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A NORTH PORTLAND MAN DIES AFTER POLICE RESPOND TO A FIGHT AND THE MAN HAS A MEDICAL PROBLEM - October 20, 1998

A 37-year-old man who scuffled with police Monday night died this morning in a Portland hospital.

Richard Dickie Dow died at 6:50 a.m. at Legacy Emanuel Hospital, said Claudia Brown, a hospital spokeswoman.

Brown would not say what injuries might have caused Dows death.

An autopsy is scheduled for this afternoon, said Cheryl Kanzler, a Portland Police Bureau spokeswoman.

Police received a call about 10 p.m. of a fight outside a Winchells doughnut shop in North Portland, Kanzler said.

When several officers arrived, they encountered only Dow and tried to subdue him, Kanzler said.

But he began having a medical problem, Kanzler said, and police then called emergency medical personnel.

Kanzler said police were investigating, and officers who were at the scene will be interviewed.

“This is not being treated as a deadly force situation, she said.

Jack Tyrrell, who said he was Dows uncle, said Monday night that his nephew was afraid of police. He said Dow had a mental illness and problems when he was off his medication.

“Hes been known to throw rocks at cars and things like that before, Tyrrell said.

Tyrrell did not witness the altercation.

OFFICERS PLACED ON LEAVE IN DEATH – October 21, 1998

Eight Portland police officers were placed on administrative leave Tuesday after a man with a history of mental illness died in their custody as they tried to restrain him in connection with a street fight.

Richard C. “Dickie” Dow, 37, of North Portland was pronounced dead at Legacy Emanuel Hospital about 7 a.m., nine hours after a school police officer was unable to control him at North Fenwick Avenue and Lombard Street, police said.

An autopsy Tuesday showed Dow suffered two rib fractures and several bruises and scratches, but State Medical Examiner Larry Lewman said no injuries were sufficient to explain his death. The cause of death awaits the results of toxicology tests and further investigation, Lewman said.

“We are currently hampered by a lack of information that needs to be supplied by the others involved in the altercation, Lewman said in a prepared release.

Witnesses and relatives contend that police mishandled the incident and ignored pleas from Dows mother and stepfather, who sought to calm their son and alert police of his mental health problems but were handcuffed and taken into custody.

“I was just trying to explain to them he has a mental problem . . . that I can calm him, said Barbara Vickers, Dows mother.

Detective Sgt. Cheryl Kanzler, a Portland Police Bureau spokeswoman, said she could not respond to the concerns Tuesday because most officers involved had not yet been interviewed. Administrative leave is routine in all custody deaths. Two Portland homicide detectives have been assigned to the case.

“We need to take this one step at a time and do a thorough investigation, she said. Its very premature to make any conclusions about what happened out there.

Witnesses also questioned why police did not provide immediate first aid to Dow or permit a neighbor to do emergency cardiopulmonary resuscitation when he stopped breathing at the scene. The Police Bureau discontinued CPR training for officers in 1991, Kanzler said.

“We have EMS and ambulance personnel who are there in a matter of minutes, she said. If you apply CPR wrong, you can seriously damage or kill somebody.

The incident began about 10 p.m. Monday when an anonymous caller alerted police to a fight in the street outside Winchells Donut House on North Lombard Street. A Portland school police officer, who was not identified, was the first to respond. He found one man chasing another and tried to stop Dow at North Fenwick Avenue and Lombard Street.

Dow, police and witnesses said, did not respond to police orders to stop. He was walking very quickly west toward his house, 7305 N. Fenwick Ave., when the school patrol officer caught up with him and struggled with him, police and witnesses said. The officer said Dow appeared extremely agitated.

“At some point that officer called for Code 3 cover. He was engaged in a fight with this person and was not able to control the guy, North Precinct Cmdr. Rick Rictor said. Code 3 is a heightened call for backup.

Dow was a diagnosed schizophrenic and lived with his mother and stepfather. They had just returned home from a bowling league Monday night and were eating sandwiches when they heard Dow.

“I heard my son screaming for help, Barbara Vickers said. I got up and went outside. I saw him tussling with someone down the street. He was yelling, Help, Mom, help. Just let go of me. . . . Help, Mom.

Once she realized Dow was struggling with a police officer, she tried to intervene, shouting to the officer that her son had a mental health problem and that she could calm him down.

“Please don’t hurt him anymore. We can calm him down, she said she and her husband, Ted Vickers, yelled at the officer.

Witnesses said about eight officers surrounded Dow. When they tried to subdue him, he had a medical emergency, Kanzler said. Some witnesses said police used pepper spray on Dow, but Kanzler said she did not know whether that was the case.

The officers then lowered Dow to the ground. Other officers handcuffed the Vickerses and detained them in a patrol car for apparently interfering.

“Dickie was laying on his side, said Tim Maher, a neighbor. They rolled him onto his back, and he was motionless. They took off his handcuffs, and one of the officers yelled, We need a mask. We need a mask. Hes not breathing.

Deborah Howes, who lives next door to the Vickerses, heard the commotion and walked outside. She saw Dow on the ground and a circle of officers around him.

“I offered to do CPR, Howes said. They said the ambulance was coming.

Emergency medical personnel arrived at the scene at 10:21 p.m. They transported Dow at 10:32 p.m., and arrived at the hospital at 10:38 p.m., said Neil Heesacker, a Fire Bureau spokesman.

Police did not know what sparked the original fight, and no arrests were made.

The Vickerses were detained at police headquarters for several hours and were told their son was in the hospitals intensive care unit when they were released about 3:30 a.m. They were not arrested.

When they arrived at the hospital an hour later, Dow was not breathing on his own. He never regained consciousness, his mother said.

The family said doctors told them Dow had gone into cardiac arrest and stopped breathing at the scene, but emergency medical personnel were able to revive him. At the hospital, Dow went into shock, his family said.

Dow was diagnosed with paranoid schizophrenia and manic depression when he was about 18, his parents said. He had a juvenile and adult arrest record, which included burglary, criminal trespass, harassment and motor vehicle charges. His most recent brush with the law was a fourth-degree assault charge in 1995.

He sometimes would hear voices and talk to himself, his family said. About five years ago, he was sent to Dammasch State Hospital for about 10 weeks and prescribed special medication. He hadn’t been taking any medication for the past three years and would let his mother give him only St. Johns Wort tea, Barbara Vickers said.

“Ill be the first to tell you my son was no angel, she said. He had a record, and hes been to the penitentiary. But he has not been in trouble for a long, long time.

Neighbors, who were aware of Dows mental illness, were disturbed by how police handled him.

“His parents could have definitely defused the situation if they were allowed to, Howes said. He dealt with his mother like he was a 5-year-old.

About 50 officers are specially trained to deal with mentally ill people as part of the bureaus crisis intervention team. Kanzler said she did not know whether an officer from the team was called to the scene Monday night.

All bureau officers also receive basic training on how to handle people in crisis, whether the crisis stems from mental illness, drugs or other reasons, said Capt. C.W. Jensen, head of the training division.

Robin Blair, a clinical psychologist, said police may operate in a confrontation mode when dealing with criminals. But such an approach may not work with a mentally ill person.

“The No. 1 rule is to be calm and to de-escalate the situation, said Blair, director of Behavioral Health Services at Woodland Park Hospital. Going into direct confrontation mode and arousing fear isn’t helpful . . . it leads to a lot of tragedies.

Mayor Vera Katz urged residents to await the results of the investigation before making judgments.

“To do a good investigation takes time. Meanwhile, it is extremely important that none of us — city officials, police, citizens or the media — jump to conclusions before the facts are fully known.

ACCOUNTS OF MANS DEATH IN CUSTODY DON’T AGREE – October 22, 1998

Richard C. Dickie Dow, a mentally ill Portland man who died in police custody Tuesday, aggressively turned on a school police officer who tried to question him about an apparent fight outside a doughnut shop, police said Wednesday in their first account of the incident.

Portland School Officer Dennis McClain was the first to respond to a call of a fight Monday night outside a Winchells Donut House on North Lombard Street. Dow, 37, grabbed McClain when he got out of his car to investigate, shouting obscenities and saying things that were not understandable, said Detective Sgt. Cheryl Kanzler, a Portland Police Bureau spokeswoman.

“He just turns on him, comes at him and grabs him, Kanzler said. Dow has his arms pinned and is moving the officer down the street.

The police account, based on investigators initial interviews of officers involved in the altercation, conflicts with statements Dow’s mother, stepfather and other neighborhood witnesses gave shortly after Dow was pronounced dead early Tuesday at Legacy Emanuel Hospital.

“I can only tell you what I saw with my own eyes, Barbara Vickers, Dow’s mother, said Wednesday. When I walked out and down the block, it was not my son who was holding onto anybody. The officer was holding my sons arm and swinging him around in circles. I really do not expect the truth because the police are going to put a spin on it the way they want to. Dow’s relatives and neighborhood witnesses contend police used excessive force with Dow and mishandled the situation, ignoring pleas from his mother and stepfather to let them calm their son, who suffered from paranoid schizophrenia.

Since the incident late Monday night and Dow’s unexplained death early Tuesday, Portland police had released few details on the incident.

On Wednesday afternoon, detectives began interviewing officers who either were directly involved in the altercation or witnessed it. They scheduled additional interviews with officers through next week. Two primary homicide detectives are handling the investigation, with help from the East County Major Crimes Team and the Multnomah County district attorneys office.

Police also Wednesday released the names of the officers they are interviewing. In addition to McClain, the Portland Police Bureau officers are Steven Andrusko, James Darby, Anthony Christianson, John Rebman, Kathleen Pahlke and Sgt. Chris Uehara, all of North Precinct; and Tom Lawton and Randal Yoshimura from Northeast Precinct.

According to the police account released Wednesday, two men were standing in the parking lot of the doughnut shop Monday night when Dow walked up and challenged them to a fight. A truck driver noticed a disturbance and called 9-1-1 from the shop at 10:11 p.m.

McClain, who was in the area, responded to the call, radioing his arrival across the street from the shop at 10:12 p.m. McClain saw Dow walking south across North Lombard Street when he stopped his car and got out, Kanzler said.

“He asks Dow, Whats going on? Whats happening here? Mr. Dow is very aggressive in his mannerisms. Mr. Dow walks towards him while saying obscenities and rather bizarre things to him, she said.

Police said that when Dow grabbed McClain, the school officer radioed at 10:12:58 for police to step up cover. At 10:14 p.m., McClain radioed for Code 3, the heightened emergency code that signals an immediate response from other police.

“During the struggle, the officer is able to get to his radio to call for Code 3 cover, Kanzler said. The officer is trying to break away.

Dow’s mother and stepfather, who live on North Fenwick Avenue, heard Dow screaming for help. They both ran from their house and said they saw an officer holding Dow’s arm and trying to spin him around. The mother and stepfather said they both pleaded with the officer not to hurt their son because he suffered from a mental illness and that they could calm him down. By the time other officers arrived, Dow’s mother and stepfather were both handcuffed and taken into custody.

Police have not discussed what occurred next other than saying officers tried to subdue Dow, whom they described as being in an extremely agitated state. Police did confirm Wednesday that officers used both pepper spray and batons to try to subdue him.

Dow stopped breathing at the scene, but paramedics revived him before transporting him to the hospital. An autopsy conducted Tuesday showed Dow sustained two rib fractures and several bruises and scrapes but no injuries sufficient to explain his death.

Portland Mayor Vera Katz met Wednesday with several police commanders and Kanzler for an update on the investigation. Katz said she plans to meet today with Chief Charles Moose, who has been out of town attending an International Association of Chiefs of Police Conference in Utah, and have a news conference.

