Update (11/13/23): Allegheny County Executive-elect Sara Innamorato today called news of lawsuits against Adelphoi — the private, nonprofit contractor hired to run the Shuman Juvenile Detention Center — “deeply concerning,” calling transparency in youth detention “a main priority for our administration.”

“This sets off alarm bells,” Innamorato said when asked about PublicSource’s reporting on Adelphoi and the recent complaints filed against it in federal courts.

“I want to understand more of what’s going on and what we’re looking at,” Innamorato said, “and ultimately that’s why above all else, as we open up a detention facility, we have to make sure that there is public oversight like the Jail Oversight Board, that there’s community voice there, that we are investing in a way as a county so there is enough capacity there for highly trained staff, that there’s resource providers that have access — there’s just a lot of sunshine on that facility.”

Prior to Shuman’s 2021 closure, the county operated a Juvenile Detention Board of Advisors.

“The unfortunate reality is our history of administering Shuman isn’t a great record either,” Innamorato noted.

She stopped short of suggesting a reversal of the county’s contract with Adelphoi.

“We are going to look at the terms and see what we are bound to and what best serves the needs of the young people who are caught up in this system at the moment,” she said, adding that there are now “kids in the county jail and we want to make sure that we can get those kids out of that facility and into one that is specialized and geared toward the young people who are there.”

Allegheny County’s pick to run Shuman hit with negligence lawsuits

Reported 11/9/23: When Allegheny County announced in September that it would reopen its youth detention center, it praised the private contractor hired to operate it. 

“Adelphoi has a proven track record as a leading and highly respected agency” in caring for “delinquent and dependent children,” said President Judge Kim Berkeley Clark, of the Court of Common Pleas, in a press release. “This is a crucial step toward creating a safer and more supportive environment for juveniles in the county.”

That record includes accusations of failing to protect children from abuse, according to two civil lawsuits filed just days after Adelphoi Western Region signed a $73 million contract to hold arrested youth at the Shuman Juvenile Detention Center.   

One is a class-action complaint filed in federal court in Philadelphia, accusing Adelphoi USA — one of seven affiliated nonprofits based in Latrobe — of a broad pattern of “negligent staffing” and failing “to enact safety measures and other policies to protect the children.” As a result, according to the complaint, “vulnerable youth … were exposed to predators and abusers.”

The other complaint, filed in federal court in Harrisburg, seeks civil damages for the survivor of former Adelphoi Services employee Tabitha Dunn, who pleaded guilty to corruption of minors and endangering the welfare of children in relation to her work with a minor to whom she was assigned as an in-home worker. 

The attorneys who filed the suits told PublicSource their clients experienced severe trauma while in Adelphoi’s care and allege that some of the entities are responsible for failing to protect them from harm. 

It’s important that “the institutions harboring these abusers” are held accountable, said Renee Franchi, an attorney representing the young male in the case against Adelphoi Services.  

David Wesley Cornish, a Philadelphia attorney, filed the class-action suit on behalf of eight plaintiffs who allege they were abused by staff at Adelphoi facilities throughout the state. 

“It’s not just one or two people … that are saying this,” said Cornish. He said his clients “had never met each other,” but made similar accusations of mistreatment by Adelphoi staffers. 

The lawsuits — and another filed last year against Adelphoi Village in Westmoreland County court — raise questions about the plan for Shuman and speak to broader concerns about youth incarceration, which some advocates say exposes children to physical and mental harm and the risk of abuse.

Adelphoi said it can’t comment on pending civil complaints, but takes “extensive steps” to protect the children in its care, including training and supervising its staff and reporting incidents to Pennsylvania State Police and ChildLine, the state’s call center for reporting child abuse.  

“We remain committed to providing a safe and nurturing environment for every child under our care,” said Karyn Pratt, Adelphoi’s vice president of marketing and strategy development, in an email. 

Clark announced in September that Shuman — which closed in 2021 after the state revoked its license — will reopen under Adelphoi management. County and court officials signed a contract with Adelphoi that month. The center could begin holding youth again as soon as this winter if renovations to the facility are completed on schedule. 

Amie Downs, a spokesperson for the county, referred all questions about Adelphoi to the county’s court system. Joseph Asturi, a spokesperson for the county’s Court of Common Pleas, declined to answer questions, including how civil complaints might inform the court’s monitoring of Adelphoi’s work. 

How Adelphoi landed a $73 million contract to operate Shuman

Shuman first opened in 1974 in a brick building near the Allegheny riverfront in Lincoln-Lemington-Belmar. The county managed it for decades until the Pennsylvania Department of Human Services revoked its license for multiple violations. 

Walter Harris was 14 years old when he was first held there in the mid-1980s. He was growing up in Section 8 housing in the Hill District, and stole clothes and nice things he couldn’t afford. He was caught in a Sears store after closing time and charged with theft and trespassing. 

The idea of being locked up scared him, but he calmed down after arriving at Shuman and bonding with other kids. He was sent there about a dozen more times until he turned 18 in 1988. “After that, you’re prepared,” he said, describing youth detention as an onramp to his time in state and federal prisons as an adult. 

Harris’s experience gets to the core of a debate about how to help youth who’ve been arrested — and whether detention is the right approach. 

After Shuman closed, law enforcement leaders complained they had no place to put youth they deemed too dangerous to be released. Pittsburgh Mayor Ed Gainey even partly blamed spikes in gun violence — without citing evidence — on Shuman’s closure. “We should have never closed Shuman without a plan,” he told reporters after a triple homicide on the North Side. 

Advocates, on the other hand, pushed for approaches outside the carceral system, which disproportionately locks up Black people.  

“I don’t think there is any benefit or value in incarcerating children,” said Muhammad Ali Nasir, who goes by his emcee name, MAN-E, and is the advocacy, policy and civic engagement coordinator at 1Hood Media. The county should invest in non-carceral approaches, such as working to end poverty and investing in schools instead of reopening Shuman, he said. 

Under pressure from judges, law enforcement and other public officials, the county searched for a private operator to take over the site. It had “a strong preference” for one that would run a youth detention center, according to a request for proposals released last year.       

Enter Adelphoi, one of the largest youth service providers in the Pittsburgh region. It submitted a proposal to reopen and provide detention services at Shuman. The county accepted the bid and drew up a contract to pay Adelphoi $73 million over five years — an annual cost that’s 40% higher than what it paid to run the facility itself.     

Under the contract, Shuman will hold youth aged 10 to 20 who are from or found in the county. They may have been charged with serious offenses, deemed aggressive or at risk of leaving an unsecured facility, adjudicated delinquent or some combination of those. 

Read more about Adelphoi’s pledges to Allegheny County

County Council sued to block the plan, asserting its authority to approve or deny the use of county property. And advocates criticized the high price tag — which they said could instead go toward non-carceral programs — and lack of public oversight over the decision to reopen Shuman.     

“I don’t think that taxpayers have had enough input [and] I don’t think the kids who have gone through the juvenile legal system have had any input,” said Tanisha Long, Allegheny County community organizer for the Abolitionist Law Center. “This decision was made in the dark by the courts and [County Executive] Rich Fitzgerald.”

The county’s announcement stirred “mixed emotions” in Harris, now 52 and a member of the Elsinore Bennu Think Tank for Restorative Justice. He tries to help the youth of today by volunteering for ALC Court Watch, a team that observes court proceedings, including decertification hearings. And he’ll soon launch the Pittsburgh location of Fathers on the Move, a mentorship program for youth involved in the criminal justice system.   

“My mission is to make youth incarceration so rare that I have to find a new career,” he said. 

Though he believes Shuman should be reopened, he can’t be sure a private contractor who’s “out to make money” shares his mission.

“Who are they?” he asked about Adelphoi. “And what is their track record?” 

Who is Adelphoi and what is its track record? 

