title: Data-Driven Human Rights: Using Dual Loyalty Trainings to Promote the Care of Vulnerable Patients in Jail.
abstract: 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.
authors.affiliation: Director of Policy and Evaluation in the Bureau of Correctional Health Services at the New York City Department of Health and Mental Hygiene.
authors.forename: Sarah
authors.initials: S
authors.lastname: Glowa-Kollisch
authors.affiliation: Special Assistant to the Commissioner of Health at the New York City Department of Health and Mental Hygiene.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Graves
authors.affiliation: Special Assistant to the Assistant Commissioner of Correctional Health Services, Bureau of Correctional Health Services, New York City Department of Health and Mental Hygiene.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Dickey
authors.affiliation: Medical Director of the Bureau of Correctional Health Services at the New York City Department of Health and Mental Hygiene.
authors.forename: Ross
authors.initials: R
authors.lastname: MacDonald
authors.affiliation: Deputy Medical Director of the Bureau of Correctional Health Services at the New York City Department of Health and Mental Hygiene.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Rosner
authors.affiliation: Director of Mental Health of the Bureau of Correctional Health Services at the New York City Department of Health and Mental Hygiene.
authors.forename: Anthony
authors.initials: A
authors.lastname: Waters
authors.affiliation: Assistant Commissioner of the Bureau of Correctional Health Services at the New York City Department of Health and Mental Hygiene.
authors.forename: Homer
authors.initials: H
authors.lastname: Venters
mesh_terms: D003695:Delivery of Health Care; D057286:Electronic Health Records; D006282:Health Personnel / Q000193:education*; D006806:Human Rights; D006801:Humans; D009519:New York City; D011329:Prisoners; D011330:Prisons; D012637:Security Measures; D000078329:Workforce