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Narcan could help keep some addicts alive long enough to recover, but Oregon restrictions keep it scarce

Posted by Jenny on 7th March 2013

By Erin Fenner, Willamette Week, March 6, 2013

Dr. Gary Oxman

Dr. Gary Oxman

Dr. Gary Oxman spent his career trying to save people who don’t care whether they live or die.

Oxman—who just retired as health officer for Multnomah, Clackamas and Washington counties—has long wanted to do more to rescue drug users.

He was one of the earliest supporters in Portland of free needle exchanges, aimed at stopping the spread of HIV among addicts who share syringes. That idea, first floated in the late 1980s, was often met with derision: Why should we condone the use of dangerous drugs by making it safer for addicts to keep shooting up?

Oxman helped champion a needle-exchange program in Portland, and he says it’s the reason the city never saw the explosion of HIV among drug users as other communities did.

“Pure and simple,” Oxman says. “Something that went very right.”

But Oxman, who retired last month, has been unable to reverse another epidemic: opiate addiction.

In Oregon, unintentional drug overdoses now kill more people than car accidents. The drugs that are driving up those numbers and killing most often are opiates—heroin and prescription pain medication, including methadone. In 2011, Oregon saw nearly 300 people die because of opiate overdoses—the highest year yet for heroin deaths. The rate of people dying from opiate-related overdoses has more than tripled in the past decade.

In fact, Oregon has the highest rate of opiate abuse among people under 25 than anywhere else in the country.

More than half the drug overdose deaths in Oregon are linked to prescription opiates such as OxyContin and Vicodin.

In Multnomah County, the top killer is heroin. Nearly half of drug users addicted to heroin here say they got hooked first by taking prescription pain pills.

Gov. John Kitzhaber has called the state’s addiction to these drugs “calamitous.”

Oregon has tried to battle drug addiction with education and treatment programs.

But Oxman wants the state to go further.

He wants to expand the use of another drug that will snap users out of an overdose of heroin, methadone or pain pills.

It’s commonly called Narcan, and for more than four decades paramedics and emergency-room personnel have injected it into people dying of opiate overdoses to give them a chance to hang on.

Across the country, recovery agencies and treatment centers have been making Narcan (also known by its generic name, naloxone) available to drug users’ friends, families, counselors and even addicts themselves—giving them a chance to deliver a life-saving dose before paramedics arrive.

Considered radical when it started, the wider use of Narcan has saved as many as 10,000 lives by reversing the effect of overdoses.

But Oregon—once in the forefront of helping protect the health of drug addicts—has not joined in.

Now, Oregon senators are considering a bill to make it easier to distribute Narcan. By doing so, lawmakers will shift the state’s efforts to fight drug overdoses not just with education, prevention and treatment, but by giving addicts a safety net even as they practice self-destructive behavior.

“These overdoses are individual and community tragedies,” Oxman says. “They can be treated, and so we don’t need to have people dying needlessly.”

A native of Minneapolis, Oxman came to Oregon after graduating from the University of Minnesota Medical School in 1978. When he was in private practice in the early 1980s, he recalls seeing patients he suspected were describing problems with pain that didn’t exist.

“They were trying to manipulate me into giving them opiates,” Oxman, 60, says. “That’s always been there in the community. It’s just way worse now than it was a few decades ago.”

Oxman was named Multnomah County medical director in 1984, and the county’s public health officer three years later. Around 2000, Oxman helped reverse the spike in heroin deaths, in part by targeting addicts themselves with information about how to use the drug more safely.

The overdoses the Portland area sees now are not driven by heroin alone. The long line of drug deaths often begin at the prescription pads of doctors.

Nearly half of the prescriptions tracked by state officials last year were for opiates. That amounted to 3.7 million painkiller prescriptions—nearly one for every resident of Oregon.

Drug users say painkillers lead to addiction—43 percent of heroin users in Multnomah County say they were first hooked on prescription painkillers. (Heroin is often cheaper and easier to get than prescription drugs.)

These drugs have created a widespread occasion of death. More than 60 percent of current opiate abusers say they’ve seen someone overdose in the past year.

“The docs are sort of trapped in this situation where patients are in pain and there’s no logical alternative,” Oxman says. “It’s not bad doctors. It’s the structure of the health-care system that’s really driving this.”

Tom Burns, director of pharmacy programs for the Oregon Health Authority, says in many cases physicians and dentists overprescribe pain meds to avoid having to write repeat prescriptions.

But Burns says the state has no intention of challenging physicians’ autonomy when it comes to making medical decisions. “We’re not Big Brother,” Burns says.

Instead, the state has tried educating doctors. In 2009, the Oregon Legislature created the Oregon Prescription Drug Monitoring Program, intended to help physicians track their patients’ prescriptions, no matter who writes them. A medical professional who’s concerned about a patient’s use of OxyContin, for example, can log on and see if the patient has been “doctor shopping” by getting prescriptions from other sources.

Ryan Lufkin is a deputy district attorney in Multnomah County who focuses primarily on drug crimes—he estimates he’s handled 1,100 drug cases in the last three years. He says too little money spent on recovery and treatment programs makes matters worse.

“The solution that seems to be the gold standard from a criminal-justice perspective is a treatment bed straight from a jail bed,” Lufkin says. “The ultimate goal is not conviction, but treatment.”

Last fall, Vero Majano came to Portland to help organize a film festival at the national convention of the Harm Reduction Coalition, an organization that works to help protect the health—and the rights—of people who use drugs.

Majano manages a drop-in center for the homeless in the Mission District of San Francisco. A social activist for years, Majano says most people don’t understand the goal of harm reduction—in part because they demonize the drug-using community.

“There’s this thing around drug use being evil,” she says. “So the idea is that drug users are also bad. If people were to look at trauma, how people self-medicate—people use [drugs] for good reasons.”

Majano’s views reflected the message at the conference, which drew hundreds from around the country: Drug users should have no fewer rights to have their health and welfare protected than anyone else.

Yet proponents say society should do more than simply jail people who use drugs, or try to combat addiction through education and treatment programs. It also means helping keep addicts alive and healthy, even when they show no signs of stopping their drug use.

Jake Rhew

Jake Rhew

Take the case of Jake Rhew.

Rhew was born in Pullman, Wash., in 1982, and attended Sam Barlow High School in Gresham. His family recalls Jake as a kid who loved to fish, raft the Clackamas River and stood up for people who were powerless—even as a kindergartner, he protected other kids from school bullies.

“He had a good heart—a compassionate soul,” Rhew’s stepmother, Kathy Thomes-Rhew, says.

Before he was out of high school, Rhew got hooked on pain pills and stole medication from his family.

Rhew earned a GED diploma and enlisted in the Army National Guard, only to get kicked out. He moved to his father’s house in Troutdale, stole to buy drugs, and tried to hide track marks on his arms. From 2009 to 2011, Rhew was arrested and charged five times for theft and once for possessing heroin.

