Wednesday, December 14, 2011

Budget cuts reduce mental-health staffing, services in Texas prisons

Kristi Nix at the Pasadena Citizen has a report ("Budget cuts mean fewer medical workers to treat Texas' mentally ill inmates," Dec. 13) on the effects of budget cuts on mental-health care at Texas prisons. The story opens:
State budget cuts handed down during the recent legislative session left the Texas Department of Criminal Justice with a dangerously-low $6.1 billion biennial budget, approximately $97 million less than last year’s funding levels. As a result, the mental health care system suffered layoffs along with the rest of the prison health care services. And although treatment and medications were left untouched, fewer medical workers are now left to treat mentally-ill inmates.

“We were given dollars for facility staff, dollars for pharmaceutical care and dollars for hospitals and some specialty care. The cuts that came to the facility staff included 24 mental health employees that were laid off,” said Dr. Owen Murray, Vice President of University of Texas Medical Branch Correctional Managed Health Care system.

Roughly 80 percent of Texas inmates are treated by UTMB, 14.2 percent of which have been diagnosed with serious mental illness. Owens said universal changes to mental health care services caused the number of mentally-ill offenders to increase significantly each year .

“Given the erosion of infrastructure we are seeing trends that are alarming,” he said. “We’re seeing natural fallout from that change, and that is more of the seriously mentally ill patients in the state are migrating into the correctional environment via jail or prison.”

And although the demand for services continued to increase, the mental heath care system suffered staffing reductions in 2011 as a result of state budget cuts. Last July, UTMB announced 50 unfilled positions would remain vacant and 130 health-care workers would be laid off, 24 of which were mental health care workers.

Staffing cuts in turn increased the inmate-to-staff ratio from 58 to one upward to 65 inmates for every mental health care worker.
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1 comment:

DeathBreath said...

My, my, my, how interesting. When I was in the bottom of the UTMB-CMC Viking ship being flogged, I noticed an escape route and took it. I was quite fortunate. When I left in 2009, UTMB-CMC was moving closer to unethical behavior given the patient to staff ratios.

Now, if you are a member of the GOPig party, you hardly ever noticed the changes. If you a member of this elite party, I urge you to bow your head, get on your knees, and pray. Others can continue reading.

Please, tell me this. How has UTMB-CMC managed to maintain ACA standards with fewer staff members? Do we have complacent ACA auditors? Do we have people cooking the books?

I can assure you of one thing. The ACA audit is a total joke. Facilities know about upcoming audits for months and sometimes years in advance. ACA audits are all about "outcome." This outcome involves having hundreds of separate files where policy is presented with supporting documentation. Beyond that, auditors come in and interview a few patients and leave.

In order to find an effective ACA coordinator, you need to observe the environment for individuals with untreated OCD. They love their jobs.

I've always contended that ACA accreditation is a countermeasure to the Ruiz lawsuit. Initially, UTMB-CMC was in complicance with Ruiz while TDCJ-ID blundered along with Administrative Segregation issues.

If you did not know it, Ad Seg is where problems occurred. Since there has been widespread incarceration of those with serious mental illnesses across this nation, the identification and treatment of these individuals is appalling.

In Ad Seg, those with psychosis tend to decompensate. It is rather difficult to interview and observe someone in a cell with other offenders yelling & screaming nearby. If you can get security to bring them to the office, you might get a better sample of their mental status, but feigning is a frequent phenomenon.

The truly stupid clinicians don't always recognize the "negative" symptoms of psychosis. Some offenders feign positive symptoms on a frequent basis. Some, are quite talented at feigning. Others are not quite as sophisticated. It takes a skilled clinician to effectively assess this unique population. I am afraid many of these clinicians have aleady left the system.

But, skilled clinicians cost the state more money since many have years of experience, accrual, and benefits.

I am still scratching my head concerning how UTMB-CMC can get by with seemingly "unconstitutional" conditions. Prison treatment is a federal issue, first. Here is a fine example of why states need to have federal intervention.