NJ- Prison teleconferencing system cuts costs of inmate evaluations

2-3-2009 New Jersey:

The pilot "telepsychiatry" program provides mental health screenings on a television conference system with a doctor available at any hour.

NEWARK, N.J. Police across Middlesex County saw the pattern. Suspects being taken to the county jail suddenly said they were suicidal, triggering a required trip to a hospital where two officers had to stay with the inmate until he was examined.

"Word got out on the street that if they just threatened bodily harm to themselves, they would get a stay in a hospital and good meals, when they had no intention of committing suicide," said Sayreville Police Chief Edward Szkodny.

That ended last November when a pilot "telepsychiatry" program began at the jail, providing mental health screenings on a television conference system with a doctor available at any hour, ending time-consuming trips to hospitals and saving thousands of dollars in overtime costs, according to police and county officials.

Doctors are available weekdays at the jail in North Brunswick, formally called the Middlesex County Adult Corrections Center, but no psychiatrists were available evenings and weekends.

"If you're bringing in an inmate on a Friday night and have to go to a hospital, he may not get a full evaluation until Monday," South Brunswick Police Chief Raymond Hayducka said.

Two officers working overtime were assigned to each inmate in a hospital, said Hayducka, the president of the Middlesex County Chiefs of Police Association.

"We were tying up officers for two or three days at a time. It could run up a couple of thousands of dollars in costs for a weekend. It was a source of frustration for all the chiefs," Hayducka said.

Jail warden Edmond Cicchi and county police chiefs began discussions more than six months ago on a plan using doctors from CFG Health Systems, a Marlton company that provides medical services for jails as well as other correctional facilities and programs across the state.

The Public Defender's Office, which represents most of the inmates, has been cooperating with the jail in the pilot project and waiting to see the results.

"We're reserving full judgment until we see the data," said Thomas Rosenthal, spokesman for the Public Defender's Office. "It appears to be an innovative approach to accelerate an initial screening."

Nearly all 25 municipal police departments in the county and the Rutgers University Police Department are participating in the pilot program at the jail, sharing the $20,000 annual cost.

Psychiatrists have performed evaluations via television since the early 1990s, and CFG has used similar programs for 10 years and now completes 3,500 such consultations annually, company officials said.

However, this is the first use of the system for people being admitted to a jail.

"That sounds like a great use of the technology," said John Wetzel, warden of the Franklin County Jail in Chambersberg, Pa., where telepsychiatric consultations have been used for more than four years.

Wetzel, immediate past president of the Pennsylvania County Corrections Association, said jails across that state use similar systems, though not for inmates being admitted.

"Psychiatrists are at such a premium, it's difficult to get them to a facility and it's expensive," Wetzel said. "The key is to get the police back on the street quickly. It's much easier to bring a prisoner to the jail than to bring him to a hospital," he said.

Middlesex County Deputy Freeholder Director Christopher Rafano and Freeholder Mildred Scott said the program reduces the time officers spend with the prisoners and saves the tax dollars spent on overtime.

Scott, chair of the county Law and Public Safety Committee, and a retired 28-year veteran of the county sheriff's department, recalled "being tied for hours and full days with inmates at hospitals. It's also a safety issue that you're stuck in a hospital for hours."

CFG officials said they are providing inmates with quick access to a psychiatric screening.

"I would much rather have a person evaluated in 30 minutes than wait for hours," Brian Levin, CFG director of telemedicine, said.

Both Wetzel and CFG noted studies have shown benefits of telepsychiatric consultations.

Jerry Lee Lewis, a psychiatrist with of the University of Iowa Health Center in Iowa City, said that agency had provided psychiatric consultations in prisons for several years.

"It's probably just as effective as doing it in person, especially if there is a social worker at the jail to follow through with the patient," Lewis said.

While small details might be missed through teleconferences, doctors have found this has little or no impact on their evaluations, Lewis said.

Hayducka said the new jail program is "not denying services to anybody."

Any inmate who is evaluated and found in need of medical services would be taken to a hospital, but Levin said that since the program began Nov. 7, CFG doctors have evaluated about one inmate per week. ..News Source.. by TOM HAYDON, The Star-Ledger