“Jake was desperate,” Thomes-Rhew says. “It wasn’t the Jake we knew, and that’s what heroin can do to a person.”

Rhew often recorded his battle with drugs on his Facebook page. “5 months sober,” he wrote in June 2010. Two weeks before his last overdose, he wrote, “Damn going to sleep is a lot harder then [sic] passing out.” And three days before he died, he posted a photo of himself: short-cropped blond hair, broad nose, clean white T-shirt, cautious smile. “Lookin’ good Jake,” a friend wrote.

On Aug. 23, 2011, Rhew, 29, was living at the men’s residence center run by Volunteers of America in Northeast Portland when he and another client slipped into a bathroom to shoot heroin. Rhew was already in full nod by the time the center’s staff found him.

They couldn’t revive him and he choked on his vomit. It’s the center’s only death.

“The counselors did everything that could be done,” Thomes-Rhew says, but the staff didn’t have access to Narcan. “At least he would have had a chance.”

Greg Meenahan, director of development and communications for Volunteers of America, said medical privacy rules prevented him from talking about Rhew’s death. But he says he would want Narcan in the hands of the organization’s staff.

“We view this as a life-saving medication,” Meenahan says. “If we were able to have it, there’s little doubt that we would use it.”

Narcan is a brand name for naloxone, developed in New York in 1960 by researchers who found the drug had a remarkable ability to block the effects of heroin and other opiates.

The use of Narcan isn’t quite as dramatic as perhaps the most famous scene of reviving someone in the throes of a drug overdose: the stabbing of Uma Thurman’s character in the heart with an adrenalin-filled hypodermic needle in Quentin Tarantino’s Pulp Fiction.

The drug is often injected into the skin or a muscle, such as the biceps or thigh, and also comes as a nasal spray. Narcan throws the overdose into reverse—people can go from being blue and not breathing, to gasping for air in an instant withdrawal.

John Sanborn

John Sanborn (who asked that his face not be photographed)

John Sanborn knows how it feels.

He says he’s been “Narcanned” by paramedics during heroin overdoses. Like the time he cooked up shot after shot in a Portland State University restroom. Or the time other junkies dragged him into a downtown apartment hallway and left him for dead.

“It’s horrible if you’re living with an addiction,” Sanborn says of Narcan’s effects. “It brings you right down to where you were before you started shooting.”

Narcan, Sanborn says, gave him a new chance at recovery. He’s currently in Central City Concern’s Community Engagement Program and is reconnecting with his 9-year-old son. “I realized that if I ever wanted to have any kind of a life,” he says, “I was going to have to stop using drugs.”

Sanborn got Narcan the way almost everyone in Oregon does: from a medical professional. But nearly 20 years ago, activists in other states realized the greater potential of the drug to save lives.

Dan Bigg, executive director of Chicago Recovery Alliance, says his organization had already seen harm-reduction strategies work with needle exchanges, slowing the AIDS epidemic among IV drug users.

“[We] turn to the next big issue, which is overdose,” Bigg says. “Why not use the existing pathways to get [Narcan] into the hands of people who overdose?”

In 1996, Bigg’s organization began to train and distribute naloxone to laypeople. He says he has administered naloxone to an overdosing person at least six times.

In 2010, Illinois finally made it legal to do what Bigg’s group had been practicing, but he says he’s frustrated that other parts of the country are behind.

“It’s a pure antidote,” Bigg says, “and you’d think it’d be available to scores of people suffering from premature death.”

By that time, according to the Centers for Disease Control and Prevention, the use of Narcan by nonmedical professionals had broadened: Nearly 200 programs in 15 states and the District of Columbia were making Narcan more available. A 2012 CDC report said these programs helped reverse the effects of drug overdoses in more than 10,000 cases.

The CDC also found “many states with high drug-overdose death rates have no opioid-overdose prevention programs that distribute naloxone.” That includes Oregon.

Allan Clear, executive director of the Harm Reduction Coalition in New York, says Narcan should be ubiquitous, especially in a city like Portland that has an opiate-overdose problem and has been a leader in needle exchanges.

“Overall, nationally, it’s not that well-known as a community intervention program,” Clear says. “In New York City and San Francisco—when the health department got on board—it really added that level of legitimacy to it. There’s always been this level of caution because naloxone is one of those drugs you prescribe to use on someone else.”

Dr. Sharon Stancliff, medical director of the Harm Reduction Coalition, says Narcan hasn’t proved controversial in many communities.

“In New York, we actually have it set up so different kinds of agencies can distribute it to whoever they want,” she says. “It has gone from being this sort of edgy thing to really becoming mainstream.”

Dr. Sandro Galea, chairman of the epidemiology department at Columbia University, says Narcan was controversial in New York because people believed making it widely available would encourage drug users to indulge in opiates.

Galea’s studies showed that drug users were not encouraged to be more reckless with heroin by having Narcan handy.

“There is no excuse for not making naloxone widely available to the [drug-using] community,” Galea says.

If drug-overdose deaths are so common here, why is Oregon so far behind in the movement toward Narcan?

Oxman says cities and states that moved ahead with making Narcan more available also have more vocal and organized groups advocating for the welfare of drug users.

“I think when you get a critical mass of folks who believe in a particular issue, that makes organized action easier,” Oxman says. “It’s not that Portland lacks the drug users—we have lots and lots of drug users.

“Government is not in a position to be the leaders of harm reduction. It’s really a community activity. And it is really bewildering why that hasn’t been more prominent here.”

Kathy Oliver, executive director of Outside In

Kathy Oliver, executive director of Outside In

In Portland, the organization that helped pioneer the needle-exchange program, Outside In, has been the obvious place to experiment with making Narcan more available.

Outside In works with homeless youth and what it calls “marginalized people.” Kathy Oliver, Outside In’s executive director, says health-care workers in the organization’s clinic on Southwest 13th Avenue near Main Street are allowed to both inject and prescribe Narcan to people for use only on themselves.

Oliver would like to see Narcan more widely available. “The reason I want to do it is the same reason I wanted to open the syringe-exchange program,” she says. “Death by overdose is preventable, so giving people the means to protect themselves makes sense.”

But Outside In has been largely silent on the issue, despite the high overdose rates in Multnomah County. Oliver says she’s aware that scores of other organizations like hers around the country have distributed Narcan or promoted its use.

“We did think the best way to achieve [a community pathway for naloxone] would be through the legislative and not through Outside In being a political advocate,” she says.

In Salem, state Sen. Alan Bates (D-Medford) has introduced a bill to expand access to Narcan. Jackson County, where Bates lives, saw 30 people die in 2012 from opiate drug overdoses, according to Dr. Jim Shames, the county health officer.

