It is hard to know a patient whose complaints, history, and clinical presentation in prison might be quite different from whatever they were prior to incarceration. A case teleconferencing program has begun between NYU and Bedford Hills Correctional Facility (NYS Dept. of Corrections, with psychiatric services from NYS Office of Mental Health). A 40 year old woman with a history of schizoaffective disorder since age 18, complicated by polydrug abuse had multiple arrests and hospitalizations. Problematic issues were unremitting distressful hallucinations (commands to use drugs, family allowing suicide), full scale IQ measured at 77, and many treatment and discharge issues. NYU staff found she had been admitted to Bellevue six times and had a very positive relationship with one of the attending psychiatrists (who estimated her intelligence as at least average), under whose care she had her longest period of being free from drugs, was stable in residential treatment, and about to start her general equivalency diploma. While the psychiatrist validated the strength of the relationship, she and the discharge summaries illuminated the patient's preprison characterological problems and sociopathic behavior that probably will be reactivated on release. The role of telemedicine in this encounter was crucial in that the psychiatrist could see the patient before discharge, have a realistic discussion with her, and shoreup her motivation. Physical barriers had kept them apart for more than two years and probably would have continued to do so while the patient was released and most likely would have relapsed.
Learning Objectives: At the conclusion of the session, participants will be able to 1. Describe the differences usually encountered between preprison and prison presentations, 2. Discuss the importance of gathering past histories from all possible sources, 3. Describe how case teleconferencing differs from usual case conferences
Keywords: Prisoners Health Care, Telemedicine
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.