Meanwhile, Dow’s family is planning a candlelight vigil at the corner of North Fenwick and Lombard Street at 9 p.m. Friday.

“Were all concerned that we will be able to get through the questioning of the officers as soon as possible. There’s nothing were going to be able to say until that work is done, Katz said.

POLICE TRAINING GIVES BASICS ON DEALING WITH MENTALLY ILL – October 22, 1998

Officers encounter a suspect who may be suffering from a mental illness.

What do they do?

All Portland Police Bureau officers are given training on how to handle someone with a mental illness, but some situations require them to seek specialized help.

That’s when they call in the bureaus Crisis Intervention Team, composed of more than 100 officers who have had in-depth training on how to approach a mentally ill person and defuse a potentially volatile situation.

But when members of the team aren’t available, first-response officers must handle the situation.

Its unclear if CIT officers were called Monday night when police in North Portland scuffled with Richard C. Dickie Dow, a 37-year-old man who family members say had a history of mental illness. Dow collapsed during the scuffle and died nine hours later. An autopsy said his injuries from the scuffle were not sufficient to cause his death.

Family and witnesses of Mondays altercation question how police handled the case. But police say if officers are confronted with someone who is violent — even if the person has a mental illness — the first thing to do is take control of the situation.

“If you have an immediate violent crisis, you’re not going to use talking techniques, said Detective Sgt. Cheryl Kanzler, a Police Bureau spokeswoman. At that point, you need to take immediate action, she said.

Sara Westbrook, the teams coordinator, said each member of the Crisis Intervention Team has gone through 40 hours of specialized training.

The training includes a basic course on chronic mental illness, developmental disabilities and the areas mental health system, Westbrook said.

The average officer, on the other hand, gets a four-hour overview during police academy training, Westbrook said.

While the team has more than 100 members, only about 60 work the streets, Westbrook said. The rest have either been promoted or transferred to non-uniform positions.

“We never seem to have enough to fill the ranks, said David Barrios, an officer on the Gang Enforcement Team who received the training about three years ago.

“Ideally, there would be a CIT officer assigned to each shift at each precinct, Barrios said.

Neil Falk, an assistant professor of psychiatry at OHSU, has helped train members of the CIT team for the last two years.

“I discuss how to approach someone and figure out if someone is mentally ill, Falk said.

Sometimes, that can be difficult if a suspect is violent. But in general, he said there are certain clues.

“Are they doing something that looks unusual? Falk said. For example, is the person wearing five coats in the middle of summer or almost nothing in winter?

Falk also teaches officers to listen and respond to what suspects say.

“Are they complaining about being followed by police or FBI? Falk said. You need to know what questions to ask. Are you feeling depressed? Are you feeling suicidal?

In a situation when a suspect has been in a fight with someone, Falk said officers should ask what the fight was about.

“See if it makes sense, he said. If he says, My neighbors been spying on me through the windows, that may be true. . . . But if he says, They’re bugging my phone and putting cameras in my room, . . . the stranger it sounds, the more likely the person has a mental illness.

Falk said its important to calm the person and de-escalate the situation.

“If someone is mentally ill, agitated and not responding to de-escalating measures, you need to make a decision, Falk said. Do you let the person walk away, or . . . take action?

If officers feel they need to physically control the person, they should use the least amount of force possible, Falk said.

“You should warn the person, he said.

Speak gently, Falk said. Were going to physically grab you. If he refuses, then you have to grab him.

Training Capt. C.W. Jensen said when police encounter any person who is violent, the first priority is to get control of the situation, even if that means using force.

The general guidelines are for officers to use only the amount of force necessary for each situation, he said.

Using force, or a control measure, could be as simple as giving a voice command, he said.

Most police encounters end at this lowest level of control, he said.

“An officer, like water, always will choose the path of least resistance, he said.

For example, an officer yelling, Stop! or Come with me, can take it up a notch by grabbing a persons elbow or wrists if the suspect is uncooperative, he said. If the suspect becomes combative, an officer may use pepper spray, Jensen said. If that doesn’t work, an officer may use a baton or bean-bag gun.

There are a whole number of tools officers can use to control someone, Jensen said. An officers response is dictated by the decision of the suspect.

It is not a stepladder approach, he said.

“Its not like the alphabet, he said. You don’t have to go from A to B to get to C. You can go immediately to C if the situation warrants it.

FEDERAL OFFICIALS PLAN TO LOOK INTO DOW CASE – October 23, 1998

The family of the man, who died in police custody, ask the Justice Department to evaluate whether civil rights violations occurred

Federal authorities said Thursday they would review a Portland Police Bureau investigation into the death of Richard C. ” Dickie ” Dow, a North Portland man who collapsed in police custody and died Tuesday.

The U.S. Department of Justice, at the request of Dow’s family, will evaluate whether any civil rights violations occurred, said Gordon Compton, an FBI spokesman.

The federal review will take place once the Portland police investigation is complete. The police report will be forwarded to the Portland office of the Federal Bureau of Investigation, which will determine whether follow-up interviews should be conducted. The information then will be sent to the Justice Department in Washington, D.C.

“We have no problem with that request,” Portland Police Chief Charles Moose said. “The work will be done, and the work will be shared.”

Mayor Vera Katz and Moose expressed sorrow to Dow’s family during a news conference Thursday at the Justice Center. Moose, speaking publicly about the incident for the first time since returning from an out-of-state conference, said he and the bureau were disturbed by the death. But he said there was no evidence of police malice.

“On the day this occurred, no one in the Portland Police Bureau was looking for this situation,” he said. “I want to stress there is no indication of any intent of malice by any officer involved.”

Dow, 37, a diagnosed paranoid schizophrenic, died Tuesday morning at Legacy Emanuel Hospital, about nine hours after he collapsed on North Fenwick Avenue as at least eight officers tried to restrain him after a police call about a fight. The state medical examiner is awaiting results of toxicology tests to determine the cause of death.

Dow’s relatives fault police for his death, saying the officers used excessive force. They have retained a lawyer and might ask another doctor to conduct a separate autopsy.

Detectives are continuing to interview officers who were involved in or witnessed the incident. They said Dow was aggressive and combative to Portland School Officer Dennis McClain, the first to respond to the Monday night police call about a fight outside Winchells Donut House on North Lombard Street.

Dow was walking across the street when McClain heard the call, stopped and asked him what had happened. Police said Dow turned on McClain, grabbed his arms and said things that McClain could not understand. Police said McClain had no chance to call a crisis intervention officer, who is specially trained to handle mentally ill suspects.

A crisis intervention officer was among the officers who responded once McClain called in a Code 3 request for emergency backup, but by then the situation had escalated, Moose said. Dow’s aggressiveness toward McClain forced officers to take control with physical force, he said.

“All indicators are the school police officer was not given any time to create any space between himself and Mr. Dow, Moose said. All indicators were this was not a CIT (Crisis Intervention Team) situation.

All Portland officers receive basic training on how to handle someone with a mental illness, but CIT officers receive more extensive training.

Barbara and Ted Vickers, Dows mother and stepfather, think officers unnecessarily beat Dow with batons as police thwarted the Vickerses attempts to calm him. The Vickerses were handcuffed and detained, police said, because they were intervening in a volatile situation, and officers didnt know who they were.

Neighbors have questioned why police did not perform cardiopulmonary resuscitation when Dow stopped breathing at the scene. Portland police discontinued CPR training in 1991 and instead rely on the quick response of paramedics and fire emergency medical providers.

“Its more important to train on the things we do well, Moose said. Unfortunately, we cant be everything to everybody.

The police investigation is expected to continue into next week, and findings will be presented to a grand jury soon after that.

Dows family is planning a candlelight vigil in their sons memory at 9 tonight at North Fenwick Avenue and Lombard Street.

Katz urged witnesses to share information by calling detectives at 823-0400.

STATE MEDICAL EXAMINER KNOWS CONDITION WELL – October 24, 1998

Positional asphyxia is a condition that State Medical Examiner Larry Lewman is familiar with.

Lewman co-authored a 1993 article that looked at 11 cases in California and Oregon of people who died in police custody. The article, published in The American Journal of Forensic Medicine and Pathology, states that the condition, which involves the cardiovascular and respiratory systems, is not uncommon but is under-reported in medical journals.

In each case, like the Monday incident involving Richard C. Dickie Dow, police encountered someone acting wild, threatening or agitated.

Lewman described such behavior as excited delirium, which is commonly produced by an excess of stimulant drugs such as cocaine, but it also can occur in a person with a mental illness. Dow suffered from paranoid schizophrenia.

In this state, the body secretes adrenaline-type hormones that can disrupt the heart, particularly an enlarged or otherwise diseased heart, Lewman said. Dow had an enlarged heart.

In all the cases studied, it took several people to control and restrain the subjects, according to the article, co-authored by Lewman and Ronald L. O’Halloran of the Ventura (Calif.) County Medical Examiners Office. In all cases, they continued to struggle while restrained initially and, minutes later, were noticed to be unconscious or dead.

Eight Portland police officers used batons and pepper spray to stop and subdue Dow. They handcuffed him and attempted to secure his feet in a hog-tie position but stopped when they noticed he wasn’t breathing.

Lewman said similar deaths are caused by a complex combination of factors and characteristically occur when police physically restrain an excitedly delirious subject into a face-down position.

Such a position impairs breathing, he said.

As a subject continues to struggle, both heart and respiratory rates increase, the chest wall is restricted and the person cannot get enough air, particularly if they are obese or have large abdomens, Lewman said.

Lewman’s 1993 paper concluded that police should be given more information on the syndrome and, at minimum, closely monitor subjects who fit the profile, especially if they are hog-tied. The paper also points out that some police agencies have eliminated hog-tie restraints to control violent suspects.

“In light of the possibility of sudden death, it seems both humane and prudent to develop some safer means of control and protection, the paper concludes.

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150 PEOPLE GATHER FOR DOW VIGIL – October 24, 1998

Four nights after her sons screams drew her from her North Portland home and she saw him collapse during a struggle with police, Barbara Vickers returned to the site Friday night.

This time, about 150 people gathered around her for a candlelight vigil in memory of 37-year-old Richard C. Dickie Dow.

Relatives, neighbors, friends and strangers encircled Dow’s mother and stepfather, Ted Vickers, as they held candles high above their heads and wore yellow ribbons pinned to their clothes in a solemn tribute to a man they say died unjustly at the hands of police.

The peaceful vigil occurred hours after State Medical Examiner Larry Lewman ruled that Dow, a paranoid schizophrenic, died of positional asphyxia and that the injuries he suffered during the altercation with police did not cause his death.

But those gathered Friday night remain skeptical. They vowed to make sure Dow’s death was not in vain and to hold police accountable.

“How can we teach kids to respect the law when the law doesn’t respect us? said Chad O’Connor, Dow’s 17-year-old nephew, before he led those assembled in Amazing Grace.

The crowd, made up of senior citizens, teen-agers and children, gathered at 9 p.m. along North Fenwick Avenue, near North Lombard Street.

The light from a red candle, placed on the spot where Dow collapsed on Fenwick, flickered in the night, illuminating bouquets of pink, red and white flowers.

Dow stopped breathing at the site after at least eight officers tried to restrain him Monday night. He was revived by paramedics but died early Tuesday at Legacy Emanuel Hospital. Police say Dow was combative toward a Portland school officer who was investigating a disturbance outside a nearby doughnut shop.

Dow’s mother and stepfather have retained lawyers and promise to have an independent review of Dow’s death conducted.

But Friday night, they were simply grateful for the community commemoration.

“I appreciate their support so much, Barbara Vickers said, grasping her husbands arm. My son was someone who was dearly loved and will be sorely missed.

An ad-hoc coalition of community members is planning a march and rally at noon today in protest of police brutality.