Ashland, a community known for staging the Oregon Shakespeare Festival, was stunned recently by the death of three men within six weeks of each other—all from opiate overdoses.

Maxwell Pinsky, 25, the son of a local blues musician, died Jan. 15 of a suspected opiate overdose; the Jackson County sheriff’s office says the toxicology reports aren’t finished yet. A month earlier, Ashland had two heroin-overdose deaths within a day of each other: Pinsky’s friend Jordan Roth, 34, the son of a retired physician; and Colin McKean, 36, son of actor Michael McKean.

Bates’ bill would make Narcan a drug that anyone—from social workers to drug users—can get training to use and be able to purchase to have with them in the case of an emergency. Part of the bill also makes people who administer Narcan in an overdose situation immune from civil prosecution.

Emergency-room physicians have warned legislators the drug can cause a powerful reaction in people coming out of an overdose if the dosing isn’t done properly.

“It’s still a large question as to whether the public should have access to this powerful drug,” says Jim Anderson, lobbyist for the Oregon Chapter of the American College of Emergency Physicians. “We have mixed emotions about it.”

Oxman says passage of the bill will mark a big step in Oregon moving toward accepting the idea that government has a role to play in helping drug users stay alive, regardless of whether they stop using.

“I think people have really come around,” he says, “to seeing what we’re trying to do is help people who have problems with drug abuse, and there’s a variety of different pathways to get there.”

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Multnomah County Has a Special Crisis Hotline for Cops. The Cops Rarely Call It

Posted by admin2 on 20th January 2013

From The Portland Mercury, January 18, 2013

Here’s something you probably didn’t know—something that’s never really been mentioned all that much in any recent discussion of policing and mental health services and federal reform in Multnomah County.

Multnomah County’s Mental Health Call Center has a special hotline in place for Portland police officers who might need help on a call where someone’s having a mental health crisis. It’s akin to a Batphone, and it’s there so a cop’s call can leap ahead of the hundreds of other calls that come into the call center on a daily basis.

There’s just one problem: The cops don’t really use it. Here’s the data from Multnomah County:

Total calls to Call Center (988-4888)
1) 2010 – 43,612
2) 2011 – 54,759
3) 2012 – 67,375 (highest ever)

Police calls to Call Center on dedicated police line
1) 2010 – 27
2) 2011 – 27
3) 2012 – 21

I [Denis Theriault] asked for the data after talking with county officials about some of Police Chief Mike Reese‘s comments in this week’s cover story. The bureau is hungry for a new drop-off center where cops can take people in crisis, lobbying hard to wrap the facility into the city’s police reform settlement with the US Department of Justice.

And county officials bristled when Reese said the county’s Crisis Access Treatment Center—a 16-bed mental health facility made possible with and state funding—wasn’t working because “they have procedures against” taking people there. That’s not exactly true, county spokesman David Austin told me. Cops can take someone to the CATC provided they phone first. On the dedicated police line! But here’s some more distressing county data, looking at both the CATC and the county’s urgent walk-in clinic in Southeast:

Calls by police on dedicated line requesting Drop-Off to CATC
1) 6/2011-12/2011 – 0
2) 2012 – 0

Calls on police line for information/referral to UWIC (Urgent Walk-in Clinic)
1) 2010 – 0
2) 2011 – 0
3) 2012 – 0

So, yeah, something’s not working. The question, maybe, is what. The gold standard for the police bureau is a place, like a 24-hour drop-off center, where officers don’t have to spend any time on intake—something they used to have in Providence’s old Crisis Triage Center until it closed because of budget cuts. The CATC doesn’t operate that way. But it’s got to be better than the revolving door of the emergency room, which is where cops currently take people in crisis.

And if it’s not any better, given that no officer has ever called to start the CATC intake process, how would anyone actually know?

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Mike Reese might have been mayor; for now he’d rather be the face of police reform

Posted by Jenny on 18th January 2013

By Denis Theriault, The Portland Mercury, Jan. 16, 2013
Chief Mike Reese

Chief Mike Reese

The thought was hard to escape. If life had gone just a little bit differently—if the feds had waited to crack down on Portland cops for years of rough treatment of the mentally ill, if Occupy Portland hadn’t sprouted right when it did in 2011, if last year’s mayoral election hadn’t shaped up as a frantic fundraising race—Mike Reese might still be sitting down with me.But he wouldn’t be in uniform.We’d be a few blocks away from his spacious office on the 15th floor of downtown’s Central Precinct. We’d be on the third floor of city hall—in the mayor’s office.

That isn’t, of course, what came to pass. Reese, who became chief in May 2010, only briefly chased the job eventually won by Charlie Hales. He bowed out just early enough to keep things from being too awkward when Hales officially became, as of this month, Reese’s boss. And now? Reese says he wants to stay right where he is—joining, if Hales lets him, the ranks of Portland’s longest-tenured police chiefs.

That won’t be so easy. Though he could choose at any point to float off into a young retiree’s life of guitar practice, youth sports coaching, and running, Reese will instead guide the police bureau as it enters into its most tumultuous chapter in decades.

Federal reforms will force new limits in how officers use force, fire Tasers, and interact with mentally ill people—a potentially unsettling shift for the rank and file that’s already sparked tension with the police union, the Portland Police Association (PPA). Money is tight, raising the specter of job cuts. And police accountability groups, despite a palpable opening of the bureau under Reese, still rail at an institution they see as too insular and self-interested to ever create real change.

The chief talked about all of it during a wide-ranging interview earlier this month. Responses are slightly edited for length and clarity.

_________________________________________________________________________________________

MERCURY: Let’s start with the US Department of Justice (DOJ) settlement. The court process is obviously still unfolding, but the federal judge overseeing the agreement has also said the city and the feds are free to privately implement whatever they want while waiting for his blessing.

REESE: We’re moving forward on critical issues irrespective of what happens at the courthouse. We’re forming a behavioral health unit—selecting officers and creating an advisory board. We’re working on training for crisis intervention officers and the selection process for those folks. We’re going to move forward as quickly as possible, being mindful that there is a process. We want to get the advisory board in place and have them help us design some of the training.

_________________________________________________________________________________________

Who are you recruiting for that panel?

I’ve met with the head of the [local chapter of] the National Alliance on Mental Illness [NAMI] and some of their constituents. We want Cascadia and Central City Concern and Transition Projects to be part of that, and other treatment providers, too.

_________________________________________________________________________________________

How close is the crisis intervention team to launching?

We had 55 people apply. We’ll take everybody who meets the standards. So if we have 55 officers who want the job, and they have no performance issues and they’re hard-working and their supervisors think they’re right, we’ll train them all.

_________________________________________________________________________________________

What will be the policy changes on use of force?

We want to move forward on the Taser policy. We want to make sure our officers are trained on recent court rulings and community expectations. We are at the final stages of getting feedback from the Portland Police Association and the Department of Justice. Then we’re going to start training on it. And our overall use of force policy? Same thing.

