Saturday, September 23, 2006

In The Family Way

I think there's a rule among correctional switchboard operators that any telephone caller who sounds angry or has a strong foreign accent must immediately be routed to the psychology department. That's the only explanation for some of the calls we get; usually it's a family member calling to demand a reason why their loved one hasn't been transferred to a maintaining facility yet or hasn't had a parole hearing or why he wasn't taken to court on the appointed day. Sometimes they need to yell at someone because of that very unfair sentence that will keep Loved One from paying their bills. Now, keep in mind that the psychology department doesn't have anything to do with any of these issues. The purpose of our involvement mainly is to give the caller someone to vent at, and occasionally to provide a little community education about the prison intake process.

Most folks don't usually think about family involvement in correctional healthcare but they definitely do get involved. As a general rule I don't mind talking to family members who call if the inmate says it's OK. It's a good thing for me to have someone on the "outside" helping me keep an eye on my patients. They have more regular contact with my patients than I do and they are fairly good at identifying early symptoms of relapse. Regardless of their reason for calling, at some point in the conversation I make a habit of telling them to keep an eye on Loved One and to call the psychology department if they notice anything of concern. That quickly turns a potentially adversarial relationship into an alliance---and I think it surprises them. They expect to get dismissed or blown off, or they call expecting that any prison doc is going to be a heartless Nazi. And it gives me a chance to emphasize to them that Loved One has been seen and is going to be followed regularly. I tell them to remind Loved One about his next scheduled appointment and to take his medicine.

The sad phone calls are the ones involving first-time inmates. By the time someone ends up in prison they have usually run the gamut of lesser sanctions and failed repeated 'second chances'. Then I hear from the naive current girlfriend or the exhausted mother in their last futile attempt to rescue Loved One from the consequences of his stupidity. I must tactfully suggest that it would be best for them to care for themselves during this time of reprieve and let Loved One fend for himself. It's hard to do that without sounding like a heartless Nazi, but someone has to suggest that it's time for Loved One to grow up. Mostly I think they need someone who can empathize with their frustration and emotional fatigue.

Once in a blue moon I'll get a call from a family member after someone has been released. Those are the phone calls I like because it means my patient has actually decided to stay in treatment---they're calling for prescription refills or referral information, or records for a free society psychiatrist. Those are the patients I don't usually see again. And that's a good thing.


Sarebear said...

Ok, for a second I thought you were announcing a pregnancy.

*chain has been officially yanked, or leg has been pulled* hee hee

That's very interesting.

I have a brother who, it seemed out of the blue, from a good Mormon family, married, with three kids, all of a sudden (not really, as behind the scenes he started with other things and eventually worked his way to this) embezzles some money, thus ending his career as an accountant, his marriage, and lands himself in jail after months of various court appearances, etc.

I had those same thoughts, of, "Good. Now mebbe he'll realize something, having to live the consequences." I mean, I felt bad that he was hurting (although from his own actions, though), and in a scary place, and hoped that nobody hurt him there or anything . . . I was ANGRY, as he tried to involve ME in the embezzleing by sending "envelopes" to my address, and that was when the spit hit the fan, and everyone found out, and we were told to just mark it return to sender . . . so I had, and still have I guess, a lot of anger that he'd put me and my little family in legal and moral jeopardy . . .

Anyway. He got prescribed Wellbutrin, which he's still on, and he's alot more even, now. I don't know the diagnosis, but I'd guess that he's probably bipolar.

I still don't know how I feel about having a, well, jailbird brother, cause I've never sorted it out. He was in for 5 months, about 4-5 years ago.

Like you wanted to know that!

I kinda wanted to ask him about his experience w/shrinks in jail (before I ever met you guys) because I kinda wanted to know if they diagnosed him, so I'd know what to tell in the family history for the mental health professionals I started seeing last year.

He still had farther to go to hit rock bottom, though, after getting out of jail . . . a couple years of that, though, and then he started turning his life around. Seems to be on the straight and narrow. Like you want to know all THAT . .

Anyway, I guess I have all sorts of mixed up feelings about it.

Dinah said...

Perhaps you could lobby our governor to provide support goats to the distressed family members of mentally ill inmates?