Police And Jails Providing Much Of State’s Mental Health Care

From OPB.org, March 6 2008

LISTEN – Police And Jails Providing Much Of State’s Mental Health Care

If someone you care about gets sick enough, you take them to the doctor — or maybe even the hospital.

But if an illness is mental, rather than physical in nature, the symptoms are more confusing — and sometimes downright threatening.

For example, a person struggling with mental illness might start shouting aggressively in the street or tearing their clothes off. And that behavior is more likely to bring them in contact with a police officer than a doctor.

Indeed, as large mental institutions have closed, jails — by default — are becoming the biggest providers of mental health care in the state.

In this installment of OPB’s “On our Minds” series, Kristian Foden-Vencil reports on the strain this places on the corrections system and the mental health system.

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Over the last few years, Oregon’s police departments have had some tragic run-ins with people suffering from mental illnesses.

For example, 42-year-old schizophrenic James Chasse, died in 2006 after city and county officers forcibly arrested him — breaking 26 bones. They thought he was urinating in public and may have been on drugs.

In 2001, José Mejía Poot was shot and killed by Portland Police officers while in a mental hospital — after they’d been called to subdue him.

In response, police bureaus all over the state, including Portland, have added tutorials on mental illness. Some have also started circulating officers through ‘Crisis Intervention Training’ programs.

Clackamas County Sheriff, Craig Roberts, explains how he decided the training was necessary.

Craig Roberts: “I responded to a call with an individual with two cans of gasoline next to him, dressed in a silver outfit with a lighter, ready to commit suicide. I didn’t realize until I got close enough to see what’s going on, and I thought this is ludicrous to be learning how to negotiate with someone with mental illness with a lighter in his hand, and that’s what we’re expecting out of our troops.”

While such a scenario can be terrifying for a cop, it’s hard to imagine what it must be like for the person experiencing the psychotic break.

Take the case of Portlander, Ashleigh Brenton, a 52-year-old wife and mother. She went to fill her car up with gas one day and started thinking everyone was out to kill her.

When the gas attendant stuck his arm through her car window, to take the money she held in her hand, she sped off — dragging him down the street. He managed to struggle free but police had to crash into Brenton’s car to get her to stop.

Ashleigh Brenton : “And they had me at gun point and told me to get down on the ground, which I refused. I wouldn’t cooperate because I thought they were bad men and I thought they were going to kill me anyway. And I told them, ‘No, I’m not getting down. I know you’re not the police.’”

Eventually, she was taken to jail.

Ashleigh Brenton: “I was in a special cell for a few days because I wouldn’t cooperate with them. I wouldn’t give them my fingerprints because I thought they were going to cut my fingers off. It was a horrible experience. They have us strip-searched and things like that. I thought they were getting me ready to put me into slavery, into prostitution. I thought they were raping women in jail. I just thought the worst and I truly believed this.”

After two years at the Oregon State Hospital, Brenton is now taking medication and living on her own in downtown Portland.

Ashleigh Brenton: “Yes I think things could have been done differently. I don’t believe that people that are mentally ill should be in jail first of all. I think they should be in a hospital, getting medication, getting help.”

Brenton’s is a point of view that you won’t find many taking issue with — least of all those in law enforcement. But the fact is, when someone with a mental illness breaks the law, they are held accountable — just like everyone else.

But to try and avoid nightmares like those experienced by Ashleigh Brenton, inmates are asked a series of questions when they’re first booked into jail.

Troy Rutledge: “I want you to stand on the red line. Show me your coin pockets inside out. Show me what I missed. Two cents.”

Deputy Sheriff Troy Rutledge books a man who only wants to be known as George into the Clackamas County Jail. He’s accused of not having his license while driving. After he’s searched and stripped of his shoes and jacket, Rutledge conducts the mental illness screening.

Troy Rutledge: “Have you been hospitalized or recently seen by a medical or psychiatric doctor for an illness.

George: “No.”

Troy Rutledge: “Do you have any of the flowing, breathing problems, cancer, diabetes, epilepsy, seizure, head injury, heart trouble, high blood pressure, hepatitis, convulsions, kidney problems, tuberculosis, ulcers, mental health problems, a prosthesis or any other medical problem we should know about.”

George: “No.”

The screening does get a bit more thorough.

Troy Rutledge: “Are you thinking about hurting yourself.”

George: “No.”

Troy Rutledge: “Have you ever attempted to hurt yourself.”

George: “No.”

Troy Rutledge: “Do you have visual or auditory hallucinations.”

George: “No.”

Troy Rutledge: “Have you been treated or prescribed medications for depressional, emotional mental health issues in the past year.”

George: “No.”

George seems fine and is escorted away to have his mug shot taken.

But if inmates answer ‘yes’ to any of those questions here, they’re taken to see Glenn McArthur. He’s the mental health specialist who tries to make sure they get the medications they need.

Glenn McArthur: “I think we have a pretty good track record here of catching these folks. The deputies are quite skilled, the nurses are, you know everybody that works here has been doing this for quite a while.”

The health system in Oregon, as in the rest of the United States is in crisis.

Costs are skyrocketing, millions of children and adults remain uninsured and even working people are going without health care. Presidential candidates are promising plans that will come to the rescue.

Often people are stabilized quickly. They go to court and their offences are dealt with promptly. But sometimes, a mentally ill person will deny they have a problem and refuse to take medication.

Then, says McArthur, they end up waiting for weeks, or even months, for court appointments and evaluations at Oregon State Hospital — the only place in Oregon where someone can be forced to take medication.

McArthur says when they come back, they can again refuse to take their meds.

Glenn McArthur: “Yeah, some people get caught in the system. Well, quite a few people get caught in the system — going back and forth from here to the state hospital.”

Clackamas County is one of a half dozen counties in the state that has a mental health court, designed to help people negotiate this convoluted system. But McArthur and others wish there were a crisis center, or some other safe place that cops could take the mentally ill instead of jail.

Glenn McArthur: “There isn’t a lot in the community. We’ve got our ER’s. We’ve got a couple of place in Salem, but there’s very few places to send somebody.”

David Delvallee: “There is definitely a need for other types of crisis respite alternatives.”

David Delvallee heads the Oregon arm of the National Alliance on Mental Illness, or NAMI.

David Delvallee: “There is definitely a need for other types of crisis respite alternatives, places where the police can bring an individual, who’s obviously suffering from mental illness and that the crimes don’t rise to the level that they need to be incarcerated.”

Such a place used to exist — in Portland at least – the Crisis Triage Center. But a combination of budget cuts, the increasing number of uninsured Oregonians, and rising healthcare costs, spelled its end.