Portland police still can’t measure effectiveness of response to mental health calls, say police consultants

Oregonian, September 15, 2017

Portland police still lack the ability to track whether officers are using less force against people with mental health issues three years into a federal settlement that was supposed to improve their response, outside consultants say.

“We do not believe the PPB has the data systems in place to adequately measure the effectiveness of their unique system,” the Chicago-based consultants wrote in a report recently filed in federal court.

READ – COCL COMPLIANCE REPORT, Third and Fourth Quarters: July through December, 2016

The city-hired consultants, Rosenbaum & Associates, tried to evaluate the bureau’s Enhanced Crisis Intervention Team of officers who receive more than 40 hours of training to handle mental health crises. They work regular patrol, are scattered among the bureau’s three precincts and go to mental health-related emergency calls if they’re available.

A U.S. Justice Department investigation found in 2012 that Portland police used excessive force against people with mental illness. The negotiated settlement with the city, approved by a federal judge in 2014, calls for changes to Portland policies, training and oversight.

The agreement recommended a different method of crisis response modeled after a strategy Memphis police started that has a team of trained officers respond to mental health crisis calls as their full-time role. The team reports to one high-ranking supervisor.

“PPB continues to operate with a modified Memphis model but has yet to produce data to demonstrate its effectiveness and responsiveness to the Portland community,” the report said.

The consultants say they suggested that the Police Bureau track frequency of mental health calls, adequacy and availability of the specially trained officers by precinct and shift, outcomes of the calls and differences in outcomes when enhanced crisis intervention officer can’t respond.

The bureau had been using a special screen that pops up on an officer’s mobile computer to fill out information on all interactions with people who exhibit mental illness. But police halted the practice after the District Attorney’s Office advised them that the information must be shared with defense lawyers if the people faced criminal prosecution.

To address the district attorney’s concerns, the bureau switched to a different type of screen that an officer completes only if the call requires a written police report, to make the information more accessible for sharing with the defense at prosecution.

But that means the information no longer reflects all police contacts with people suffering from mental illness, consultants Dennis Rosenbaum and Amy Watson found.

Data the consultants reviewed from March 2016 through Jan. 31 showed that 10 percent, or 18,748, of Portland police calls had some type of mental health element involved. Of those, 6.3 percent, or 1,179, were considered of a type that should draw an enhanced crisis intervention officer. Of those 6.3 percent of calls, the officers with the extra training responded nearly 70 percent of the time.

The consultants asked the city Bureau of Emergency Communications, which dispatches police to 911 calls, for more detailed information on mental health calls, but the bureau said it didn’t have the staff to perform such data extraction or analysis. The consultants said the Police Bureau also has access to the information, but it also said it didn’t have the staff to provide a data review.

“This significantly limits (both bureaus’) capacity to analyze trends and assess the adequacy of their mental health response system,” the consultants said.

Mary Claire Buckley, principal management analyst who works on the Police Bureau’s Department of Justice compliance team, said the bureau is working to compare the outcomes of responses to mental health calls by enhanced crisis intervention officers versus other officers. She said she anticipates that analysis may be available next month.

Justice Department lawyers also noted in a report this summer, “Our team has repeatedly heard from officers, on ride-alongs and in the (enhanced crisis) training, that they are frustrated by repeated contacts with known individuals … who they take to the hospital only to be released, over and over without any answers from PPB about what they should do.”

The consultants also found that the bureau has failed to embrace computer tracking to identify at-risk officers or patterns of problems that would allow for early intervention, as required under the federal agreement.

The consultants said police supervisors who oversee the system have resisted their recommendations “time and again.”

Police supervisors have told the consultants that the system’s setup meets the settlement’s requirements. It does track supervisors’ performance reviews of officers under their command, and the rate that the officers use force as a ratio of their arrests and compared to that of other officers on their shifts.

The Justice Department expects more, the consultants said.

“We have seen little in the way of meaningful progress during this review period. … After two years, we believe more progress should have been made and urge PPB to make substantive changes,” the consultants wrote in their quarterly report, covering July through December 2016.