The march will begin at the corner of Northeast Martin Luther King Jr. Boulevard and Cook Street.

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FINDINGS INDICATE MAN NOT BEATEN TO DEATH – October 24, 1998

Richard C. ” Dickie ” Dow, a mentally ill North Portland man who collapsed in police custody, died Tuesday from positional asphyxia, State Medical Examiner Larry Lewman said Friday.

The findings indicate that injuries Dow received in the altercation with police did not cause his death.

“The rampant speculation that Mr. Dow was ‘beaten to death’ is simply not true, and this rumor should be put to rest,” Lewman said in a news release.

Positional asphyxia usually occurs during forcible restraint involving an agitated person with a mental illness or who has used an excessive amount of stimulant drugs, Lewman said.

Lewman said the condition is not uncommon, and Dow’s is the second such death in Portland in more than a year. On Oct. 11, 1997, Reginald B. Gafford, 29, a Multnomah County jail inmate with a history of mental illness, died after struggling with deputies in a jail hallway.

Dow, 37, a diagnosed paranoid schizophrenic, collapsed Monday on North Fenwick Avenue when at least eight officers tried to restrain him after a police call about a fight. Nine hours later, Dow died at Legacy Emanuel Hospital.

Dow’s family blames police in the death, saying officers beat Dow with batons while trying to subdue him.

Lewman said Dow suffered six blunt force blows to his torso and legs, some of which are consistent with baton use.

“The only internal injuries were two fractured ribs on the left side,” Lewman said.

Police have said they used pepper spray and batons during the scuffle, but Lewman’s investigation rules out Dow’s injuries as contributing to his death.

“We’re glad that at least it will be put to rest that Mr. Dow was not beaten to death,” said Detective Sgt. Cheryl Kanzler, Portland Police Bureau spokeswoman.

Photographs Dow’s family took in the hospital hours after the incident showed blood coming from Dow’s nose and ears.

But Lewman said the bleeding depicted in the pictures is common in similar medical emergencies. It is caused by the heart pumping blood, which has a decreased efficiency in clotting, into injured areas.

Investigators for the law firm of Rieke & Savage, retained by Dow’s family, are conducting their own inquiry into the circumstances surrounding Dow’s death, attorney Forrest Rieke said.

“The condition that this doctor described has to do with people who are extremely agitated,” Rieke said. “We are working to see who was the cause of the excitement.”

Rieke said his firm has received permission to have Dow’s body held for an independent examination.

Kanzler took issue with the characterization that police pushed Dow into the excitable state that contributed to his death.

“The police had nothing to do with the state of agitation Dow was in when police arrived,” Kanzler said. “Dow physically grabbed a uniformed officer and dragged him down the street. He was already excited when police contacted him.”

Lewman’s investigation is nearly complete. Microscopic studies and additional toxicology tests should be finished next week.

Extensive toxicology tests already have been performed, Lewman said, and those tests did not detect cocaine or methamphetamine, commonly found in victims of “positional asphyxia,” Lewman said.

He also said medications commonly used to treat Dow’s longstanding psychiatric disorder weren’t present, which indicates Dow was not prescribed the drugs or for some reason was not taking them.

Dow had an enlarged heart and some coronary atherosclerosis, which “may or may not have played a role,” Lewman said.

Detectives say the incident began when Dow grabbed Portland School Officer Dennis McClain, who was the first to respond to a call about a fight Monday night outside Winchell’s Donut House on North Lombard Street.

Police said Dow approached McClain and grabbed the officer’s arms; the officer then called for emergency backup.

Officers said they needed to use physical force to subdue Dow, who was extremely agitated.

The police investigation into the death is continuing and will be presented to a grand jury for review, possibly next week. The FBI also will review the findings.

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400 JOIN MARCH TO DEMAND AN END TO POLICE BRUTALITY – October 25, 1998

An estimated 400 people rallied Saturday afternoon in downtown Portland against police brutality, less than a week after the death of a man in police custody.

Escorted by police motorcycles and patrol cars, the four-mile peaceful march down Martin Luther King Jr. Boulevard to the Justice Center primarily was sparked by claims that police brutality led to the death Tuesday of 37-year-old Richard C. Dickie Dow in North Portland.

On Friday, the state medical examiner determined that Dow did not die from injuries caused by police batons but from positional asphyxia, a condition that can afflict drug users and some people with mental illnesses while they are being held down.

The protest — organized by the October 24 Coalition, a group of organizations and individuals — rolled out a more-than-yearlong list of complaints and alleged abuses by city, county and federal law enforcement officers.

Among the signs protesters carried in the march were: Stomp Out Police Brutality, Communities United To Stop Police Brutality and No One is Free/When Others Are Oppressed.

One large banner listed what it termed One year of police violence in Portland. Another sign, carried by a child, read: Where Does My Future Stand With Police Brutality? Joseph Keller, whose son, Deontae [Keller], 20, was killed by police in February 1996, rode in the bed of truck as he led chants, offered commentary and directed a slate of other speakers over a boom mike.

March leaders, dressed in bright-yellow T-shirts with the words Monitor printed on the back, took turns leading the chants over hand-held bullhorns.

Frequently, motorists driving past the almost two-hour procession waved and honked in support. People emerged from shops along the four-mile route and shouted encouragement or waved.

One motorist chided the marchers for protesting police actions even as motorcycle units and patrol cars were escorting the march.

Later, Keller urged the marchers to send up an appreciative cheer to their police escorts. We have some excellent police officers in this town, Keller said. Were not mad at them . . . they’re doing what they should, protecting us. . . . But there are others on the force who arent doing what they should. Thats who were going to have to get out of those positions.

Agreement to that came from Travis West, a former wrestling champion who said he was shot by a beanbag shotgun during an Aug. 17 protest in Northeast Portland.

“Theres a cancer running loose in Northeast Portland, West said at a post-march rally on the Justice Centers front steps. The cancer involves the Portland police doing things that we would consider needless deaths and homicides. No matter what color you are or what your ethnic group or creed, murder is murder.

“Power is a very dangerous thing, West said. And the abuse of power is what were dealing with here. . . . Nows the time to stop it.

Dan Handelman, a march spokesman, said the Portland coalition believes that Portland’s citizen review board, the Police Internal Investigation Auditing Committee, needs more independent oversight powers. It also opposes mandatory-minimum sentences for victimless crimes and the use of less-than-lethal beanbag shotguns for crowd control.

The group also wants the city to research whether law enforcement officers should continue to be allowed to use pepper spray.

Helen Ruth Sherman, a longtime Northeast Portland resident, said she is concerned that many of the confrontations between the police and community members have racial overtones.

“Maybe we need to sit down and talk about these things, said Linda McKinney, another Northeast Portland resident who said that she fears for the safety of her two biracial children. Mothers are saying they can’t sleep at night because they fear the police will kill their children.

“Unless people in all of our communities get together, its not going to stop, said Hyung Nam, a high school teacher who lives in Southeast Portland. Nothing is going to change unless we come together.

POLICE THE PORTLAND POLICE – October 26, 1998

An independent look into police handling of a North Portland man who collapsed in police custody and died Tuesday is exactly what this community needs. We also need police who can — and will — quickly administer potentially life-saving CPR when its desperately needed.

Federal authorities said Thursday that they would review the Portland Police Bureaus investigation of the circumstances surrounding the death of Richard C. Dickie Dow. The 37-year-old man, a diagnosed paranoid schizophrenic, died at Legacy Emanuel Hospital about nine hours after he collapsed on North Fenwick Avenue as at least nine officers were trying to subdue him.

Dow’s relatives say police used excessive force. Examination showed at least six blunt-force blows to Dow’s torso and legs, some consistent with weapons used by police. But none of Dow’s injuries was life-threatening, and the coroner and state medical examiner found no indication that Dow died of those injuries.

Instead, the examiner concluded that Dow died from positional asphyxia. As he struggled and police restrained him in a prone position, his breathing became more difficult. Finally, his heart stopped.

Still, the family’s complaints about excessive police force deserve investigation. Some police agencies have eliminated certain restraints in controlling violent subjects, according to Dr. Larry V. Lewman, the state medical examiner. At a minimum, prone, hogtied subjects should be closely monitored for vital signs while awaiting or being transported for medical care, he wrote in the American Journal of Forensic Medicine and Pathology in 1993 — advice that regrettably few police agencies have taken.

The circumstances of Dows sudden death should be fully and openly explored. Weve called time and again for public inquiries where police are involved in deaths.

One important reason is that openness is vital to police credibility. Portland cant talk community policing and then shut out the community on policing the police.

Openly analyzing police performance can remove some concerns about internal cover-up. It can provide needed information for upgrading services, such as treatment for mental problems. It can argue for needed changes in police policies and training — a need that became apparent Tuesday when police restrained a highly upset man in a prone position where his breathing could become restricted, and then did not administer CPR after he stopped breathing.

Were aghast that Portland police discontinued cardiopulmonary resuscitation recertification in 1991. Now they rely on the response of Fire Bureau and ambulance paramedics — while fire officials warn that it takes up to 15 minutes for emergency crews to respond to some calls.

Police Chief Charles Moose says of his officers, Its more important to train on the things we do well. No, sir. Portlanders dont expect to see their police officers standing around when someone desperately needs CPR. For people who arent breathing, seconds are precious.

We dont know if Dow could have been saved, but we do know that Portland police should reinstate CPR training immediately — and practice it when its needed. They also should review their restraint procedures involving agitated, violent prisoners.

Reports are mixed about whether any of the Portland bureaus 50 officers specially trained to deal with mentally ill people were on the scene. The goal ought to be one such officer at every precinct on every shift.

Members of the East County Major Crimes Team — investigators from the sheriffs office, Gresham Police Department and District Attorneys Office — are working with Portland detectives investigating police handling of Dow. Now, federal authorities will evaluate whether any civil rights violations occurred. A grand jury could be asked to consider — in secret — possible wrongful behavior, and Portland police will conduct their own internal investigation.

That’s significant oversight of Portland police performance, and reports will be forthcoming. But police performance is a public concern. It needs to be considered in public.

PORTLAND POLICE WILL REVIEW CPR OFFICER TRAINING – THE BUREAU STOPPED PROVIDING REFRESHER COURSES IN CARDIOPULMONARY RESUSCITATION SOME YEARS AGO – October 27, 1998

The recent death of Richard C. Dickie Dow will prompt Portland police to review whether to bring back refresher CPR training for officers, and it is stirring debate about whether statewide standards for law enforcement should be adopted.

The Portland Police Bureau stopped providing refresher training in cardiopulmonary resuscitation between 1989 and 1991 as part of a massive cutback in training. It was reinstituted for a short time under then-Chief Tom Potter in November 1991 but discontinued by spring 1992, bureau records show.

“We will revisit the CPR issue, as we will any other issue raised in this investigation, Detective Sgt. Cheryl Kanzler, a Portland police spokeswoman, said Monday.

Dow died in police custody last Tuesday after he collapsed during a struggle with at least eight police officers. Dow stopped breathing on North Fenwick Avenue, and despite a citizens offer to help resuscitate him, police waited for paramedics, who revived him. Dow died the next morning at Legacy Emanuel Hospital, and State Medical Examiner Dr. Larry Lewman determined that the cause of death was positional asphyxia.

All Portland officers who complete basic training are certified in cardiopulmonary resuscitation after a four-hour course. But their certification has been allowed to lapse the past six years.

Both Chief Charles Moose and Mayor Vera Katz have said the CPR refresher courses were not reinstituted because the city relies on the quick response of Portland firefighters and ambulance personnel.

“Its not proven to be an issue, Moose said last week.

Katz, who serves as police commissioner, said she would be open to re-examining bureau policy.

