Is Klamath County on the right track to reducing inmate population?

From the Klamath Falls Herald and News
March 2017

By Kristi Cardwell, who is a current graduate student at the USC Suzanne Dworak-Peck School of Social Work. She is a graduate from Oregon Institute of Technology with a Bachelor’s In Applied Psychology and has lived in Klamath Falls, Oregon since 1998.

The State of Oregon requested that specific counties in Oregon send fewer prisoners to state run prisons.

This request was made in 2015 in hopes to prevent the state spending additional funding to expand current bed capacity at Deer Ridge Correctional Institution in Madras.

In early 2016, 800 inmates were moved to a bigger facility to contain the influx of prisoners at a cost of $2.5 million and by the end of 2016 the state approved an additional 200 beds costing another $3 million.

In an effort to combat the increase of inmates in both a prison and jail setting, Klamath County with Klamath Basin Behavioral Health (KBBH) has implemented a Jail Diversion program, an Assertive Community Treatment team (ACT), a Mobile Crisis Team and Mental Health Court.

The purpose of these programs is to require misdemeanor and low-level offenders to receive the option of mandated treatment alternative to jail time. For felony and mid-level offenders who pose minimal risk, the option of being monitored in the community by the Psychiatric Security Review Board (PSRB) is preferable to jail or prison time.

Many people still have the idea that if you have a mental illness and you commit a crime that jail or prison is the best option to house these individuals and oppose the idea of maintaining these individuals within the community. Those in opposition point out that people could attempt to feign mental illness when committing crimes to avoid punishment.

In May of 2015 House Bill 2420 was passed to allow local community mental health programs to evaluate defendants locally instead of sending them to a state hospital facility which saves taxpayers money. During these evaluations a complete mental health assessment is conducted by a licensed therapist qualified in making valid mental health diagnoses and that is just what is happening in Klamath County.

Clients are successfully being managed within our community under the supervision of KBBH case managers, Klamath County Community Corrections, Southern Oregon Monitoring Service, and various other treatment partners. Together all of these programs save the taxpayers money.

Oregon Department of Corrections reports it costs taxpayers $94.55 a day per inmate or approximately $34,500 a year. The United States Courts report the same offenders in a community setting would cost approximately $3.90 a day per offender or approximately $1,425 a year. With community based programs it is clear to see that a savings of approximately $33,000 a year per offender would be a desirable outcome to taxpayers.

Mental health clients in a prison or jail facility do not receive the treatment they need while incarcerated. Correctional staff is rarely appropriately trained to handle mental illness and those who need treatment typically do not receive it. Un-medicated or under-medicated mental illness can worsen leading to further offenses when released.

The majority of offenses are due to probation or parole violations for non-compliance of release agreements. According to the Bureau of Justice nearly a quarter of mentally ill inmates had served three or more prior incarcerations.

With community based treatment programs such as ACT, PSRB and jail diversion case managers ensure that clients follow through with mandated treatment judgments such as psychotherapy, drug or alcohol treatment, and psychiatric medication management.

With the upcoming appointment of a new District Attorney to Klamath County our community leaders need to ensure that an appropriate candidate is put in place by our Gov. Kate Brown.

We need a District Attorney that can support and stand behind the idea of Smart Decarceration not only to save the taxpayers thousands of dollars but to ensure that all people receive the adequate treatment and are not just housed in jails and prisons as an easy fix.

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Multnomah County Jail is No Place for People with Mental Illness

In March 2017 Disability Rights Oregon (DRO) released, “A Merry Go Round That Never Stops: Mental Illness in the Multnomah County Detention Center.” Staff attorney Sarah Radcliffe authored the report following an extensive investigation. The report finds that, in many ways, prisoners at the local jail are punished for having a mental illness. Treatment and conditions are traumatizing, dangerous, and even life threatening. The report offers recommendations to help jails and community providers successfully meet the needs of Oregonians with severe mental illness.