The Police Bureau says the Employee Information System is intended to allow a “comprehensive review” of an officer’s performance on the job, benefit the bureau and officers by “facilitating professional growth” through feedback from supervisors — but may not be used to make decisions about discipline, transfers or promotions.

The consultants said they’d like to see the tool used to ” help save officers’ careers and encourage good policing in general.”

The system flags officers in the computer database if they have used force in 20 percent of their arrests in the prior six months, if they have used force three times more than the average number compared with other officers on the same shift, if they receive two or more complaints with similar allegations or if they have received three or more complaints within the prior six months.

The consultants said the system should track much more information over a longer period, including complaints against officers, their total number of responses to 911 calls, their use of force overall and compared to force used by officers by shift and precinct, ratio of force to arrests and ratio of force used to suspect injuries and officers injuries.

They also recommended that the system track the type of complaints, sustained complaints, ratio of complaints to interactions on the job, tendency to engage in car or foot chases after suspects, their use of sick leave, how frequently they charge a suspect with resisting arrest and how that compares to officers by shift and precinct.

About 90 percent of the flags that arose from the current system aren’t forwarded to an officer’s direct supervisor, but reviewed by the system administrator, the report said.

Seattle police, in contrast, require a direct supervisor review to determine if an intervention, such as mentoring, is warranted.The Los Angeles County Sheriff’s Office has a performance review committee of three commanders that makes such decisions.

“The adequacy of the current review process is unknown because of a lack of documentation, but on its face, does not appear sufficient in light of best practices,” the report said. “Also, a system of intervention has not been established to our knowledge which is the primary goal of (such) systems. As such, we see no evidence that officers who truly would benefit from supplemental instruction and guidance are receiving it.”

Buckley said the bureau has made changes to the system since the consultants completed their report. For example, more is being shared with officers’ direct supervisors when a flag is triggered in the system, and the supervisors are now required to document if they took any action, such as a debriefing, extra counseling or training, Buckley said.

The bureau has met the settlement requirements governing what the system tracks and what would trigger an alert about an officer, Buckley said.

“Certainly we’re going to be looking at improvements to the system. But we first want to comply with the settlement agreement before we’re able to add things,” she said. She added that the bureau’s resources are limited, noting there’s one sergeant who is in charge of the Employee Information System, and the programmer is based in Denver.

The consultants expect to release an updated report next month.

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Announcement – Oregon Advocacy Award

Nominate a mental health or addiction advocate for the Oregon Advocacy Award here.

The Oregon Advocacy Award is given annually to a great advocate for people with mental illness and addiction in Oregon.

The Advocacy Award is given by the Mental Health Association of Portland at the Oregon Law & Mental Health Conference. The winner is announced prior to the annual conference, and given at the conference.

The Award represents the perspective of persons represented by advocacy – persons who have experienced mental illness and addiction.


Advocacy Award Committee Members for 2018

Lakeesha Dumas – Office of Consumer Engagement Coordinator, Multnomah County
Mike Hlebechuk – Oregon Health Authority, retired
Stephanie Matheson – Youth Without Borders, Klamath Basin
Lisa Naito – Naito Public Affairs
Bob Joondeph – Disability Rights Oregon
Brenton Gicker – White Bird Clinic, Eugene

Complete Award information is here.

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Unfuck Your Brain: Using Science to Get Over Anxiety, Depression, Anger, Freak-outs, and Triggers

Review of Unfuck Your Brain: Using Science to Get Over Anxiety, Depression, Anger, Freak-outs, and Triggers, by Faith Harper and published by Microcosm Publishing, by Meredith Mathis.

See – Unfuck Your Brain: Using Science to Work Through Your Shit via Kickstarter, help get this book on tape.

Faith G. Harper is a experienced mental health provider. She is a trauma-informed therapist, a licensed clinician with certificates in sexology, integrated life coaching, and clinical nutrition, and is a board supervisor and a teacher. Harper’s goal is to cram what she has learned from decades of being in the field into a digestible, helpful guide for anyone looking to understand and begin working through their trauma informed physical and emotional responses to the world around them. Harper writes that the biggest takeaway from this book, if any, should be that these responses to the world, be they anger, anxiety, addiction or “the rest of it” are adaptive.