The Adelphoi nonprofits operate in Pennsylvania, Ohio, New York and Delaware. They’ve served youth in the Pittsburgh region for more than 50 years. 

Based in Latrobe, Adelphoi provides foster care, education, in-home services and youth detention to nearly all counties in the state. Across its seven entities, Adelphoi made over $68 million in total revenue in fiscal 2022, with its largest arm, Adelphoi Village, a group home business, pulling in about $44 million. Combined, the Adelphoi entities employ around 600, according to Pratt. More than 1,000 youth receive its services every day. 

Adelphoi declined a PublicSource request to tour one of its detention centers and did not make an executive available for an interview. Pratt, the group’s marketing executive, answered detailed questions via email.  

She said Adelphoi isn’t new to the county. It serves about 60 youth per year here, including those who need shelter or are in the foster care system. After Shuman closed, the county placed youth it wanted to detain in Adelphoi facilities in nearby counties, including group homes in Westmoreland County, she added. 

Pratt called the lack of available beds a “detention crisis” in the region. She drew a straight line between the closure of Shuman and an uptick in youth fleeing Adelphoi’s group homes. She said non-secure group homes provide “an inappropriate level of care” for some youth, which is why a detention center is badly needed.    

At least one longtime advocate for incarcerated people agrees. 

Richard Garland is desperate to keep kids out of adult prisons, which he said is where some will end up if they don’t receive services while they’re in the more rehabilitative juvenile justice system. There were 25 children in the Allegheny County Jail on Nov. 8. 

Garland, the executive director of Reimagine Reentry, which provides services to formerly incarcerated people, said Adelphoi is a “tried and tested” provider of therapy and other supportive services. He described having good experiences with them that date back to the 1990s, when he first started his violence prevention work.     

But he was alarmed by the allegations in the civil complaints, which PublicSource shared with him during a recent interview. “That sends up a real big red flag for me,” he said. 

Adelphoi’s care for ‘vulnerable’ children questioned

Franchi’s client — anonymized as A.M.M. in the civil complaint — was a child in the Bradford County foster care system when he encountered Dunn, an Adelphoi in-home worker at the time. The complaint alleges she groomed him via phone messages and during trips to his foster home. She was soon barred from contacting him by a Protection From Abuse order. 

“Adelphoi knew or should have known that Dunn had inappropriate contact” with the minor, according to the complaint, and the firm “did not take steps to intervene or protect” him.

The complaint says she eventually kidnapped him, withheld food and water from him, and repeatedly sexually and physically abused him. When Dunn let him drive, it alleges, he sped on a highway to try to get pulled over by police, leading to Dunn’s arrest.

Dunn’s attorney didn’t respond to a request for comment.

The suit seeks damages from Bradford County, a county caseworker and Adelphoi Services for being “indifferent to the risk of sexual victimization to children in county custody.”

Pratt said Adelphoi reported the abuse to state police and ChildLine, and was “wholly supportive of the legal process and consequences” imposed in the criminal case.  

The separate class-action lawsuit alleges a longstanding pattern of “negligent staffing” and cases of abuse dating to 1998. The class of the suit includes current or former residents of any Adelphoi juvenile facility who “were subjected to either physical, mental, and/or sexual abuse by any [Adelphoi] staff members … and/or either had their educational opportunities deprived,” according to the complaint.

It accuses Adelphoi USA, the parent organization, of failing to properly screen, train and supervise its employees, some of whom sexually and physically abused the plaintiffs. “Many of the children who were abused at Adelphoi USA were vulnerable, intellectually disabled, and already fleeing from abuse,” according to the complaint. The nonprofit’s staff “took advantage of children who had already been victims of sexual abuse and were at Adelphoi USA to seek healing.”

The complaint alleges Adelphoi USA also misrepresented the abuse as part of plaintiffs’ treatment. The abuse often took place during “therapeutic sessions,” which made the plaintiffs believe it was “normal” and “medically necessary,” the complaint says.

The complaint argues that attempts to deceive plaintiffs toll the statute of limitations to file claims for physical and sexual abuse.     

It was “almost impossible” for children to stop the abuse or get help because Adelphoi USA limited their phone usage and cut off their contact with the outside world, according to the complaint.  

Some amount of violence and abuse “is almost inevitable when you lock people up,” said Sara Goodkind, a professor at the University of Pittsburgh’s School of Social Work. She added that some facilities are better-managed than others. 

“We’ve heard really concerning things about Adelphoi,” said Jessica Feierman, senior managing director of the Juvenile Law Center in Philadelphia. But “those kinds of stories” aren’t unique to them and happen in public and private facilities across the state and country.  

How will Adelphoi operate Shuman?

Shuman has a long history of failing to protect young people from harm, according to a report, co-authored by Goodkind, that explored ways to end youth incarceration in the county after Shuman closed. 

The researchers interviewed young people — ranging in age from 14 to 27 — who were held at Shuman. They described moldy food, inadequate medical care and unsanitary conditions there. Many said staffers were abusive and predatory, though a few were helpful and supportive. One described Shuman as a place that “grooms kids for crime, not healing.” 

PublicSource asked Adelphoi if it believes it can do better. 

Pratt said Adelphoi “maintains the highest standards of care” across all its programs, including detention. Its management of Shuman will be trauma-informed, she said, though she didn’t specify what that will look like. 

Adelphoi will bring in UPMC Children’s Hospital of Pittsburgh to provide nursing care and manage medication, which is a condition of its contract with the county. Medication errors were among the violations that led to the revocation of Shuman’s license.

The lawsuits raise questions about how Adelphoi will screen candidates for jobs at Shuman.   

Pratt said Adelphoi has already begun interviewing candidates for 25 open positions at Shuman. They’ll be screened via child abuse and criminal history checks, and their fingerprints will be run through the FBI database.  

She didn’t answer a question about how much Adelphoi will pay workers at all levels at Shuman, though she said wages would be competitive in the local market.

Goodkind said the least qualified and trained workers in a detention center tend to work undesirable shifts and often aren’t paid “more than you might get … for working at Target.” While all staff are capable of abuse, the risks are elevated with low-paid, undertrained “line staff,” she said.    

Adelphoi faced a labor shortage during the COVID-19 pandemic that forced it to scale back services and ask staff to work overtime, according to its most recent annual report.  

A civil complaint filed last year in the Westmoreland County Court of Common Pleas by plaintiff Timothy Rice alleges that insufficient staffing contributed to Adelphoi’s failure to protect him from a stabbing attack by three other residents when he was placed at Adelphoi Village in Latrobe.

“At the time of the stabbing, it is believed there was only one member on staff in the facility which is against standard policy,” said the complaint. 

The complaint alleges that proper Adelphoi policy requires at least two staff members to be on duty at all times to ensure the safety of residents. It also alleges that failures, including understaffing, allowed Rice’s attackers to possess a weapon despite one of them having a known violent past, and slowed the response to the attack. 

Rice’s attorney, Daniel Soom, declined to comment. 

Pratt said Adelphoi’s staffing issues have eased; it has seen a 65% decrease in open positions over the past four months. 

The county is paying Adelphoi a flat fee of $7,800 per day for 12 beds, with the goal of expanding to 60 beds for $39,000 per day. Pratt said that should reassure community members who are concerned about incentives for “maximizing the number of youth in the program.” 

Incentives to fill beds have backfired before in Pennsylvania: Luzerne County judges sent children to for-profit jails in exchange for kickbacks in the notorious “Kids for Cash” scandal, which didn’t involve Adelphoi. 

While a flat fee is good, it could still incentivize judges and other stakeholders to send more kids to Shuman, said Jeffrey Shook, a professor at Pitt’s School of Social Work. 

