Incarceration is not health care; police are not physicians

By Gustav Cappaert, Contributing Writer

In May 2010, someone called the Portland police to report a man talking to himself and spitting on cars in Old Town. When a police officer arrived, he found the man unwilling to be handcuffed. The officer hit the man with pepper spray and four Taser blasts. The man had schizophrenia.

The officer was not reprimanded for his response, and is now a co-defendant in a trial for a separate case of police brutality. His is not an isolated offense; the Portland area has seen at least 160 police involved deaths. In September 2012, the U.S. Department of Justice confirmed what most in the mental health community already knew when they “exposed” a longstanding pattern of excessive force by the Portland Police Bureau (PPB). In October, the city and the federal government reached an agreement. Under this plan, the city will add two Mobile Crisis Units — in which a mental health worker is paired with a police officer — revise its use-of-force policies; hire internal investigators; and create the Community Oversight Advisory Board which will meet twice a year.

The city has attempted to address excessive force before. This time, their effort is well-funded — new staff and training is projected to cost $5 million annually. What’s more, the federal government is holding the city accountable to implement the plan. Time will tell whether these reforms meaningfully change the relationship between the police and the community.

What PPB policies will not change are the problems at the root of how our society deals with mental health. Of course the police should be well-prepared to handle mental health crises, but they should not be the first interaction for a person in need of treatment. When law enforcement is the first response, courts, jails and prisons follow.

When people with mental illness end up in prison or jail, they are unlikely to receive adequate treatment, if any at all. Additionally, when they are released, people are issued a 30-day supply of prescription medication with little additional help. Often unable to navigate health care bureaucracies, and without an advocate, people with mental illness are likely to end up in the public safety system once again.

The Justice Department is actually conducting another investigation of Oregon’s treatment of individuals with mental illness. The early conclusions of that report are that the state is failing to provide adequate community-based services, supportive housing, and early intervention. “Many individuals,” the report finds, “receive services through only an emergency room or a jail.” The National Alliance for Mental Illness (NAMI) agrees. In its 2009 mental health report card, Oregon received a C, due to its lack of public hospital beds and reports of abuse at Oregon State Hospital. A 2010 Oregon Health and Science University study found a severe shortage of psychiatric beds in Oregon’s public hospitals, with most beds reserved for emergency holds for people awaiting criminal trial. The report states: “It is extremely important to note that there is, in essence, no room for the voluntary patients in either state or community hospital beds.”

Oregon has been penny-wise and pound-foolish when it comes to dealing with mental health. More than that, state policies have set up a situation where law enforcement, courts, prisons, and jails are often the first response to individuals with mental illness. Lives could be saved by diverting people with mental illness to community treatment and mental health courts. Tragedies and crimes could be prevented by adequately funding community-based treatment for people with mental illness and employing people to conduct early intervention.

We are set to add over 2,000 people to the Oregon prison population in the next ten years, at a cost to taxpayers of $600 million. To a large degree, future prison growth is the result of failing to fund smart, up-stream investments in building healthy communities. Connect the dots: early intervention and treatment won’t just save lives, it will mean our limited resources will be spent on more impactful community infrastructure than growing our prison system.

It should not take another condemnation by the Department of Justice to force Portland to get its act together, and the state legislature should take notice what is happening in Portland. It is time to direct more funding to mental health programs outside of the criminal justice system so that fewer people end up inside it.

Author info: Gustav Cappaert is with the Partnership for Safety and Justice. PSJ is a statewide, non-profit advocacy organization dedicated to making Oregon’s approach to crime and public safety more effective and just.

One response to “Incarceration is not health care; police are not physicians

  1. Prevention is better than cure, and treatment is better than prison. How can such logic be ignored?

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