The people who work there are for the most part good people trying to do the best they can,” said Dr. Wil Berry, a psychiatrist who completed a six-month rotation at the Multnomah County Detention Center (MCDC). “However, the product of the system as a whole is that we’re torturing very sick people. I hate myself for being part of it.”

In March 2017, a report published by Disability Rights Oregon (DRO) estimated that 400 to 800 of the 1,000 prisoners held in Multnomah County, Oregon, jails have some form of psychiatric disorder. Sarah Radcliffe, a DRO attorney who authored the report, concluded that jail medical and mental health care is “woefully inadequate.” She faulted staff with limited training and an over-reliance on “correctional tools” to deal with mentally ill prisoners – especially the “rampant use of solitary confinement, punitive use of restraints and suicide watch, and routinized force.”

As a federally funded agency under the Protection and Advocacy system, the DRO had access to jail incident reports, prisoner medical records, and interviews with jail employees and prisoners. The investigation revealed alarming abuse of mentally ill detainees at MCDC, with several egregious examples highlighted in the report.

One case involved a 55-year-old schizophrenic prisoner who was tasered twice by a guard who was escorting him to the shower. When the prisoner fell to the floor, the guard straddled him and repeatedly punched him in the face with closed fists.

The prisoner’s facial injuries were so horrific that jail staff wrapped a blanket around his bloodied head “to reduce the impact at the hospital on civilians,” according to an incident report. The prisoner sustained eight facial fractures, including some that had shattered into multiple fragments – trauma normally associated with high-speed car crashes. The guard was later commended for what the Multnomah County Sheriff’s Office determined was an appropriate use of force.

In another example featured in the report, a guard tasered a mentally ill prisoner in the back, causing him to fall and hit his head. He lost consciousness and sustained a head wound that bled profusely. When the prisoner regained consciousness, he was combative. Guards responded by strapping him into a restraint chair and putting a spit mask over his face.

A jail counselor who witnessed the incident said the guard, identified only as KQ, had tasered the prisoner “seemingly without provocation.” KQ claimed, however, that the prisoner clenched his fists and exhibited an aggressive facial expression. But KQ and the prisoner had had a previous altercation, too.

“I can’t believe you guys put me back in there with that guy,” the prisoner told investigators. “He is out of control and needs counseling.”

A jail supervisor agreed, concluding that KQ “appears to draw a sort of perverse satisfaction from his ability to escalate even the most basic and benign of inmate interactions into a crisis situation.”

An internal investigation ultimately concluded that “it appears the force used in this incident was not justified.” The case was referred for prosecution, but the district attorney’s office declined to indict the guard.

Radcliffe was so alarmed by both cases that she met with Multnomah County Sheriff Mike Reese. To his credit, Reese agreed to launch an internal review of jail policies. He also promised that KQ and the guard who had fractured the other prisoner’s face would be moved to positions where they have no contact with detainees.

The Sheriff’s Office did not dispute any of the report’s findings. Yet Reese stopped short of promising to reform his department, saying instead that the entire county must work together to “prevent the criminalization of mental illness.”

“We know we have additional challenges we want to overcome,” he stated.

At a November 2017 meeting of the County Board of Commissioners, Reese reported that 466 corrections employees had received training since the DRO report was released, using “a new curriculum based on a crisis-intervention model.” Over the summer of 2017, he said additional training in “mental health first aid” had been provided to 450 staff members.

Speaking at the same meeting, Sheriff’s Office Facility Services Manager Katie Burgard noted that in May 2017 the county had added a “focused mental health sergeant” to its staff, also assigning a deputy to manage mental healthcare inside MCDC. Two new consultants will be hired to provide assistance during intake and disciplinary actions.

Corrections Health Director Dr. Michael Seale reported hiring a full-time psychiatrist and renewing a fellowship program with Oregon Health Sciences University that provides an additional weekly psychiatrist visit at the jail.

“We’re not afraid to take a look at ourselves,” Sheriff Reese told commissioners – who were upset by the DRO report.

“It was really shocking to read,” admitted Commissioner Sharon Meieran.

Reese shared some additional news with the board members: A pilot diversion program for mentally ill arrestees began in November 2017. Modeled on similar programs for drug users, the new program allows deputies to transport willing arrestees to a behavioral health clinic if mental illness is suspected. County prosecutors then communicate with Cascadia Behavioral Health before any charges are filed. Reese’s Chief of Staff, Stephanie Prybyl, said one or two people were being diverted every day, adding that the program could be expanded from downtown Portland to cover all of Multnomah County.

Stating she was “encouraged by the progress,” Radcliffe, the DRO attorney, cautioned that these were “just the first steps” toward addressing the concerns highlighted in her report. For example, leaving it up to deputies to determine who receives a mental health evaluation may subject some arrestees to racial or other forms of bias. She also criticized the Sheriff’s Office for continuing to place mentally ill prisoners in solitary confinement, which her report said leads to an “exacerbation of symptoms and behaviors.”

“The jail cannot be a treatment and therapeutic environment,” she insisted.

Radcliffe said she would like to see the Sheriff’s Office divert arrestees needing mental health evaluations to Unity Center for Behavioral Health, which has been receiving six to eight patients a day by ambulance transfer from the Portland police department since opening in the northeast section of the city in February 2017.

Dr. Seale said preliminary discussions had taken place, though Sheriff Reese stated he knew of no conversations regarding ambulance transfers to Unity – an indication that more work needs to be done to ensure mentally ill arrestees and prisoners get the treatment they need. 

 Sources: The Oregonian, OregonLive, droregon.org

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