Severely mentally ill inmates spend too much time in their cells, says new report

Oregonian, May 5, 2017

Male inmates with the most severe mental illnesses are allowed out of their cells for only a few hours on average each week despite a pledge last year by the Oregon Department of Corrections to increase the amount of time, a leading disability rights organization says.

The finding is part of Disability Rights Oregon’s progress report on the state’s promise to improve conditions in the Behavioral Health Unit at the Oregon State Penitentiary in Salem. The report was released Wednesday.

Read the Oregon Department of Corrections chief’s letter to Disability Rights Oregon’s report on a unit that houses severely mentally ill inmates. The agency released the letter on Tuesday in response to a public records request.

Workers in Oregon prison unit say critical report inaccurate

Sgt. Jeff Hernandez and counselors Katie Bell and Tyann Etzel said mental health and security staff have a generally cooperative relationship that has significantly improved in the past year.

The advocacy group in 2015 issued a report detailing “a hopeless and dysfunctional program” responsible for 40 inmates with serious mental illnesses. The report concluded that inmates spent a vast majority of their days in their cells in an area facility that was dark, stifling and foul-smelling.

“It was sort of like a dungeon,” said Joel Greenberg, an attorney with Disability Rights Oregon. Greenberg authored the 2015 report, as well as the new progress report. “People were howling and screaming. It was a very bad situation.”

The group identified three top concerns in its initial report: isolation of prisoners who spent 23 hours a day in 6-by-10-foot cells and were let out for one hour or less; lack of access to timely mental health services that left inmates spiraling out of control and typically resulted in the use of force by corrections officers; and a culture in which advice of mental health professionals was consistently ignored and mental health crises were handled instead through the use of stun guns, pepper spray, riot gear and restraint chairs.

Corrections officials agreed to make key changes, including adding staff to the unit, improving training, increasing space for treatment and educational programs and allowing inmates housed in the unit to spend on average 20 hours per week outside of their cells. The also agency hired an outside consultant, Joel Dvoskin, who is a clinical psychologist, to help with the reforms. The state has so far paid Dvoskin $85,799 for his work.

Greenberg said the prison system has made “impressive and meaningful” improvements. The use of force on the unit, for instance, has declined. So has the number of inmates trying to harm themselves. Fewer inmates have been placed on suicide watch. The facility unit itself has been improved: The bathrooms received a coat of paint and 42 TVs were installed, though a dozen were later destroyed by inmates, according to the report.

But prisoners in the unit still spent less than five hours a week outside of their cells, which the progress report called “a deeply concerning failure.”

Greenberg’s report notes that inmates spend more time out of their cells now than they did when the state agreed to the reforms, but he added that progress has been “erratic.”

The advocacy group attributed the lack of progress to a “vexingly high” turnover among mental health professionals in the unit, a disproportionate discipline of inmates in the special unit compared with the general population and an “overemphasis on security concerns.”

The group said it plans to investigate complaints that corrections officers retaliated against clinical staff “to determine if needed mental health services are being blocked due to the desire of some staff to assert authority rather than to further” the unit’s mission.

Colette Peters, director of the Department of Corrections, said she takes the progress report “very seriously.”

She said a chief obstacle to increasing time for recreation and treatment is the facility itself. The agency sought and received money from the Legislature to add a modular building on the grounds of the state prison for the special unit. Lawmakers set aside $5.1 million for the building and additional staffing. The governor’s proposed budget calls for another $6.9 million for the unit. The building is expected to open in 2018.

“We are working in that direction,” she said. “We have seen lots of progress. We recognize we are not perfect. We are not where we want to be, but we are truly headed in the right direction.”

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Public Hearings about Portland Police Reform – upcoming dates

Citizens concerned about the fate of police reform in Portland will have the chance to offer input at five upcoming forums – four hosted by the Independent Police Review, and one hosted by the Albina Ministerial Alliance Coalition for Peace and Justice.