Harper communicates that these adaptive strategies are learned behaviors which made sense in the circumstances in which they were developed. By somehow breaking down something as complex as neurobiology in a very accessible way, Harper explains how and why the brain/body develops the way it does after traumatic events, and how this causes us to develop behaviors that negatively affect our daily life. From there, she explains how to undo, rework, or ‘unfuck’ as she would say, the feedback loop of our neurological responses and our behaviors. She offers hope that learning the what’s and how’s of it all can begin a process of regaining a sense of agency in your life. Or, as she wrote more clearly, “…this book is about the why you are miserable so you can do something about it.”

Unfuck Your Brain makes both academic and professional information accessible. The complexities of a topic are reworded, broken down, and organized in a way that making it much easier to read and understand without sacrificing nuance. Alongside the scientific explanations of it all, Harper offers practical advice, guidelines, treatment options and small exercises a reader can use to start locating their own feelings, responses, needs, etc. The book mirrors a lot of what someone might learn through either years of studying in the field, or even from years of being a patient with a good trauma-informed therapist. Harper makes no overstated promises, just gives thorough guidelines, and encouragement that it is possible to learn your particularities and (re)adapt for a better life, even if yours is a complicated, difficult, and long process.

For every chapter and subsection of this book, I thought of a new handful of friends and family who I wanted to share it with. It is many resources in one. Beyond establishing trauma as a key element in forming behavioral patterns, it covers dynamics of anxiety, PTSD, depression, grief, anger, addiction and more; it is thorough. I found myself simultaneously wanting to share it with a partner who I thought could benefit from certain sections, while wanting them to read other sections to better understand things I go through. It’s a good guide for anyone affected by these topics, or people who are close to people who are, which is a lot of people. It’s potentially helpful for people who don’t necessarily need therapy, for people who are in therapy and could use some new guidelines and strategies, and/or most people who have difficulty naming and acting on what’s going on with them … again, a lot of people.

I’m thankful I read it, I will probably read it again, and I will definitely be recommending it to most of my friends, family and mental healthcare providers.

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Universal Health Services wants a new hospital in Oregon

This is an archive of documents pertaining to the petition by Universal Health Services to the State of Oregon to build a 100 bed private psychiatric hospital in Wilsonville, Oregon. The petition application for “NEWCO” began in Fall of 2016. The Mental Health Association of Portland is an affected party to the petition.

Universal Health Services, also functioning under the name Fairfax Behavioral Health, has private psychiatric hospitals in Everett, Monroe and Kirkland Washington, and has proposed new facilities in Thurston and Spokane Counties. In Oregon, Universal Health Services owns Cedar Hills Hospital.

MEDIA

Hospital Backers Sue Oregon Health Authority, Alleging State is Trying to Hide Public Records Behind Huge Fees
OHA initially said the request would cost $4,500, then allegedly demanded an additional $44,600 to begin providing documents.
September 12, 2017

Mental Health Provider NEWCO Oregon Inc. Pursues Antitrust Lawsuit Against Oregon Health Authority – press release
Tort claim notice alleges OHA promoted anti-competitive collusion between Portland-area hospital monopolies
August 16, 2017

Wilsonville psychiatric hospital applicant sues Oregon Health Authority
June 23, 2017
OHA rejects proposed 100-bed psychiatric hospital in Wilsonville
February 24, 2017

National health care firm proposing $36M psychiatric hospital in Wilsonville – Oregon Business Journal, October 2016

Wilsonville’s Development Review Board Panel B approves mental health hospital application, Facility would focus on serving adolescent patients – Portland Tribune, February 2016

DOCUMENTS

NEWCO’s initial application and attached documents (PDF – 614 pages / 412 MB – via dropbox)

Letter of Intent from Lifeways Inc., a proposed 16 bed psychiatric hospital in Hermiston, October 2016

Meeting Announcement for Certificate of Need for NEWCO, to occur November 17, 2016.