  • Offer treatment for mental illness, rather than criminalize it
  • End solitary confinement for people with serious mental illness
  • Strengthen supports for people with mental health issues in custody
  • Create a new protocol for responding to mental health related behavior in jail
  • Improve oversight and accountability to remedy systemic race and disability disparities, and prevent staff misconduct

READ – A Merry Go Round That Never Stops: Mental Illness in the Multnomah County Detention Center (PDF)
READ – A Merry Go Round That Never Stops: Executive Summary (PDF)
READ – A Merry Go Round That Never Stops: Recommendations (PDF)

READ – Letter to Multnomah County Commissioners by DRO’s Sarah Radcliffe (PDF)


READ – Response from Commissioner Meieran to DRO report (PDF)

Oregon Justice Resource Center: Response to new report on conditions for people with mental illness in the Multnomah County Detention Center

Lewis and Clark Law School: Clinic students integral to DRO report on treatment of mentally ill in detention center

Interview with Sarah Radcliffe on XRAY.fm – begins at 1:03:00 

Chair Deborah Kafoury  statement on the DRO report on Multnomah County Detention Center

Interview with Sarah Radcliffe and Sheriff Mike Reese on OPB Think Out Loud

Interview with Sarah Radcliffe on KBOO Prison Pipeline – begins at -27:00


Report Finds Harrowing Conditions for Mentally Ill in Multnomah County Jail

Portland Skanner, March 2017

The Multnomah County Detention Center is under scrutiny by Disability Rights Oregon, after an investigative report by the nonprofit revealed the jail’s rampant use of solitary confinement, restraints, and routine force against its mentally ill detainees.

Over half of the 1,000-plus inmates being held at Multnomah County’s two jails have been diagnosed with mental health issues. The most serious cases are deferred to MCDC, a 10-floor maximum-security facility in downtown Portland run by the Multnomah County Sheriff’s Office.

The disturbing 57-page report highlights the prevalence of racial disparities in the county jails as well. According to additional Multnomah County studies compiled and reviewed by DRO, “Black detainees are hugely overrepresented among detainees experiencing mental illness.”

African Americans are 5.6 percent of the county population, but represent 19 to 20 percent of those in jail, and 41 percent of those with mental illness, according to one sample.

Due to DRO’s status as the protection and advocacy service for Oregon, its attorney Sarah Radcliffe gained access to the jail’s incident reports and medical records, as well as conducted interviews with staff members of the sheriff’s office and 45 inmates.

While the organization has monitored several statewide county jails, Radcliffe said MCDC raised some serious red flags during her routine visit.

For example, inmates are segregated based on mental health severity; the more severe, the less out-of-cell time the inmate gets. This means continual solitary confinement. Numerous interviews with inmates revealed that many spent three to 12 months without fresh air.

“From a legal perspective, that’s low-hanging fruit,” said Radcliffe. “It’s clearly illegal to do that.”

Furthermore, staff deputies have not received de-escalation or crisis intervention training. Instead, they fall back on correctional tools, which do not equip them to deal with mental illness.

In a formal response to DRO’s report, Sheriff Mike Reese expressed his willingness to “strengthen support” for those in custody that suffer from mental illness.

Solitary confinement, restraints and use of force

While MCDC holds one-third of the county’s jailed population, it accounts for 83 percent of incidents involving force against a detainee.

That’s likely because “solitary confinement drives adverse events,” a consultant of Sheriff Reese was quoted as saying in the report.

In other words, the more one is subjected to solitary confinement, the more one’s behavioral health slips – prompting agitation, violence and confrontations with staff, which is then met with more solitary confinement, restraints and force, and so on.

For African American detainees it’s much worse.

“Once incarcerated, Black detainees appear almost twice as likely to disciplined, twice as likely to be subjected to physical force, and almost twice as likely to be “voluntarily” restrained,” reads the report.

DRO found that suicide watch is generally more agonizing than punitive recourse, as inmates are stripped of their personal belongings, mattress and blankets, and are forced to dress in only a heavy smock. They are denied visits, phone calls and showers.

One inmate, referred to Mr. Clifton in the report, suffers from serious psychosis and was placed on suicide watch. After his soap, book and mattress were removed, Clifton grew exceedingly upset. When he tried to run, guards used a taser on him and carried him back to the cell, where he began to bang his head against the floor. A deputy straddled Clifton and forced him into a restraint chair, where he remained for over six hours.