The Mental Health Association of Portland is a member of the AMA Coalition. In 2012 the US Department of Justice found the Portland Police Bureau has a pattern and practice of harming people with mental illness. The 2014 Federal lawsuit, USA v. City of Portland, has sought to amend that harm with additional training, development of facilities to benefit people with mental illness, and changes to city policy.

The AMA coalition will hold a public forum to take feedback on the city’s progress with the Department of Justice Settlement Agreement.

6 to 8 p.m. April 25 at Maranatha Church, 4222 NE 12th Ave.

Leaders of the AMA Coalition will update the community on the status of the city’s settlement agreement with the US Department of Justice, and take input on the April 3 draft compliance report on the city’s reforms. Comments on that report are due May 2.

Two members of the Compliance Officer/Community Liaison team from Chicago have committed to attending the forum. For more information about the AMA Coalition forum, contact Chair Dr. LeRoy Haynes, Jr., or co-chair Dr. T. Allen Bethel at (503) 288-7242.

In addition to the AMA Coalition public forum, the Independent Police Review will hold five listening sessions in the coming weeks:

10:30 a.m. – 12 p.m. April 15 at the Immigrant and Refugee Community Organization, 10301 NE Glisan St.
6:30 – 8 p.m. April 19 at Multnomah Arts Center, 7688 SW Capitol Hwy.
6:30 p.m. – 8 p.m. April 25 at Charles Jordan Community Center, 9009 N. Foss Ave.
2 p.m. – 3:30 p.m. April 28 at Matt Dishman Community Center, 77 NE Knott St.

Citizens also can comment on the settlement to the Independent Police Review at constantin.severe@portlandoregon.gov, by postal mail at Independent Police Review, 1221 SW 4th, Suite 140, Portland, OR 97204, or by voicemail, (503) 823-0146.

It’s left unstated by both the AMA Coalition and the Independent Police Review what will be done with the collected feedback.

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Eugene / Springfield’s CAHOOTS-Metro has new, increased hours of operation

CAHOOTS-Metro has new, increased hours of operation beginning April 1st, 2017

We are pleased to announce that White Bird Clinic’s CAHOOTS-Metro program (“Springfield CAHOOTS”) is growing. As of April 1st, 2017, CAHOOTS-Metro will be available from 9am to 3am; that’s 16 hours per day—everyday.

Thanks to a federal grant to Lane County for mobile mental-health crisis-intervention services, CAHOOTS-Metro began serving Springfield and Glenwood in January of 2015. Since then, the program has operated from noon to 11:30pm daily. The increase in service hours beginning on April 1st will be followed by a move to 24-hour service later this year.

CAHOOTS (“Crisis Assistance Helping Out On The Streets”) was formed in 1989 by White Bird Clinic to assist or substitute the Eugene Police Department in situations involving a mental-health crisis, as well as various other types of problems (primarily related to addiction, homelessness, poverty, etc). CAHOOTS is currently available 24-hours per day in Eugene, with two vans operating during peak hours.

Each CAHOOTS team consists of an emergency medical technician (EMT) and a mental-health crisis-worker. Services provided include crisis-counseling, transportation to shelter & treatment facilities, non-emergency medical care, and more—all at no cost.

Eugene’s CAHOOTS program—which responds anywhere in Eugene’s city limits—can be reached by calling the Eugene Police Department non-emergency dispatchers at #541-682-5111.

CAHOOTS-Metro—which covers Glenwood and Springfield—can be reached by calling the Springfield Police Department non-emergency dispatchers at #541-726-3714.