Portland police used to provide training to keep officers CPR certification updated, but then-Chief Richard Walker decided to cancel all in-service training in 1989. He halted the courses because he wanted to keep officers on the street fighting gangs and drug dealers, instead of taking them off the street for one week of review training per year.

The CPR refresher training was reinstituted in November 1991 after a man died in police custody, but that was discontinued by spring 1992, Portland police Training Capt. C.W. Jensen said.

The bureau has not been able to pinpoint why it discontinued the training, but Jensen suggested it might have been because of concerns about officers liability or contracting communicable disease.

We have a great emergency medical response in Portland, Jensen said. This is the first time the issue has been raised, so I wouldn’t say its been a problem.

The general requirement to maintain CPR certification consists of a three-hour refresher course every two years, said William Collins, Multnomah County’s director of emergency medical services.

“I dont know why Portland wouldn’t do the training — its not that onerous, Collins said. Even if theyre not designated the first-responders, police are often the first people on the scene. It would definitely be a plus if they were trained.

Dr. John Jui, director of Multnomah County’s emergency medical services and an associate professor of emergency medicine at Oregon Health Sciences University, would support a state mandate requiring police to maintain CPR training.

“It would make sense that any law enforcement would have a minimum CPR certification that is updated regularly, Jui said. The data from the medical literature is very clear: If you do CPR alone the chances of survival doubles on someone who has stopped breathing.

Jui dismissed police concerns that if officers did not do CPR properly, they could make things worse.

“There’s not a risk if you’re going to try to save somebody, Jui said.

Portland firefighters, Multnomah County sheriffs deputies and Oregon State Police all receive continual CPR training.

During the next legislative session, lawmakers are expected to consider whether the state should adopt maintenance training standards for all law enforcement.

Alan Scharn, deputy director of the state Department of Public Safety Standards and Training, said that debate could include things from CPR to firearms training.

POLICE GAVE DOW CPR, INTERNAL REPORT SAYS – November 13, 1998

Two Portland police officers performed CPR on Richard ” Dickie ” Dow last month when the mentally ill man collapsed and stopped breathing in their custody, a summary of a police investigation shows.

The four-page report reveals the findings of the Portland Police Bureau’s internal investigation into Dow’s death Oct. 20. It also provides a synopsis of the officers’ testimony to a Multnomah County grand jury hearing the case.

The police account conflicts with statements witnesses made after Dow’s death but states that two neighbors changed their stories from the initial statements they gave police the night of the incident.

Dow, 37, a paranoid schizophrenic, collapsed on North Fenwick Avenue on Oct. 19 as officers tried to restrain him after he assaulted a school police officer responding to a call of a fight. Dow died the next morning at Legacy Emanuel Hospital. His mother and stepfather, who tried to tell officers about their son’s mental condition, were taken into custody and later released.

Police said Thursday that they earlier chose not to refute witness statements that officers failed to conduct cardiopulmonary resuscitation because they did not want to interfere with the investigation.

“They were trying to protect the integrity of this investigation,” said Detective Sgt. Derek Anderson, a police spokesman. “They were scrupulously loyal to this investigation and didn’t even broach the allegations that were flying around. Now that the investigation is complete, the facts are what we hope people will hang their hats on.”

The grand jury testimony is expected to be completed today, with State Medical Examiner Dr. Larry Lewman called to testify about the autopsy results. Once the grand jury completes its work, the Police Bureau will release the full investigative report. The full report also will go to federal officials, who will determine whether civil rights violations occurred.

An independent inquiry into Dow’s death also continues at the request of his family.

Dow’s mother, Barbara Vickers, who testified before the grand jury, said Thursday that she does not accept the report.

GRAND JURY RETURNS NO INDICTMENT IN DEATH – November 14, 1998

A grand jury on Friday unanimously declined to indict Portland officers in the death of Richard C. Dickie Dow, a mentally ill man who died last month in police custody.

As police welcomed the outcome, and Dow’s attorney, family and neighbors criticized the decision, Police Chief Charles Moose appointed two committees to re-examine whether officers need additional training in CPR, or training in alternative tactics for handling suspects with extreme violent tendencies.

“I understand the necessity to continue to learn and grow, Moose said. Certainly this incident has brought those two issues to the forefront.

Dow, 37, a paranoid schizophrenic, collapsed in police custody Oct. 19 as officers tried to restrain him. Two officers attempted to do CPR, police said. Paramedics soon arrived and revived Dow, but he died the next morning at Legacy Emanuel Hospital.

The grand jury met for six days and heard 35 witnesses, including several whose accounts contradicted police testimony, Multnomah County District Attorney Michael Schrunk said.

The Portland police investigative report on Dow’s death, released Friday night after the grand jury was dismissed, continued to point up discrepancies between what officers and witnesses said was done to assist Dow once he stopped breathing.

Schrunk said it was not a matter of the jurors believing one side over another but a consideration of the cumulative facts.

“Obviously my clients are concerned about such a conclusion, and don’t agree with it, said Forrest Rieke, an attorney for Barbara and Ted Vickers, Dows mother and stepfather. He said his investigators are continuing an independent inquiry. Federal officials also will examine the police investigation to determine whether civil rights violations occurred.

Schrunk made it clear that the grand jury decided only that there was no criminal culpability. It did not decide whether officers violated Portland Police Bureau policy or used excessive force, whether officers might be liable in a civil lawsuit or whether police procedures and training are appropriate.

State Medical Examiner Dr. Larry Lewman ruled Dow died of positional asphyxia, or sudden death syndrome, in which a persons body position interferes with respiration, resulting in suffocation. The condition usually occurs during forcible restraint involving someone with a mental illness or who has used an excessive amount of drugs.

Portland officers are trained to assess whether a suspect is likely to suffer from the syndrome. When possible, they are trained to limit the suspects physical exertion.

Police said Dow was uncontrollable, flailing his arms and kicking officers even as they used pepper spray, struck him with batons and took him to the ground in an attempt to control him.

Dr. Peter Kohler, president of Oregon Health Sciences University, will lead a committee examining whether police need better training on how to recognize or react to sudden death syndrome.

“Do most officers want a prettier, simpler solution than beating a guy down with a baton or putting him down on his chest? Yes, said Tom Mack, secretary-treasurer of the Portland Police Association. If the bureau or citizens can come up with something that works better, then were all for that.

Fire Chief Robert Wall will head a committee on emergency medical response that will evaluate whether police should have continual CPR training, what type of medical equipment they should carry and how much new training or equipment would cost.

Portland police receive CPR training when they join the bureau as part of basic academy courses, but the bureau eliminated annual refresher training in 1992 because of budget and staffing shortfalls.

According to the Portland police investigative report released Friday, the incident began when Dow made threatening remarks to two men outside the Winchells Donut House on North Lombard Street. One of the men called 9-1-1 after Dow threatened to poke one in the eye with a screwdriver.

Portland School Officer Dennis McClain was the first to respond. Once he got out of his car, he said, Dow grabbed his wrists and dragged him about 150 feet.

McClain called for emergency backup. Six officers tried to restrain Dow, but he continued to flail and kick officers as they tried to subdue him with pepper spray and their batons, the report says.

Officer Steven Andrusko grabbed Dow in a bear hug and took him to the ground. Once he was face down on the ground, with his head to the side, officers managed to cuff Dow’s hands. As they crossed his ankles and bent them to his buttocks, they noticed he had stopped breathing.

Police immediately removed the handcuffs and rolled him over.

Officers Kathleen Pahlke and John Rebman attempted CPR, but the effort did not go smoothly because of problems with a protective mask, documents show.

Pahlke screamed for an officer to get her a protective mask as she bent Dow’s head back to clear his airway. The mask is a device with a bag attached that allows artificial respiration without actual mouth-to-mouth contact.

“I started to do CPR, applied a couple of chest compressions, and Officer Pahlke said we need to get some air in, get, get him breathing first, Rebman told investigators. About that time, the mask showed up. We attempted to give him a couple of breaths, three, four real good hard breaths with that. And I never saw his lungs inflate at all. So, about that time, we kind of briefly stopped.

Rebman, who received CPR training in 1991 but has had no refresher course since, said he had trouble snapping on an airway piece attached to the protective mask that sealed off Dow’s nose and mouth.

“From my training many years ago, I kinda remember that you snap that onto the fixture inside of the mask, and then that airway goes down inside the mouth, he told investigators. I just couldn’t get it on. So rather than to continue fighting with it, I made an effort to just use the mask without that and see if it wouldn’t work.

Paramedics told investigators that when they arrived, they did not see police providing emergency medical care. Several neighborhood witnesses also said they never saw officers perform CPR.

Some were disappointed with the outcome of the grand jury.

“I’m not terribly surprised, but I’m very angry, said Deborah Howes, who said she offered to perform CPR at the scene the night of the incident but was told to move away. Police, in their report, said Howes probably did not see officers perform CPR because she went into her home briefly to shut off running bathwater.

“I’m mostly angry that they’re trying to discredit me, Howes said Friday. Were not happy that there isnt justice in this system.

The Portland police investigation included accounts of several prior altercations Dow had been involved in, including a 1995 unprovoked assault against a Fred Meyer food department manager.

At the time of that incident, Dows sister confided to store security that Dow’s family never knew how he would act when he was off his medication. His mother and stepfather have said Dow had not been using medication for months.

Nine officers involved in the Dow incident took three days of paid administrative leave after Dow’s death, and all have returned to work. Two received hate mail. Some told investigators the incident was terrifying.

“I was afraid, said Officer James Darby, who was blinded by pepper spray used against Dow. When you’re involved in an encounter like this, and everything that you’re taught to be true is suddenly not, and nothing you’re doing is working, and this person is still coming at you and still attacking you . . . that’s a terrifying position to be in.

Moose said his decision to review police training and procedures is not a reflection on the officers who were involved.

“I think we have a ruling that certainly tells me that they all performed very admirably, he said. Yes, its a tragedy, but there is no one here to be blamed.

Neighbors and friends of the Dow family plan a candlelight vigil Friday where Dow collapsed, marking one month since his death.

ACCOUNTABILITY IN DOW CASE PORTLAND POLICE BUREAU IS RIGHT TO REVIEW TRAINING, PROCEDURES EVEN THOUGH GRAND JURY CLEARED OFFICERS OF CRIMINAL WRONGDOING – November 15, 1998

This appeared to be an unsigned editorial from The Oregonian’s editorial board

The decision of a Multnomah County grand jury not to bring charges against Portland police officers involved in the Oct. 19 death of Portlander Richard Dickie Dow confirms what many people already believed.

Police were doing their difficult job.

Dow’s death was tragic, but not criminal. It could not have been predicted. Nor was it, in the grand jurys judgment, the result of criminal police misconduct.

There are some questions that remain about the incident, but the grand jury’s decision should lay to rest the most pressing public issues.

The police bureau also released Friday its reports of the investigation into Dow’s death. That was the right decision. The report will provide the public with a basis to make judgments about both the grand jury decision and the Portland Police Bureaus actions during the incident and afterwards.

Police Chief Charles Moose also made the right decision in launching a review of the bureaus readiness to perform basic first aid in situations surrounding incidents like the Dow case.

That is a training-and-procedures question, mostly. But, the police probe of the Dow incident noted that, at one point, officers were scrambling around in an effort to find a CPR pump. So the inquiry should determine, among other things, whether police cruisers in Portland carry the proper equipment for such things. (Moose points out, again correctly, that CPR does not actually require any special equipment, although having it is better than not having it.)

Moose also said that the bureau would ask Dr. Peter Kohler, president of the Oregon Health Sciences University, to lead an assessment of the bureaus training on how to deal with Sudden Death Syndrome, which is what medical examiners concluded killed Dow. All of those steps are prudent responses to what the bureau learned from the Dow incident and its investigation of it.

