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Nurse practitioner could help expand mental health services at jail

Herald-Times - 10/28/2019

Oct. 28--Monroe County Jail officials want to hire a psychiatric nurse practitioner as part of a proactive approach to providing mental health services to inmates.

"Jails are becoming the largest mental health providers in the community," Monroe County Jail Commander Sam Crowe said last week during a Monroe County Council work session. "Many people in the jail have serious mental health issues."

Crowe said to hire a psychiatric nurse practitioner, the jail's overall medical services budget would need to increase from around $732,000 annually to $801,000. He said that increase is needed not only to pay the nurse practitioner to come to the jail four hours per week to see clients, but also an anticipated increase in medication expenses for inmates.

Hiring a nurse practitioner would supplement other efforts in the jail to help those inmates in need of mental health services. This includes having a licensed social worker making trips to the jail and the Monroe County Problem Solving Court Program, which has a mental health court component. According to the county website, the mental health court "strives to reduce recidivism among offenders with serious and chronic mental health issues through early identification, increased supervision and increased facilitation of service provision, while preserving community safety and promoting judicial efficiency."

Crowe said adding more resources to help inmates who have mental health problems would also benefit staff and the community. He said whenever he can he tries to address such challenges in house. For example, he said last month officers took part in an eight-hour mental health first aid class. Crowe said some elements of the training included becoming able to recognize mental health symptoms in individuals and knowing how to respond.

"Any time we can do training like that, we are just benefiting everybody," Crowe said.

Jim Baugh, a licensed clinical social worker who works with mental health clients in the jail, said while the nurse practitioner would have the ability to write prescriptions, it does not mean that they would start medicating everyone coming to the jail. He said they still have to follow strict protocol to determine what is best for the client.

Council Attorney Margie Rice said hiring a psychiatric nurse practitioner would require amending the jail's contract with Advance Correctional Healthcare Inc. Rice said the current contract, which is renewed annually, states it can be modified so long as both parties agree.

Crowe said he has reached out to Advance Correctional Healthcare Inc. representatives about writing an amendment to the agreement and would like to bring it back for the county commissioners' approval as soon as possible.

County council member Shelli Yoder expressed concern about only hiring someone for four hours per week. She said based on the need for such a position, it seemed like a drop in the bucket. Crowe said the four hours per week figure was recommended by Advance Correctional Healthcare Inc., based on a formula they use.

County Council member Kate Wiltz said she is fully supportive of adding a psychiatric nurse practitioner to provide needed mental health services to inmates. While the council has been holding off on taking some criminal justice-related steps until a comprehensive study of the overall system is completed, she thinks having a psychiatric nurse practitioner in the jail is a good exception.

"I am excited to get you some more support for your whole team," Wiltz said.

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