They could say, “We’re paying for it, we’ve got to move kids into this system,” he said, warning that “the deeper kids get into a system, the more likely they are to stay in a system and go into the adult system.”

Goodkind said it’s important to understand that detention facilities typically house young people for short periods of time before they’re adjudicated or found delinquent. That means many will be held at Shuman before it’s been determined that they’re guilty of an offense. 

She added it’s a common misconception in the community, and even among some political candidates, that detention centers provide long-term rehabilitative services. The average stay at Shuman was around 12 days when it closed, according to the county.  

Pratt said Adelphoi’s goal is to “minimize as much as possible” the amount of time youth spend in detention. That way, they’ll be placed into treatment plans that “most align with their unique needs.”  

But Long isn’t buying it.  

No matter how private detention contractors market themselves, she believes they will always “default” to a carceral approach. If they really wanted to help kids, they would do it “without the requirement of incarceration.”  

Harris said he recidivated after his time at Shuman because he was sent back to his traumatic home life with no support. He’d like to see a program for incarcerated youth “whose goal is to put themselves out of business.” If the county tried hard enough, it could work toward that goal, he said.  

“But a corporation can’t have it because they’re trying to make money.” 

Correction: The complaint filed by A.M.M. names as defendants Adelphoi Services Inc., Bradford County and a county caseworker. An editing error in an earlier version of this story indicated another defendant.

Venuri Siriwardane is PublicSource’s health and mental health reporter. She can be reached at venuri@publicsource.org.

Tanya Babbar is an editorial intern at PublicSource and a junior at the University of Pittsburgh. She can be reached at tanya@publicsource.org. 

Charlie Wolfson contributed.

This story was fact-checked by Jack Troy.

This reporting has been made possible through the Staunton Farm Mental Health Reporting Fellowship and the Jewish Healthcare Foundation.

Adelphoi’s pledges

Key points in the nonprofit firm’s role with, and promise to, Allegheny County, expressed in its contract and in responses to questions from PublicSource:  

• Adelphoi said it has an “impeccable” licensing history with the Pennsylvania Department of Education and Department of Human Services. It’s accredited by The Joint Commission, the nation’s oldest and largest independent healthcare accreditor.  
• About 79% of youth placed at Adelphoi facilities completed its programs in 2022 and 80% remained out of care one year after they were discharged.
• Adelphoi said it will provide youth held at Shuman with education, medical and dental care, mental health services, recreational opportunities and spirituality services. 
• Adelphoi’s contract with the county allows it to use “physical techniques” to manage crises at Shuman. Staff are trained to use “alternatives to restraint” first, but will use “passive restraint” in situations that pose “imminent danger to oneself or others,” according to Karyn Pratt, Adelphoi’s vice president of marketing and strategy development. All restraints are recorded via camera systems and reported to the placing agency.   
• Adelphoi will influence how courts and probation officers make decisions about youth in the criminal justice system. It will provide those stakeholders with a “high-level view of all clinical and assessment information” about a child. It will also provide that information to the treatment provider that a court or probation office selects for that child. 
• Elizabeth Miller is Adelphoi’s medical director and is responsible for clinical practice and overall care at Adelphoi facilities. She is a professor of pediatrics at the University of Pittsburgh’s School of Medicine, and is chief of the Division of Adolescent and Young Adult Medicine at UPMC Children’s Hospital of Pittsburgh.

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Allegheny County is moving ahead with a year-old initiative to hire a consultant to plan what could be drastic alterations to the county jail, potentially including decreasing its capacity by half or more. 

Almost a year after releasing a request for proposals, the county has chosen a firm and is now negotiating a contract, according to the county controller’s office. The chosen firm is CDI Architects, a subsidiary of TranSystems. 

The county has done business with CDI Architects multiple times in recent years, and its former parent company, L.R. Kimball, designed the jail in the 1990s. Both entities were bought by TranSystems in 2021.

A spokesperson for TranSystems declined to comment and directed PublicSource to “our client, the county, for this request.” 

Amie Downs, a spokesperson for County Executive Rich Fitzgerald, said the county does not discuss bid selection processes before they are complete, but that “this is the next step in the effort we’ve undertaken to reduce the jail population in Allegheny County and implement reforms in the justice system.”

When Jail Oversight Board member Bethany Hallam asked Warden Orlando Harper about the project during a July 7 public meeting, Harper said he could not comment and added, “I have to do a little more research in order to provide information.”

The call for bids said the county seeks an overhaul for the jail and suggests that 500 to 1,000 beds would be “appropriate for Allegheny County’s population and crime rate.” The jail’s current capacity is more than 2,000. Its average daily population this year is 1,670, down from an average of 1,822 over the last three years.

The request left it to consultants to propose just how to accomplish the overhaul, suggesting that plans could include redesigning the current facility, increased use of other facilities or creating an entirely new facility.

The proposal period opened July 1, 2021, and closed Sept. 1, 2021. The county made no public announcement about the initiative or the ensuing bid process. 

Read the complete request for proposals here.

Bret Grote, the legal director of the Abolition Law Center, said the jail’s population can and should be reduced, but the county’s request for proposals does not adequately explain how it will make that a reality.

“I have a lot of questions about how the county and the court system would be engaged, and the police agencies,” Grote said. “If you just changed the design of the building, that’s not going to change the number of people sent there every day.”

TranSystems, a Kansas City, Missouri-based company with national reach, advertises expertise in architecture, aviation, infrastructure, construction and program management and other areas. TranSystems acquired CDI Architects in 2021 when it acquired L.R. Kimball, an architectural firm whose Downtown Pittsburgh office address is now listed on TranSystem’s website. 

The county has signed several contracts with CDI for engineering and architectural services in recent years, paying $1.1 million when it was under the L.R. Kimball banner and more than $725,000 under TranSystems.

With the jail-related contract under negotiation and the proposal still under wraps, it’s unknown how much a potential contract could cost the county or what the scope of work could be. 

Six other firms submitted proposals for the project, according to the controller’s office. They are: AE Works, GCL Companies, HDR Architects, Justice Management, POH Architects and STV Architects. The proposals are not publicly available until a contract is formally awarded.

The request for proposals was tied to the Safety and Justice Challenge grant the county received from the John D. and Catherine T. MacArthur Foundation in 2018. The county website says the project’s goals are to reduce the jail’s population and reduce racial and ethnic disparities in the criminal justice system. 

In an application to renew its MacArthur grant, the county wrote that it will “complete a community-informed process to develop a blueprint and capital budget request for a redesign of the jail aimed at shrinking its footprint.”

The same application lists several proposed actions to reduce the population of the jail, including:

• a study of racial disparity in bail decision-making 
• expedited court processing 
• reducing probation detention  
• preventing incarceration of people in mental health or substance abuse crises.

The jail has been the subject of intense scrutiny over the last year, with a controversial training contract, chronic staffing issues and a string of deaths among the incarcerated population raising advocates’ fury and putting the jail’s administration on the defensive. 

News of this request for proposals was met with skepticism from jail reform advocates last summer. Hallam, also a county councilwoman, said then that she feared the project would result in more, smaller facilities. Another council member, Liv Bennett, said she wondered if the county would be “morphing what incarceration looks like instead of decarceration.”

Charlie Wolfson is PublicSource’s local government reporter and a Report for America corps member. He can be reached at charlie@publicsource.org and on Twitter @chwolfson.

Keeping local government accountable to you is our job at PublicSource. Civic Briefs is an ongoing series to share more important news and information with you in real time.

The post Allegheny County moving toward contract to reshape jail appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.

Erin Dalton painted a grim portrait at the kickoff meeting of Allegheny County’s starkly named Crisis Response Stakeholder Group.

“People are cycling through our crisis systems. Our emergency rooms. Our homeless system,” Dalton, then a deputy director of the county Department of Human Services, told a Zoom room full of government and private sector officials, according to her slide presentation. County data identified 763 people who frequently faced mental health crises. Nearly three-fifths of the people who cycled in and out of the jail were getting mental health services.

