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What Happened to James Chasse: 2007-02-18

Wednesday, February 21, 2007

Mental illness training for police closer to reality

from The Oregonian, by Maxine Bernstein

Portland police are hearing from people who suffer from mental illnesses and are also listening to fellow officers discuss their own family members' struggles in a new crisis intervention training curriculum that began this month.

Lt. Sara Westbrook said the revamped curriculum is more focused around real people.

"Because we're hearing it from our own," she said, "the message is 'There is no "us" and "them." ' "

Westbrook, recently appointed as coordinator of the bureau's mental health training, invited members of Central City Concern and Cascadia Behavioral Healthcare's Project Respond, the county's mental health crisis outreach program, to suggest ways the curriculum could be improved.

Westbrook said she's striving to make the training useful for officers who are encountering more and more people suffering from mental illness on the street. In 1995, when she went through the 40-hour instruction, Westbrook said it was interesting but the outside instructors, including therapists and other mental health experts, didn't have the perspective of police.

"Frankly, they talked above us," Westbrook said. "It was too academic for us."

Two-year process

The new training is expected to last two years to get all patrol officers and sergeants, as well as Multnomah County sheriff's deputies, certified as crisis intervention officers. It came in response to the Sept. 17 death of James P. Chasse Jr. in police custody. Chasse, 42, suffered from schizophrenia when police encountered him and chased him, thinking he was acting oddly and possibly on drugs. Officers knocked Chasse to the ground and a struggle ensued to handcuff him. Chasse died from broad-based blunt trauma to his chest. He had no drugs on him or any in his system.

In October, Mayor Tom Potter announced he'd set aside $500,000 over the next two years to help Portland police run all patrol officers through 40 hours of specialized training on dealing with people suffering from a mental illness.

Portland's 40 hours of crisis intervention training for officers had been voluntary since the program began in 1994 under former Chief Charles Moose. Portland police and mental health advocates, including psychologists and psychiatrists, have provided the instruction, which includes classroom and realistic scenario training. The officers were taught how to approach and talk to someone in a crisis in order to defuse the situation before it escalated into violence.

The bureau videotaped three to four people with mental illnesses telling their stories. One of the four had significant contact with police several years ago. The bureau also asked officers to relay their own stories about relatives who suffer from mental illness. The videotaped accounts are played as part of the training. In addition, the bureau plays old TV episodes of "COPS," some dating to 1985, to critique.

Through critiques, officers are taught the proper way to interact with people suffering from mental illness, such as the proper tone of voice and body language to use, Westbrook said.

Program draws praise

Westbrook briefed community representatives about the new training at Tuesday's Chief's Forum.

Jason Renaud, of the Mental Health Association of Portland, lauded the bureau's efforts. Renaud said he was pleased Westbrook brought in Central City Concern and is including addiction as an element for the mental health training. He also applauded the sharing of officers' own stories.

"That's taking advantage of that trusting relationship to open up people's minds and hearts to behave with compassion," Renaud said. "This is a big step, and these are the right people making it."

A couple of forum members expressed an interest in sitting in on the training. Forum members T. J. Browning and Richard Brown suggested that any "us" versus "them" mentality between police and the community usually evaporates when all are sitting in the same room together.

A closed session

But Westbrook was hesitant to open the training to outsiders. She said strangers would stifle some officers from sharing their personal stories. Already, she said, some officers are resistant to the mandated training since it's coming in the aftermath of the Chasse case. Westbrook also declined to allow a media representative to sit in on part of the training, saying it would inhibit discussion.

Richard King, president of the Portland Police Association, said it'll be great if police learn something new in the training, but he's not that enthusiastic about it, either. "Every time something happens, we create more policies and training," King said. "I think police officers are pretty used to this dance."

Police Chief Rosie Sizer said she recognizes that the crisis training is only one piece of a larger puzzle.

"It's not going to change every encounter" the chief said, "but I think it's going to improve the services we provide to these people."

Chasse death sparks a change

from The Oregonian

Chasse death sparks a change

I n the wake of a mentally ill man's death in police custody last fall, the Portland Police Bureau has moved with impressive speed to improve departmental policies. One change announced this week clarifies what police should, and shouldn't, do when they use force and have reason to believe the confrontation may have resulted in injuries.

On the "should" list: Police should explain how much force they used. Paramedics, jail nurses and other emergency medical personnel need to know that, but it apparently wasn't fully communicated Sept. 17, when James Philip Chasse Jr. died in police custody.

On the "shouldn't" list: Police, in general, probably have no business transporting badly injured people to the hospital, unless there is no other way to get them there. An ambulance should do the transporting.

The obvious exception, of course, is when it's the best or only way to save someone's life. One concern about the new policy is that it involves a certain amount of additional paperwork that may bog things down rather than speed things up. Not every situation can be scripted according to policy. Under some circumstances, it's conceivable that the new policy could actually hinder or slow emergency response to an injured person instead of hastening it, as the policy is supposed to do.

Chasse, 42, died in police custody while officers were, belatedly, transporting him to a hospital. Had Chasse been taken to the hospital via ambulance --or if the true extent of his injuries had been understood --Chasse might be alive today.

