Prison-University Collaboration

I am writing to applaud the efforts of Dr. Peter Silberfarb and his colleagues at Dartmouth Hitchcock Medical Center in implementing a program to provide psychiatric treatment to prisoners in New Hampshire (Psychiatric News, August 17).

My experience of working in our local jail mirrors that of others who have noted much undiagnosed mental illness. Being in a relatively isolated area, however, has allowed me the opportunity to see former prison patients in the psychiatric ward and former hospital patients in the prison. The similarities in their clinical presentation in either setting is often striking and suggests that it is sometimes just the luck of the draw whether police take a mentally ill person to jail or to the hospital.

There are differences, of course, but over the years, the differences have become less marked than the similarities. I have seen inmates who, when treated correctly, have yet to re-offend. My experience agrees with a statement in the article that inmates are often extremely appreciative of receiving good care.

Regarding security and violence, the jail is a far safer place to work than the hospital as the staff are more easily accessible in an emergency and are not so intimidated by the patients as are nursing staff in a hospital. An added plus is that no one pressures you to discharge a patient in prison prematurely. Patients don’t complain to you or negotiate about getting out of prison.

I am very encouraged to see the development between Dartmouth and the state of New Hampshire and hope that the initiative spreads as there are many people in the correctional system who can benefit from psychiatric treatment.