Continuity of What Health Care?

I read a remarkably disturbing statistic this week, which claimed that "incarcerated people have up to 12 times the risk of death within the first two weeks after release, and up to four times within the first year" (Dr. Ashwin Vasan, quoted in MI-Cure, 02/2020). This startling statistic probably reflects both a staggering failure of the MDOC to effectively address opioid addiction through prison treatment (resulting in heroin overdoses soon after release from prison), and, as the source of this quote notes, a lack of continuity of health care for released prisoners. 

To be fair, opioid addiction is very complex, and addiction specialists in prison do try to help addicts change their thinking and behavior. But, the pull of addiction is intensely strong, and the programs in prison that seek to address this problem are not always very effective. Mental health issues also contribute to addiction relapse, and continuity of health care directly affects how released prisoners with mental illness are treated. 

Michigan House Bill 4700 (which passed the House in December) seeks to address the continuity of care issues for discharged prisoners with mental health challenges. This bill would be a step in the right direction of ensuring that these released prisoners are released into a managed health care situation that would reduce their risk both of relapsing into drug addiction and of committing additional crimes. The bill is still waiting Senate approval and signing by the governor. 

I support legislation like this one that tackles these complex issues. However, I have seen little adequacy in the MDOC's own health care services, so I am skeptical of any claims of continuity of care. If this bill expects to give a released prisoner the same level of health care he/she receives in prison, that is not saying much. As yet another example of inadequate care, I have recently been suffering with a chronic cough as the result of a bad cold over a month ago. After kiting health care services to see a nurse, I waited a week to be put on call out, only to be told I'd have to be rescheduled (which could take more days). 

Undoubtedly, this cold/flu season has been pretty bad, even in prison, so health services is likely overwhelmed with requests for service. But in the hour and a half I sat in the waiting room, only to be told I'd be rescheduled, health services saw fewer than half a dozen prisoners. Instead, some nurses were out on lunch break while others stood around chatting. Because correctional health services are not federally funded, they are not required to meet certain clinical standards (MI-Cure, 02/2020). This is abundantly clear in how they conduct their services. 

I want to be fair to the hard working nurses and other health care providers who do their best to provide quality services, but I also want to note that these are exceptions to the rule in prison. Health care services for incarcerated people are often limited by incentivizing money-saving policies, bureaucratic idiocy, and a general unconcern for prisoner health issues. 

I'm grateful for legislators attempting to resolve the gap in health care for people released from prison, especially for those with mental health needs. This is greatly needed. But so much more work is needed, including drastically improving the apathetic attitudes and lack of adequate care currently offered in prison.