Friday, June 8, 2007

Is Lee Baca Overruling His Own Medical Staff?

As Paris Hilton returns to jail, she may need to avail herself of the mental health services offered by the Los Angeles County Sheriff's Department. What can she expect? This report from King County Washington (Seattle area) offers a clue.

Problems with medical errors aren't the only health-care issues at King County's two jails. A confidential 2004 report obtained by The Seattle Times also reveals questions about treatment of inmates with mental illnesses.

According to that report, by forensic psychologist Dr. Keith Curry: "A combination of dangerous conditions, inadequate staffing, poor screening, barriers to access and outright denial of care, questionable legal practices and lack of discharge planning were found."...

Curry found that nearly a quarter of the inmates admitted to jail were not screened for psychiatric problems within three days of their booking. The timing was problematic, he said, because it is dangerous for someone with psychiatric problems to go without their drugs for that long a period....

Among the changes is an aggressive psychiatric screening process for new inmates being booked into the jail, said Jail Health Executive Director Bette Pine. The goal, she said, is to see any inmate with a possible psychiatric problem within their first 24 hours in jail.

You'll recall that LASD has the following procedures on its books:

If he/she is already at the Inmate Reception Center at the downtown Los Angeles County Jail, he/she will be screened for mental illness, as well as other health concerns, upon arrival. It is very important that they be direct and honest to benefit as much as possible from this screening process. Assure your family member that it is OK to discuss his/her physical and mental condition, diagnosis, medications, etc., with the staff conducting the screening....

This shouldn't be a problem in the Hilton case. Presumably any mental illness that she's suffering has been declared to LASD loud and clear.

It's interesting to note that in both King County and Los Angeles County, the major concern that they have is to make sure that mental patients receive their medications. Or, as critics of psychiatry would state, to make sure that these people are adequately drugged up.

From US Magazine:

After serving just three nights in jail, a source says Hilton was sent home because the facility medical staff could not administer her prescribed dosage of medication.

Perhaps there's a half truth in that statement.

Let's say that you're being treated by Doctor X, but you then come under the custody of a hospital, or a nursing home, or a jail. At that point it doesn't matter what Doctor X says; the doctor in charge at the facility has complete control over your medical treatment.

So perhaps Charles Sophy was prescribing drug X for Paris, but the LASD medical staff decided to prescribe drug Y instead.

This could lead to a doctor fight, in which Doctor X argues that drug x is best for his/her patient, while the facility doctor says that drug Y is appropriate.

If this was the issue that led to Hilton's temporary release - I mean reassignment, then Lee Baca is in even deeper water.

In effect, Baca is saying that the sheriff's medical professionals should be disregarded, in favor of the medical professionals retained by the inmate.

We already know that the Association of Los Angeles Deputy Sheriffs is mad at Lee Baca. Are the medical professionals in the Correctional Services Division also mad at him?


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