_________________________________________________________________________________________

What are you hearing from PPA President Daryl Turner? He’s been critical of the process.

The PPA was frustrated that they weren’t at the table during our negotiations with the DOJ. But the DOJ was very clear that conversations were confidential and between the city and the Department of Justice. We recognize there might be labor contract implications, and that’s written into the agreement.

_________________________________________________________________________________________

Some changes, like assigning sergeants to go out to do hands-on use of force investigations, happened months before the settlement took shape. But you told community groups you wanted to wait before tightening the bureau’s Taser policy. How did you draw that distinction?

With the Taser policy, we had a lot of conversations with community groups. So that took a while. And then there were some court cases before the Ninth Circuit Court of Appeals that we were waiting for, to give us guidance on overall Taser policy. That happened probably in July or August. By then we knew the Department of Justice findings were going to come out. They were telling us it was going to be soon, so we said let’s wait on what happens with that before moving forward.

_________________________________________________________________________________________

The deal calls for a new medical facility where officers can drop off people in crisis. It’s supposed to open this summer. I’m not sure that’s going to happen.

Some of those things are out of my control.

_________________________________________________________________________________________

How did that get into the settlement?

Both the Department of Justice and the police bureau sought a different model than the one we have. The DOJ had looked at other cities that had a single location to drop people off. We used to have that model. It worked very well for us, so we strongly advocated for it.

_________________________________________________________________________________________

The county pretty recently opened its own Crisis Access Treatment Center. How well has it been working?

I don’t know. It doesn’t work for us. We’ve never taken anyone there.

_________________________________________________________________________________________

What about it isn’t working?

They have procedures against it. I can’t take anybody there.

[Asked for comment, Multnomah County spokesman David Austin clarifies that police are free to take people in crisis to the CATC, provided they call first to start the admissions process. “The police absolutely have access to the CATC and to other critical mental health services designed to help people in crisis. Because we’re all partners. This is a community issue, and we all have a stake in figuring out the best ways to serve anyone a mental health crisis.”]

_________________________________________________________________________________________

The mayor has repeatedly stressed the need for a “culture change” in the bureau. What comes to mind when your new boss says that about an organization you’ve run for nearly three years?

He heard from a lot of folks in our community who want the Portland Police Bureau to be in sync with their values. You know, these are challenging times for police organizations around the country, because as crime has fallen, the work that officers do has fundamentally changed.

As I have said since I became chief, our officers have to have better relationships with social service providers than they do with the jail. Homelessness and drug addiction, poverty and mental health issues are not problems easily solved by society, much less law enforcement.

_________________________________________________________________________________________

Has the bureau’s new training advisory committee started meeting?

I don’t know if Bryan Parman, the training captain [and also president of the city's other police union, the Portland Police Commanding Officers Association], has made final selections or not.

_________________________________________________________________________________________

Will you release their names?

Absolutely. We had, I think, 41 people put in for it. I didn’t look at all 41 résumés. But I saw the list and thought it was a great group. We were hoping we would get nine to 12 people to participate. Obviously a group of 41 is hard to manage. But I told Bryan I don’t want nine or 12 happy people and another 29 who are pissed off at me.

Let’s take this opportunity to reimagine what we thought about the training advisory committee. So we’ll have three different subcommittees looking at defensive tactics, our patrol tactics, and looking at, maybe, firearms or Tasers. And you have a smaller executive committee. We would let people pick which area they were most interested in. I’m hoping everybody who put in will get to participate.

_________________________________________________________________________________________

And, let’s confirm: Despite initial reports, the meetings will be open?

The meetings will be open. If the committee decides there’s something confidential to review, then it can close the meeting. But otherwise the meetings will be open.

_________________________________________________________________________________________

Let’s talk about your relationship with the PPA. Daryl Turner has said the DOJ reforms are already causing injuries, citing an unusual spike in hurt officers late last year. Is he correct?

I haven’t seen any of the recent injuries tied to the settlement agreement. One, the agreement hasn’t been finalized yet. It’s in the court process now. Certainly officers now are, I think, considering it. They want to know what our Taser policy will be, where it will end up. And our force policy, where will that end up. They want to be trained so they can be in sync with court rulings around Tasers and use of force. Those officer injuries occurred because we interacted with people who were violent and intent on hurting us and the community.

_________________________________________________________________________________________

And you don’t foresee injuries being an issue when the settlement is finalized?

All those injuries came in a very short amount of time. We’ve had a couple of months since then. Things seem to be moving along as they always have. Use of force is down. We just had our most recent report for 2012, and force incidents have continued to drop. Our officers continue to be very thoughtful, and judicious, in how they approach their job. Force is very little of what we do. In a city of 600,000 people we use force on average twice a day to take someone into custody or enforce the law. It is a quarter of a percentage of all contacts. It’s only 3 percent of all arrests.

_________________________________________________________________________________________

Daryl Turner also has come out and accused you—after Sam Adams challenged an arbitrator’s reinstatement of Ron Frashour, the officer who killed Aaron Campbell—of lying and conspiring in the case. He’s attacked Lieutenant Robert King, formerly your top spokesman and a co-author of Frashour’s training review, implying he wasn’t truthful during arbitration. What’s it like being in the same room with Turner?

Daryl and I get along very well. There’s always going to be tension between labor and management. He has a role to play. He has a bully pulpit as the elected union president. Some of it’s because we are in a contract year, so he’s positioning for a contract. You’ll have to ask Daryl why he’s messaging things that way. Certainly, just on a personal level, Daryl and I like each other. We get along very well.

_________________________________________________________________________________________

So when he says those things about you, those strong statements he’s put out in the press, that doesn’t…

Well, that’s in the press. I don’t know if he has said them or not.

_________________________________________________________________________________________

Yes, but he’s also written them. He’s put them out in the union newsletter.

I disagree with his characterizations of the arbitration process. Certainly Robert King is one of the most respected people in this organization, a person of high integrity and ethics. I stand behind his work on the training review. Robert did an exceptional job. It’s interesting that no one is picking a part of the training review and saying it’s wrong. They’re going after the process. The training review, if you read it, is spot on. It is a very accurate reflection of the issues in play in the Frashour case.

_________________________________________________________________________________________

You mentioned the media. You’re alluding to the fact that reporters may not shade things correctly.

I don’t mean that. I just mean that Daryl will say something, and different media sources pick that up. You know, controversy sells papers. I respect the fact you guys have a job to do, and a little tension between labor and management doesn’t hurt things.

We are both on the same page in terms of keeping our officers safe, and doing everything we can to train our officers. There is a process that gets us there. And that process, because of the federal investigation, was a little compressed. We tried to get the policies done quickly. We may have not followed the best process at times. At the end of the day, Daryl and I really agree that we want the members of the bureau to be safe and well trained. We both agree we have exceptional officers here.

