Portland OR December 9 2019

On a brisk, 40-degree afternoon two days before Thanksgiving, Portland police responded to a call from the city’s psychiatric hospital and found a man sitting on the ground of the ambulance bay, handcuffed and shivering in just a T-shirt and shorts.

A security guard told two officers that the man had been released from the Unity Center for Behavioral Health but wouldn’t leave.
The guard told police the man apparently had taken crystal methamphetamine and should go to detox.

Officer Eric Dinnel, specially trained for crisis intervention, saw the man muttering unintelligibly. He and his partner didn’t notice signs of intoxication but found the man was suffering a mental health crisis and told the security guard they couldn’t take him to a detox clinic.
The guard then urged them to arrest the man for trespassing on hospital property or for harassing a therapist earlier.

The scenario was exactly the type of problem identified earlier this year by the nonprofit Disability Rights Oregon in a report called “The Unwanteds,” describing how hospitals rely on police to arrest discharged patients for trespassing, criminalizing mental illness.

In this case, police called Project Respond, a nonprofit mobile mental health crisis team, which sent two crisis professionals to the scene. An ambulance also arrived.

“I explained to this guard and the other two who were there, that I was not comfortable with an arrest for trespassing at a mental health facility, when the ‘suspect’ was clearly in mental health crisis and was there seeking their assistance,” Officer Thomas Brennan wrote in his report.

After some discussion on whether Project Respond or police should put a mental health hold on the man and have him taken to another hospital, a psychiatrist from Unity Center ultimately emerged and quickly agreed that the 48-year-old homeless man should be returned and treated at Unity Center.

Sarah Radcliffe, managing attorney for Disability Rights Oregon’s Mental Health Rights Project, praised police for successfully challenging the security guards’ effort to have the man taken to jail.

“I’m encouraged to see the police pushed back,’’ Radcliffe said. “Security (guards) aren’t really trained to distinguish between someone willfully trying to cause a disturbance and someone in need of mental health care.’’

The encounter also highlights what appears to be a disconnect between security staff and Unity clinical staff, the need for more community-based mental health care options that don’t rise to the level of hospital care and a gap in the around-the-clock transport service to take people to detox, Radcliffe said.

Elsewhere, some hospitals now require a clinician to consult with security guards before they call police to seek a trespassing violation against a patient or former patient.

“Security should be second chair in a clinical facility,’’ she said. “The clinical staff should be driving the approach to who needs care.’’

Unity Center officials are reviewing what occurred.

“Leadership and staff have already started an internal discussion to determine the issues that led to this incident and will use the learnings to help minimize a similar reoccurrence,’’ said Brian Terrett, a spokesman for Legacy Health, which operates Unity Center. “It is our goal to provide a safe and caring environment for both individuals in a crisis and the staff that are caring for them.’’

Here’s what happened, according to police reports:

About 3:15 p.m. on Nov. 26, the two police officers headed to Unity Center in Northeast Portland after noticing no one had responded yet to a call an hour earlier from Unity for a Central City Concern van to bring the man to detox. The officers checked if a van was available and were told no driver was working that day.

A manager for Central City Concern’s Hooper Inebriate Emergency Response Service (known as CHIERS) confirmed Friday that its service is operating on a limited basis now because of fewer staff members. It used to be available around-the clock seven days a week.

When police arrived, they found the man sitting on the concrete. He wore only a T-shirt and shorts though he had a plastic bag beside him that held pants, socks, shoes, a hat and a coat.

Dinnel tried to talk to him but he wouldn’t respond. “He looked through me, as if I wasn’t there,” Dinnel wrote in a report. The officers asked security to remove the man’s handcuffs.

Dinnel and Brennan then asked the man to put on his clothes. He put on only a thin suit jacket.

When the officers said they were reluctant to arrest the man for trespassing, the security guard said the man had harassed a therapist and wanted him arrested for that.

Unity Center for Behavioral Health

About 3:15 p.m. on Nov. 26, Portland police responded to the Unity Center for Behavioral Health and found a man seated on the ground inside the ambulance bay, shivering in a t-shirt and shorts, in 40-degree weather, according to police. “All of his actions and appearance indicated he was experiencing some form of mental crisis,’’ Officer Eric Dinnel wrote in a police report.

A therapist had said the man tried to strike him and grazed his arm, according to the police reports. When the officers approached the man, he pulled his arms to his chest, “tensed up,” pulled away and wouldn’t do what the officers asked.

“Since the governmental interest in this case was minimal, and the potential for injury to (the man) was a possibility, we released our grip to avoid using force on a subject clearly in crisis,” Brennan wrote.

The police backed away and again told the guard they weren’t willing to use force on someone they had no probable cause to take to jail and who they believed needed care.

The man’s “mental and physical welfare was the priority over taking him to jail,” Dinnel wrote.

But a security guard was still adamant that Unity wanted the man off its property and told the officers that the man had kicked a car in the parking lot, according to police.

The officers asked their supervisor, Sgt. Steven Wuthrich, to come to the scene, as well as Project Respond workers and an ambulance. Police often rely on Project Respond, run by Cascadia Behavioral Healthcare, to assist with calls.

Wuthrich tried to talk to the man but made no strides.

As all on the scene tried to come up with a plan and alternative to taking the man to jail, a Unity psychiatrist came out. After a quick look at the man who remained on the concrete outside, the psychiatrist agreed he needed to be brought back in for evaluation and care.

The officers, Project Respond workers and ambulance medics quickly lifted the man onto a gurney and wheeled him back inside. Police ended the call about 6:30 p.m., just over three hours after their arrival.

Unity Center officials said they couldn’t discuss the specifics of the encounter. They did say Unity cannot keep patients against their will unless they meet requirements for a mandatory hold.

Although police didn’t find that this man exhibited signs of recent drug abuse, Unity officials said patients under the influence pose unique challenges for staff in emergency care and that the use of intoxicants doesn’t mean the person is in a psychiatric crisis.

As or the man’s state of undress in the cold, Terrett said Unity won’t force clothes on someone who doesn’t want them “to help individuals maintain their personal rights and dignity.”

Unity’s security guards receive 80 hours of crisis training but it’s not at the level of crisis intervention training that law enforcement receives, according to Terrett. A behavioral health technician was present at some point when security was interacting with the man in this case, Terrettt said.

“There are various perspectives about what occurred and why it occurred, and the leadership of Unity Center looks forward to working with community partners, including the Portland Police Bureau, to identify ways to help care for and treat our community’s most vulnerable citizens,’’ Terrett said.

The day before the man was found shivering outside Unity, he’d been released from Multnomah County jail on his own recognizance. He had been booked Nov. 24 on accusations of fourth-degree assault and harassment at the Econo Lodge off of Northeast Sandy Boulevard. That case is pending.

Last fall, U.S. District Judge Michael H. Simon asked the Police Bureau’s Behavioral Health Advisory Committee to regularly monitor the number and types of arrests at Unity. Simon approved the city’s settlement with the U.S. Department of Justice in 2014 after a federal investigation found police used excessive force against people with mental illness.

From May 2018 to Feb. 28, 2019, officers made 16 arrests at Unity, 14 involving discharged patients, according to police. Compared to the 6,149 people served by Unity in that time, the arrest ratio was low, according to police.

“We continue to work with our partners at the Unity Center to problem solve issues in a compassionate manner related to those who experience mental health issues,’’ said police Lt. Tina Jones, a bureau spokeswoman.

oregonian.com

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