Several incidence reports tell similar stories of brutal inmate handlings. Moreover, the excessive use of restraints was alarming, said Radcliffe.

“In the corrections setting, restraints are used pretty liberally with no oversight,” she explained. “One thing that stood out to me in the initial visit with Multnomah County was they said, ‘A lot of our inmates request restraints, so we’re using them voluntarily.’”

That is questionable, according to Radcliffe, and likely unheard of.

At MCDC, African American detainees comprised 34 percent of individuals who purportedly submitted to the restraint chair on a “voluntary” basis.

Misconduct of staff

With MCDC staff having inadequate mental health training, their hardline disciplinary approach is thoroughly reviewed and discussed in Radcliffe’s report.

She points out that the use of tasers, spit hoods, and restraints is inconsistent with current clinical best practices for crisis intervention.

Dr. Wil Berry, a former OHSU forensic psychiatric fellow who spent a six-month rotation at MCDC, was interviewed by Radcliffe. While Berry claimed that most of the jail’s staff have good intentions, he said in the end, “We’re torturing very sick people. I hate myself for being part of it, and then I feel I don’t want to be there, and I feel guilty for leaving those patients behind. The cognitive dissonance required to work there is exhausting; it’s crazy making.”

The report discloses that two deputies, at DRO’s request to Sheriff Reese, have been removed from interaction with detainees and are currently under investigation for alleged disrespectful comments, exorbitant use of discipline and efforts to provoke and enrage inmates.

Yet Radcliffe’s findings hint at a larger, more complex systemic flaw in criminal justice, which spans beyond Multnomah County. With a statewide shortage of behavioral health services, combined with a lack of public tolerance for mental illness, unstable individuals are trapped in a revolving door: picked up, locked up, let go and caught in the dragnet again.

As a whole, people with mental illness serve much longer sentences for misdemeanors than the general population, while jails offer little in the way of treatment.

Making improvements

In the report, Radcliffe has outlined a number of concrete recommendations to improve the conditions and policies of MCDC. She underscores the importance of healthcare and community for people with mental illness, rather than criminalization.

Concerning racial disparities, DRO suggests that the sheriff’s office track demographics on a number of points, including restraints, suicide precautions, discipline and segregation. It also advises using the demographics to identify and correct any staff members that demonstrate a pattern of bias towards an inmate.

“When you have a lot of individual staff discretion and no oversight, you’re bound to have bias,” Radcliffe explained.

When The Skanner approached Sheriff Reese for a comment, his response was sent via email: “I have directed a comprehensive review of our policy and procedures regarding the agencies’ use of force and systems of accountability,” wrote Reese. “We will continue to collaborate with system partners to identify innovated ways to ensure all adults in our custody are treated with dignity and respect.”

Radcliffe also submitted a formal letter to Multnomah County Chair, Deborah Kafoury, asking for her support on a short list of proposals. Among them: moving all detainees with mental illness to Inverness County Jail, where they can access fresh air and programming, as well implementing crisis intervention training for all jail deputies.

Kafoury responded with her own letter, in which she explained her intent to make changes. “I’m meeting with hospital administrators to make sure our jail isn’t a place where patients can be abandoned.”

If the county fails to move towards concrete improvements, Radcliffe told The Skanner that DRO will consider seeking formal litigation.


Jail is no place for the mentally ill

Portland Tribune, March 2017 – op ed by Sarah Radcliffe, JD of Disability Rights Oregon

Between 40 to 80 percent of people incarcerated in the jail have mental health concerns.

We all want to live in a city where people have access to the robust community services they need to be healthy and the housing and other public supports that provide a stable foundation for people to live their lives.

Our recently published investigative report found that people with severe mental illness are entering Multnomah County Detention Center — a place woefully unprepared to meet their needs — at an alarming rate. These individuals endure treatment and conditions that are traumatizing, dangerous and even life threatening. People are then discharged back to city streets without adequate supports, often in worse condition.

Cycling people with mental illness through our jail doors while failing to meet their most basic healthcare needs inflicts incredible harm on human beings who are in urgent need of care. And it squanders precious public resources, while doing nothing to improve public safety or the livability of our community.