Dalton, who now directs the department, asked the group how the system tasked with handling behavioral crises might be redesigned.

That was September 2020. Fourteen months later, the county is taking the first steps in what it hopes will be a comprehensive redesign of the way behavioral health problems stemming from mental illness, substance abuse and poverty are handled.

This month and next, the department plans to ask for proposals from service providers that would:

• Show up at the scenes of behavioral health crises and provide help
• Assist police in diverting people with mental health problems from the criminal justice system to social services
• Provide short-term housing for people who are experiencing worsening mental health or substance use symptoms
• House people who are released from jail and who have mental health needs.

The department is also preparing for the local rollout, next year, of an emerging national 988 suicide prevention hotline, which Dalton hopes will absorb some of the behavioral crisis-related calls that now go to 911.

UPMC’s resolve Crisis Services is likely to remain an important part of the behavioral crisis system, according to Dalton, despite criticism of it during the stakeholder process.

Dalton said she hopes that in the coming years, people facing mental health crises will be less likely to face arrest or incarceration, and instead “more often than not … get the kind of response they need and can go on with their lives.”

‘Diving into the gaps’

The county quietly created the stakeholder group three months after the murder of George Floyd by a Minneapolis police officer. That killing ignited protests and energized debate over law enforcement’s handling of incidents driven by poverty, mental health and substance use.

“This is a point of crisis, but it’s not a new crisis,” and it has evolved over recent decades as mental health care has shifted from big psychiatric institutions to community settings, Dalton told the group at its first meeting, according to her slides. The county convened 30 people – county and City of Pittsburgh officials, police chiefs, philanthropy executives, nonprofit leaders and academic researchers – in hopes of addressing a question Dalton posed: “How can we use the moment of crisis to improve care?”

PublicSource used the Right-to-Know Act to get documents detailing six months of closed-door meetings of the stakeholder group. In an interview and a written overview, Dalton and her department’s Manager of Special Initiatives Jenn Batterton then described the emerging plan to redesign the system.

A behavioral crisis, according to the stakeholder group’s definition, is an incident in which emergency services respond to someone’s mental health distress, substance use, intellectual disability including autism, or homelessness.

Since 2007, the job of responding to many such incidents has fallen to resolve Crisis Services. That UPMC unit gets around $1.6 million from the county, plus reimbursements from the state and private insurers, to provide mobile crisis response teams, a walk-in center and short-term residential services for people with mental health emergencies.

In October 2020, a resolve official told the stakeholder group that there was ample communication and collaboration between that organization and law enforcement. In later months, though, stakeholder group members called resolve “not useful” with a walk-in center that was an understaffed “dumping ground,” according to the documents provided to PublicSource. Some said resolve’s mobile teams take “forever and a day” to get to people in need and then “simply leave” if the person in crisis is uncooperative.

“I think we do very well,” said Dr. Jack Rozel, resolve’s medical director, in an interview Wednesday with PublicSource. “We have mobile crisis teams dispatched more than 70% of the time within an hour, en route.” Given the volume of calls, walk-ins and mobile crises, he said, resolve staff handles matters effectively the vast majority of the time.

When people got into the mental health treatment system, the diagnoses and treatments provided were skewed by race, the stakeholder group learned.

Dalton told the group that white clients of the behavioral health system were much more likely to be diagnosed with conditions like anxiety and addressed with outpatient care and medication-assisted treatment. Black clients, by contrast, were more likely to be diagnosed with schizophrenia, schizoaffective disorders and adjustment disorders, and to be involuntarily committed for care.

By February, the stakeholder group developed 16 broad recommendations, meant to improve outcomes by preventing crises, intervening earlier, handling scenes differently and providing services afterward.

“That’s when all of the work had to start, even though, obviously, the [stakeholder] process was important — extremely important,” said Batterton, of the county Department of Human Services. Since then, she said, department staff has been “really diving into the gaps,” and now it’s ready to start filling them.

Gap 1: No alternative to 911

If you dial 911 and report an emergency, you should get “immediate” public safety service, according to the county. If you’d rather summon resolve’s social workers, you can dial the less-memorable 1-888-796-8226 (or 1-888-7-YOU-CAN).

That should change in mid-2022 when 988 service becomes fully operational nationally. 

Pennsylvania’s Department of Human Services is drafting legislation on the funding and structure of the service in the commonwealth. A department spokesperson told PublicSource that the 988 line won’t just address suicide prevention.

“There could be fewer calls going to 911 and more calls going to 988, which we would envision as beneficial,” said Dalton. “We want less 911 calls. We want, more often, human services supporting people for things that are human services needs,” and 988 calls should trigger that kind of response.

Who will field the 988 calls? They could go directly to resolve, said Dalton, but that hasn’t been decided.

Gap 2: Rapid response to crises

Officials at resolve have long said that their teams of mobile crisis workers are usually dispatched to the scene of a crisis within half an hour of resolve’s switchboard receiving a call, but they’ve confirmed that it sometimes takes hours.

The county doesn’t intend to replace resolve. “I absolutely think that we’re in a good situation locally that we have a lot to build on,” said Dalton. “I can’t imagine a world in any short and medium term in which resolve isn’t part of the solution.”

“We hope to be involved with any of it and all of it that’s appropriate,” said Rozel. He added: “We don’t want to replicate or disrupt any of the really great services that are out there.”

Dalton’s department plans, in December, to invite other organizations — especially those led by Black and LGBTQ community members — to submit proposals for social work teams that would hurry to the scenes of behavioral crises.

Eventually, the county also wants to create a new, civilian-run system for transporting people who have been involuntarily committed for mental health treatment. Right now, police handle that. Batterton said she’s talked with officers who “don’t want to be cuffing people who are in behavioral health crisis.”

Gap 3: Alternatives to arrest

Local debate over police handling of incidents, especially involving Black residents, revived last month when a man died the day after Pittsburgh police shocked him with a Taser during an arrest in Bloomfield. Jim Rogers, who was Black, was accused of theft and failing to comply with police commands. Allegheny County police are investigating.

Pittsburgh police addressing incidents rooted in poverty, mental health or substance abuse now have the option of calling in a team of social workers staffed by the Allegheny Health Network [AHN]. Launched early this year, the AHN teams have responded to around 500 incidents, according to Dan Palka, administrative director of AHN’s Urban Health and Street Medicine program.

AHN’s work with the city resembles a decade-old concept called Law Enforcement-Assisted Diversion. LEAD encourages police officers to connect people in behavioral health crises to social service coordinators rather than arresting them.

The county is now working with the University of Pittsburgh’s Congress of Neighboring Communities, a coalition of the city and suburbs, to create a LEAD program outside of the city. By year’s end, Dalton’s department intends to seek proposals from vendors that would work with at least 13 suburbs, likely by sending case managers to supplement police at the scenes of behavioral crises.

Gap 4: A place to go, other than jail

The Allegheny County Jail and hospital emergency rooms are among the common gateways to mental health treatment. Dalton would like to create another option.

In December, the county plans to invite proposals to create one or two short-term residential “respite centers” for people with mental health or substance abuse problems who want to get help before a full-blown crisis puts them in the hospital or jail. At these centers, people could get support from peer counselors and referral to other resources.

This month, the county also plans to seek proposals from agencies that would provide housing for people with mental health problems who are leaving the jail.

Diversity and fair pay

Dalton said she’d like to see “a world where outcomes aren’t so disparate by race and other characteristics.”

Woven through the county’s plan are two concepts: involving Black-led and LGBTQ-led organizations in the emerging solutions, and paying the workers family-sustaining wages.