_________________________________________________________________________________________

Which reporters do that the most? I fully realize you might be looking in my direction.

The media can create a perception that government isn’t working. And it really matters that you get the story right. If we are doing something wrong, and you want to outline whether or not we’re doing our best work, I’m okay with that. But I don’t think it helps to create controversy just to create controversy. Does that make sense? I have a responsibility to this community. You have a responsibility, too. You have to provide balance. If it’s there.

Sometimes it isn’t.

True.

_________________________________________________________________________________________

Charlie Hales has told me he won’t declare—during the budget process—that the police automatically will suffer less than other bureaus. What does a 10 percent cut for the bureau look like?

Those are going to be difficult decisions for the city council. I really respect the fact that they have difficult decisions to make and balancing to do.

It can be counterproductive to community safety to close a community center—where kids have opportunities to play and interact in a positive fashion—just to save police jobs. Or to lay off firefighters to save police jobs.

And I respect the members of the council. They are good people, very thoughtful. We will provide them with information about the police bureau’s priorities, but We are not policing in a vacuum. We police in a community that has a lot of competing issues.

For example, our top priority with our school police officers is the safety of kids and staff and visitors. But our second priority is to help kids graduate. That has very little to do with our mission as a bureau, but everything to do with the future health of the city and long-term public safety issues. If we can get kids to graduate and become productive members of society, then they’re not in the criminal justice system. We’re all about looking at long-term ways to reduce people’s intersection with the criminal justice system.

_________________________________________________________________________________________

It sounds like you’re at least contemplating the possibility of layoffs.

I don’t know if it’ll get to layoffs. We may have vacancies we don’t fill. There are some opportunities to look at other cuts. In the past we’ve paid for some functions at the county. The county may have to pick those up. We fund a couple of deputy district attorneys. We pay for identification techs who work in the jail. We’ve got the Hooper Detox Center and the CHIERS service. Those are all areas that elected officials can work through.

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Some reports have come out, recently, charting racial disparities in police statistics. The most controversial looked at the bureau’s traffic and pedestrian stops. But a lot of people were heartened when, at a community meeting where those stats were revealed, officers actually said that yes, maybe, racism might be a factor in police work. Do you agree—and does that merit more introspection?

It does, and also the fact that there is a disparate impact on people of color throughout the criminal justice system—both as victims and as people who are incarcerated. We have to look at that impact, but it crosses so many different lines. You look at schools. Kids of color—there is a disparate impact in the discipline process there. You look at graduation rates. It’s everywhere in society.

It’s not just in law enforcement. And I really think it requires us to take a very frank look at everything we do with an equity lens.

_________________________________________________________________________________________

The bureau is improving how it collects and tracks data. Will that lead to answers?

Yeah, I mean, certainly you want to look at that. Because that can help you question why it looks that way. But, um, you know, sometimes the answer is obvious. You look at gang violence right now. Some 75 percent of the victims in gang shootings are African-Americans. That is a disparate impact. Most of the gang problem in Portland involves African-American gangs. So we have to ask ourselves as a community why a young person of color sees more hope in joining a gang than staying in school. Certainly, because of the role we play in law enforcement, we need to be at the forefront of that discussion.

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Only two people died last year as a result of officer-involved shootings. Other shootings obviously also happened, but that number is down. What’s changed?

With officer-involved shootings, again, we are a city of 600,000 people. They fluctuate. Last year we had six. Before that we had four. The year before that, six again. It goes up and down. They are such a small number that it’s hard to say it’s going this way or that for any specific reason. You have to look at larger trends.

Nationwide, if you look at us in terms of population, we are at the lower end of major cities in terms of shootings. If you just look at the metrics of it, the drop in our force numbers has been significant over the past five years. Not just officer-involved shootings but in broader categories where there’s enough data to actually get a sense that this is changing the culture of the organization.

_________________________________________________________________________________________

I was reminded of something that emerged in the transcript of the Frashour arbitration hearing. You said, “We don’t have a right to shoot him. He never displayed a weapon. He didn’t take any offensive action for the officer.” That’s a strong standard others have taken umbrage with. Officers don’t think that’s realistic. It also could apply to some of the other police shootings last year. Is that the lens through which you see discipline?

All of these situations, you have to look at them individually. Specific to Aaron Campbell, and not any other incident, you had a young man who had not committed a crime, who had not threatened to harm anyone except himself, who hadn’t displayed a weapon, and who was running away from the officer. So all of that goes into the totality of the circumstances that I weigh when I look at whether that shooting was justified. My answers in arbitration were specific to that set of circumstances.

In other circumstances, we will look at those on an individual basis.

_________________________________________________________________________________________

So if an officer is reading those remarks in the paper, on our blog, on the union newsletter, they shouldn’t assume that it applies to them?

Yeah, again, officers have a duty and a responsibility to protect themselves and the public from imminent danger. It’s hard to sit in hindsight and look at those incidents and judge them—but I have to. It’s my job. I respect that officers have to make split-second decisions. And I think we make really good decisions in the vast majority of cases. In the Campbell case, the officer didn’t make the best decision.

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The mayor has said he doesn’t support the ongoing court fight against Frashour’s reinstatement. Right now, he’s not on active duty. Will that change under Charlie Hales?

That’s a question for the mayor.

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That’s not something you’ve discussed yet?

No.

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If he asked you to do that, would you?

I respect the arbitration process. The city entered into it with the PPA in good faith.

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The arbitrator said he should be on active duty. So if Hales agrees, then…

At this point the council and the mayor have made a decision. I work for the mayor, and I’m going to follow his direction.

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Hales said pretty early that he wanted you to stay. And it’s January, and here you are. Has he laid out any goals for you? You’re eligible for retirement.

Now why did you have to go and say that?

_________________________________________________________________________________________

I’m just asking. Are you here to help him get on his feet? Or do you want to see this through longer than you actually have to be here?

I really believe that stability of leadership through this organizational change is critically important for the bureau and the community. I serve at the will of the mayor. I have a civilian boss, and I give him my best advice and I follow his direction.

But I would like to stay for a few more years, and the management team I have up here, I hope, can stay with me. I believe this is one of the longest tenures, since I’ve been a police officer, of any chief’s office.

It is two and a half years for all of us, and that’s a long time for a group of leaders to stay in place. I feel like I’ve got a team, with [Assistant Chief] Eric Hendricks and [civilian director of operations] Mike Kuykendall and [Assistant Chief] Larry O’Dea, who are just superb. I really appreciate the fact that they are willing to keep at it.

_________________________________________________________________________________________

One last question. Will you run for political office again?

I have a great job.

