Disability Rights Oregon’s report “Mental Illness in the Multnomah County Detention Center’’ highlights the challenges faced when people with mental health issues enter the criminal justice system. Mental health and substance abuse issues often complicate how the necessary rules in a jail environment are followed and enforced.
Multnomah County agrees that the county jail is not -- and should not be, a therapeutic treatment center.“I am deeply troubled by these accounts of how people are being treated at the Detention Center,’’ Chair Deborah Kafoury said. “We appreciate Disability Rights Oregon’s efforts to show the painful challenge we have long faced as a community: that there are people in jail who require treatment in a therapeutic setting.’’
Chair Kafoury said that as a community, we must find an alternative to using jail as a treatment of last resort.“As a County, Health Department and Sheriff’s Office, we can and must do a better job for people with mental illness,’’ Chair Kafoury said. “And that includes people in our custody.’’
Toward that end, Chair Kafoury is:
- Directing Health Department Director Joanne Fuller to assume responsibility for Corrections Health and work with Dr. Michael Seale, medical director for Corrections Health, to increase access to treatment and recovery for people in jail.
- Meeting hospital administrators around appropriate discharge of people with mental illness to the jail.
- Supporting Corrections Health staff working with a nationally-recognized consultant to evaluate medical and mental health staffing. Corrections Health provides 24/7/365 nursing and mental health consultant coverage, as well as a mental health nurse practitioner and psychiatrist availabile on-site.
- Continuing investment in mental health care before and after jail through:
- Corrections Health maintaining its full-time eligibility specialist who has enrolled more than 1,300 people and confirmed enrollment of more than 900 people in the Oregon Health Plan in the last year alone so they can get care after discharge.
- Continuing pre-booking diversion programs such as the Law Enforcement Assisted Diversion program or LEAD which will divert people with substance abuse problems (and often a co-occurring mental health issue) facing low-level drug crimes from the jail to services and treatment.
- Funding mental health intervention professionals and peer navigators at homeless shelters to provide care for people who are discharged.
“We have already taken some important steps to make sure we have the right staffing in place, and to ensure people leaving jail have healthcare coverage so they can receive care in the community,’’ Kafoury said. “But this report also shows we also have far to go.”
Chair Kafoury said she has also directed the Health Department and Dr. Michael Seale, Corrections Health Medical Director, to work with the Multnomah County Sheriff’s Office to:
- Keep more people with mental illness people from ever being booked into the detention center.
- Work with the Sheriff's Office to minimize the use of administrative separation for individuals with mental illness to allow for the least restrictive housing possible and to promote enhanced access to services
- Pursue opportunities for improved links to community resources for substance use and mental health upon release from custody
- Explore options to enhance access to care during custody to facilitate treatment planning and promote stabilization.
- Review the judicial issues of detainees with long stays to promote efficiency and to improve communication.
- Understand that changing the system isn't just about adding people and programs. "It’s also about building a culture of safety, recovery, care and connection to the community,'' Chair Kafoury said.