The county plans to insist that the agencies hired to fill the service gaps pay their workers $15 an hour or more. Dalton said human service workers are traditionally underpaid, and it is probably cheaper, in the long run, to improve their pay than it is to continually replace and retrain them. If initiatives like LEAD are to succeed, she added, the employees will need to develop relationships with members of the public and law enforcement.

County Executive Rich Fitzgerald has so far dedicated, for mental health services, $9 million of the county’s $380 million allocation of federal American Rescue Plan funds. Dalton also expects that Medicaid will cover some of the new services, and she hopes that private insurers will “be chipping in.”

Long-term, such investments will pay off, she predicted.

“I do envision a smaller jail,” she said. “If there are fewer people ending up arrested and jailed for nine months awaiting trial on something, there will be returns and resources to the community.”

Rich Lord is PublicSource’s economic development reporter. He can be reached at rich@publicsource.org or on Twitter @richelord.

This story was fact-checked by Amelia Winger.

The post Behavioral crises often lead to jail. Allegheny County plans to change that. appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.

A dispute raged this month between the Allegheny County Jail administration and the Jail Oversight Board as the board sought information on and eventually banned a company the jail had contracted to train correctional officers.

After the board voted, 4-3-1, on Monday to ban the training company C-SAU and its operator Joseph Garcia from working in the jail, Warden Orlando Harper blasted the decision. “I do not intend to follow it,” Harper said on Tuesday as he described the motion as banning him from conducting “literally any training.” Ambiguous language in the order appears to have led the warden to interpret the directive as far more broad than the board intended.

The dispute and the uncertainty of what might happen next brings the board and its authority to the forefront. If you’re wondering what the board is, how it works and what power it has, read below:

Who sits on the board?

The board is commissioned and empowered by state law. Its current form dates to 2009, when an amendment to state statutes converted the former Prison Boards (which dated to a 1980 state law) into the current Jail Oversight Boards [JOB] in certain counties. 

State law calls for the board to include nine people: 

• the county executive (currently Rich Fitzgerald) 
• two judges of the Court of Common Pleas, including the president judge or a judge designated by the president judge (currently President Judge Kim Berkeley Clark and Judge Beth Lazzara)
• The county sheriff (currently William Mullen)
• The county controller (currently Chelsa Wagner)
• The president of County Council or their designee (currently Councilwoman Bethany Hallam, designated by Council President Pat Catena)
• Three citizen members (Currently Terri Klein, Gayle Moss and Abass Kamara)

Some of the elected officials opt to send a proxy to JOB meetings in their stead. At Monday’s contentious meeting, Fitzgerald sent Deputy County Manager Stephen Pilarski and Mullen sent Sheriff’s Deputy Kevin Kraus. Early on in the meeting, Hallam asked Clark, who chairs the board, to bar the two from voting, saying that the law makes no mention of proxy voting. Clark allowed them to vote, citing precedent — the law doesn’t mention voting procedure at all.

The citizen members can’t be employees of the county or the state, should be “representatives of the broad segments of the county population” and are appointed by the county executive and approved by the council. 

What does the board do?

State law gives the board broad responsibility over the jail, as well as investigative and observational duties.

“The board’s administrative powers and duties shall include the operation and maintenance of the prison and all alternative housing facilities, the oversight of the health and safekeeping of inmates and the confirmation of the chief executive’s selection of a warden,” the law reads.

The law specifically charges the JOB with:

• Ensuring that living conditions in the facility are “healthful and otherwise adequate”
• Conducting unannounced inspections of the jail at least twice annually, including interviews with inmates without the presence of the warden. The board is to produce a written report for each inspection and make them public. (No inspections took place during the pandemic until this month, Hallam said, and written reports do not appear to be available online.)
• Ensuring the prison is following all relevant local, state and federal laws
• Investigating any allegations of inadequate conditions. The law says that all books, papers and records of the prison, the warden and inmates are to be available to the board at all times. (The warden blocked access to unredacted jail policies as recently as this year.)

The law grants the board the power to “promulgate such rules, regulations and forms it deems necessary for the proper administration of the board and for the operation of the prison and alternative housing facilities.” 

So what happened this week?

The JOB passed a motion on Monday, forbidding the jail from doing business with C-SAU and its lead trainer, who came under scrutiny for his mysterious work history and using militaristic methods in the past. 

Tuesday, the warden announced his intention to disobey the board’s directive — though he interpreted it as banning all training, and said he would in fact pause work with C-SAU after the board’s decision. When PublicSource asked the county executive’s office for his stance on the warden’s statement, spokesperson Amie Downs said Fitzgerald relies on the experts that run his departments and does not like to micromanage them.

“They are continuing to rely on the Warden and his 33+ years of correctional experience, as well as his track record of making improvements at the jail that have resulted in ACA certification, a reduction in the number of suicides at the facility, and continued efforts to reduce the population at the facility,” Downs wrote in an email. 

“Warden Harper continues to have the administration’s full support.”

Does the warden have the authority to overrule a JOB directive? Alexandra Morgan-Kurtz, a managing attorney at the Pennsylvania Institutional Law Project, said he does not.

“The statute is very clear about what powers the board does have, and it says things in very clear, unconditional language,” Morgan-Kurtz said. “While the statute talks a little bit about the warden’s duties, it doesn’t say anywhere that the warden can overrule or ignore the oversight board. If the people who drafted the statute had any intention of the warden having that type of power, it would be included in the statute.”

It’s not entirely clear what would happen if the jail follows through on disobeying the board. Brad Korinski, chief counsel to board member and County Controller Chelsa Wagner, suggested that the matter could end up in court. Board member and County Councilor Hallam tweeted an image Tuesday with the text, “See you in court.”

“The warden acknowledged the JOB’s power when he stopped the training conducted by Garcia,” Korinski wrote in an email to Publicsource. 

President Judge Clark declined to comment and Judge Lazzara could not immediately be reached for comment.

Morgan-Kurtz said her group has never seen a dispute like this. “In any counties I’ve interacted with, there’s never been a question. The Jail Oversight Board does or says something, and the warden follows it.”

Charlie Wolfson is PublicSource’s local government reporter and a Report for America corps member. He can be reached at charlie@publicsource.org and on Twitter @chwolfson.

The post How powerful is the Jail Oversight Board? appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.

Lucy sat in her car on a cold January day outside the Allegheny County Jail for eight hours, waiting for her son John to be released.

John wanted her to be there, she said. He worried he might relapse on heroin if she wasn’t outside the jail to greet him. When he was finally released, he started crying. 

“Momma, I’m sorry,” he told her. “I’m sorry.” He told her his addiction was his own fault.

Lucy began looking for a doctor’s appointment to get him back on his medications, which he wasn’t able to receive in jail. He was taking two drugs to treat his bipolar disorder, and Suboxone, a prescription drug used to help stabilize people with opioid use disorders. But she couldn’t find anyone who could see John right away.

In the days after his release in 2011, John, then 27, helped his 15-year-old sister with her math homework. He talked with his mom about his plans to expand his medical staffing business. And he made plans to take his 5-year-old daughter to a Christmas show at the Benedum Center for the Performing Arts. Lucy asked that their last names be withheld to protect John’s daughter.

John bought a couple of stamp bags of heroin, so that he wouldn’t feel the effects of his drug withdrawal so much when he was with his daughter. 

But they never made it to the show.

John overdosed in the bathroom of a coffee shop. 

Since John’s death ten years ago, more than 4,500 people have died of an overdose in the county, hundreds of them after leaving the jail. An Allegheny County analysis of overdose deaths between 2015 and 2016 showed that almost one in every five people who died of an overdose had been released from jail at some point in the previous year. About half of that group died within 90 days of being released and a quarter died within 30 days of leaving the jail.