[Laughter erupts. Reese's current spokesman, Sergeant Pete Simpson, chimes in with: "Did he ever run for political office before?" Reese replies: "Yeah, exactly!" Reese, in late 2011, had set up a fundraising committee to run for mayor and was reaching out to endorsers and donors, but decided against formally filing papers.]

_________________________________________________________________________________________

People don’t consult [political adviser] Mark Wiener just to consult Mark Wiener.

I am very humbled by the opportunity to serve. And I really like our new mayor. And the council. I respect every one of them. This is going to be a really good year.

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Peer-delivered services draw capacity crowd at statewide conference

Posted by Jenny on 14th January 2013

By Jenny Westberg, Portland Mental Health Examiner, Jan. 14, 2013

Kristi Jamison

Kristi Jamison

“My life and the lives of others depend on it.”

That’s how Amy Anderson describes peer-delivered wellness services. So it’s not surprising that peer services — a key part of the CCO (coordinated care organization) model used in health care reform — were on the program for last week’s CCO Oregon conference. What’s surprising is that these services were not originally on the agenda.

Although getting a place on the program “does demonstrate a progressive, flexible, collaborative approach, ‘we’ had to ask to be a part of the conference. We hope to be asked in the future,” said Kristi Jamison, executive director of Empowerment Initiatives in Portland, who led the breakout session.

In fact, Jamison added, “This is the first time any consumer panel at a statewide provider conference occurred.”

Sellout crowd

The two-day conference, Transforming Care 2013, was held Jan. 8-9 at the Oregon Convention Center.

Jamison led a panel discussion the second day of the conference, called “Effective Community Engagement.” Every seat in the house was filled.

Panelists were:

  • Amy Anderson, CAC and Executive Board member for Multnomah County
  • Chris Bouneff, executive director of NAMI Oregon
  • Jawanza Hadley, Wellness & Organizational Development Consultant
  • Angel Prater, Director, Intentional Peer Support, Community Counseling Solutions
  • Beth Quinn, board director of Cascade Peer & Self Help Center

Backed by evidence

In 2011, landmark legislation wrote Peer Wellness Specialists, Personal Health Navigators and Community Health Workers into Oregon law (see ORS 414.665).

There is ample evidence for Peer Wellness Specialists. “A research base has been established that demonstrates that peer-delivered services are an effective component of mental health care” with a range of positive results, according to draft committee recommendations by members of the Oregon Health Policy Board.

Amy Anderson (L) and Jawanza Hadley

Amy Anderson (L) and Jawanza Hadley

A sign of hope

“The importance of peer-delivered services, in my experience, is that when we receive a service from someone who has had similar lived experience and seeking or in recovery of some sort, there is a natural connection,” said Hadley.

Hadley also said he was encouraged by the language being used by providers during the conference when discussing self-direction, wellness and recovery. “To me,” he said, “this is a sign that there is hope that we are moving away from the traditional medical model and towards the idea that everyone and anyone can recover from whatever challenges we may be experiencing in our life.”

Love, time, commitment

Anderson said peer-delivered services have been vital in helping her meet the challenges of two life-threatening health conditions, diabetes and cirrhosis of the liver.

“Without peers, mentors and community health workers in my life I would probably not be alive today,” said Anderson, whose health is now stable. “Just knowing there is another person out there I can talk with when I have my fear moments brings happiness and comfort.”

“Peers help teach and guide others by giving back, of their love, their time and finally their commitment to seeing the person improve no matter how long it takes,” Anderson said. “No one could begin to understand what facing death feels like, except those who also live on the edge.”

“Someone to walk with”

According to Jamison, “Having someone with similar life experience to go to appointments, facilitate provider contact, assist with provider appointments — someone to walk with — can not only reduce missed appointments (which providers care about) but it enables the person to learn to be a better self manager. Ideally, as they gain skills and tools, they share with others in their previous situation.”

Peer-delivered services are “based on the concept of mutuality,” Jamison said. “Everyone needs an advocate and a friend. I think providers finally understand that improved health outcomes include a truly person-based holistic approach, and Peer Wellness Specialists bridge that gap.”

Focus on quality

The conference, which was attended by over 500 people, included a video address by Kathleen Sebelius of the U.S. Department of Health & Human Services.

“We’re emerging from a system of skyrocketing costs and mediocre results, and we’re moving toward a new system that emphasizes care coordination, prevention, and quality care rather than quantity,” Sebelius said. “This transformation will mean better health, better care, and lower costs for all Americans. But it can’t happen without leaders like [those at the conference] showing the way.”

Insult to injury

Jamison said the panel she moderated was well received and the topic resonated with the audience.

However, after having to ask to be on the program, insult was added to injury — the session was cut short, leaving no time for questions and answers.

“It was very offensive and frustrating,” said Jamison.

CCO Oregon, when planning next year’s conference, should take note.

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Jury finds cops used excessive force; city must pay $306,000

Posted by admin2 on 10th December 2012

By Aimee Green, The Oregonian, Dec. 10, 2012

Gallagher Smith and attorneys

Gallagher Smith (left) with Portland attorneys Jason Kafoury (middle) and Greg Kafoury

A Multnomah County jury ruled Monday that the city of Portland must pay a 27-year-old man nearly $306,000 after police used a stun gun and pepper spray on him, punched him and dog-piled on top of him before they unlawfully arrested him for criminally trespassing on a downtown sidewalk.

The money represents one of the bigger jury awards in recent excessive force cases against police, who. are revising their Taser policy after federal investigators found officers often misused stun guns, especially against mentally ill people.

Jurors found that police falsely arrested, battered and maliciously prosecuted Gallagher Smith after he quarreled with a doorman on Nov. 13, 2010, at the Aura nightclub on West Burnside Street. The doorman told Smith he’d have to wait at the end of a long line again even though he’d just been in the club and had gotten a stamp on his hand before stepping outside. The doorman eventually flagged down police.

Smith walked away from the club as police followed. Smith questioned police about what law prevented him from standing on a public sidewalk.

Both sides agreed that police wouldn’t explain why. As officers tried to handcuff Smith, he pulled his arms into his chest. Smith said he was immediately punched in the face. The scuffle that ensued was his attempt to protect himself, he said.

But one of the officers testified during the four-day trial that Smith clenched his fists from the beginning and his body language indicated he was looking to pick a fight. Smith never hit or kicked police, his attorneys said.

Officer Patrick Johnson fired his Taser at Smith, but the probes didn’t pierce his skin. Officer Sean McFarland then used his Taser and hit his mark. Police said Smith was defying orders to stay on the ground.

Johnson pepper-sprayed Smith twice and police punched him in the back before half a dozen officers piled on top of him. Smith was handcuffed with his feet tied to his wrists and charged with criminal trespass, interfering with a police officer and resisting arrest.

Smith said he had smoked pot and was drinking that night, but his attorneys argued that had no bearing the officers’ overreaction.

