Essay on reducing the cost of dementia in prison

An unintended result of recent criminal justice sentencing policies has been a significant increase in the number of prison inmates suffering from dementia. Due to increased average age and the common presence of other dementia risk factors in the inmate population, this issue is expected to only grow over time. Dealing with this prison health concern is important, especially given the greatly inflated cost of housing and treating inmates with this disease. Coupled with the shrinking prison budgets due to governmental deficits, this is a problem that needs immediate attention. Essentially, there are two methods of dealing with any health care issue within the prison population – reduce the cost of treating those already in the system and reduce the demand for the health care by reducing the number of prisoners with the disease.
One means of reducing the cost of treating dementia is to leverage the precise problem that is trying to be addressed – the large number of inmates suffering from this disease. With high volume of health care needs, discounts can be negotiated. Among the areas where volume discounts or some other healthcare consortium could be organized would be in pharmaceuticals or in high-level medical services required for dementia patients. For more day-to-day type services, hiring dedicated in-house staff with a focus on obtaining the least expensive, but still effective, staffing for the services being provided could be a cost-savings approach. However, the in-house solution should always be compared to what could be obtained in the outsourcing market, particularly if an out-sourcing situation shifts human resource issues away from the prison system as staffing issues is an anticipated problem with the care of criminals that are mentally ill. In general, if the prison population requiring this type of care could be housed together, there would likely be cost savings by reducing the number of specialized approaches needed, although the $90, 000 per bed per year cost of the already existent dedicated New York facility mentioned in the article is staggering.
Another possible consideration would be the formation of some sort of volunteer or training program for doctors and nurses within the prison system for those interested in donating or perhaps gaining experience in the treatment of dementia patients. By allowing persons at the internship level the chance to learn treatment techniques with the patient population, it may be possible to provide the needed care at greatly reduced cost. One possible method of payment that would be highly practical would be medical or nursing school loan forgiveness. This program would also have the added benefit of increasing the number of health care professionals with practical experience in this area. As the population ages, this kind of expertise will be more and more in demand, thus by utilizing the prisons as a place where experience can be gained, it may be possible to get the labor needed to provide high quality care, but at a greatly reduced cost.
The second approach to reduce the cost of any health care need is to reduce the demand for it within the prison population. This can be accomplished through reduction of the prison population suffering from dementia. Some possible programs would include compassionate release programs for those near the end of life, re-evaluation of prisoners suffering from dementia as to their actual threat to society and allow release of low risk persons, or outside programs that help those not yet incarcerated but already suffering from mental illness to be better parolees and thus decrease the chance that they will end up becoming bringing their mental illness issues into the prison system. A final consideration, as mentioned in the article, would be a repealing of the mandatory sentencing policies that have caused the dementia issue in the first place.
Another possible route for cost reduction due to reduced demand is a greater focus on preventative care within the imprisoned population. The article states that high rates of depression, diabetes, hypertension, and head trauma all contribute to the ultimate development of dementia. Most of these conditions are treatable and can be managed over time. If greater attention is placed on the younger inmates to get proper treatment and control of the contributory factors during their incarceration, it is less likely that they will develop dementia in the future, perhaps slowing the rate of growth of prison populations suffering from dementia.
Thus, there are two main ways to reduce the cost of dementia to the prison system – reduce the cost of those already receiving the treatment or reduce the number of prisoners within the system with dementia. This essay provides a number of possible approaches to accomplish these goals. As attractive as it would be to provide one over-arching solution to this problem and merely argue for its adoption, a single solution to this issue is overly simplistic. Instead, it is anticipated that a complex problem like this should be addressed all feasible ways so attacking this problem from all possible sides is the urged approach. In this way, it is much more likely that some impact on the issue of dementia behind bars would be seen with these efforts.