On Monday morning, Lucy was one of more than 180 doctors and health experts, community members and formerly incarcerated individuals, who sent a letter urging the jail to immediately begin to administer drugs like Suboxone and methadone to incarcerated people with substance abuse disorders, like the one John had. The letter was emailed to Allegheny County leaders, including the warden and the county executive.

The county, which historically has limited medication-assisted drug treatment to pregnant women, says it has been working for the last two years to implement a broader program. Currently, nine people in jail are receiving Suboxone, including one pregnant woman, and 16 people are being treated with naltrexone, a drug that inhibits desire for opioids but doesn’t have an opiate effect like Suboxone.

In an emailed statement, county spokesperson Amie Downs said a” task force has been working for two years to prepare the jail to begin administering these drugs. The group “examines training and education for personnel, diversion programs, medication access in jail and in court-involved populations.”

On Thursday, the county’s Jail Oversight Board voted against a motion to require medication to be given to people who already had a prescription for a drug like Suboxone. Jail officials at the meeting said the motion presented logistical and legal challenges. And in Monday’s letter, the health experts said treatment should be expanded even further, to include anyone with an opioid use disorder, not just those with existing prescriptions.

“For years, we have been told that the adoption of buprenorphine [Suboxone] to treat inmates with [Opioid Use Disorder] is imminent,” the letter to county officials reads. “We can no longer afford to wait.”

The situation is ‘dire’

The number of drug overdose deaths in 2020 spiked for the second year in a row in Allegheny County. Although overdose data can take months to be confirmed, there are already 687 confirmed overdose deaths last year, the second highest all-time total, after 2017.

The situation is “dire,” the letter says and further accuses jail leaders of bypassing funding that other counties have taken up to pay for programs helping individuals continue their addiction treatment in the jail. Downs said the county is applying for a grant to help fund the jail’s program.

Drug-assisted treatment for opioid use disorder is “the gold standard” for treatment in the industry, according to a variety of experts who work to help people with addiction. In 2017, county health officials recommended that the jail adopt the treatment, because of evidence that it reduces drug use, overdoses, crime and infectious diseases.

“It would be illegal and unethical to deny someone their diabetes or heart medication when entering the jail, yet this is routinely done for people with [opioid use disorder] who are at the greatest risk of dying from overdose in the community following their release,” the Monday letter reads.

The letter says around 500 people should be eligible to receive treatment. The county did not answer questions from PublicSource about how the jail assesses whether a person has an opioid use disorder or how many people in the jail would be eligible. 

The jail is working toward providing methadone but does not have the federally required license to do so, said Laura Williams, chief deputy warden of healthcare services, during the May 6 Jail Oversight Board meeting. It plans to present a request for proposal [RFP] for qualified vendors to bid to be able to provide methadone on-site. The county said the RFP is being drafted now but did not provide a more specific timeline for moving forward. 

The jail also hired a substance use case manager in December to build a program to provide medicines like Suboxone and refer individuals to community providers upon their release. 

Several of the individuals who signed the letter to county officials said the recent effort to supply medicine to a few individuals is not moving fast enough. Alice Bell, who serves as overdose project prevention coordinator at Prevention Point Pittsburgh, said the county has known for years that drugs like Suboxone help save lives. 

“This is not something that is in dispute. The jail has not said this is a terrible idea. They said, ‘Yes, we agree, we’re going to do it.’” she said. “The issue is it’s taking forever.”

Prevention Point has put resources into creating new mobile units to help make Suboxone more easily available to people during the pandemic. “And if any of those people end up getting arrested, then it’s kind of all for nothing: They’re kicked off of Suboxone, forced into withdrawal, and have to start from scratch, if they don’t die of an overdose first,” she said.

If the county was as serious about the opioid epidemic as it was the COVID-19 pandemic, she said, it would be moving a lot faster. The difference is that the coronavirus can affect anyone, but there is still stigma against drug users. “If we really think this is an epidemic, we need to act like it’s an epidemic,” she said. “We need to move quickly and use the tools that are well documented to be effective.”

Eric Hulsey, who also signed the letter and works as a senior technical advisor in the overdose prevention program at Vital Strategies, said that incarcerated patients who take drugs like Suboxone and methadone are less likely to commit further crimes or overdose once they leave. More than 1,000 children in Allegheny County lost a parent to an overdose between 2002 and 2017, according to a research letter Hulsey published in the Journal of American Medical Association – Pediatrics. Hulsey said his involvement in the letter campaign is as a concerned citizen and not in conjunction with his job.

Formerly incarcerated people who seek treatment after being released from state prisons are often in a better place than people who come from the county jail, according to Alex Perla, who signed the letter and works as director of admissions and marketing at Jade Wellness Center, a substance abuse treatment center in Allegheny County. 

Many of the state prisons, Perla said, connect the individuals to therapists and follow-up treatment, in addition to stabilizing medications like Suboxone. But many of the people who were forced to detox in jail, never even show up to their appointments after their release, Perla said.

“There are systems doing it and they are doing it well,” Perla said. “We are not creating a wheel here, we just have to adapt it to our own jail population.”

Jail progress?

At Thursday’s Jail Oversight Board meeting, jail officials outlined the plan for expanding its medication assisted treatment program and explained some of the challenges that have kept them from offering treatment to everyone who needs it. The board voted down a proposal to immediately expand the treatments because of logistical and legal hurdles.

During the meeting, board member Bethany Hallam introduced a motion to expand the use of medications for opioid use disorder to anyone who has it already prescribed to them. The jail has a contract with Tadiso, an outpatient opioid treatment facility in the North Side, which enables the company to provide methadone to people at the jail. In the past, the recipients have been limited to pregnant women.

Hallam’s motion was in part prompted by a letter from the PA Institutional Law Project about a 71-year-old man who was denied methadone while in jail.

At the March board meeting, Hallam urged jail administration to move faster to expand treatment to everyone who needs it. “To know that there are people going through this right now, month after month after month, and we say ‘Oh it is in the works.’ The RFP still has not gone out,” she said.

Williams said the motion to immediately expand treatment would present logistical challenges, such as requiring the jail to renegotiate its contract with Tadiso and hiring additional staff to provide required accompanying counseling services. 

The motion failed in a 2-2 vote.

“My heart is there,” said board member Terri Klein, who abstained from voting. 

“I think it’s the right thing to do, but I am so conflicted if we can’t implement it the way the regulations state.”

Former medical employees and formerly incarcerated people told PublicSource individuals often must wait in the jail’s intake department while enduring severe detox symptoms, without proper medical oversight. 

Advocates and health providers have fought to provide medicines like methadone and Suboxone at the jail for years. Nurse practitioner Allie Palm, who signed the letter and worked at the jail in 2016, said she pushed to provide naltrexone to individuals with opioid use disorder but was met with resistance by other medical staff. “It was just a fighting battle,” Palm said. 

Correction (5/12/2021): This story previously misstated the funding source for the jail’s new substance use case manager position.

Oliver Morrison is PublicSource’s environment and health reporter. He can be reached at oliver@publicsource.org or on Twitter @ORMorrison.

Juliette Rihl is a reporter for PublicSource. She can be reached at juliette@publicsource.org or on Twitter @JulietteRihl.

The post Addiction medication at Allegheny County Jail could save lives. Advocates say little has been done as local overdoses rise. appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.

This month, I wrapped up an 8-month reporting project on the Allegheny County Jail. The project, which started out as a single story about mental health at the jail during the pandemic, morphed into an 11-part rollercoaster of a series that uncovered the facility’s staffing crisis, its controversial use of the restraint chair and more.

Each day was a crash course on covering correctional facilities, which are infamously opaque. How do I build sources inside the jail? What’s the best way to ensure our journalism doesn’t endanger the people I speak to? How do I balance my own mental health while reporting on such an intense beat? This project provided answers.

