CONTRABANDS IN JAIL

Contrabands in Jail, Narcotics, and the Implications for Nursing Risk Management

Contrabands in Jail, Narcotics and the Implications for Nursing Risk Management

Introduction

Jail nurses were never meant to coordinate care in emergency rooms, mental hospitals, or substance detoxification and treatment facilities, but by law nurses systematically assess and provide safe housing and treatment for detainees with mental, medical, and substance related disorders. Despite the extensive array of services offered in jails, there remains uncertainty about the extent of the medical, mental, and substance related treatment needs among jailed detainees. This is because of inadequate or inaccurate assessment but confounded by the detainees' fear that disclosure may lead to stigmatization or punitive responses (Sykes, 2008).

Therefore, it is obvious why neither the time nor the funds have been allocated to develop better intake assessments for detainees at the jails. As a result, piecemeal assessment has occurred. In the instance that piecemeal assessment is completed for a detainee appears that jail clinicians, researchers, drug court, and mental health court providers, and other community-based mental health and addiction treatment providers are often interested in many of the same medical, mental, and addiction-related questions to assess treatment needs. Unfortunately, these groups go about assessing detainees in ways which are redundant but different enough to make it difficult to meet each other's needs.

Discussion

Challenges to Assessment and Treatment: Co-Occurring Disorders

An individual who has one or more substance-related disorders as well as one or more mental disorders is said to have a co-occurring disorder. The main challenges to health providers are to initially able to accurately diagnose the both disorders and design a treatment program that addresses both. For incarcerated individuals, a poorly designed or inadequate treatment program is often a recipe for recidivism. Co-disordered individuals assessed and treated with traditional nonintegrated methods are significantly more likely than those with single disorders to drop out of treatment and be incarcerated during the first year after treatment.

Jailed people have the most medical, mental, and substance-related needs and receive the least amount of treatment when compared with community samples, jailed men, sentenced women, and sentenced men. According to a recent anonymous survey by the Bureau of Justice Statistics (BJS), more than 75% of jailed people in the United States have mental health problems, and of these, more than 75% meet the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IVTR) criteria for substance abuse dependence (Schmid, 2000). Each year more than 1 million people are committed, and released from local jails. Most bailout or negotiate an early release into a community-based treatment program within a week of admission. Those with mental illness and co-occurring substance disorders have less means to make bail and may be too cognitively impaired to summon the motivation required to negotiate the community-based treatment system. Thus, they continue to “fall through the cracks” and remain housed at the jail, where more than 75% of these people have undetected and untreated mental health problems.

Under Reporting and Stigmatization

Some of the challenges to the ...