Prison Psychiatry

[prominence]

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I have heard of psychiatry residents making a nice supplemental income by moonlighting in jails.

does prison psychiatry pay well as a full-time job? (Note: i am not referring to psychiatrists who get paid additional for forensic evaluations to make court appearances.)

what precautions are taken to ensure the safety of a psychiatrist, if any, in prisons/jails?

does the psychiatrist meet with the criminal face to face without any security personnel being present in the room? or do they talk to each other in booths via phones with a transparent barrier (as seen on tv or movies) separating the psychiatrist and criminal?

if anyone has such experience, please share. thanks.

 

[OBfan]

I have heard of psychiatry residents making a nice supplemental income by moonlighting in jails.

does prison psychiatry pay well as a full-time job? (Note: i am not referring to psychiatrists who get paid additional for forensic evaluations to make court appearances.)

what precautions are taken to ensure the safety of a psychiatrist, if any, in prisons/jails?

does the psychiatrist meet with the criminal face to face without any security personnel being present in the room? or do they talk to each other in booths via phones with a transparent barrier (as seen on tv or movies) separating the psychiatrist and criminal?

if anyone has such experience, please share. thanks.

interesting post. I'd love to hear about it as well.

 

[Ca$h MaNi]

Yeh, I hope it's not like the interaction I remember from the movie "Batman Begins" between the psychiatrist and the prisoner...in that case he was face-to-face with the prisoner.

Great movie by the way...two brown thumbs way up on that one!
👍 👍
😉

 

[lloyd braun]

I am very interested in pursuing prison psychiatry as a career, so I will tell you what I know. As far as salary goes, I have seen quotes around 160K, but that is just from one source and is only for psychiatrists in California, which is one state that is trying to increase salaries: See pn.psychiatryonline.org/cgi/content/full/41/17/5. I would imagine that benefits would be pretty good as well since you would be a government employee, but I really have no idea. My interest has obviously been purely because of my interest in the prison environment with salary/benefits being an afterthought for me.

As far as how these patients are interviewed, I do have some firsthand experience to share. For my college thesis, I interviewed prisoners in a US prison and prisoners in an English prison and compared the responses. During the interviews, I was alone with the inmate, who was often, but not always chained by the feet and/or hands. There was always a guard around outside if I needed one, but I never was threatened in my 60 or so interviews.

I was pleased to see this post, as it is hard to find people who are interested in prison psychiatry. I welcome any more questions and would be appreciative of any more input to the above remarks.

 

[prominence]

thanks for the insight lloyd!

 

[Anasazi23]

I'm on my forensic elective right now. It's...interesting.

To answer your question, I'll say that it depends on the prison/jail.

In many cases, the psychiatrist will examine the patient/inmate in an interview room, with security present or close nearby. From what I've seen, the inmates are usually happy to get out of the cell and talk for a while. Though some particularly nasty antisocials or those with severe psychopathy couldn't bother with the interview. I think the glass/phone thing is mostly for lay visitors.

I've seen pay range in the Psychiatric News from around 110k to close to 200k, depending on the area.

 

[Hurricane]

I did part of my med school psych rotation at the county jail. They had two psychiatrists - one male and one female - and each saw patients of the corresponding sex. They did this a couple afternoons a week, in addition to their own practices.

During the interviews, the door was open and security was nearby, but not close enough to listen in. They were always mindful of having the inmate sit furthest from the door. The only exception to this was suicide watch rounds, when we had to go to the cells. That's the only time I was a little scared, and it was the female inmates who skeeved me out 10x more than the men.

 

[sistermike]

I wouldn't know the answer to this question; however, I do know of an FNP who had approx. 5 years experience as a psych RN who did get a position at a prison working as the primary psych. The prison does have a psychiatrist in a private practice who will work a few hours every few weeks to basically see those patients whom the NP is unclear of.
The NP makes close to $100K, so I suppose if a psych MD/DO were able to get into a prison as a full-time staff member, they would be making a nice chunk of change.

 

[MacGyver]

I did part of my med school psych rotation at the county jail. They had two psychiatrists - one male and one female - and each saw patients of the corresponding sex. They did this a couple afternoons a week, in addition to their own practices.

I know of a male prison that has a female psych there full time.

Its absolutely stupid to have a woman psych in such an institution. Only a matter of time before she gets raped.

 

[prominence]

how are the hours in prison psych?

 

[sistermike]

I know of a male prison that has a female psych there full time.

Its absolutely stupid to have a woman psych in such an institution. Only a matter of time before she gets raped.

Usually in a setting such as that, there is always a guard who accompanies the inmates while seeing the psych (especially if she is female). Or if the guard doesn't accompany the inmate, the doc is able to press a button and the guard is right outside of the door. I am sure rapes have occurred, but I bet they are far and few these days. I am sure she wouldn't have accepted the position if she would known it was unsafe.

 

[MacGyver]

Usually in a setting such as that, there is always a guard who accompanies the inmates while seeing the psych (especially if she is female). Or if the guard doesn't accompany the inmate, the doc is able to press a button and the guard is right outside of the door. I am sure rapes have occurred, but I bet they are far and few these days. I am sure she wouldn't have accepted the position if she would known it was unsafe.

