xxAACP Newsletter, Volume 13, Number 2, Spring 1999

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Participants in the Workshop then emphasized how practitioners in correctional facilities feel left out of organized psychiatry. There seems to be very little available in the way of educational opportunities or communication with other practitioners.

The special pressures and problems related to correctional work were then discussed. The psychiatrist is sometimes seen adversarially, as a member of the correctional staff, and this creates problems with trust. There should be a clear delineation of the role of the psychiatrist in a correctional setting. It is important to distinguishing and keeping separate the forensic role and the clinical role. Too often the roles are blurred.

Stress is a constant problem. Should the practitioner be full-time or not? If full-time, there is a danger of burn out. There is a need to advocate for research in this area, which is lacking. This population may be particularly suited for well structured studies in violence, brain damage, etc. Many correctional psychiatrists have found that inmates want to participate in such studies - it helps them feel better about themselves - that they are contributing. The issues of dual-diagnosis and mentally ill chemical abusers is of great importance in correctional psychiatry. Another member of the audience spoke of the failure of our country's drug policy that has resulted in often severe overcrowding. He believes that a caucus could speak on these issues in a way that a committee could not.

The participants agreed that the creation of a membership component within the APA would help the APA help practitioners with specific concerns such as the development of appropriate treatment strategies, the development of targeted training opportunities, etc. In addition, such a group could help the APA assure effective roles for psychiatrists in correctional settings.

At the conclusion of the workshop, the attendees voted unanimously to create a Caucus of Psychiatrists Practicing in Criminal Justice Settings. The Caucus has officers, and dues, publishes a Newsletter, and has adopted By Laws. It has met regularly at the Annual Meeting of the APA. It has adopted a mission statement which states:

We, the members of the Caucus of Psychiatrists Practicing Criminal Justice Settings, recognize with concern the growing numbers of severely mentally ill individuals detained in correctional and other secure settings. Our goal is to improve the identification and treatment of these individuals in order to fortify their ability to adapt and benefit from available resources. We believe these resources must include the ability to provide psychotropic medication in a manner consistent with a community standard of care, in an environment designed to respect human dignity and to provide for basic needs. We endorse efforts to provide a broad range of rehabilitation services, and encourage the participation of mentally ill offenders in these services. The Caucus of Psychiatrists Practicing in Criminal Justice Settings agrees to support and encourage participation in activities designed to decrease the stigma of mentally ill offenders. We encourage our members to provide mental health education to security staff and correctional health care professionals.

We call upon our colleagues to take leadership roles in the formation of correctional mental health policy, and to act as patient advocates on both an institutional and national level. We win conduct clinical research in accordance with current ethical standards in order to advance the state of our knowledge regarding the care of mentally ill inmates. We will disseminate this information to our colleagues, our patients and their families. Finally, the Caucus recognizes the potential for ethical conflicts inherent to practice in correctional settings. We hold duty to our patients foremost and provide care in accordance with established professional ethics.