In hopes of demystifying jail reporting and empowering other journalists to try it, I gathered these lessons into every reporter’s favorite medium: a Twitter thread. I’ve adapted it here for you, our readers, to give you a look behind-the-scenes of what it took to report those stories.

Yesterday, I wrapped up an 8-month long reporting project on our local jail. Starting out on the jail beat can be daunting, so I want to share some reflections on what I’ve learned since then. Buckle up… (thread)

— Juliette Rihl (@JulietteRihl) April 7, 2021

So, here are seven things I learned from reporting on the Allegheny County Jail:

• Avoid words like “inmate” or “prisoner.” I was guilty of this until it was brought up to me by activists and other journalists, but that language is stigmatizing and dehumanizing. “Incarcerated people” or simply “person” or “individual” are easy swaps. (The Marshall Project just published a great project about this.)
• It’s not as hard to find sources as you might think! Over 1,000 members of our community are incarcerated at the jail every day. Facebook groups are a great place to start, as are attorneys and advocacy organizations. Many people are happy to bring more awareness to these issues.
• Be understanding of why sources request anonymity. Speaking out can put incarcerated people in danger. Explain how their comments will be used, ask them (multiple times, if possible) if they are comfortable having their name published and allow them to change their minds. Also be intentional about what information you include about people — news stories are Googleable and can follow people for years. This initiative by The Boston Globe is a really thoughtful way of addressing this.
• Mail is your friend. It’s often impossible to call up an incarcerated person, so if you need to get in touch with someone, write them a letter. This has been surprisingly successful in my limited experience. Also, who doesn’t love getting mail?
• A big one: Speaking truth to power can be scary, especially for young journalists. Statements of authority should be vetted like any other source. Not doing so is bad journalism and can harm people. I had to remember that many times, including for this story.
• Human sources are essential, but record requests can also be helpful, even if they get denied or redacted. In the course of 7 months, I filed 35 requests to Allegheny County regarding the Allegheny County Jail: 18 were granted in part or in full; 16 were denied or granted but completely redacted (as in the case of the mental health policies); one is still pending. These requests provide valuable information about the jail, such as employee complaints about understaffing and holes in medical scheduling.
• Establish work boundaries and prioritize your mental health. I used to take calls from sources whenever they called, especially since folks at the jail have little control over their schedules. But this led to me being “on” at all hours of the day and I quickly became burned out. It’s important to remember that you are not personally responsible for changing the criminal justice system.

These reflections are just my personal takeaways, and much of what I know I’ve learned from trailblazing criminal justice journalists, activists and incarcerated people themselves.

There’s a big need for more coverage of correctional and criminal justice issues. I hope starting conversations like this can help make more journalists comfortable with tackling these issues — and keep more readers like you invested in this sort of reporting.

I’d also really like to hear your thoughts. What did I leave out or get wrong? How can reporters better cover the issues incarcerated people face? What other questions do you have? Send me an email at juliette@publicsource.org.

Juliette Rihl is a reporter for PublicSource. She also can be reached on Twitter @JulietteRihl.

The post What I learned from reporting on the Allegheny County Jail appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.

Justin Rape was a teenager the first time he landed in the Allegheny County Jail.

His struggle with mental illness — and consequently, law enforcement — started when he was a child. Growing up, he grappled with rejection from his father, and his ADHD and social anxiety were difficult to manage for his mom, a single parent of five children. “She’d have to call the police to get me under control,” Rape said, recalling fits of yelling and throwing items.

By age 14, he was a “frequent flyer” with the police, who sometimes took him to psychiatric hospitals for inpatient treatment. There, he was prescribed medications like Klonopin, which is used to treat seizures, panic attacks and anxiety. That’s where his reliance on substances began. “I remember taking it the first time and within the half hour, being like, ‘Wow, I feel better now.’ … That should have been a warning sign,” he said. A few years later, he tore knee ligaments in a dirt bike accident and was prescribed hydrocodone and oxycodone. He was quickly hooked on opiates. 

Since then, Rape, now 33, estimates he’s been to the Allegheny County Jail [ACJ] over 20 times, all for charges he said stem from his addiction and mental health issues.

“Incarceration was pretty much my psych ward,” he said.

During his stays at the jail, Rape remembers being prescribed numerous medications for his mental health after brief visits with a psychiatrist. Yet counseling was never offered, he said.

The absence of counseling and reliance on medication is a common occurrence in facilities like ACJ, where many incarcerated people would benefit from therapy, but problems like high population turnover, understaffing and lack of funding make delivering care complicated.

Few jails provide regular one-on-one therapy, instead relying primarily on psychotropic medications to treat incarcerated people with mental illness. By contrast, prisons typically offer a wider variety of mental health treatment options, as they have more resources and less turnover. 

Yet some experts, while acknowledging logistical challenges, told PublicSource that therapy would be extremely beneficial for the jail population and suggested solutions such as group therapy or connecting them with more robust services before they become incarcerated. 

Rape described the drugs as a “Band-Aid” for his mental health issues. “As far as I understand jail, it’s supposed to be rehabilitation,” he said. “You’re not rehabilitating, you’re just pacifying.” 

ACJ has made efforts. In March, a recently hired psychologist provided 80 therapy sessions, most of which took place in confidential settings, according to Chief Deputy Warden of Healthcare Services Laura Williams. “As far as, is everybody who needs [therapy] receiving it? Maybe not. But everybody who is prescribed it receives it,” Williams said at the March Jail Oversight Board meeting.

According to a report from the warden, 46 people — or 3% of the population — received cognitive-behavioral treatment between Dec. 16 and Jan. 15. 

In contrast, in a Jan. 12 one-day snapshot, about 19% of the jail population — 324 people — had a prescription for psychotropic medications, according to information obtained via a public records request. That’s in line with the average for a county jail, correctional mental health experts say.

ACJ has psychiatrists evaluate individuals and prescribe medications when necessary, and mental health specialists intermittently check in with people and conduct crisis management. Some former mental health providers at ACJ saw a greater need for therapy. 

“Most of the people I saw, they needed therapy,” said Allie Palm, a psychiatric nurse practitioner who worked at the jail for three months before quitting in 2016. She said many of her patients at the jail had untreated post-traumatic stress disorder [PTSD]. ”Maybe they needed a small dose of medication, but they definitely needed therapy.”

But former staffers also describe a litany of challenges. 

Dr. Peter Hauber, a psychiatrist who worked at the jail between 2016 and 2019, said in an ideal world, providing therapy at the jail would be “enormously helpful.” But he also acknowledged the cost and resources necessary to do so, including hiring enough staff and having a private space to conduct sessions. “Where do they see these people? I’m seeing these people in a gymnasium,” he said.

Dr. Gail Kubrin, a psychiatrist who worked with Hauber at the jail for roughly the same time period, echoed the logistical concerns. “You can’t get into in-depth, individual therapy with someone in jail because they might get released. And if you’ve opened up all this traumatic stuff and then they’re gone, that can actually be dangerous,” she said. 

Kubrin remembers the jail previously providing group therapy on topics like insomnia or stress management, which she supported bringing back. “Those seemed to be helpful. The patients really liked them.” 

In a September interview with PublicSource, Williams said the jail was able to offer more group therapy before the COVID-19 pandemic, but that social distancing measures have made doing so difficult. The county did not respond to requests for comment for this story.

While some incarcerated people have raised concerns that medication was overused, Kubrin said she and her colleagues were careful to prescribe medications appropriately. But she agreed with concerns that the jail depends on medications to treat mental health issues, rather than also incorporating other forms of treatment. “There is an overreliance on medication because there isn’t any therapy … because there’s so little else that’s possible,” she said.

The pandemic exacerbated mental health — and treatment difficulties at Allegheny County Jail 

The pandemic has imperiled the mental health of many incarcerated people.