READ – this press release as formatted PDF

READ – Springfield’s mobile mental health clinic poster (PDF)

READ –

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Put the Junction City hospital to better use

GUEST VIEWPOINT: Put the Junction City hospital to better use
By Gary Crum, published in The Register-Guard, April 10, 2017

In a March 9 guest viewpoint, state Rep. Julie Fahey, D-Eugene, argues that we must keep the Junction City hospital open. As one of the most outspoken opponents of the construction of the hospital and a continued critic of its operation, I say we must close the Junction City hospital.
Fahey cites the mission of the state mental health system: “therapeutic, evidence-­based, patient-centered treatment focusing on recovery and community reintegration.” She does not mention that a key mandate for mental health treatment requires that it be provided in “the least restrictive treatment setting available.” The Junction City state hospital, a high-security, locked-ward facility, is the most restrictive treatment setting available.

I, along with every professional psychiatric group in the state and every patients’ advocacy group, favored the state investing in earlier intervention with 16-bed community-based facilities, walk-in clinics, short term intervention and diagnosis facilities, out-patient support systems, and mobile intervention crisis teams such as CAHOOTS. The Legislature, instead, chose to spend more than $100 million to build the Junction City hospital with an annual cost of over $400,000 per patient At full capacity, that per-patient cost would drop to $280,000 per year.

At the time Gov. Kate Brown proposed the closure of the Junction City hospital, there were enough open beds at the Salem hospital to serve all the patients from Junction City. The statement that the closure would result in overcrowding, an unsafe environment for employees and a reduction in patients’ overall quality of care is a scare tactic. Additionally, if we keep that “least restrictive treatment setting available” in mind, it’s quite likely that some (perhaps many) of the patients now in locked-ward facilities could be safely, more humanely and more effectively served in community-based facilities.

The Catch-22 is that construction and staffing of the Junction City hospital has monopolized available funding, leaving a void where those less restrictive treatment settings should be on the continuum of services. Those community-based 16 bed facilities cost about $70,000 per patient per year. Additionally, the federal government has been reimbursing states about 50 percent of the cost of such services.

Locked-ward placement does not qualify for such reimbursement. This means that, even at that full-capacity cost of $280,000 per patient per year at the Junction City hospital, the state could provide for eight patients’ placement and treatment in a community-based facility for each locked-ward patient. At the hospital’s current cost of $400,000 per patient, it’s more than an 11-to-1 ratio. The state has put all its mental health care dollars in one basket — the wrong basket.

The $100 million to build the Junction City hospital has been spent. That’s the strongest argument for continuing to fund it. There’s no doubt in my mind that, given current patient populations, fiscal realities and the need for community-­based services, that hospital would not be built today. But it has been built, so what does the state do with the facility if it’s closed?

We know that many of those incarcerated in our prisons today are young, have drug or alcohol abuse issues that were associated with their crimes, and do not do well in the general prison population. We’ve heard repeatedly that such people need treatment, not prison. I agree. The Junction City hospital facility is built to the security level of a minimum- or medium-­security prison.

I suggest the hospital be converted to a minimum- or medium-security state corrections facility dedicated for the incarceration and treatment placement of people identified by the courts as appropriate candidates for such placement. I suggest the rehabilitation programs at the facility be specifically focused on substance and alcohol abuse treatment, job skills and personal development to promote employment and successful reintegration into the community upon release. This could be a model program, truly focused on rehabilitation and reintegration.

The governor’s proposed budget includes $20 million to reopen a mothballed women’s prison near the Oregon State Penitentiary. An easy, cost-effective move would be to, instead, move the current Junction City hospital patients to the Salem hospital (there is room) and transfer ownership of the Junction City facility to the Department of Corrections to meet that need for expanded capacity. This would release millions of mental health dollars for community support, save the Department of Corrections the cost of refitting and reopening a shuttered facility, provide a state-of-the-art facility for the women’s prison, and keep the employment base provided by the Junction City facility.

We have built the hospital. It’s not necessary for its current use. We have a need which can be met by putting it to another use, promoting community mental health care, saving the state tens of millions of dollars, and protecting local jobs. Let’s consider an opportunity that would benefit all of us.

Gary Crum of Junction City is a retired teacher and counselor.

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