For an individual with mental illness, jail is the worst place in the world to be. Our investigation found that people with mental illness at the jail suffer physical injuries, face threats to their health due to inadequate medical response, and endure severe isolation in solitary confinement. In spite of the widespread understanding that solitary confinement harms people’s health and exacerbates mental illness, detainees with mental illness at the jail rarely access fresh air or human contact. Even visits with mental health workers often occur through the food port of a cell.

The jail is under-resourced, understaffed, and under-trained to meet the behavioral healthcare needs of this influx of people in mental health crisis. Between 40 to 80 percent of people incarcerated in the jail have mental health concerns. Yet deputies working in the jail receive no mental health or crisis intervention training. With the only tools within their reach, deputies ends up, in effect, punishing people for having a mental illness.

Gaps in community supports have resulted in more people in psychiatric crisis on city streets. But rather than locking people with mental illness behind closed doors in our jails, we need to invest in upstream community resources, such as affordable housing, supported housing and mental health services.

What can we do to help create more stable communities? Ask your Multnomah County commissioner to support policies that: treat individuals with mental illness in the community; end solitary confinement for people with serious mental illness; strengthen supports for people with mental health issues who are in custody; create new protocol for responding to mental health related behavior in jail; and improve oversight and accountability to prevent jail staff misconduct and remedy systemic race and disability disparities.

We need to step up our efforts to keep more individuals with mental illness out of jail by strengthening community services and supports. But we must also hold our jails accountable when they don’t meet the needs of people with mental illness who end up in their custody.

Sarah Radcliffe is an attorney for Disability Rights Oregon, which on March 8 released a report on the conditions inside the Multnomah County Detention Center. The report can be found at https://droregon.org/


Time to focus on mentally ill at Multnomah County Detention Center

Oregonian, March 2017 – unsigned editorial

When it comes to the contentious and complicated issues of criminal justice and the mentally ill, all sides agree that Oregon’s prisons and jails are the worst possible place for people in need of medical help.

Still, due to a lack of therapeutic and housing options in Portland, the mentally ill make up at least 40 percent of the population of Multnomah County inmates, who most often are held in the Detention Center in downtown Portland. This growing inmate population presents a regular and complicated set of problems not only for county jails, but also for state prisons across Oregon and the nation.

And yet Multnomah County can no longer shrug off its experience as simply part of a national epidemic. As city and county leaders acknowledge systemic service gaps and nod in sympathy, a chilling real-life cuckoo’s nest exists high above Southwest Second Avenue within view of two Starbucks and a popular vegan restaurant.

An alarming report covered by The Oregonian/OregonLive’s Jeff Manning has shone a much-needed, public spotlight on how mentally ill inmates are treated at the facility.

The report, released this week by Disability Rights Oregon, was the third to highlight a disturbing pattern of violence and solitary confinement used to control sick inmates.

One schizophrenic inmate was so badly beaten by a deputy that jail staff wrapped his fractured face in a blanket so as not to traumatize the public when he arrived at the hospital. Another deputy tackled a mentally ill inmate, dislocating his hip and shattering the socket, yet he wasn’t provided medical care for more than six hours.

Another inmate who’d attempted suicide days before being charged with trespassing spent 14 months at the center, mostly in solitary confinement. Alone for hours on end, his conditioned worsened to the point he wouldn’t eat and pulled out his own tooth.

And on and on.

Dr. Wil Berry, a psychiatric fellow who worked a six-month rotation at the Detention Center assessed the situation with frightening clarity. “The product of the system as a whole is that we’re torturing very sick people. I hate myself for being part of it, and then I feel I don’t want to be there, and I feel guilty for leaving those patients behind. The cognitive dissonance required to work there is exhausting; it’s crazy making. There are various coping strategies: you can burn out, you can detach, you can become sadistic . . .”

What’s happened in the uppermost stories of this building in the heart of Portlandia is disgraceful and cannot continue.

Sheriff Mike Reese told The Oregonian/OregonLive Editorial Board that he doesn’t dispute the findings of the most recent report. And while it provides numerous recommendations on which Reese can act, the first should be to move as many mentally ill inmates as possible out of the Detention Center and into the more appropriate Inverness Jail in Northeast Portland.