I imagine that its not allowed to routinely have a guard inside the room where the inmate is, due to patient-doctor confidentiality. I know at the prison where this woman works, they are not allowed to be in the same room. They have to wait outside somewhere.

The button thing wont prevent any violence or rapes. We are talkikng about lifers in for murder who have absolutely nothing to lose by attacking the psych. They havent had any contact with women in years, they are sexually starved and wont think twice about it.

 

[Therapist4Chnge]

I imagine that its not allowed to routinely have a guard inside the room where the inmate is, due to patient-doctor confidentiality. I know at the prison where this woman works, they are not allowed to be in the same room. They have to wait outside somewhere.

From my understanding the "client" is the prison system, and NOT the inmate. I don't work in the forensic arena, and I'm not sure to what extent this applies, but I'm pretty sure that is how it works.

-p

 

[sistermike]

I imagine that its not allowed to routinely have a guard inside the room where the inmate is, due to patient-doctor confidentiality. I know at the prison where this woman works, they are not allowed to be in the same room. They have to wait outside somewhere.

The button thing wont prevent any violence or rapes. We are talkikng about lifers in for murder who have absolutely nothing to lose by attacking the psych. They havent had any contact with women in years, they are sexually starved and wont think twice about it.

I understand the patient/doctor confidentiality, but common sense would tell us that the prison system has imposed some sort of safe guards. If there were no safe guards in place, I highly doubt that a female (or male for that matter) psych's would take a position if they knew that their life was at risk.

My female friend who works as an NP psych in the prison system has told me that there are security measures taken. She hasn't gone into much detail with me, but she has spoken about patients who are of threat are shackled and secured to their chair -- the chair is also somehow secured to the floor, so the inmate is not able to move from their position, even if they tried with all of their strength. That is the only security measure she has spoken of, but I know they have some others. I will have to ask her.

 

[prominence]

That is the only security measure she has spoken of, but I know they have some others. I will have to ask her.

please ask her. i would appreciate it. thank you.

 

[lloyd braun]

The button thing wont prevent any violence or rapes. We are talkikng about lifers in for murder who have absolutely nothing to lose by attacking the psych. They havent had any contact with women in years, they are sexually starved and wont think twice about it.

Are you speaking from experience or are you merely generalizing about a subject it sounds like you know very little about?

 

[sistermike]

From my understanding the "client" is the prison system, and NOT the inmate. I don't work in the forensic arena, and I'm not sure to what extent this applies, but I'm pretty sure that is how it works.

-p

I am pretty sure you are correct in assuming that. From my understanding as well, the client is considered to be the prison system, and not the inmate. I am trying to recall a freshman year class I had in criminal justice. I know inmates have very few rights -- they are basically stripped of all basic rights and in a sense become "property" of the state. I believe this is why the prison system is the client, and not the patient.

 

[Psychintern2006]

I am pretty sure you are correct in assuming that. From my understanding as well, the client is considered to be the prison system, and not the inmate. I am trying to recall a freshman year class I had in criminal justice. I know inmates have very few rights -- they are basically stripped of all basic rights and in a sense become "property" of the state. I believe this is why the prison system is the client, and not the patient.

I beg to differ, I have seen lot of mental health agencies using the word client for the patient, both forensic and general. The right of a 'patient' is the same whether he is in prison or out of prison, in terms of health services.

 

[Anuwolf]

I know of a male prison that has a female psych there full time.

Its absolutely stupid to have a woman psych in such an institution. Only a matter of time before she gets raped.

Yeah you tell them MacGyver! Now off to our next episode! 😀

I think prison/jail psych is pathetic! Why the hell should an inmate deserve such service when the reason why hes/shes in there is to be punished for the crime that they commited? Yeah lets give them medication to help them to feel more comfortable in prison... geeze what the hell is our world coming too?!??!
The inmate has more rights than the victims..

If you cant do the time... DON'T DO THE CRIME! SIMPLE AS THAT!

I rather have my tax money go to the victims that need more therapy then the filthy scum whos in prison.

 

[Therapist4Chnge]

Yeah you tell them MacGyver! Now off to our next episode! 😀

I think prison/jail psych is pathetic! Why the hell should an inmate deserve such service when the reason why hes/shes in there is to be punished for the crime that they commited? Yeah lets give them medication to help them to feel more comfortable in prison... geeze what the hell is our world coming too?!??!
The inmate has more rights than the victims..

If you cant do the time... DON'T DO THE CRIME! SIMPLE AS THAT!

I rather have my tax money go to the victims that need more therapy then the filthy scum whos in prison.

I wish it was that easy.

I know as a citizen I have very strong views about our prison system, but as a professional I also am aware that in certain circumstances you can make a positive change and hopefully help curb continued maladaptive behavior. I will never work in that arena because of my personal views, but I can see where certain interventions can be beneficial to the inmate AND the tax payer.