Obviously, none of them are likely to bring an end to the case quite yet.

Lawyers for Dow’s family are conducting their own investigation of the incident, as is their right. Nobody knows where that will lead, though many of us have guesses.

In the areas where the general public has legitimate concerns about police training and conduct, though, the bureau appears to be taking all the right steps.

Moose complained last week that calls for police accountability, in this space and elsewhere, gave the impression that police had engaged in some sort of misconduct in the Dow case. We never did think that, and intended to convey no such impression.

But accountability is important.

Police have more power than average citizens. They are armed and backed by the power of the state. Their actions should be subject to greater scrutiny.

Obviously a grand-jury investigation amounts to close scrutiny, but true accountability extends beyond that. By releasing its investigative report, speaking more-or-less freely, and undertaking reviews of its policies and training, the bureau, under Moose, has begun to take the concept seriously.

DOW’S FAMILY EXPRESSES CONCERNS – December 4, 1998

The family of Richard C. ” Dickie ” Dow and their attorney will assemble Saturday at the site where the 37-year-old mentally ill man collapsed in police custody to press concerns that his October death has not been fully investigated.

Although a grand jury determined that there was no criminal wrongdoing in Dow’s death and declined to return indictments against the officers involved, Dow’s family and lawyers are not satisfied.

Through their lawyer, the family issued a three-page statement Thursday that listed 17 questions and concerns. The law firm is in the initial stage of its own investigation, and the U.S. Department of Justice is expected to evaluate whether civil rights violations occurred.

“We recognize we’re just getting started,” said Forrest J. Rieke, a lawyer representing Barbara and Ted Vickers, Dow’s mother and stepfather. “The family has worked with us to generate questions we’re pursuing. The issue primarily is how to help those who have lost the ability to think rationally, and how do we avoid provoking them once we identify they have a problem.”

Dow, 37, a paranoid schizophrenic, collapsed in police custody Oct. 19 near North Fenwick Avenue and Lombard Street. Officers were trying to restrain him after they say he assaulted a Portland school officer responding to a disturbance outside a doughnut shop.

He stopped breathing at the scene. Two officers attempted to perform CPR but had difficulty. Paramedics were able to revive him, but he died the next day at Legacy Emanuel Hospital.

The state medical examiner ruled the cause of death was positional asphyxia, or sudden death syndrome, in which a person’s body position interferes with respiration, resulting in suffocation.

The Dow family questions whether the police use of pepper spray against Dow affected his condition, why police detectives had to wait several days to question some officers involved and why Dow’s mother and father were handcuffed when they tried to alert police of Dow’s mental illness.

“The detectives conducted a complete and thorough investigation. All that information was referred to the grand jury,” said Detective Sgt. Derek Anderson, a Portland police spokesman. “All we’re interested in is the truth. We wouldn’t inhibit the Dow family from doing whatever it is they think is necessary.”

OFFICER HELPS THE MENTALLY ILL IN CRISES – December 10, 1998

When Officer Keith Morse began patrolling Portland’s streets seven years ago, one of the most disturbing parts of the job was picking up mentally ill people and figuring out how to get them help.

“I’d have someone in the car who is extremely suicidal, and I’d be driving around for four or five hours searching for a place to take them,” Morse recalls. “It was an abominable situation.”

At other times, Morse might take a schizophrenic person who was hearing voices and acting belligerent to a hospital emergency room. By the time they reached the hospital, the person had sometimes calmed down, and doctors would snap, “Why’d you bring him here?”

Today, finding the proper care for people suffering from mental illness is one of Morse’s strengths. And mental health agencies often call on him to help calm a person or ease a situation.

Those abilities prompted the Multnomah County chapter of the National Alliance for the Mentally Ill to honor Morse as its 1998 Crisis Intervention Officer of the Year during its annual awards banquet in November.

“Everybody always breathes a sigh of relief when Keith shows up. Things just seem to go smoothly,” said Sara Westbrook, coordinator of the Portland Police Bureau’s Crisis Intervention Team. She nominated Morse for the honor.

Morse, one of 97 Portland officers specially trained to handle calls involving the mentally ill, is the third officer the group has honored. Past recipients were Michael Malanaphy in 1997 and David Barrios in 1996.

Morse, 32, is a patrol officer assigned to Central Precinct. Since his training as a crisis intervention officer 21/2 years ago, he often is tapped to respond to calls of attempted suicides, those involving people who are severely depressed or mentally ill. He also responds to calls for backup from other officers who may need his specialized training in working with the mentally ill.

He said he sought the special 40-hour training because he wanted to better understand the mentally impaired and their challenges. Many calls, he said, are disturbing. A paranoid schizophrenic who cuts herself repeatedly to release the demons inside her and a depressed teen-ager who tries to swallow a dozen razor blades are among those he has faced.

“To me, it was extremely fascinating to think what goes on in a person’s mind to drive them to do that,” Morse said.

A graduate of the University of Oregon, Morse majored in business and minored in psychology.

“So with my training in psychology, this just bridged my interests,” he said.

With the January 1997 dedication of the Providence Crisis Triage Center, at 5228 N.E. Hoyt Street, east of Providence Portland Medical Center, police now have a place to take the mentally ill where they will be guaranteed 24-hour psychiatric evaluation, care and counseling. On average, Portland police refer about 70 people a month to the center or to other mental health agencies, Westbrook said.

Becca Surls, a Project Respond outreach worker who assists the homeless and mentally ill, said Morse’s low-key style and caring personality have made him effective. “He’s very calm and interacts well with our clients,” Surls said. “He treats them all respectfully. Sometimes when people won’t even engage with us, they will talk to him.”

On one call, for example, Morse rallied a church group to help a mentally ill woman who loaded all her clothing and furniture in 20 shopping carts and then pushed them block by block, thinking this was how she would move to Salem. Morse persuaded the church group to help haul her belongings back to her apartment, avoiding a potential property seizure.

“When we run into roadblocks and can’t figure out what to do, he is very effective in coming up with alternative options with us,” Surls said.

Last December, the Chief’s Forum, a group of community representatives who meet twice a month with the police chief, presented Morse with its highest honor, the Nathan Thomas Memorial Award, for his efforts Sept. 6 in saving the life of a man who was threatening to jump off the Fremont Bridge. Morse called the man’s sister in New York on a cell phone and relayed messages between the two, and finally Morse grabbed the man’s arm as he began to teeter on a 4-foot-wide ledge.

Morse said he wants to dispel the notion that crisis intervention officers always can defuse a violent situation. For example, in the case of Richard C. ” Dickie ” Dow, a paranoid schizophrenic who died in police custody after struggling with officers Oct. 19, police said the situation already had escalated, leaving no time for crisis intervention techniques. Morse was not involved in the Dow case.

“I’m a police officer first and responsible for taking control of a situation and ensuring the public’s safety,” he said.

Yet as a crisis intervention officer, more often than not he works to ensure that someone who is mentally ill receives needed care.

“Knowing I can provide something that makes a person who has lost touch with reality feel a little better is satisfying,” Morse said. “You can make a difference.”

COMMITTEE ADVISES THAT POLICE UPDATE THEIR CPR TRAINING – April 30, 1999

Six months after a mentally ill man died in police custody after officers had trouble performing CPR, a committee has recommended that the Portland Police Bureau resume refresher training in cardiopulmonary resuscitation for all officers.

“It was sort of a logical conclusion,” said Dr. John Jui, director of Multnomah County’s emergency medical services. “Police get CPR training in their basic academy. So if police already have this knowledge, it makes sense to keep that training up-to-date.”

On Oct. 19, Richard C. ” Dickie ” Dow, 37, a paranoid schizophrenic, collapsed in police custody on North Fenwick Avenue. His death, and the problems officers had administering CPR, prompted Police Chief Charles Moose to set up the committee.

Moose has yet to formally sign off on the recommendation, but the bureau’s training division is already prepping to provide refresher CPR and basic first-aid classes in September. To remain certified, police would receive about eight hours of training in basic first aid and CPR every other year. The committee estimates it will cost $86,000 to provide training and equip police cruisers with protective breathing masks.

“We’ve had preliminary discussions, and we’re ready to put this on if that’s what the chief of police chooses to do,” said Capt. C.W. Jensen, who heads the training division and was on the committee.

Assistant Chief Mark Paresi said the recommendations will be further explored next week when Moose is in town. Moose is in New York at a National Crime Prevention Council meeting.

Other metro-area police departments, such as Gresham, Hillsboro and Beaverton, provide ongoing CPR and basic first-aid training. Some agencies, such as the Oregon State Police and Multnomah County Sheriff’s Office, offer more advanced emergency medical training.

Portland police stopped providing CPR refresher training between 1989 and 1991 as part of a massive cut in training. It was reinstituted in November 1991 but discontinued by spring 1992 because of budget and staffing shortfalls.

Two officers who tried to perform CPR on Dow had problems using a breathing mask. At least one of the officers had last received CPR training in 1991 and told investigators he had trouble snapping an airway piece to the protective mask that sealed off Dow’s nose and mouth.

Dow’s family is troubled that police were not current in their training, said Forrest Rieke, a lawyer representing the family.

“In my own view of community policing, the whole concept of having the police acting like friends of the citizens, as opposed to an aloof entity just driving around, is to have these kinds of services available,” Rieke said.

Fire Chief Robert Wall, who led the committee, suggested the bureau keep officers up-to-date in CPR and not move for more advanced training at this time.

“There are occasions when police are the first ones on the scene,” Wall said. “It’s always easier to maintain training than start new training.”

Yet the committee did recommend that the bureau study whether to equip police cruisers with automatic defibrillators.

Since 1997, Multnomah County sheriff’s deputies have had about 10 machines assigned to patrol cars and river patrol boats. But because of an agreement that the deputies will be dispatched only to emergency medical calls in unincorporated parts of the county, the machines rarely are used, said Lt. Brian Martinek, a sheriff’s spokesman.

Medical experts say they are effective. CPR will keep blood moving to a victim’s brain, but if the heart has stopped — what is known as ventricular fibrillation — rapid defibrillation is needed to save the victim from a heart attack. The defibrillators cost $3,500 apiece, and equipping the Portland police fleet would cost nearly $1 million, the committee estimated.

SOME POLICE CHANGES, CALLS FOR CHANGE – October 21, 1999

A year after a mentally ill man died in police custody after officers had trouble performing CPR, the Portland Police Bureau has resumed refresher training in cardiopulmonary resuscitation.

But relatives of Richard C. ” Dickie ” Dow and others who gathered Wednesday for a vigil outside City Hall to mark the anniversary of his death demand that much more be done.

“What police did is too little, way, way too late,” said Dow’s mother, Barbara Vickers, who joined nearly 20 others in the peaceful protest.

People for Police Accountability, a group of community members who have held monthly vigils to remember Dow, called Wednesday for stronger civilian oversight of police conduct, training in alternative tactics to defuse volatile situations with mentally ill people and a ban on police use of pepper spray.

A grand jury in November unanimously declined to indict officers in connection with Dow’s death. But the incident pushed Portland police to resume annual CPR refresher training for officers.

Incident outside doughnut shop On Oct. 19, 1998, Dow, 37, a paranoid schizophrenic, collapsed on North Fenwick Avenue as officers tried to restrain him once they were called to investigate a disturbance outside the Winchell’s Donut House on North Lombard Street.

Two officers, including one who had last received CPR training in 1991, attempted to perform CPR on Dow but had trouble using a breathing mask. Paramedics arrived and revived Dow, but he died the next morning in a city hospital.

Portland police receive CPR training when they join the bureau as part of basic academy courses, but the bureau eliminated annual refresher training in 1992 because of budget and staffing shortfalls.

