Data-Driven Human Rights: Using Dual Loyalty Trainings to Promote the Care of Vulnerable Patients in Jail

• Published in: Health and human rights 2015-06, Vol.17 (1), p.124-135
• Main Authors: Glowa-Kollisch, Sarah, Graves, Jasmine, Dickey, Nathaniel, MacDonald, Ross, Rosner, Zachary, Waters, Anthony, Venters, Homer
• Format: Article
• Language: English
• Subjects: Bioethics; Condoms; Criminal punishment; Delivery of Health Care; Electronic Health Records; General Health and Human Rights Papers; Health; Health Personnel - education; Human Rights; Humans; Internet; Jails; Job training; Loyalty; Medical practice; Mental health; Mental health services; New York City; New York, New York; Patients; Physical trauma; Prisoners; Prisons; Prisons - manpower; Punishment; Records; Security; Security Measures; Surveys; Training; Vulnerability
• ISSN: 1079-0969; 2150-4113; 2150-4113; 1079-0969
• DOI: 10.2307/healhumarigh.17.1.124

Dual loyalty is an omnipresent feature of correctional health. As part of a human rights quality improvement committee, and utilizing the unique advantage of a fully integrated electronic health record system, we undertook an assessment of dual loyalty in the New York City jail system. The evaluation revealed significant concerns about the extent to which the mental health service is involved in assessments that are part of the punishment process of the security apparatus. As a result, dual loyalty training was developed and delivered to all types of health staff in the jail system via anonymous survey. Six clinical scenarios were presented in this training and staff members were asked to indicate whether they had encountered similar circumstances and how they would respond. Staff responses to the survey raised concerns about the frequency with which they are pressured or asked to put aside their primary goal of patient care for the interests of the security mission. The online training and follow-up small group sessions have revealed widespread support for more training on dual loyalty.