On one end sits a prisoner facing a screen, the sound of a freeway hundreds of miles away faint through the computer speakers. On the other end, next to that freeway, sits a doctor in a nondescript office building near Houston. Telemedicine brings the two together, allowing Dr. Li-Yun Chuo, a psychiatrist for University of Texas Medical Branch, to see patients in prisons across Texas.
While the nation struggles with an overall shortage of mental health providers, so do prisons, where the demand for mental healthcare is stunningly great: Of the 2.2 million people currently in prison or jail in the U.S., 26% of those in jail and 14% of those in prison met the Bureau of Justice Statistics' "threshold for serious psychological distress," compared to just 5% in the general population.
"There's a huge need inside for mental health support," said Brad Brockmann, executive director of the Center for Prisoner Health and Human Rights. "One of the big issues is the stigma of mental illness. It's particularly true in hypermasculine environments, like a prison setting."
So, just as rural populations are turning to telemedicine, so too are state correctional systems. They're using the technology not only for the physical health of the incarcerated but for mental health as well. Video-connected care may not solve the U.S.' mental healthcare provider shortage, but it may ease the problem, especially in prisons, where barriers to care stem from the physical constraints of the facilities themselves.
"Without telemedicine, we'd really be hurting," said Dr. Joseph Penn, director of mental health services for UTMB Correctional Managed Care.