The refresher courses resumed this year and are being taught by Portland firefighters, said Detective Sgt. Cheryl Kanzler, bureau spokeswoman.

Dr. Larry Lewman, the state medical examiner, ruled that Dow died of positional asphyxia, or sudden death syndrome, in which a person’s body position interferes with respiration, resulting in suffocation. The condition usually occurs during forcible restraint involving someone who has a mental illness or excessive drug use.

Portland officers are trained to assess whether a suspect is likely to suffer from the syndrome, and they are trained to limit the suspect’s physical exertion in those situations.

Sudden death syndrome Former Chief Charles A. Moose had asked Dr. Peter Kohler, president of Oregon Health Sciences University, to lead a committee examining whether police need better training on how to recognize or react to sudden death syndrome.

“That’s still under review,” said Officer John Wrigley, a bureau public information officer. “No changes have been made.”

Barbara and Ted Vickers, Dow’s mother and stepfather, hired an attorney to look into Dow’s death. No legal action has been taken. Forrest Rieke, their lawyer, said Wednesday the difficulty of the case revolves around the medical explanation of Dow’s death.

“The problem is they diagnosed a condition that is inconsistent with the circumstances of his death,” Rieke said. “Until we understand that difference, we can’t go forward.”

Rieke criticized police for what he described as negligence in failing to keep officers updated in CPR training. “That nonsense was remedied,” he said, “and that’s how it should be.”

PORTLAND LEARNING TO CALM CRISES – May 11, 2001

Officer Homero Reynaga, who has been with the Portland Police Bureau for three years, says he wants to be prepared for anything he may encounter when dispatched to an emergency call.

That’s why Reynaga volunteered to spend 40 hours this week in specialized Crisis Intervention Team training.

Reynaga is among 18 officers who will complete a week’s worth of training today on how best to resolve crises involving people who are mentally ill.

“When you’re on a call, you want to be ready for anything. This was one of the things I didn’t feel prepared for,” Reynaga said Thursday, between classes. “A lot of times you don’t have the resources to know where to refer people with mental health problems. This way, I’ll be able to do that.”

The Portland Police Bureau began training officers to be part of its first Crisis Intervention Team in July 1995. Of more than 1,000 Portland officers, 93 are now trained as Crisis Intervention Team officers, having completed a 40-hour certification course. Of those, 62 work in patrol and respond to the majority of crisis callouts.

By mid-May, another 15 Portland officers will be Crisis Intervention Team certified. One class will graduate today, and another will go through the training next week. In addition to Portland police, some Portland school police, Gresham officers, Portland State University security and Multnomah County parole and probation officers are participating.

“We’re training these officers to use better communication skills,” said Officer Ed Riddell, the team’s coordinator. “We’re not training them to be the panacea in all crisis negotiations.”

Two high-profile cases, the October 1998 death of Dickie Dow, a mentally ill North Portland man who collapsed during a struggle with police, and the April 1 fatal shooting of Jose Victor Santos Mejia Poot by police in a psychiatric hospital, have put more attention on the bureau’s crisis intervention training.

Police and mental health professionals have collaborated to provide the training. In the past week, officers have received classroom instruction on how to identify mental illnesses and personality and childhood disorders, and how to use communication skills to intervene in crises. They also spent one day learning about community resources by visiting mental health facilities in the Portland area, including hospitals, residential treatment centers, drop-in day-care centers and the Crisis Triage Center.

“It’s kind of nice to go in that atmosphere frequently so when you’re confronted with a person, you’ll know how to deal with that,” said Reynaga, who visited a downtown drop-in center run by the behavioral health care company Unity Inc.

On Thursday, nurse practitioner Dan Kamada, who works at the Columbia River Correctional Institution, gave officers tips on how to “talk down” someone who is angry, agitated and hostile.

He said there is a normal progression of emotions, from a state of calm to anxiety, anger, hostility and then violence. The best time to intervene is when someone is anxious or angry and the best way is generally through dialogue, he said. When police encounter someone who is anxious, officers should ask what’s wrong and encourage the person to tell the officer about it. This shows that police are interested and gives the disturbed person a sense of release.

“As long as dialogue continues, you’ve got them engaged and that’s the whole point,” Kamada said.

Once people become more stressed, they will hear less of what someone is telling them. In these situations, police should use short sentences and constantly repeat themselves. They should also use gestures to give clear directions. “The differences in how messages come across has to do with how they’re delivered,” Kamada said.

In past years, Portland police have not been able to fill their class slots for crisis intervention training and thus opened it to officers from the region. Some in the bureau remain skeptical of the program.

“I think more value is being seen in the training from command staff and younger officers,” Riddell said.

The city’s Bureau of Emergency Communications generally dispatches a Crisis Intervention Team officer to a call that a dispatcher knows involves someone with a mental illness. If there is no such officer available in the district where the call originated, a dispatcher can pull a crisis trained officer from another district to respond.

Portland Police Chief Mark Kroeker said he wants to expand communication training to all officers. Now, officers receive four hours of training on dealing with the mentally ill during basic training and two additional days of training on mental health and basic crisis intervention in the bureau’s advanced police academy.

Portland Officer Ross Scott, with the bureau for two years, signed up for the Crisis Intervention Team training. He said, “I figure the more training you can have, the better.”

STREET BEAT A GARDEN SITS WHERE A TROUBLED SON DIED IN 1998 – October 19, 2001

Seeds of solace: A community garden will be dedicated today in memory of Richard C. ” Dickie ” Dow, the 37-year-old mentally ill man who died in October 1998 after a struggle with Portland police.

The garden, assembled by Dow’s mother, Barbara Vickers, features flowers and a plaque at the North Portland site where Dow collapsed. Since Dow’s death, his family has held monthly vigils at the site, near the corner of North Fenwick Avenue and Lombard Street. Today marks the three-year anniversary of Dow’s death.

The garden dedication will take place from 6 to 9 p.m.

Dow, a paranoid schizophrenic, collapsed in police custody Oct. 19, 1998. Officers were trying to restrain him after they say he assaulted an officer responding to a disturbance outside a doughnut shop. Dow stopped breathing at the scene. Two officers attempted CPR and paramedics were able to revive him, but he died at a local hospital the next day. The state medical examiner ruled the cause of death was sudden death syndrome, in which a person’s body position interferes with respiration, resulting in suffocation.

A Multnomah County grand jury determined there was no criminal wrongdoing on the officers’ part.

For information about the garden, contact People for Police Accountability, or Portland Copwatch, at 503-236-3065.

From The Portland Business Journal, October 18, 1998

Nurse Chris Olson still remembers the suicide victim’s face like it was yesterday.

It was a slow Sunday and the man was in a holding cell at the Multnomah County Detention Center in downtown Portland. “All of a sudden they screamed for a nurse,” recounts Olson, who was working medical reception that day. The man had hung himself. She and other workers tried desperately to resuscitate him, to no avail.

“When I just looked at him, I knew it was hopeless,” recalls Olson, a veteran nurse who started her position at the Detention Center in 1997. “It was really very scary,” she says. “It was traumatizing.”

The man had come into the jail earlier that day and seemed fine. To this day, she can’t think of anything that could have been done differently.

“I still think about it all the time,” she adds.

Welcome to jail nursing. It’s not a job for the faint of heart.

Imagine having a career where you interact with known murderers, child abusers, rapists and thieves. Where many of your “clients” have mental health disorders, drug and alcohol addictions, or both. Where communicable diseases, such as tuberculosis, pose serious threats to your own health. Where you have to be let through several locked doors just to get to the job. Where your conversations and actions are monitored, and your safety is in the hands of sheriff’s deputies who must oversee dozens of inmates simultaneously.

Nurse Barbara Lieuallen faces that reality every day.

It’s Sept. 29, and Lieuallen is doing her rounds at the Detention Center, located inside the Justice Center at Southwest Third Avenue.

She’s one of a handful of nurses and three physicians working day shift on a 24-hour medical schedule in the jail. No matter how heinous their crimes, Lieuallen is ready to see inmates. She’ll look them in the eye, offer them compassion, medication and medical expertise.

“We provide a safety net for the very bottom of the barrel,” says Lieuallen. “Somebody has to do it. I have a strong spiritual need to do it.”

“Their behavior gets so institutionalized you forget,” says nurse Brooks Plowden, who also does rounds at the jail. “They’re not in here for very nice things. The biggest creep in the world in terms of his charges can be the most charming and engaging here.”

As long as the inmates are cooperative and treat them with respect, the nurses can overlook their charges–in fact they find they must, so they can focus on the issues at hand–good medical care.

“You can’t look so much at the larger picture,” says Plowden. “We depend a lot on each other, going into the lions’ dens.”

9 a.m.: Facing the lions

Three carts line up in the narrow, white hallway at the jail.

They look like industrial airline food carts, but instead of food they hold dozens of pill vials, wound dressings and first aid supplies. Their drawers are tinted sea-green, luring the eye from the overwhelming gray and white environment.

Three nurses check their medical supplies in the jail pharmacy, edging around one another in a well-rehearsed dance. Drugs are a major part of the health care program. The county spends an estimated $2,000 every other week, just for the antidepressant Prozac, according to a corrections health nurse.

The six drawers in each cart are checked and then checked again. Each nurse flips through her clipboard assignments.

Then it’s time for medical rounds to begin. Dozens of the 676 inmates at the downtown jail need some type of medical attention or ongoing prescription.

Lieuallen checks the bulletin board for the current patient roster: nine people being watched for heroin withdrawal, four isolated for possible tuberculosis, one man on intravenous antibiotics for a severe kidney infection and nine pregnant women–all high risk. Two inmates on “suicide watch,” one of whom tried to hang himself with a blanket the day before. And that’s just a partial list.

Lieuallen fidgets a bit, maybe because she’s been assigned to treat some of the rowdiest units of male inmates at the jail.

“Did you draw the short straw?” jokes Sgt. Robert Camp, a sheriff’s worker who is escorting Lieuallen on her rounds. Corrections health is under the auspices of the county health department, not the sheriff’s office, but deputies protect the health care workers.

“I definitely want (a guard) with me in 7A,” says Lieuallen, referring to a ward of particularly testy inmates. It’s not common, but a year ago a nurse was slammed against a wall by an irate inmate after she refused to give him narcotics.

The cart trio rolls down a narrow hall, veers right and stops in front of institutional chrome elevators, too marred to see a reflection.

One of the nurses mumbles something about how easy it would be to get lost in the maze of hallways. Each hall is blocked by locked doors, controlled by sheriff’s workers hidden behind darkened glass offices. They also monitor the cameras that keep watch on the passages.

Lieuallen pauses before each hall door to wait for someone to flip the switch. She goes through two more sets of locked glass doors before she reaches the guard station.

“Welcome to 7 Alpha,” booms Deputy Roderick Lightner Sr., sounding like a character out of an Alien movie. Only a handful of the 64 inmates in 7A are outside their cells. Most remain locked in until Lightner jabs some release buttons on his control panel for ones who need medication or are seeking treatment. Inmates in this unit don’t expect release soon, and tension is thick. There are a few catcalls and mumbled comments.

The deputy watches the nurse, but spends time scanning the floor, occasionally raising his voice to chastise an inmate who’s shouting for more food or trying to draw attention to himself. Visitors tend to get prisoners stirred up and Lightner doesn’t want any problems. A few men push their faces against the 4-inch wide window in their wooden doors to get a better angle to watch Lieuallen.

Lightner’s station has mostly bare counter tops, save a purple Holy Bible, a 1998 standard diary and a Scrabble game. His demeanor is that of someone who doesn’t allow clutter, just as he doesn’t permit misbehavior. “It takes a certain amount of tolerance,” says Lightner, a 10-year-veteran of the sheriff’s department. “Not everybody can do it.”

