PsychoStud.com

Read March 2008

April 3, 2008

Well, it was a very slow week. We finally returned to some resemblance of normal. We have changed the way inmates are allowed to move, trying to minimize their lingering time and access to other inmates. With such a slow week, I must admit that I occasionally longed for lock-down days. Anyway, I was able to read some articles and check out a lot of potential on-line, peer-reviewed journals to potentially submit articles. The federal government is not big on employees searching the internet for personal reasons. Still, I figure what I was doing was not simply personal reasons. After all psychologists are obligated to stay up on current research in the field. Also, any publications by BOP psychologists serves only to boost the bragging rights of the Bureau. So I see any future publications as serving the Bureau as well.

April 7, 2008

Today was more of a typical day for me. I spent my entire morning in SHU seeing almost every inmate. I got more of the usual, inmates asking to be pulled from their cells, asking for medication, wanting to see a female psychologist, etc. Apparently, several inmates liked the color of my shirt as I got several “compliments.” “That’s a pretty shirt you got on Dr. Smith. Your a pretty boy. I’d like to kiss you right on the mouth. I’d like to get you in 4-point restraints right up against this fence.” Today, I think I got more propositions than the female psychologist I was with.

My afternoon was spent like so many before. This Saturday morning an inmate was placed on suicide watch after making superficial cuts to his neck and hand. While, the inmate has history of feigning mental illness and being suicidal for secondary gain, he remained on watch over the weekend primarily because he refused to speak to any of the psychology staff, preventing a mental health assessment from being conducted. With the help of medical personnel, I was able to get the inmate to speak enough to conduct an assessment. True to form, the inmate was seeking a transfer and a single cell. He was removed from suicide watch. Of course, just because someone is seeking secondary gain does not mean they will not harm themselves. This is an area psychologists in correctional settings have to be weary of. Inmates have been known to go to extraordinary lengths to get something as simple as a phone call or someone to listen to them complain. In fact, removing someone from suicide watch says very little about what they might do to harm themselves. Rather, it is more an indication that the available information suggests that the inmate is not suicidal, that is, not wanting to die. Frequently, inmates will go on to make some suicidal gesture after being removed from watch. In these cases, the inmate’s behavior is seen as a correctional issue rather than a psychological issue and “sound correctional techniques” are recommended, although Psychology Services continues to participate in making management recommendations.
April 8, 2008

Today I went on-call for a week. Working at a USP typically makes this an unpleasant responsibility. Working at a complex with 4 institutions doesn’t help matters as I am responsible for all four facilities after work hours and on the weekend.

My workday was nothing really out of the ordinary. I am one of two staff psychologists routinely responsible for the USP. This just happens to be the last week at this institution for the other psychologist who is transferring to another BOP institution. I’m expecting a serious bump in work load. Anyway, this evening I was called from the USP just as I was unlocking my front door. An inmate in SHU was stating he was going to start cutting on himself if Psychology did not show up. This particular inmate has a history of threatening to kill himself or engaging in superficial self-harm for secondary gain. In fact, he does this several times a month. He particularly likes to speak to female psychologists and being placed on suicide watch were he has a history of “pleasuring” himself sexually when female staff are present. Tonight I suspect he was attempting to ascertain who the on-call psychologist is so he can plan out his week. He was informed that I was the on-call psychologist. Nothing else was heard out of him for the remainder of the night.

