatal consequences for the families who initiate the contact by calling for assistance with their loved one, and conversely, often dangerous situations for the police in responding to the same. But what happens after the arrest of these individuals is generally not as publicized. The Emporia Gazette in Kansas recently had a series of articles regarding fewer mental health institutions in that state, with the lack of funding and facilities resulting in, among other things, more mentally ill inmates in local jails.

The number of inmates with mental illnesses is just one of many unique challenges to health care providers working in a correctional setting. While historically the inmate population has had a high prevalence of mental health issues, many published studies cite the closing of state mental institutions and inadequately funded community-based programs as a large factor in the increase of individuals in custody with mental health issues. According to one recent article, there are now more people with serious mental health disorders in Chicago’s Cook County Jail, New York’s Riker’s Island, or the Los Angeles County jail than there are in any single psychiatric hospital in the nation. ¹

While the United States Supreme Court addressed the provision of a constitutionally protected right to health care in prisons and jails in the 1976 case of Estelle v. Gamble, subsequent litigation has also led to expanded health care services. Correctional health care workers are now faced with the provision of protected and mandated services for incarcerated individuals with many challenges- other health conditions of these inmates, often chronic; cost constraints; special needs of women and juvenile offenders; aging populations; substance abusers; and communicable diseases; just to name a few. With the added responsibility of being the sole health care provider for such a large number of mentally ill individuals, it would appear the provision of correctional health care is becoming a community service of care and education in a setting where the primary focus is punishment and supervision. The result is that the role of correctional health care workers continues to change and expand in an attempt to meet these increased demands. While answers are being sought to these issues and public policy regarding treatment of mental illness progresses, these professionals continue their efforts to meet their many roles on a daily basis.

¹ Macmadu, Alexandria, and Josiah D. Rich. “Correctional Health is Community Health.” Issues in Science and Technology32, no. 1 (Fall 2015).