An inmate with a shaved head hustles up to Lieuallen. Both speak in hushed tones. At one point the nurse leaves the station enclosure to get a better look at the inmate’s feet. She jots some notes in a file and he shuffles away.

Lieuallen says the inmate claims he had surgery for flat feet and is angling to get a downstairs cell so he won’t have to trudge up the white-grated stars to the second level.

An older man is next in queue. He wants to know whether his family has brought in his eye glasses. They haven’t. “Are you going to be in jail long?” asks Lieuallen. Another three to five days, at least, he says, adding, “Getting behind on my reading.”

The next man approaches, silent as he shows Lieuallen his wristband, which gives his inmate number. She looks up the chart, puts a few pills in a paper cup and watches him swallow them down with water to ensure that he actually downs the medicine. Some inmates save up pills to barter with other inmates or sometimes end up taking a lethal dose.

“Johnny you have a call,” shouts Lightner, hailing a balding man as he snaps his console to unlock the door. The inmate pads by, headed toward a phone in the direction Lightner indicates.

Johnny returns from his attorney’s call. His father has just died. He gets Lightner’s permission to make a call.

Another prisoner asks the nurse to be switched to a bottom bunk because of his seizure disorder.

Typically those kinds of disorders are noted and accounted for when prisoners go through their admission questionnaire, Lieuallen explains. Everyone must answer a series of questions and be observed by a medical triage before they ever get near a cell. If they stay longer than two days, the jail mandates testing for tuberculosis. But sometimes folks don’t disclose everything.

Sgt. Camp notes that changes, even if made for health concerns, can disrupt the jail pecking order. “Everything is in the here and now; they don’t understand consequences.” Inmates fight over even the most insignificant details, like who eats first or who walks first. Like children.

9:49 a.m.: The “predators”

Lieuallen rolls into the next unit, a divided room overseen by Deputy Elliott Ness. Some of the jail’s most unsavory characters–child molesters and rapists–are housed here. But tension doesn’t seem to be present and Ness jokes with the inmates as they line up at the nurses’ station.

“You’ve got to watch where you house people,” says Sgt. Camp. “Child molesters, rapists are at the bottom of the ranks. Most of these people are predators. They exploit people. They associate niceness with weakness. If you do something nice for them they think they have something over on you. It’s a totally different mentality.”

Sgt. Camp says these inmates are housed together for their own safety. Other inmates have kids and families on the outside and don’t take kindly to child molesters. Inmates who are testifying against others also are placed in this unit, he adds.

Several inmates are walking around. TVs are blasting in both common areas and there’s a hum of conversation. Two men in unit C are playing chess.

Prisoners queue up to see the nurse. They know the routine. If they’re taking pills, they come with a small cup of water to swallow it down.

Paul, one of the prisoners, downs a cupful of meds with water. He says he has been satisfied with the jail health care services, but he’s sour on the fact that his Medicaid plan won’t cover his antidepressants and anti-anxiety meds in jail.

He’s facing charges that he abused his son, says Paul, whose last name is withheld on request by the jail. He’s accused of beating his child and withholding food. Enough to depress anyone. He denies the charges, but had plead guilty to some misdemeanors because he’d gotten involved in some other trouble related to his drug addiction.

Heroin.

“I guess when I was on the drugs I was pretty cranky,” he adds. His sentencing was slated for mid-October. If he’s found guilty, he’ll get 13 years. He says he’ll surely file an appeal.

Another chubby-cheeked man with a crew cut echoes that assessment of health care. “Actually it’s pretty good,” he notes. The man takes four prescriptions a month, a $20 hit. But the medicine, including anti-psychotics, has helped him squelch inner demons that earlier prompted him to try to hang himself. “I hear voices,” he says. He sees a jail psychiatrist twice monthly. Another $10.

Was it an interruption in his medicine that prompted some behavior that got him arrested? That’s a much-cited pattern for an increasing number of mentally ill folks in jail. “No,” he shakes his head, his eyes suddenly going vacant. “I got myself in here.” He volunteers nothing more and moves away.

The man was a child molester, Sgt. Camp explains, his victims including several Russian children.

Only a few prisoners line up to see Lieuallen on the right wing of the unit. One prisoner needs a different request form. She examines one man’s throat with a light and makes some chart notes to get him some pain medicine. An older man gets a bit heated when he’s asking Lieuallen for regular shoes to wear because the jail-issued, plastic sandals hurt with his gout condition.

Lieuallen doesn’t let the discussion escalate. She promises to check on his request and firmly ends the conversation. Getting regular shoes in jail is a big deal, she explains later, because it’s considered a privilege that the lieutenant in charge doesn’t often allow.

By 10:30 a.m. Lieuallen is wheeling back to the fourth floor and drops off her cart. She heads to the 10-unit infirmary. En route she calls out “Hi honey” to one inmate. Lieuallen says the woman is mentally ill, alcoholic and homeless, and is chronically in and out of the jail. Lieuallen explains that the nurses discovered the woman had a severe mental illness during one of her earlier visits after she’d detoxed the alcohol.

A lot of Lieuallen’s clients are repeat visitors, many of whom are harmless if they can stay on their medications or off the narcotics.

“People arrested on methamphetamines are the worst,” says Lieuallen. “They’ve been up straight for 48 to 70 hours. It’s like looking at an animal being electrocuted. Little petite woman have this incredible strength. They’re thin, they don’t eat, their teeth are destroyed. They don’t take care of their kids. As a nurse, it’s hard to see this in people you care about.”

Lieuallen recalls a genial, educated Central African teacher jailed here a few years ago as a political refugee. He needed regular kidney dialysis, a service the jail contracts out in the community. He was deported at his home country’s request, only to die a short while later because he couldn’t get the medical attention he needed.

Lieuallen stops in a locked mental ward unit. There’s a fan facing out from the guard’s station. Sometimes it can be a bit smelly. Deputy Rick Wallace encourages inmates to take a couple showers a week, cajoling and occasionally forcing prisoners into the tile-lined room. More than five years ago, when the prison allowed smoking, he recalled, cigarettes provided a good incentive. Now, he’s able to bribe a lot of them with coffee.

10:55 a.m. Next Stop: The Hole

Near the mental unit, Lieuallen stops by a special area known simply as “The Hole.”

The Hole is a grimy, locked hallway with 10 individually locked cells–something akin to a kennel for the worst of the bad dogs. The small cell windows to the outside are frosted, furthering the isolation.

Depending on behavior, inmates may get only 15 minutes a day, and sometimes even less, outside the cell.

And when they do get out, they are allowed only to pace the locked hall, barren except for a shower and a wall phone. Occasionally the prisoners rip the phone off the wall and hit each other with it, Lieullen says.

Earlier in the day one prisoner had rubbed feces on the wall. Hair stubble remains on the floor where another had gotten a haircut. The ceiling is yellowed with water stains.

No one needs medical attention in The Hole today, but when they do, says Lieuallen, transactions are done through the door’s food delivery opening. The quiet casts an eerie mood.

One inmate looks out as Wallace illustrates a sliding cover that can blacken out even the modest window in the door.

To one wants to stay in The Hole for long.

11:10 a.m.: Back to the future

Lieuallen returns to the medical unit, heading into a work room/break room. That’s one of the few places in the jail besides the restrooms where workers aren’t on camera or near listening devices.

She sits down to talk with some of the other nurses, debriefing the day or talking about the world outside. There may be files to check. They have to prep for the next round that will come right after lunch.

Most days, Lieuallen and the other nurses make sure they get outside the jail for lunch and fresh air.

Explains Lieuallen, “Everyone has to get outside; it’s just too weird.”

By Robert Landauer – editorial columnist for The Oregonian, October 13, 1998. Not available elsewhere online.

A woman obsesses on the biblical passage dealing with Ezekiel’s Wheel. She interprets it as a command to drive. She obeys until she crashes the car and is injured.

Another woman hears God announcing intimate details of her life on the radio. She is terrified and flees.

“I have committed the unforgivable sin,” a man cries to the Rev. Craig Rennebohm.

The mental -health chaplain to Seattle’s street community relates these encounters to make two points:

Mental illness is frequently expressed in religious terms.

Spiritual support is vital to help many people with mental disorders, as well as their families, cope with the illness and reduce the risk of relapses.

Oregon’s state mental -health workers help more than 70,000 people like these each year. Families and private agencies help thousands more. Yet the state’s most recent survey of behavior risks found almost 17,000 adult Oregonians who said they needed mental -health care but believed it was unavailable to them.

Public budgets won’t meet all needs. Most private support groups are financially thin.

This picture is dark but need not be bleak.

Several factors hint that the clergy and their congregants ought to be top prospects to help keep tabs on those in their faith communities who have mental illnesses.

Clergy outnumber psychiatrists by nearly 10-to-1. Religious leaders — persistent generalists in an era of professional specialization — are spread through all income, ethnic and racial communities, urban and rural, more equitably than health professionals.

Churches and synagogues bring enduring messages: No one is hopeless. No one is expendable. Everyone has infinite value.

The faith groups are spiritually grounded, community-based and service-oriented.

Every congregation eventually feels mental disorders’ effects. One family out of every five has a member who has directly experienced long-term, disabling mental illness, advocacy groups say. Many other family members will suffer shorter-term mental -health crises. Two-thirds of the mentally ill live at home. They are in the pews.

Yet few religious shepherds know how to help care for this part of their flocks.

That was the point of a Portland conference last week, “Mental Illness: Challenge to Faith Communities.” In it, people with mental illnesses helped the Archdiocese of Portland and other religious and mental -health organizations describe the need for help from the spiritual sector.

Faith communities are powerfully positioned to move Oregonians beyond indifference or tolerance. They can offer basic-needs aid (reassurance, sense of belonging, resource referrals, food), education, counseling and companionship that help families adjust to living with the illness. They can advocate for adequate care. Their actions can erase any stigma attached to mental disorders in their congregations.

A final thought: Separation of church and state doesn’t forbid all cooperation between public agencies and faith communities. Worship groups can help public mental -health workers by offering recreational, training, housing and respite services to their own members, their families and others.

As relationships develop, trained members of what some churches call “healing teams” could join case-management teams that public agencies form for clients needing heightened monitoring.

When might that be proper? A conference participant tells of new medicines that wonderfully quiet the demons that horrify him. But the prescriptions also silence “the voices of the angels that comfort me.”

Recruit a trained voice from his church to restore that comfort and aid his recovery.

By Robert Landauer – editorial columnist for The Oregonian, October 10, 1998. Not available elsewhere online.

Ideas are most stirring when they serve people. A Washington County conference this week on “Violence and Mental Disorders” makes the point.

Attendees’ eyes are drawn to a photo in the program of a serene young woman and to a declaration:

“This conference is presented in memory of Monica Cuenca, a loving daughter, valued friend and dedicated clinician. Monica was murdered while working at a respite facility for consumers with mental illness.”

On Dec. 20, 1994, Howard Allen Bethea, a Hillsboro man with a history of mental illness, walked into the Banyan Tree mental -health facility where he had lived and shot Cuenca, 28, with a handgun while she played a board game. Bethea thought she had gotten him in trouble with his parole officer.

Until now, this story only has had victims. Certainly, Cuenca and her family. Possibly Bethea, sent to prison for life. He might have avoided this dismal end if we could spot those stumbling toward violence and step in before they fall into the pit.

Those who serve the mentally ill are traumatized, too. They and their families wonder each day how risky it is to be helpers.

Every death like this also shocks the mentally ill. They dread being stigmatized by someone else’s behavior. They fear that they, too, might do fatal damage to others or to themselves if they are ignored when their diseases knock them into tailspins.