Letter from NAMI Oregon requesting “affected party status,” October 2016

Letter from OHA to Fairfax Behavioral Health System about incomplete application from NEWCO, September 2016

Cedar Hills Hospital basic financial records for 2013-2016

Universal Health Services – 2015 Annual Report

Universal Health Services & “Willamette Valley Behavioral Health” – PATIENT WINDOW SIGHTLINE DIAGRAM (2015)

Universal Health Services – “Wilsonville Behavioral Health Hospital” – “Response to OHA CON Comments,” October 2016

UHS “Willamette Valley Behavioral Health” patient schedule – October 2016

Cover Letter to OHA from Fairfax Behavioral Health, October 2016

Responses to OHA questions about NEWCO – unsigned & undated, but likely from Fairfax Behavioral Health and associated with cover letter above.

Universal Health Services – “Wilsonville Behavioral Health Hospital” – floor plan of proposed hospital, October 2016

Cover letter and responses to OHA questions about NEWCO, August 2016

Cover letter and responses to OHA questions about NEWCO<, March 2016

Cover letter and responses to OHA questions about NEWCO, June 2016

Cover letter and responses to OHA questions about NEWCO June 28, 2016

Metro West Ambulance rescinding letter of support, September 2016


These documents have not been titled or dated yet.

NEWCO Responce

SEIU Comment re UHS-NewCo CON Wilsonville (final)

Transcript of Public Hearing_2016-11-17

Comment Letter to CN Program Revised FinalDec1

Attachmentsfor CON ltr12022016

Letter from Free By The Sea to Jana Fussell, December 2016

Letter from Salem Health to Jana Fussell, November 2016

Letter from Oregon State Senator Tim Knopp to Jana Fussell, November 2016

Message from SEIU to Jana Fussell re County Sheriff log, November 2016

Sheriff Reports for 10300 SW Eastridge Street (Cedar Hills Hospital)

Audrey S_BlachlyLE

NEWCOKaiserAffected

20161117120210569(1)

20161117120210569

Wilsonville Mayor’s Ltr of Comment – UHS Hearing 11_17_2016

20161118085102311

20161118085145255

20161118085221369

20161118085322687

20161118123156215

20161123124516868

DRO testimony re NEWCO 11-23-16

Letter to Janet Fussell Dated Novemer 282016

NEWCO CON Testimony — NAMI Oregon

Comment Letter to CN Program Revised FinalDec1

20161202142604167

20161202142614764

Rescinding Letter of Support 9-26-16

SEIU Affected Party Status Request

NEWCODROaffected 11-3-16

20161108073348756

NEWCO SEIU Affected 11-09-2016

NEWCO SEIU Affected 11-09-2016

20161110133043893

Kasper Affected Party Status Application for App Number 765

NEWCO Legacy Affected 09-10-16

20161114115345586

NEWCOprovidenceaffected

Providence_NEWCO CON_Affected party 111016

NEWCOannkasperaffected

Emergency Department Boarding of Psychiatric Patients in Oregon – A Report to Oregon Health Authority – FULL VERSION, October 28, 2016
=Emergency Department Boarding of Psychiatric Patients in Oregon – A Report to Oregon Health Authority – BRIEF VERSION, October 28, 2016
Jangho Yoon, PhD
Jeff Luck, PhD
Megan Cahn, PhD
Linh Bui, MIPH
Diana Govier, MPH

response letter 010417

White Paper Response_Final 010917- 1st Version

Newcotimeex3

RESPONCE REQUESTED — OHA – Request for extention of time for NEWCO (CN#675)

Cedar Hills Email

FW NEWCO CN #675 Delayed Decision

Occupancy Rates

NEWCO Responce

LegacyResponse to reconsideration hearing3172017

NewcoInformalHearing-amended

NewcoInformalHearing

Signed Ltr to Selover re Req. for Hearing

NEWCO Oregon Inc. Request for Informal Hearing

email correspondence for the NEWCO Certificate of Need (#675) application – 1 2017

Letter from Fussell to NEWCO – 9 2016

Public Meeting Notice 10-28-16

20161024142349196

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