EXCLUSIVE: Doctor shortage, sickout by psychiatric staff hit state's largest jail

KALIHI (HawaiiNewsNow) - Mental health staffers staged a "sickout" at the state's largest jail Thursday to raise the alarm about their struggle to care for psychiatric patients at Oahu Community Correctional Center.

Prisons officials said the safety of inmates is not at risk. But critics who asked to remain anonymous also said the facility's medical unit is severely understaffed.

Thursday's sickout comes just days after the jail was released from federal oversight of its mental unit.

OCCC in Kalihi has 1,247 inmates, many more than its official capacity of 954. On Thursday, four key mental health staffers called in sick, concerned about a lack of staffing and resources. They're also worried about a lack of qualified, licensed employees in the mental health department that has about a half dozen vacancies, sources said.

A psychologist, nursing supervisor and two psychiatric social workers who staged the sickout are the most experienced at overseeing prisoners on suicide watch, sources said.

Prisons officials claimed all OCCC modules were "adequately covered" by another psychologist and psychiatric social worker and two psychiatric residents, doctors in training who just started at the prison in the last few days.

"We've had long standing problems in terms of providing medical and mental health care for inmates going back at least to my involvement which was in the late 70s and the first class-action which was initiated in 1980," said lawyer Eric Seitz, who has repeatedly sued the prisons for decades, forcing more money to be spent on care.  He said he has two lawsuits pending about the state failing to provide prescription pain medications to inmates.

"The primary problem has been the inability and unwillingness of the state to allocate sufficient funds," Seitz said.

State officials said there were seven inmates on suicide watch at OCCC Thursday,  "... any licensed medical staff can assess and admit an inmate into suicide watch at any time.  That includes nurses, nurse practitioners, psych social workers, etc.  So safety of the inmate is not an issue."

OCCC is also suffering from a severe doctor shortage in its medical unit, with just one of three full-time physician's positions filled.  So the state is looking to hire a temporary M.D.

"Adequate care is being provided to the inmates and pre-trial detainees at OCCC.  Doctors on call will handle the complex cases.  Nurse practitioners and Advance Practice Nurses oversee the routine matters," the prisons department said in a statement.

A prisons spokeswoman admitted many of the situations are far from ideal at OCCC, but she said it's very difficult to fill vacant medical positions behind bars because of low pay and few people want to work in a prison environment.

Mental health treatment services at OCCC have been under oversight of the U.S. Department of Justice since Dec. 28, 2008.  That oversight ended with a joint dismissal filing on June 25, a Department of Public Safety spokeswoman said.

"OCCC remains committed to all the treatment and services standards set during the seven and a half year oversight period under strict internal self-auditing and quality review programs," prisons officials said in a statement.

"The obligation on the part of the prisons is to provide the same quality of care to people who are prisoners as people on the outside get.  The standards are the same.  And unfortunately, they've never lived up to those standards," said Seitz, who filed a class-action lawsuit against OCCC and the women's prison in Kailua in 1980 over substandard medical and mental health treatment of prisoners.  The case settled in 1984, and the state was forced to spend more money on inmate care, Seitz said.

Seitz warned the situation could repeat itself.

"Unless the Legislature and the (Ige) administration deals with it very soon, what's likely to happen is there will be another class action, and essentially, a monitor will be appointed to take over and run the health systems in the prisons and that way, basically, the state won't have any say, they'll just have to pay for it," Seitz said.

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