Smith said he wasn’t ignoring police orders, but simply trying to crawl out of traffic after he ended up in the street during the encounter. He suffered a black eye, road rash on his face and Taser marks on his abdomen. He also was diagnosed with post traumatic stress disorder and said he’s lost his trust in police.

Jurors awarded nearly $16,000 in legal fees for his criminal defense, medical bills and counseling. They also awarded $290,000 for his pain and suffering.

After the verdict, juror Patty Smith said police were wrong to rough up and arrest Smith, and most of the verdict was an acknowledgement of his lasting psychological injuries.

In June 2011, a judge acquitted Gallagher Smith of all criminal charges, but found him guilty of second-degree attempted criminal trespass, a violation similar to a traffic citation and not a crime.

During closing arguments, Smith’s attorney Jason Kafoury contended that police hoped to win a criminal conviction against his client to forestall a lawsuit when they learned Smith had a clean record and they were wrong to rough him up.

Deputy City Attorney David Landrum told jurors that he accepts the earlier decision by Judge Youlee You that police didn’t have probable cause to arrest Smith. But Landrum said police try to use their best judgment during difficult situations.

“We get these ideas that police officers are these automatons — they’re robots, right?” Landrum said. “… They’re just people, and we put them in this position when you’re having trouble, when something is going wrong, it’s as simple as ordering a pizza. You dial them up. … They’ve got to figure out what’s going on and ‘What do I do about it?’”

The Police Bureau’s internal affairs unit investigated the confrontation and cleared the officers of wrongdoing, police spokesman Sgt. Pete Simpson said after the verdict.

Kafoury applauded Smith for courage in standing up to police when he asked them what law he was breaking by standing on the sidewalk.

“Some of you may be wondering ‘…Why don’t you just say, ‘Yes, sir,’ and keep on moving?” Kafoury said. “There’s one thing that history has proved: If we don’t defend our rights, we lose them.”

After the verdict, Smith hugged his attorneys. He summed up his feelings in one word: “Relieved.”

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Mental illness in Portland: He got kicked off the bus, but he didn’t go away

Posted by admin2 on 23rd October 2012

Editorial column by Susan Nielson of The Oregonian, October 7, 2012

A disheveled man boarded the Hawthorne bus one morning last week and sat near the front, agitated and in some kind of pain. The debris on the back of his coat suggested he slept outside the night before, and perhaps many nights before that.

Ten minutes later, the bus driver kicked the man off the bus. The rest of us made it downtown, but he didn’t. Though nothing terrible happened, there’s nothing like sharing a bus with someone in poor mental health to raise some hard truths about his journey.

The bus that morning was like any other day, crowded with office workers and Portland State students. Two women came aboard and said a man at the bus stop had been harassing them. The man boarded and announced that he needed to reach the hospital to have some sutures removed. Then he eyeballed the rest of us.

The commuters got very interested in their reading material. No eye contact: It’s the first rule of thumb when in an enclosed space with an unsettled stranger.

The man sat there vibrating with discomfort. Before long, he punctuated the air with random remarks and expletives that triggered a warning from the bus driver. A few riders moved farther away. Meanwhile, a bridge lift brought traffic to a halt and made the bus’s interior feel more confined. What happened next is fuzzy in my mind, but the man got into a short but tense exchange with a fellow passenger that ended with each of them threatening the other at close range.

At some point, the bus driver warned that a police car was nearby and officers could be summoned. It never came to that, thankfully. After several deft attempts to help the man stay calm, the driver asked him to leave — and then just like that, the man was gone.

A couple riders briefly applauded. Like a big jerk, so did I.

When you live in a city of any size, social problems are part of the urban landscape. People who appear to be homeless and mentally ill are passing time in the city parks, scavenging for cans in the neighborhoods and panhandling near the transit lines. You forget that these people are not extras in the movie of your life, adding some interesting grittiness to the background. You forget that many are suffering in ways you don’t understand.

But sometimes, people with visible problems aren’t on the other side of the park, but four feet away, right in front of your face.

This is doubly true during an economic downturn, when long-term unemployment and housing problems push more people toward the margins. Oregon’s rate of homelessness is third highest in the nation, according to the Kaiser Family Foundation, and homelessness raises the risk of minor and manageable mental health problems developing into major and chronic ones.

David Hidalgo

David Hidalgo

You see this in Portland and in cities across the country, said David Hidalgo, director of Multnomah County’s mental health and addiction services. Each person in obvious distress brings up some uncomfortable questions, he added.

“What do we do to get this person help? Who is responsible for this guy?” Hidalgo said. “We go to work, we go home to our families, and who knows where he goes?”

Multnomah County, like the rest of Oregon, is trying to strengthen its safety net. Through more outreach and better coordination of health care and social services, the goal is to keep more people out of crisis, on their medication, in stable housing, out of the emergency rooms and, ideally, employed. A secondary goal is to live up to the promise of deinstitutionalization, which was supposed to move people out of psychiatric wards and into the community, where they could thrive with enough support.

The safety net does save lives, but it’s nowhere near meeting the needs. As a result, we have police officers responding to endless mental health calls and bus drivers doubling as counselors.

The next morning, I asked the bus driver if the incident was stressful. He shrugged, all nonchalant in his mirrored sunglasses.

“It comes up, and you have to deal with it,” he said.

He’s right, of course. It comes up, and you deal with it. This confrontation on the bus was minor in the scheme of things. This particular man was likely harmless, like the majority of people in poor mental or physical health.

What sticks with me now is that this man said he needed to get to a hospital. He probably needed to reach his destination more than anyone else on the bus, yet he lacked the capacity to ride without getting kicked off. Maybe he reached the hospital eventually, and maybe he was connected with social workers and housing specialists who will help him transform his life. But I fear he got on another bus, and another bus after that, without going anywhere at all.

Multnomah County’s 24-hour crisis line number for people who need help, or are concerned about someone in crisis, is 503-988-4888.

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Business as usual at the Multnomah County jail

Posted by admin2 on 1st October 2012

Editorial column by Steve Duin, from The Oregonian September 29, 2012

Kenneth Yeo was shooting hoops in Hillsboro five years ago when he noticed the Washington Country sheriff’s patrol cars circling the park and decided the jig was up.

As the hoop was a few short blocks from the county jail, Yeo was once again imagining things. That’s not surprising: He has been diagnosed with anxiety disorder, bipolar disorder, schizoaffective disorder and post traumatic stress syndrome.

Nonetheless, Yeo presented himself at the jail and asked if he had an outstanding warrant.

As a matter of fact, Yeo did — failure to appear in Multnomah County — so Washington County took him into custody.

Yeo, 29, had a history at the facility; he was jailed there for two months in 2005. “They knew what happened to him when he didn’t get his meds,” says Joel Greenberg, an attorney with Disability Rights Oregon. Yeo reminded the intake staff that he needed those drugs.

