Monday, December 03, 2007

What Good Are Psychologists?

So this morning I'm scheduled to see eleven people and an officer catches me at the door, before I even have my coat off, to tell me that one of my patients is down and waiting to see me. I get to the clinic and see two of our institutional psychologists sitting in an office, chatting. I don't think too much of this---it's the usual morning start, they've made the morning coffee---until I happen to see the morning clinic schedule for the psychologists.

Four fulltime psychologists are scheduled to see a total of six patients today.

The thought flitted through my head: "What good are these people?"

The unvarnished truth is that a single correctional psychiatrist will see as many patients in a given year as three fulltime psychologists. This is pretty consistent from what I've learned from talking to correctional psychiatrists in other states. And this makes sense---the vast majority of referrals are medication issues and they can't do anything about that so the referrals get routed directly to me. I also get the diagnostic dilemmas, the unexplained mental status changes that you need medical training to sort out. (Heaven help me if I see another inmate in alcohol withdrawal diagnosed with schizophrenia.) Psychiatrists see more people because they are trained to do things that psychologists can't do, and psychiatric issues come up much more frequently than psychological issues.

That being said, the psychologists I work with are wonderful. They have great senses of humor, they help me keep up my morale and they don't hesitate to step up to the plate to help with what they can help with. They handle the emergency referrals that come up during my clinic. When the secretary is off or out sick (I don't have a clerk of my own, I have to borrow help from the psychology department secretary), the psychologists help traige referrals, set up my clinic schedule and pull charts.

They have their own specific professional duties, of course. They give input into classification decisions (where an inmate is assigned to do his time, what security level he needs) as well as input into program eligibility. When requested they'll do parole assessments and respond to staff needs in case of crisis (suicide response debriefing, mass disturbance debriefing, etc). They provide crisis intervention counselling, substance abuse groups, sex offender therapy and set up behavior plans for inmates who require them.

So this is what psychologists are good for in prison, in case you were curious.