Correctional Psychiatry Flashcards
According to the 2011-2012 DOJ Survey, how many detainees reported “severe psychological distress” in the past 30 days?
- 1 in 7 prison inmates
- 1 in 4 jail detainees
- F > M
- violent offenders = property offenders
According to the 2011-2012 DOJ Survey, how many detainees reported a past mental health history?
37% of prisoners
44% of jail detainees
MDD most common
According to 2011-2012 DOJ Survey, what percentage of detainees have SMI?
15-24%
What is the most common dx in male and female detainees?
substance use disorder
58% of prisoners and 63% of jail inmates
MJ most common
what percentage of male inmates have dx of ASPD?
50%
jail suicide stats
- leading cause of death
- risk distributed over time, often close to court hearings
- whites highest rate
- M > F
- violent offenders higher risk (5x > drug offenders)
- kidnappers highest
prison suicide stats
- second leading cause of death (7%) after medical causes
- M > F
- whites
- age unrelated to risk except <18yo
- violent offenders 2x greater
- most occur after the first year
Brown v Plata
USSC 2011
Overcrowding of CA prison system found to be primary cause of unconstitutional care.
PRLA permits inmate “cap” to alleviate constitutional violations.
USSC upheld population limit.
what percentage of inmates screen positive for drugs?
10%
classic symptom of Ganser’s syndrome
approximate answers
Other sx incl clouding of consciousness, somatic conversion, hallucinations.
McKune v Lile
USSC 2002
5A not violated by Sexual Abuse Tx Pgm (SATP) requirements to disclose prior sexual activities which could be incriminating. USSC held that SATP serves a vital penalogical purpose and that offering inmates incentives to participate does not amount to compelled self-incrimination.
Ruiz v Estelle
district court case providing guidelines for planning MH services in correctional settings.
Screening is regarded as most important service element in correctional MH.
Pennsylvania v Yeskey
USSC 1998
State prisons are ADA “public entities.”
State prison inmates can sue for violations under the ADA.
Ron Yeskey denied “boot camp” due to HTN.
U.S. v Georgia
USSC 2006
State prison inmates with disabilities can sue for money damages under Title II of the ADA.
Bell v Wolfish
USSC 1979
Bell test: Restrictions do not equal punishment so long as the restriction is “reasonably related” to a legitimate govt objective.
Inmates challenged visual body cavity searches, which were held to be permissible for both pretrial detainees and prisoner w/no cause necessary.
Turner v Safley
USSC 1987
Turner test: “reasonably related to a legitimate penalogical interest.”
Prohibition against writing did not violate 1A.
Thornburg v Abbott
USSC 1989
Censoring publications in a correctional setting does not violate 1A so long as the publication posed “intolerable risk of disorder.” USSC applied the “Turner test” and stated there was no need to demonstrate that a particular publication was “likely” to cause violence to justify banning it from a prison.
Holt v Hobbs
USSC 2015
Govt cannot substantially burden religious practice unless it is the least restrictive means of furthering govt interest.
Holding: The DOC policy was NOT the least restrictive means.
Estelle v Gamble
USSC 1976
Established the “deliberate indifference” standard.
Malpractice does not = constitutional violation, but deliberate indiff to serious medical needs of prisoner DOES = the “unnecessary and wanton infliction of pain” proscribed by 8A.
Gamble had back injury, filed a 42 USC 1983 claim that he did not receive adequate medical attn.
(USSC did not specify what mens rea constituted deliberate indifference, but lower courts interpreted that a standard of recklessness was required, and in Farmer v Brennan, USSC clarified that subjective recklessness was required.)
“deliberate indifference”
Established by Estelle v Gamble.
- serious medical needs
- unnecessary and wanton infliction of pain
- not an inadvertent failure
- no single definition of “serious medical needs”
Farmer v Brennan
USSC 1994
Deliberate indifference = SUBJECTIVE recklessness.
Dee Farmer pre-op transgender, beaten and raped in prison, filed 42 USC deliberate indifference claim.
Subjective = person knows and is aware and disregards.
(Objective = person does not know but risk is so high they should have known.)
USSC determined the mens rea required for the establishment of deliberate indifference is one of subjective recklessness. (AKA criminal recklessness, ie a person knows and is aware of a situation, which he disregards.)
gender dysphoria tx in prison
Prisons vary on policies re: continuing hormonal tx.
NCCHC says staff should follow “accepted standards developed by professionals w/expertise in transgender health.”
Washington v Harper
USSC 1990
Prison policy allowing invol meds when mental d/o caused grave disability or danger to self/others was found to NOT be a violation of 14A substantive DP rts.
USSC applied Turner test and held that prison policy was reasonably related to legitimate penalogical interests, so a judge was not required for DP.
Washington v Harper does not require:
- consideration of less intrusive means
- decisional incompetence
- judicial decision before forcible meds,
and it does not apply when prisoners are forcibly medicated in an emergency.
Baxstrom v Herald
USSC 1960
Baxstrom was held in a psych hospital after his prison sentence expired, without jury review or a finding of dangerousness.
14A equal protection was violated.
