Policy in action: Inmates' satisfaction with emergent telepsychiatric services in the Puerto Rican Correctional System

Emergent policies have been implemented in the Puerto Rican Correctional System in order to provide psychiatric services in correctional facilities far from the metropolitan areas. Telepsychiatry has been implemented to address inmates' mental health care needs, improve access to health care and maximize the efficacy of health care professionals. After one year of the implementation of new policies and procedures, more than 500 inmates in seven different locations have participated through 1619 ambulatory telepsychiatric interventions. A comprehensive quality and satisfaction plan was established to monitor this practice. The satisfaction plan included samples of inmates assessed through this service. Each inmate participates in a satisfaction survey after his/her first visit. 10% of inmates which participate in follow-up interventions voluntarily complete the same survey. Satisfaction indicators include professional's responsiveness to inmate's health care needs as well as time allocated and location for the intervention. Inmates' satisfaction with the service average more than 91% ranging from 98.5% to 78.8%, according to the correctional facility. Formative evaluation has been implemented to improve mental health policies and inmates' satisfaction. Changes in policies and practices have included appointments' coordination, telecommunication improvements, and staff training. Further enhancements are expected in response to inmates' health care needs, including the expansion of telemedicine services to cover psychology, nutrition, and health education.