Removing much of the hard labor and replacing it with television time, etc.....there is an area that I definately take exception to.....but that is an arguement for a different day. 😉

-t

 

[lloyd braun]

Yeah you tell them MacGyver! Now off to our next episode! 😀

I think prison/jail psych is pathetic! Why the hell should an inmate deserve such service when the reason why hes/shes in there is to be punished for the crime that they commited? Yeah lets give them medication to help them to feel more comfortable in prison... geeze what the hell is our world coming too?!??!
The inmate has more rights than the victims..

If you cant do the time... DON'T DO THE CRIME! SIMPLE AS THAT!

I rather have my tax money go to the victims that need more therapy then the filthy scum whos in prison.

I hope this is your idea of a sick joke. Or perhaps you have lived such a priveleged life that you are out of touch with what really goes on in prisons. Very offensive and ignorant.

 

[Pterion]

I beg to differ, I have seen lot of mental health agencies using the word client for the patient, both forensic and general. The right of a 'patient' is the same whether he is in prison or out of prison, in terms of health services.

This is of course true. In fact, in some states - particularly the south, prison mental health care is actually better than what is available in the offender's home area. I've worked in Federal and state prisons, and can tell you that in some instances that fact is really scary.

The system is the "client" (a word I abhor for healthcare services). Your first job is the "maintenance of the safety and security of the institution". Meaning that the inmate has not guaranteed nor expected right to the immediate confidentiality of his/her session content. The different ways this can be manifest is often a difficult transition for the clinician. I found that basic management decisions regarding the inmate can be trumped by the correctional officers (don't call them "guards" to their faces) if the officers' opinion differs. You will also find that many systems have extremely restricted formularies - so brush up on your old school meds.

It IS a prison, meaning the possible number of malingerers, Axis II challenges and manipulators is MUCH higher than in the world. And yes, even though not every inmate you meet is a violent offender, you must always be aware of your situation and surroundings. Physicians can and do get assaulted occasionally.

Career prison psychiatrists in many areas are not the strongest clinicians. Many are impaired physicians either working on a restricted license or about to lose it. Forensic psychiatrists who do correctional work are a different story.

 

[Anuwolf]

I hope this is your idea of a sick joke. Or perhaps you have lived such a priveleged life that you are out of touch with what really goes on in prisons. Very offensive and ignorant.

No this is not my ideal of a joke. Privilege life? Oh Please! I don't wake up and think of many ways to harm others and then actually do it. I don't put my hand on the stove and get burnt. I Obey US Laws like everybody else should. You obviously had never had a love one get murdered or been victimized, I have. You watch too many TV prison shows (HBO's OZ, Prison break,etc) and it's clogging your brain and you refuse to face reality. My post is nowhere to be offensive...

 

[lloyd braun]

No this is not my ideal of a joke. Privilege life? Oh Please! I don't wake up and think of many ways to harm others and then actually do it. I don't put my hand on the stove and get burnt. I Obey US Laws like everybody else should. You obviously had never had a love one get murdered or been victimized, I have. You watch too many TV prison shows (HBO's OZ, Prison break,etc) and it's clogging your brain and you refuse to face reality. My post is nowhere to be offensive...

I have actually never seen those shows, believe it or not. I am basing my opinions on experience working in prisons, not television. It's interesting that it sounds like you are making conclusions about me based on internet posts. Is this how you plan on evaluating psychiatric patients? I apologize regarding my previous post; let's just agree to disagree and move on with both of our privileged lives. Whaddya say?

 

[Anuwolf]

I have actually never seen those shows, believe it or not. I am basing my opinions on experience working in prisons, not television. It's interesting that it sounds like you are making conclusions about me based on internet posts. Is this how you plan on evaluating psychiatric patients? I apologize regarding my previous post; let's just agree to disagree and move on with both of our privileged lives. Whaddya say?

To make things clear.. I'm not a psychiatrist so I cannot start evaluating psychiatric patients. Those who are in prison for a minor thing such as drug possession (Users, not dealers) to robbery without violence.. I can give sympathy for those people but those who are in there for murder, rape, drug dealings,trafficking,etc IMO should not have the privileged to such service like psychiatry so they can feel comfortable in prison while they do their time. Why on earth should they be allowed to have a free service with the costing of tax payers money?

It is people like Danny rolling (Mind you hes gonna get the needle tonight) that deserve nothing more than a bullet in the head for the type of crime he has committed, especially to the children he had murdered.

 

[prominence]

Does the prison system offer full-time psychiatrists any retirement benefits, such as pensions?

Also, is it necessary to have forensic psych fellowship training to work in prisons in California or elsewhere on the west coast?

 

[chocomorsel]

Mods, why are Anuwolf's posts being deleted? He's just stating his opinion and just because someone doesn't agree with it, doesn't mean it has to be deleted.

Personally, I couldn't work in the prison system. I have a very low tolerance for nightmares and I'm easily frightened. I bet a lot of those criminals are quite scary. Or maybe I'm staying up too late watching "cold case" and "behind San Quentin" on MSNBC or History chanel. Scary stuff.