As soon as possible.

Not only does Inverness provide inmates better access to open-air recreational areas, the facility has more cells that can allow ill patients more human contact. Numerous researchers have reported that solitary confinement can not only worsen a mentally ill inmate’s condition, but that prolonged time in segregation can also cause mental illness.

Inverness also is designed to offer inmates classes and rehabilitation programs, which can help inmates gain skills and find hope. Just as important, the programming allows more people from the outside to keep an eye on conditions inside the jail.

Sheriff’s office and county health officials are well aware of what’s going and know what they need to do. The time to protect these vulnerable inmates is now.

The Oregonian/OregonLive Editorial Board


Isolation, deprivation, violence: Life in the county jail for mentally ill

Oregonian, March 2017

It was supposed to be a routine morning shower. But in the Multnomah County Detention Center, with its volatile mix of mentally ill inmates and under-trained guards, even the mundane can go quickly and brutally wrong.

On this day, a 55-year-old inmate with schizophrenia allegedly charged at the deputy who was accompanying him to the showers. The deputy tasered the man twice, causing him to fall to the floor. Rather than wait for backup, the deputy then straddled the inmate and pounded his face repeatedly with his fists.

On the way to the emergency room, jail staff wrapped a blanket around the inmate’s bloodied face “to reduce the impact at the hospital on civilians,” according to a jail incident report. Doctors later identified eight facial fractures, including some that had shattered into multiple fragments, a trauma normally associated with high-speed car crashes, according to hospital records.

The Multnomah County Sheriff’s Office later commended the deputy for his appropriate use of force.

The incident is one of a series cited in a chilling new report from Disability Rights Oregon about the conditions in the county jail for the mentally ill. An estimated 400 to 800 of the 1,000 inmates being held in a Multnomah County jail have some form of psychiatric disorder. The most serious cases are housed at the Multnomah County Detention Center, which takes up seven floors of the Justice Center Building in downtown Portland.

It was supposed to be a routine morning shower. But in the Multnomah County Detention Center, with its volatile mix of mentally ill inmates and under-trained guards, even the mundane can go quickly and brutally wrong.

On this day, a 55-year-old inmate with schizophrenia allegedly charged at the deputy who was accompanying him to the showers. The deputy tasered the man twice, causing him to fall to the floor. Rather than wait for backup, the deputy then straddled the inmate and pounded his face repeatedly with his fists.

On the way to the emergency room, jail staff wrapped a blanket around the inmate’s bloodied face “to reduce the impact at the hospital on civilians,” according to a jail incident report. Doctors later identified eight facial fractures, including some that had shattered into multiple fragments, a trauma normally associated with high-speed car crashes, according to hospital records.

The Multnomah County Sheriff’s Office later commended the deputy for his appropriate use of force.

The incident is one of a series cited in a chilling new report from Disability Rights Oregon about the conditions in the county jail for the mentally ill. An estimated 400 to 800 of the 1,000 inmates being held in a Multnomah County jail have some form of psychiatric disorder. The most serious cases are housed at the Multnomah County Detention Center, which takes up seven floors of the Justice Center Building in downtown Portland.

With medical and mental health care “woefully inadequate,” according to report author Sarah Radcliffe, the jail turns to correctional tools: “Rampant use of solitary confinement, punitive use of restraints and suicide watch, and routinized force against people with mental illness.”

It’s long been acknowledged that jails have become dumping grounds for those with psychiatric issues. But the new report offers an unflinching look at what that de facto social policy means behind jailhouse walls.

Because of Disability Rights Oregon’s status within the state’s federally designated Protection and Advocacy System, Radcliffe gained access to jail incident reports, inmate health records, jail staff and 45 inmates.

“The people who work there are for the most part good people trying to do the best they can,” Dr. Wil Berry, a psychiatrist who did a six-month rotation at the Multnomah County Detention Center, told Radcliffe. “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.”

The report found strong racial disparities. Though black detainees make up just 5.6 percent of the population, they are twice as likely to be disciplined, twice as likely to be subjected to physical force and almost twice as likely to be “voluntarily” restrained.

