Jail clinic offers mental health care to inmates

EDITOR’S NOTE: This is the final installment of a two-part series on medical care at the new Garland County Detention Center. Part two addresses mental health care at the facility.

Probably the biggest asset of the self-contained medical clinic at the new Garland County Detention Center is its mental health care component.

Melissa Jarrett, health services administrator for the clinic, said the service is critical because “a lot of the inmates have some sort of mental illness,” including those who are bi-polar or suffer from depression or anxiety, and in some cases have never been treated.

Dr. Taylor Fithian, who is also the medical director for Southwest Correctional Medical Group, which operates the clinic, is a psychiatrist who offers tele-psychiatry services at the center. Inmates are first interviewed, assessed and evaluated by Carol Gray, the center’s mental health professional, then referred to Fithian, who can evaluate them by video and prescribe medication as needed.

Garland County Sheriff Mike McCormick said mental health providers used to come to the jail for crisis intervention only. “Now (crisis situations) are dealt with proactively, greatly improving inmate and staff safety,” he said, noting that patients “are getting access to treatment that typically they never had access to before.”

Gray said a lot of the inmates have mental illnesses that have gone untreated, sometimes for years. “They may be arrested for a small misdemeanor and end up here and they need to be in a psychiatric facility. They actually have no business being in jail.”

Now those people are being assessed and referred for outpatient care or to a psychiatric hospital, she said.

“That in itself is a huge asset to the community that some of these people who fell through the cracks are finally getting the care they need,” McCormick said.

Dr. Karl Wagenhauser, the clinic’s medical director, said some inmates come in who have had chronic, long-term medical conditions that have never been addressed until they come to the jail. “Now they’re receiving treatment, improving the quality of their life and ultimately reducing the costs of their future care in the long term.”

McCormick said the center has reduced off-site medical consultation and inmate visits by 90 percent since the start of the contract with SWCMG. “It improves public safety by not exposing inmates to the public,” he said.

He also noted that inmate medical-related lawsuits have decreased, with only one new suit filed regarding a medical claim since the clinic opened. In previous years, they averaged five suits filed per year.

“Medical related rejections have greatly decreased,” he said. “Trained professionals make the determination whether to accept an arrestee where previously deputies made this determination.” He said that improves public safety as well, since officers are not tied up at the hospital gaining medical clearances instead of being available for patrol.

McCormick said inmates have also been more responsible for the cost of their medical needs under the new system. “Copays have been initiated whereby inmates pay for nonemergency medical treatment and prescriptions,” he said.

“This also reduces frivolous medical complaints, which allows medical staff to focus on legitimate needs.”

Jarrett noted there is a kiosk located in each jail pod where inmates can submit their medical complaints electronically, normally limited to two a day per inmate, which are then evaluated and forwarded to a doctor if needed.

She said they do have to send inmates to the hospital for any condition that requires 24-hour observation because they don’t have in-house beds. “Like at a doctor’s office or a clinic,” she said.

Someone with broken bones or a concussion would probably have to go to the emergency room, she said, but “they don’t have to stay in the hospital. We can provide their ongoing care after that. We can bring them back here and manage things.”

Jarrett acknowledged the costs of operating the clinic compared to the old system of transporting the majority of patients to local hospitals are about the same so far, but stressed, “‘We’ve just moved in. We’re ironing out the little kinks. Finding our flow. It’s a work in progress.”