April 9, 2008

Well, I got a “last-minute Psychology play,” as I call it. This is when an inmate who has a history of requesting to speak to psychology for questionable reasons waits until just before close of business to request to speak to a psychologist. They do this for various reasons. They may do because 1) they expect that because you want to go home you will more easily give them what they want, 2) if you do not respond to them, they can blame their acting out on the psychologist for not responding to their request for “services,” 3) to find out who is the on-call psychologist, and 4) to just piss us off. This 3:50pm request (we get off at 4:00pm) required me to call a “last-minute Psychology audible.” Knowing this inmate very well and suspecting explanation number 2 to be the cause of this request, I chose to actually go see the inmate to prevent being called in later in the night. Normally, the inmate would have been notified that he would be seen the following day. Upon meeting with the inmate he demanded that I have him removed from his cell because he was thinking about killing himself. Here is where knowing what you are doing as a psychologist comes in very handy. The inmate refused to discuss his issues at his cell door, citing confidentiality as the reason. He didn’t want other inmate’s to overhear. I can’t blame him for that and as a psychologist I take confidentiality very serious. Still, knowing this inmate as well as I do, I was not going to pull him out for anything other than a legitimate emergency. He has refused to go back in his cell in the past. I was able to conduct an assessment on the inmate without him realizing it and determined that he was not actually suicidal. (I was recently asked by an inmate how psychologists can tell if an inmate is truly suicidal. This is something I can’t actually ever see myself discussing with an inmate and I responded that it was a “trade secret.” He seemed to appreciate this response.) I won’t go into detail here as to how I was able to make this determination, though. I know this may raise some eyebrows or disappoint those who may hope to gain some secret insight, but the truth is, threats of suicide should always be treated seriously and it takes many years of training and/or experience with the subject to even hope to have a clue about what you are doing when you try to determine if someone is actually suicidal. And even if you are 100% sure that the other person is not suicidal, that does not mean the person agrees with you. It’s only when you have sufficient training and experience, and use that knowledge in a manner consistent with other practitioners, to make such a determination, that you can even hope to be protected by the law. Back to my story, the inmate was not pulled, although he was offered the opportunity to be put on a wait list to be seen one-on-one. He was not pleased with this offer and continued to demand he be pulled as I walked off the range.

As a side note, most inmates hate it when they are told they will be placed on a wait list for a one-on-one session. They are not known for their patience and many are almost pure creatures of impulsiveness. They are concerned with the here and now. However, even for those with legitimate problems (I’m not referring to mental illness here, but rather transient issues such as stressors), research shows that many individuals placed on waiting lists will have their issues resolved or no longer experience distress by the time they are seen. It speaks to the adaptability of human beings.

April 10, 2008

Tonight I got called into the USP because an inmate was bored and stated he felt like stabbing someone, breaking something, or hanging himself. There are two things the BOP takes very seriously, threatening one’s own life and breaking government property. When I got to the institution, the inmate acknowledged he was bored and stated he felt like hanging himself because he wanted attention. Basically, he just wanted to talk.

April 11, 2008

Today is the last day for the other psychologist at the USP. We had a cake and people got to come say their goodbyes. The Warden and all the Associate Wardens made an appearance, people made short speeches, and the other psychologist, a female, was given a trip to the SHU to interview a returning inmate (from another institution) with a tendency toward inappropriate behavior toward female staff members as a farewell gift. Later this evening, I was called back to the institution to see an inmate who had superficially cut his wrist. By the time I arrived, the cell mate of the inmate I was called on had been placed in restraints due to cutting on himself. Even after being placed in soft (i.e., padded) restraints, the inmate continued to cut on himself, despite being search for any foreign objects. The inmate was placed in hard (non-padded) restraints. However, he continued to cut on himself. Medical staff confirmed that the superficial lacerations were consistent with a razor blade. I have personally seen inmates hide razor blades (from disposable shaving razors) in what appears to be the back of their throats. I was once talking to an inmate who, to prove that he could kill himself, began to behave as if he were trying to regurgitate something, only to produce one of these razor blades, show it to me, and appear to swallow it again. Inmates have also been known to hide objects under their skin and to create permanent “pouches” in their skin with which they can hide contraband.