But it was the Memorial Day weekend. When the jail staff phoned Yeo’s provider, it didn’t get a call back, much less the essential medications.

By the time Yeo was transferred to the Justice Center in Portland on May 27, he was coming apart. And the Multnomah County deputies, unlike those in Hillsboro, had no sense of Yeo’s medical history.

Yeo was placed in a separation cell. Greenberg says: “Within the next five hours, he took his clothes off, stood on the toilet and did calisthenics. They have a policy that no one gets housed until they’re seen by medical, but medical never saw him.”

Instead, Yeo was moved into a disciplinary unit. “Over the next two days, he’s twice found in a flooded cell, covered with his own feces and sliding back and forth in the water,” Greenberg says. “Sorta like a slip-and-slide.

“He’s completely decompensated now. Completely out of his skull.” And still without the meds he needs for anxiety, sleep and psychosis.

Thus, when the deputies eventually attempt the cell extraction, it didn’t go well. Yeo was tased. A cut on his head required stitches. He would spend a month at OHSU Hospital, Greenberg says, “before he’s lucid enough to see his family. Depending on whether you believe me, he’s never really been the same.”

When Yeo brought this story to Greenberg in 2008, the attorney figured he had a significant tort claim.

But he also had a case of deja vu. Too many people struggling with mental illness were getting lost in a county jail that was both underfunded and overcrowded.

So Greenberg approached Jacqueline Weber, a county attorney, in February 2009 and proposed the following: The county should compensate Yeo and pay “modest” attorney fees, a total of $100,000.

And it should direct the rest of its potential financial exposure in a federal civil-rights lawsuit to changes in “how the jail processes, assesses and treats inmates with obvious or known mental illness.”

Greenberg’s ideas? Equip each inmate with a medical “passport.” Ensure that mental health professionals who can provide psych meds are on site 24/7.

Train corrections staff to understand that when they can’t determine whether the inmate’s psychosis is the result of drug use or mental illness, they can’t assume drugs are the problem.

Forty-three months later?

“We settled for $80,000,” Greenberg says. “The systemic changes they agreed to were feeble. I don’t think they’re going to change what happens at the jail.”

Because he’s been around the block a few times — he was a special-ed teacher and public defender before joining Disability Rights Oregon — Greenberg recounts this with wry resignation.

The county’s risk management was dismissive. When Greenberg decided he had no choice but to file his lawsuit, he lost his leverage. The county went on the defensive, with attorney Patrick Henry at middle linebacker.

“An opportunity lost,” Greenberg said. “Neither side got anything useful.”

Not for lack of trying, argues David Austin, the county’s communications director:

“We engaged Mr. Greenberg in conversation about ideas he had on a number of occasions and encouraged him to give us specific ideas on how we might improve the system of care. Taxpayers pay for this system that cares for some of the most vulnerable people and we hear from mental health providers and clients who get services all the time.

“The question we ask? Will the proposal lead to improved patient health and patient outcomes? Unfortunately, we are not able to agree to implement proposals that would cause a costly redirection of resources to an already underfunded system.

“It’s not realistic to bring in more doctors at the jail for a system that’s been faced with making cut after cut after cut.”

Which means that you don’t need Kenneth Yeo’s imagination to realize the Kenneth Yeo debacle didn’t change a thing.

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City Takes Another Step Toward Easing Cops out of the Suicide Business

Posted by admin2 on 31st August 2012

From The Portland Mercury, August 30, 2012

Heeding calls by advocates to find new ways to keep police officers and public-safety dispatchers out of the very touchy suicide-response business, this fall Portland officials are moving forward with yet another initiative meant to divert mental-health calls from 911.

On Wednesday, August 29, Portland City Council was expected to spend $150,000 to shore up the suicide prevention services offered by Lines for Life (formerly known as the Oregon Partnership). The six-month program will help the nonprofit roll out a new hotline that government officials, ministers, and leaders in the queer community will all promote as the first and best number to call—not 911—for someone in crisis.

Final details will be released in a few more weeks—just in time to mark Suicide Prevention Awareness Month—and skeptics already are coming forward. But if the project is successful, it could prompt even deeper changes in the way suicide calls are handled in Portland.

“The hope is people will call this number instead of 911,” says Commissioner Amanda Fritz, who oversees the city’s 911 dispatchers and who helped push for the grant along with Mayor Sam Adams. “Their staff and volunteers have extensive training in risk assessment and counseling. Our operators get some training, but not nearly to the same extent.”

The shift comes as traditional safety-net services for the mentally ill unravel in the face of budget cuts, contributing to a doubling, just over the past decade, in the number of suicide calls handled by Portland police. The perils of that dynamic came into focus earlier this year when Portland police officers wound up shooting a suicidal man atop a downtown parking garage.

Lines for Life claims that 98 percent of its calls—more than 17,000 last year—are solved without help from cops. Tom Parker, a spokesman for the nonprofit, says that’s because its volunteers can do things that 911 dispatchers can’t do: take calls that involve a weapon or the prospect of imminent harm, and spend as long as it takes until a call “de-escalates.” Lines for Life also can accept text messages and has specialists on hand if someone like, say, a veteran calls and threatens suicide.

“By us picking up the slack, with the city pointing more people in our direction,” says Parker, “we can do what we’re really effective at. It’s not a timed phone call. We’d talk as long as you needed us to talk.”

All that said, the project isn’t without detractors. Some advocates worry the city will send mixed signals about where people in crisis—or loved ones worried about them—should turn.

The city is already in the midst of a separate 911 experiment, advocates note. Under that project, when suicide calls do come to 911, dispatchers are supposed to send the “non-threatening” ones over to Multnomah County’s crisis call center. County and city officials both confirm that hundreds of calls have been diverted from 911 to the county since that program started on May 30. Meanwhile, the police bureau also has tentative plans to create its own mental health reporting unit.

“We need one number that people in crisis can call for immediate, knowledgeable information. We just put a lot of time and energy into making a go of the county program,” says Jason Renaud of the Mental Health Association of Portland. “This sounds like a competitive, confusing scenario.”

City officials, including the mayor, agree the goal should be one suicide hotline number. It could be, however, that the city is already thinking of ending its 911 relationship with the county. Which would leave the Lines for Life project as the city’s main focus.

David Austin, a spokesman for Multnomah County, says it’s too early to draw conclusions about the success of the program after just a few months. Both sides are supposed to step back in November and see if they want to deepen the relationship. But sources in city hall tell the Mercury that officials are cooling on the arrangement.

Fritz says the Portland Bureau of Emergency Communications would review both projects next year. Asked about the chance that 911 dispatchers would also start sending calls to Lines for Life instead of the county, she wouldn’t rule it out.

“We may eventually get to that,” she says. For now, “we’re seeing how it works out. Next year, we can modify all of our protocols.”

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