The sheriff’s office, which runs the county jails, did not dispute anything in the report. Sheriff Mike Reese said he’s launched a review of jail policies and called for the entire county to work together to “prevent the criminalization of mental illness.”

Researchers used pseudonyms when describing the following incidents, which took place within the last two years.

Mr. Novak

The eastern European immigrant was taken to OHSU Hospital in Portland after jumping off a bridge in a failed suicide attempt. Medical staff found him uncooperative and, after four days, Mr. Novak was arrested and charged with trespassing.

Novak spent the next 14 months in the county jail, often refusing to eat and losing a lot of weight. He was usually too scared to leave his cell and routinely turned to knocking his head against the wall. At one point, he pulled out a tooth.

After jail visits last summer, Disability Rights Oregon twice warned jail guards that Novak seemed catatonic and badly in need of hospitalization. But Novak remained locked up.

As far as Radcliffe could determine, the county made little effort to treat Novak’s mental illness. After more than a year in jail, he pleaded guilty to a parole violation and the county transferred him to federal immigration authorities, who intend to deport him.

Mr. Hernandez

Mr. Hernandez, who was known to suffer from mental illness and had spent time at the Oregon State Hospital, was lodged at the county jail in the summer of 2015 on misdemeanor charges.

One day, a guard tackled Hernandez for allegedly threatening deputies with a food tray. Hernandez could not walk afterward.

More than six hours later, Hernandez was taken to the emergency room. He was diagnosed with a shattered hip socket and a dislocated hip. After three days, he was sent back to jail. Guards claimed he often refused treatment for his hip. Other times, nurses weren’t allowed into his cell because he was being disciplined or deemed too dangerous due to his mental condition.

Hernandez was finally transferred to Oregon State Hospital, where he got regular physical therapy and time out of his cell. But he was still dependent on a wheelchair three months later when he was sent back to the county detention center. The county is trying to recover $2,000 from him for his medical treatment.

Ms. Mckenzie

Tragedy is in abundant supply in the psych ward of the county jail, even in cases that don’t involve overt violence.

Ms. Mckenzie, a 20-something skateboarder, had no criminal record before she was jailed in February 2015 on misdemeanor trespassing charges. While in custody, she became extremely agitated, stripped off her clothes and began to wipe excrement on the walls of her cell.

When she refused to be voluntarily handcuffed, deputies forced her to the ground, handcuffed her and put on a spit sock – a tight-fitting fabric used to keep an inmate from spitting. She was strapped naked in a restraint chair for more than five hours.

All communications with nursing and mental health staff was made through the “food port” in her door. She talked of suicide and wanting to skateboard in the Burnside Skatepark.

Jail officials recognized that Mckenzie was in mental crisis and transferred her to a hospital, where she was diagnosed with psychosis, possibly substance induced. She was then returned to the jail. Hospitals routinely send the mentally ill to the county jail reasoning that with its 24-hour supervision, it’s a reasonable alternative.

Four days after her release from jail, McKenzie was found dead under a bridge.
 
Mr. Wright

A jail deputy tasered Wright in the back. He fell and hit his head, which bled profusely.

When Wright regained consciousness, he was combative. Deputies put him in a restraint chair and put a spit sock on his head.

In this case, the county took a hard look at whether the deputy, identified only as KQ, was out of line. As Radcliffe wrote, that may be because the incident was witnessed by a corrections counselor, who said Wright was tasered “seemingly without provocation.”

KQ, on the other hand, insisted that Wright had clenched his fists and exhibited an aggressive facial expression.

It turned out that Wright had a previous run-in with the deputy. Wright later told investigators, “I can’t believe you guys put me back in there with that guy… he is out of control and needs counseling.”

A jail supervisor issued a harsh critique of KQ’s conduct, saying he “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.”

“It appears the force used in this incident was not justified,” The review concluded.

The case was referred to the sheriff’s office’s internal affairs unit and then to the Multnomah County District Attorney’s office. The DA declined to press charges.
Radcliffe was so alarmed by the cases of Wright and the inmate with the shattered facial bones that she met with sheriff’s officials last October.

Reese agreed to launch internal investigations of both matters and transferred both guards involved in those incidents so they have no contact with inmates.