The Washington County Health & Human Services program aims to turn Cuenca’s legacy from sadness and paralyzing fright to healing and sustained help.

About 230 social workers, mental -health specialists, police, paramedics, parole and probation officers, drug/alcohol specialists and other professionals received two days of training at the conference. It acknowledged the risk of violence but put it into perspective as infrequent or occasional. It suggested team-based case-management tools and relapse prevention that cut risks to the clients, the people who help them and the public.

A guest is left with strong impressions:

The relationship between mental disorder and violence is very weak; mental disorder makes a very minor contribution to violence in society. Victims are rarely strangers.

It is unfair and hurtful to label all people with mental illnesses as dangerous. Very few are violent and then only when experiencing particular symptoms that usually can be spotted and help offered.

But no checklist ensures that professionals, family and friends will make the right decisions all the time.

And the high school shooting last May in Springfield, where two students were killed and 22 wounded, testifies that spectacular failures will occur. They dominate the attention of press and public, while thousands of success stories, modest though they might be, go unsung and unappreciated.

It was astonishing to learn how accurate mentally ill persons are in reporting their own violent tendencies and how important it is to include them in decisions about their treatment. Police and hospital reports and people in regular contact with patients add little to the patients’ self-reports.

People, the mentally ill included, usually have a purpose for behavior, said Joel Dvoskin, New York state’s former acting commissioner of mental health. “Threats are the alternative to violence; they’re usually statements that they want you to change something. Ask them what it would take to change their mind and they usually will.”

The mentally ill often have reason to be agitated. Predators often steal their money and belongings. Yet society is more ready to view them as offenders than as victims, and to shun them.

The lessons can be reduced to this:

A lot of concerned public workers are trying to improve the odds that everyone will be able to live safely with mental illness.

From The Oregonian, October 1, 1998 – not available elsewhere online

Twice, she lost her son.

The first time was in 1996, when Michele Grussmeyer‘s oldest child, Wade, sensitive and hard-working, turned irrational and hostile. During the next year, the Milwaukie High School graduate severed friendships, beat up his brother, lost jobs and repeatedly ran away from home.

His personality became unrecognizable, his mother said. He feared that people were after him. He heard voices when others heard silence. And he threatened suicide.

In May, she lost him forever. Police found his body on a bed in a homeless shelter on Burnside in downtown Portland. He was 22.

Michele Grussmeyer hid her son’s illness for months. At first, she didn’t tell anyone that he called himself the “devil’s child,” had a demon tattooed on his back, then obsessed about having it removed.

She began to cope, she says, when she started talking about their experience. When she helped write her son’s obituary, she wanted everyone to know that schizophrenia, not only a drug overdose, led to his death.

By talking about mental illness, Michele Grussmeyer hopes that treatment can be improved and the stigma eliminated. She wants her story to help other families who are enduring what she calls “hell on Earth.”

Losing a child to mental illness “is like a color you can’t describe,” Grussmeyer said. “It scared me. Every time I thought it couldn’t get any worse, it did.

“I miss him terribly, but I don’t miss the sickness of the last two years. When I think about him, I try to think about who he was before.”

No single factor causes mental illness, said Dr. William Wilson, associate professor of psychiatry at Oregon Health Sciences University. Like diabetes, a disease caused by the body’s inability to produce insulin, mental illness is a chemical imbalance. And like diabetes, it can be controlled.

One of every 20 Clackamas County residents suffers from a significant mental illness, such as bipolar disorder, depression, schizophrenia and obsessive-compulsive disorders, said Susan Johnson of Clackamas County Mental Health. About 2,500 adults receive mental health and addictions treatment from the county annually. Drugs mimic illness Drugs and alcohol, used by about 80 percent of mentally ill people, are the byproduct of the disease and mimic some of its symptoms, such as hallucinations and personality changes, said Johnson, director of the county’s adult day treatment programs.

Grussmeyer thought her son had a drug problem, and she confronted him. Soon, symptoms of the illness emerged. After drug treatment, he was clean for six months, but his hostility continued, she said. Now she thinks he used heroin and cocaine to numb the emotional pain of schizophrenia.

In Oregon, patients undergo separate treatments for their addiction and mental illness. Johnson, other mental health officials and Clackamas County parents want a unified treatment program incorporating all aspects of a person’s care. Some state officials are pushing for that at the legislative level, she said.

Grussmeyer thinks that if drug treatment and mental illness professionals had worked together, they would have diagnosed her son’s illness earlier and treated him more effectively.

Yet the treatment options for mentally ill people are limited, Johnson said. In Clackamas County, more than 500 people vie for the 96 beds in county treatment facilities, group homes and respite centers with 24-hour supervision and care. All have long waiting lists. More than 1,000 who receive services from the county need subsidized housing.

During a crisis, there are few options. When Grussmeyer caught her son using heroin , he barricaded himself in a bedroom and threatened suicide. She called a psychiatrist, who said her son had to be removed from the house. Because there were no immediate care beds available, Wade Grussmeyer was sent to a shelter.

“I looked in his eyes, and I knew I’d never see him again,” his mother said. She called daily, but confidentiality laws prevented the shelter staff from giving her information. He never called home.

On a Tuesday, a police officer arrived at her door. Wade had died the previous weekend of a drug overdose.

Care becomes a burden

Nationally, 4 percent of the population — more than 10 million people — has a serious mental illness, not including dementia and Alzheimer’s, according to estimates from the Clackamas County Mental Health Department and Wilson of OHSU.

Fifteen percent of those people commit suicide as a result of their disease, Wilson said. The others spend their lives trying to control erratic behavior, mood swings and altered perceptions.

The people who love the mentally ill are burdened with the care they require and the stigma of the diagnosis. There is no cure, but for many treatment is effective.

Judy Redler‘s son was 5 when teachers said he was too immature for kindergarten. The Redlers, looking for reasons behind his irrational anger, took him to counseling. Teachers said he had a learning disability. Others said nothing was wrong. One counselor suggested she take the boy camping.

When Redler began teaching special education classes, she identified the symptoms in her son.

“The more I knew, the more I knew he wasn’t showing signs of special needs,” Redler said. “We weren’t thinking mental illness. It wasn’t until years later that we knew he was hearing voices.”

After 15 years, Redler’s son was diagnosed as schizophrenic. Now at 34, he hears voices, can’t hold a steady job and needs help with household chores.

But he is stable, thanks to medication. He no longer runs away or hits others. He lives on his own in a private, county-subsidized apartment. Fourteen years after the diagnosis, Redler said they are the lucky ones.

Having a diagnosis is both comforting and devastating, Redler said.

Like most parents, Redler denied the diagnosis in the beginning. She blamed her husband and herself. Now, as an advocate for the mentally ill and an active member of the National Alliance for the Mentally Ill-Clackamas County, a support group affiliated with a national group of the same name, she knows no one is to blame.

Symptoms vary

Although a genetic link indicates that mental illness is more common in families with a history of disorders, about 40 percent of people with mental illness, such as the Redlers and Grussmeyers, have no history, Wilson said.

“The diagnosis is a bit like a Chinese menu,” he said. “There are various combinations of symptoms that come out in certain illnesses.”

Usually, symptoms of bipolar disorder, schizophrenia and other significant mental illnesses don’t emerge until adolescence or early adulthood, when people struggle with identity issues, Wilson said. A trigger, which doctors haven’t identified, sets off the illness. To family members, it seems as though the person has changed overnight.

Families are likely to attribute behavior changes to stress or rebelliousness and turn to school and marriage counselors, ministers and friends before calling in a psychiatrist, he said. Sometimes the condition persists for years before they find the appropriate help. Patients frequently have more than one mental disorder, and treatments change accordingly, he said.

Those with schizophrenia — an estimated 2 million people nationally according to the American Psychiatric Association — experience altered perceptions and false realities. They may have delusions, which are unreal ideas firmly fixed in a person’s brain, and hallucinations, where they see and feel things that don’t exist. Most hear voices, but some do not, Wilson said.

“Internally, they are hearing a voice that is every bit as real as us speaking, but they have no way to distinguish what is real and what isn’t. Their circuits get crossed,” he said. “Imagine trying to grow up and develop and live in this society when you can’t hear what is real and what’s not real.”

People with depression feel despair, loss of self-esteem, apathy and fatigue. Bipolar disorder, also called manic depression, includes those symptoms combined with periods of euphoria, increased activity and changes in sleep and appetite patterns.

The tripod approach uses medication, psychosocial counseling and family counseling to effectively treat patients, Wilson said. Patients learn to cope with daily life, the medication stabilizes them, and the group helps them feel connected.

“Medications now are very effective,” he said. “There is still no cure, and most people are left with some disability, but they are much better with treatment than without.”

A judge can determine whether a person is a threat to himself or others and have that individual legally committed and hospitalized, but it is difficult to prove and not a long-term solution, Redler said. Many patients are hospitalized multiple times.

Costs of care Mental illness also takes a toll on families financially. Medication can cost hundreds of dollars a month. Private insurance plans cover some of the costs, and many mentally ill adults in Clackamas County are insured by the Oregon Health Plan, Johnson said.

People without insurance or a supportive family usually end up on the streets or in jail, she said. Of the estimated 4,500 homeless people in Clackamas County, about 35 percent are mentally ill, she said. That means there are 1,575 mentally ill on the streets.

“We need to look at our use of jails and prisons,” Wilson said. “There are a lot of people in jail from mental illness who aren’t receiving treatment. Our jail beds increase, and our mental health beds decrease. People who are disruptive in society end up in jail instead of in treatment.”

Between 5 percent and 10 percent of mentally ill people are prone to violence, he said. Most do not pose a risk to society; instead, they become victims of a social stigma.

“The more we learn, the more we understand what’s going on, and it is so pervasive,” Johnson said. Statistics from the National Alliance for the Mentally Ill-Oregon show that one in five families have a mentally ill member.

“I can’t imagine getting through life without getting touched by mental illness in some way,” Johnson said. “It does not mean you are disabled for the rest of your life. In many people, there are periods of problems, but you don’t have to be labeled crazy to have mental illness.

“The stigma is a lot of mythology and fear that mental illness means less control or that you are lazy. All of that mythology is simply not true.”

Viral infection precedes illness

Joel, 26, a military-trained electronics expert and high school graduate, doesn’t tell people he’s got what he describes as “a schizotype disorder.” The illness, triggered two years ago after a viral infection, causes irrational and sometimes obsessive behavior, such as running around stomping on people’s toes.

Medication stabilized his behavior. His mother manages his money. He has difficulty forming relationships and needs structure. He lives in a Clackamas County-subsidized apartment building for people with mental illness. He attends church, cooks for himself and does odd jobs.

“I have some highly qualified skills,” he said. “I don’t work for cheap.”

He wants to earn a college degree and buy a home one day. This year, he’s taking a college math class. Dressed in baggy green shorts, a striped polo shirt and a baseball cap pulled over his close-cropped hair, Joel said he knows his illness is invisible to most people. He worries that people will take advantage of him if they find out.

During the 40 years Mavis Cook, 66, has been clinically depressed, she was married, raised children, taught 4-H and Sunday school, and led Scout troops. She is easily hurt and often cries, sometimes for hours, about such things as her son going to kindergarten. In 1980, she was diagnosed as mentally ill.

“Sometimes you just wish you could go to bed and never wake up,” she said. Now Cook, who lives in the same building as Joel, uses medication and a strict routine to help her overcome the despair. She likes to garden, walk and baby -sit her grandchildren.

“If anyone should be afraid, we should be afraid of the people outside,” she said. “People shouldn’t be afraid of us. It’s just ignorance and fear. When mental illness comes to them, they will understand there is nothing to hide.”