April 12, 2008

I was called to the USP this morning due to the inmate from the previous night continuing to cut on himself. The Captain and Warden were considering placing the inmate in 4-point restraints. This is were the inmate’s hands and feet are independently secured to a bed for the purpose of keeping the inmate from harming himself or others. This can only be done after the inmate has been placed in soft-, then hard-restraints, and continues to exhibit destructive behavior. As a CYA-thing, the Warden wanted me to assess the inmate and make a recommendation for how to manage the inmate. BY the time I arrived at the institution, the inmate had been placed in a visual holding cell. As he was no longer cutting on himself, I could not recommend immediately placing the inmate in 4-points. As a matter of policy, the least-restrictive measure of restraint must be used to mange inmates. However, I did recommend that if the inmate began to harm himself again, he should be placed in 4-points. Keep in mind, this inmate is not suicidal. Rather he is a strong Antisocial Personality with a life sentence and plenty of time to play games.

April 14, 2008

One more night on-call. Things were pretty quite yesterday. I did learn upon coming to work that the inmate I recommended for 4-point restraints did eventually go into the 4-points. According to the lieutenant, when the inmate realized he actually was going to be placed in 4-point restraints, he stated, “Alright, game over. Let me go back to my cell.” He was taken out of the restraints and returned to his cell several hours later.

April 18, 2008

It was a fairly ordinary week. Nothing much out of the norm to report. We did get news this week that next week we will be receiving a visit from the Office of the Inspector General (OIG). If you are unfamiliar with this organization, they are like the Internal Affairs of the Department of Justice. While we don’t know exactly why they are coming, we have been told that they will be “interviewing” (as opposed to interrogating) psychology staff and specifically interested in our sexual assault behavior prevention and intervention program. We’ll see what happens.

April 25, 2008

So nothing happened with the OIG, as far as I know. I never was interviewed. Anyway, highlights from this week: Wednesday one of our more infamous inmates, who is housed in SHU and allegedly participated in the recent sexual assault and killing of another inmate (**he is presumed innocent until proven guilty**), began apparently to try to tear down the recreational fence in an attempt to get to another inmate on the SHU recreational yard. (Certain inmates are required to be rec’ed alone and the SHU recreation yard is divided into little sections by cages.) After a use of force team was utilized to gain control of the situation, the inmate was placed in a holding cage (where there is barely room for inmates to sit) where I spoke to him. He was adamant that his actions were simply because he had not received his property. In other words, this inmate was willing to break through a fence and assault or possibly kill another inmate simply because he did not get his books, pictures, letters, etc. when he thought he should get them. The inmate was placed in soft-ambulatory restraints and placed in an observation cell. Later in the day, I was called back to SHU to perform “confrontation avoidance” with the inmate. When a Use of Force team is going to be used to gain control of an inmate it is standard operating procedure to have someone, usually a psychologist, attempt to talk the inmate into complying with the orders of staff before the team goes in on him. This is an effort to insure the safety of both the inmate and the staff. The inmate had successfully come out of his restraints, and I mean completely out of both hand and leg restraints, had smeared feces on the walls, windows, and floor and was swinging the chain on the leg restraints around as a weapon to use against staff when they attempted to come in on him. While we were getting everything set up to go in on him, he busted the window out of the cell door using the restraints. This presented another challenge as I now had to have one of the team members use a Plexiglas shield to cover the window area while I talked to the inmate. Fortunately, I was able to get the inmate to throw the restraints out the window and submit to new restraints without any problems. He was then placed in the adjacent observation cell in 4-point restraints where he attempted to spit and bite a staff member. (As an aside, he has now apologized to several staff members for his behavior.)

Thursday morning, another SHU inmate required an immediate use of force and was placed in restraints. I wasn’t involved in this incident, however, whenever someone is placed in restraints a psychologist must evaluate the inmate every 24 hours to assess for psychological deterioration. On Friday we had a meeting with the Associate Warden, medical administrator, unit manager, and lieutenant to determine whether the inmate would remain in restraints. It was decided that he would. This inmate had also smeared feces on the walls, windows, and floor of the observation cell, as well as threatened to assault staff if the restraints were removed.

During the last few weeks, the Correctional Worker’s Week Committee has been sponsoring fund raisers for the upcoming Correctional Worker’s Week. Thursday I spent the afternoon washing cars and getting sunburned.