Chasse suffered from schizophrenia. When police confronted him Sept. 17, after observing him possibly urinating in public, their orders to him to stop did not compute. He was so terrified he ran away. Police chased him. It's not clear what happened next (police contend an officer may have fallen on the emaciated man), but what is known is that Chasse suffered multiple rib fractures that punctured a lung. Later that day, these injuries apparently led to his death from what a medical examiner ruled was "broad-based blunt force trauma to the chest."

Paramedics called to the scene of the police confrontation with Chasse didn't detect his injuries, however. They observed his vital signs as normal. It wasn't until Chasse suffered what apparently was a seizure in a jail holding cell that police decided to transport him by patrol car to the hospital.

As The Oregonian's Maxine Bernstein reported Tuesday, there was apparently no discussion about the possible need for speed. In hindsight, it's obvious that jail medical staff should have done a far better job of assessing Chasse's injuries. Had that happened, it would have been clear that it wasn't safe to transport him by patrol car.

Chasse's death provoked a certain amount of finger-pointing among the respective agencies involved. The new policy may help to clear up misunderstandings by delineating their responsibilities more sharply. That's good. But this change has to be monitored.

Everyone involved must ensure that the net result is to speed up care for injured people, and never, under any circumstances, to slow it down.

Tuesday, February 20, 2007

Chasse death spurs police to change policy

from The Oregonian, by Maxine Bernstein

In response to the death of James P. Chasse Jr. in police custody, the Portland Police Bureau has adopted a new policy that restricts when officers can put a sick or injured person in their patrol car and outlines what information police must share with paramedics and jail nurses, such as how much force was used during an arrest.

The Chasse case last fall spurred the bureau to meet with county health officials, jail medical staff and ambulance paramedics to find better ways to share information and coordinate how they handle people who may require medical care, Assistant Chief Lynnae Berg said.

"It was a great collaborative effort among all involved --something both officers and emergency medical staff were hungry for," Berg said.

Multnomah County Sheriff Bernie Giusto agreed. "I think there was some fairly obvious changes that we needed to make," he said.

Chasse's death revealed gaps in police and county procedures because no one recognized the significant injuries he had suffered until it was too late.

Chasse, 42, who suffered from schizophrenia, sustained multiple rib fractures, some of which punctured his left lung, early in an encounter with police on Sept. 17. Ambulance paramedics who responded to the scene said his vital signs were normal and had a Portland police officer sign for him, declining emergency transport to a hospital.

Police drove Chasse to the Multnomah County Detention Center. He appeared to suffer a seizure in a holding cell and went unconscious. A jail nurse looked through the cell door window and told police the jail would not book Chasse. There was no discussion as to whether Chasse should be taken to a hospital by ambulance or by the police. Portland officers placed him in a patrol car. He died on the way to a hospital. The cause of death was broad-based blunt force trauma to his chest, the medical examiner ruled.

Under the new policy that took effect Jan. 30, officers will no longer give rides to people who have been engaged in a prolonged physical struggle, or are seriously injured, unconscious, suffering a seizure or extremely drunk, unless a paramedic on the scene approves it.

The policy says this will include people who appear to be suffering from what police call "excited delirium," a state of severe agitation, overstimulation, paranoia, involuntary twitching of muscles and hallucinations; anyone who is having respiratory or breathing problems, such as shortness of breath or wheezing; any head trauma before or during police contact; or anyone who appears to be extremely intoxicated or under the influence of drugs.

Officers will be required to tell emergency medical staff about any force that was used against the person, something that was not fully communicated in the Chasse case.

Further, if paramedics decide a person doesn't need additional medical care and give officers the OK to take the person to jail in a patrol car, then they will provide the officer with a document detailing the medical treatment received that will be dropped off with medical staff at the jail.

If jail nurses refuse to admit someone for medical reasons, the staff will document why on a "Pre-booking Emergency Response Record," and the medical staff in the jail will determine whether the person should be taken to a hospital by ambulance or police.

"The fact of the matter is, unless it's very clearly not a risk to life or detriment to somebody's health, officers do not belong transporting people," Giusto said.

If the jail staff makes the call to summon an ambulance to transport a person in custody, then the bill for the ambulance ride, in the $500 to $600 range, will be shouldered by the county. "This will not be a free proposition," Giusto said. "But I'm not sure we can argue about money after the Chasse situation."

If the jail medical staff determines police can take someone to a hospital, the officer must inform a sergeant before transport and record the name of the medical staff member who cleared the person for police transport.

The sheriff's office is clarifying what medical assessments must be done once someone comes through the jail's door for booking. Giusto said medical staff should be doing medical screens on all people booked to make sure their vital signs are normal.

Chasse's family early this month filed a federal civil-rights lawsuit against the city, county and American Medical Response Inc., demanding wide-ranging policy changes designed to reduce excessive force by officers and provide people in custody with appropriate medical care.

The new policy will be discussed at today's Chief's Forum, which meets at 9 a.m. on the 14th floor of the Portland Police Bureau.