Psychiatrist will help jail prescribe drugs

The Spokane County Jail is turning to professional help to solve its problem with mental illness.

Starting today, the jail will have a psychiatrist review the medical histories and prescriptions of inmates in an effort to reduce the cost of providing psychotropic drugs to mentally ill inmates, Sheriff’s Capt. Dick Collins said.

“Quite frankly, the jail is not the place for the mentally ill,” Collins said. “We don’t have the programs nor the staff nor the ability to provide them the treatment that they really should receive. If they are not taking their meds and are not in programs … we become the dumping ground.”

Collins estimated that 40 percent of the 648 inmates suffer from either mental illness or conditions that require the jail provide them psychotropic drugs. In January alone, the overall pharmacy bill was $53,000. Of that, $43,000 was spent on psychotropic drugs, he said.

“This has to be one area, if we can get a better diagnosis, maybe we can start saving money,” Collins said.

So the jail will try a 90-day program with Dr. Lior Givon, a psychiatrist at Sacred Heart Medical Center, to conduct interviews with inmates via a two-way video link from jail to the hospital. Givon will review the inmate’s medical records and evaluate his or her medication and behavioral plans, sheriff’s spokesman Cpl. Dave Reagan said.

“Both Sacred Heart and the jail are exploring treatment programs that have positive and long-lasting effects for the inmates who require mental health assistance during incarceration,” Reagan said.

Currently, the jail is obligated to continue any medications that inmates are prescribed by physicians when they come to jail, Collins said. “But about 90 percent of the inmates on medication don’t have a psychiatrist’s diagnosis. This way we can get a clinically trained psychiatrist into the picture.”

Givon would then give recommendations for medications to the jail doctor and a registered nurse practitioner who can write prescriptions for inmates, Collins said.

For instance, some inmates may have five or six prescriptions to treat various ailments or conditions. The psychiatrist may decide that one or two drugs might provide better treatment, Collins said.

“At least it would reduce the amount of medications we are giving. We reap the benefit of that,” he said. “Hopefully, it will help the inmate as well.”

Last summer, Sheriff Mark Sterk said he wanted to build a pharmacy in the jail.

The county – which currently purchases its drugs at retail prices – was hoping that the pharmacy would allow it to purchase drugs at bulk prices. Last year, the jail spent $466,000 on psychotropic drugs out of a total pharmacy bill of $600,000, Collins said.

“We had to look at a different avenue to resolve that issue,” Collins said, referring the bulk purchasing. “We are still working on that one.”

Sterk also announced that the county was working with Washington State University on a grant request of $100,000 to $300,000 that would have been used to provide 30 days worth of medications to mentally ill patients after they are released, he said.

The initial grant request was denied, but the county continues to pursue a similar grant to provide medication to inmates until they can get enrolled in a local or state program, Collins said.

“Hopefully, we can stop the cycle of re-offending which caused them to be arrested in the first place,” Collins said.

The county is hoping that the reviews by Givon will reduce enough drugs for the program to pay for itself.

“That’s why we are doing a trial run for 90 days,” Collins said. “If it starts saving us some money then we will look at a long-term contract with the hospital.”