Since March, in-person visitation at ACJ has been suspended. Individuals are only allowed out of their cells for one hour a day, at most. And the jail has had several COVID-19 outbreaks, leading many people inside to fear for their health.

Last May, Richard Arrington started to feel anxious and depressed. He tried to keep himself occupied by reading the Bible, praying, writing poetry and volunteering to work. Still, it was mentally strenuous. “The lack of human contact, it’s real bad in here,” he said.

For six weeks, Arrington asked if he could speak to a therapist. He was told it wasn’t possible. “I spoke with the inmate and he is still having problems with anxiety and depression. The inmate wants one on one with a therapist. I explained that there is no therapy in the jail,” a mental health specialist wrote in his notes after visiting Arrington on July 16.

Arrington, who was released from jail in February, later expressed dismay about the absence of therapy. 

“How can you have a drug program and you got no therapy? How can you have a mental health pod, and you ain’t got no therapy?” Arrington said in a November phone interview with PublicSource. In February and March, over a third of the jail population was receiving drug and alcohol treatment. “I’m not saying I think they don’t care. I just think they don’t have the resources or [don’t] want to allocate the money to hire people to do this.”

Arrington’s experience isn’t uncommon. Jails across the country are filled with incarcerated people who need therapy but don’t get it.

According to a 2014 report by the Treatment Advocacy Center and the National Sheriff’s Association, there are 10 times more people with serious mental illness in jails and prisons than in state psychiatric hospitals. Many experts and advocates see this as a consequence of failing to provide adequate treatment. “We have much too much relied on [jails] as sort of the de facto mental health treatment providers, which they’re not,” said Ron Honberg, an independent mental health consultant and former director of policy and legal affairs for the National Alliance on Mental Illness [NAMI].

Dr. Terry Kupers, a psychiatrist with expertise in correctional mental health, has advocated for diversion programs, such as mental health courts and drug courts — both of which Allegheny County has had for two decades — to keep people with mental illness out of jail in the first place. “The fact that someone gets arrested should be a red flag to us,” Kupers said. “They are in a difficult crisis, and we should divert some resources their way to keep them out of trouble.”

Psychotherapy and psychotropic medications statistically yield similar improvements when treating disorders like depression and anxiety and are often even more effective when combined. “If you or I went to a psychologist, we would likely be offered psychotherapy before medication is tried,” said Joel Dvoskin, an Arizona-based psychologist and correctional mental health expert. “And if you can get a good result without medication, that’s better.” 

Honberg agreed. “If the goal is to actually help people get better, you need to provide a lot more than medication. And this is a real opportunity to address the problems that probably led to many of these people being incarcerated in the first place,” he said.

MAYA Organization, a local nonprofit, resumed group therapy for women at ACJ in March after a hiatus that started in 2019 due to financial constraints. So far, between four and 10 women have attended sessions in the jail’s gym, facilitated virtually by MAYA staff. “Our focus is really on creating small, safe spaces,” said Julie Evans, a therapist and program coordinator. 

Group activities range from mindfulness to socially distanced yoga. Participants can continue receiving individualized services after they leave the jail, which Evans said is crucial, especially in cases of past trauma. “We’re in a really unique position to be able to provide that continuity of service,” she said. 

After jail, treatment provides turning point 

Now, Rape is getting the help he needs. After relapsing in 2019, he went to rehab, was able to get insurance and started seeing a psychiatrist and therapist regularly. He also participates in group therapy at a methadone clinic once a month and has a registered service dog, Anubis, for support. He’s had no new charges since going to rehab.

Not all of Rape’s experiences at the jail were negative. 

During his last stay in 2019, he saw an outside psychiatrist via a telehealth visit and was prescribed effective medications that he still takes today. But overall, he said, the jail made his mental health worse. He often wakes up in the middle of the night crying because of PTSD, he said, which he was diagnosed with after leaving ACJ. “I’m constantly being attacked or stabbed in my nightmares,” he said. “That was 100% a direct result from ACJ and prison.”

Had he received proper care for his mental health conditions and had assistance navigating services, Rape believes he would have gotten far less wrapped up in the criminal justice system. “If I had someone to help work on my exact problems like I do now,” he said, “I would have been able to avoid probably a good decade of jail.”

Juliette Rihl is a reporter for PublicSource. She can be reached at juliette@publicsource.org or on Twitter @JulietteRihl.

This story was fact-checked by Matt Maielli.

The post ‘Incarceration was pretty much my psych ward’: So should Allegheny County Jail provide therapy? appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.

Editor’s note: This story was produced for Sunshine Week, an annual, nationwide celebration of government transparency and access to information taking place March 14-20. PublicSource frequently uses the Right-to-Know law, as it did in this story, and encounters varying degrees of transparency by Pennsylvania’s public agencies. 

To better understand how incarcerated people are cared for, PublicSource sought all Allegheny County Jail policies related to mental health, suicide prevention, administration of medications and accommodations for people with disabilities through a public records request in September. 

Of the six policies the county provided, five were almost entirely redacted with thick black lines, disclosing only the title and the policy’s first few sentences. The county justified the redactions by stating in an accompanying letter that the information “would be reasonably likely to result in a substantial and demonstrable risk of physical harm to or the personal security of an individual.” 

PublicSource appealed the redactions to the Pennsylvania Office of Open Records; the appeal was denied. But the five other most populated counties in the state provided similar policies, either in full or in part, providing insight into exactly the type of information withheld locally. 

Lancaster and Delaware counties provided PublicSource their policies in full, while Bucks County provided one policy in full and four more policies with light or moderate redactions. Montgomery County provided its suicide prevention and pharmaceutical operations policies in full and two other policies with redactions. After a few months of delay, Philadelphia County provided its self-injury prevention program policy with far fewer redactions than Allegheny County and 14 other policies in full.

Compare jail suicide prevention policies of the six largest counties in Pennsylvania:

• Philadelphia
• Allegheny
• Montgomery
• Bucks
• Delaware
• Lancaster

Correctional experts PublicSource spoke to described Allegheny County’s redactions, which were made by Warden Orlando Harper, as outside the norm and harmful to transparency.

“The fact that other jurisdictions are far more transparent about their policies gives lie to any claim that what’s in Allegheny’s policy is somehow a risk to security and safety in the institution,” said Michele Deitch, an attorney and senior lecturer at the University of Texas at Austin who researches correctional oversight throughout the country.

Gerard Bryant, director of counseling and adjunct professor of psychology at John Jay College of Criminal Justice, said the public should have access to all of the policies in full. Withholding the information can actually be more dangerous, said Bryant, who has 22 years of experience in the Federal Bureau of Prisons as an associate warden and chief psychologist. “Why would you want to make this a confidential document… when you’re trying to reduce suicides?” he said of the suicide prevention policy. “Bottom line is suicide is everybody’s business, and this should be transparent for everybody.”

Could transparency be harmful?

In a six-page affidavit to justify the redactions, Harper stated that knowledge of the policies “could be used to interfere with the persons who carry out the duties defined in the policies, thereby putting inmates, employees, and the public at risk.” In the document filed with the Pennsylvania Office of Open Records in October, Harper outlined specific reasons as to why each policy needed to be redacted. For example, he said the suicide prevention policy could be used to cause disruption or could allow an inmate to harm themselves without showing any of the signs that employees have been trained to look for. Every word of the 19-page policy was redacted, except the heading and the first sentence. 

Bryant disagreed with Harper’s reasoning. “All these policies could be released in their entirety, and it would not pose any threat to the safety and security of that institution, as far as I can tell,” he said after reviewing the affidavit. “I just don’t see the nexus between how the release of this information is going to lead to a disturbance or ‘nefarious’ behavior.”

Joel Dvoskin, an Arizona-based psychologist and correctional mental health expert, called the redactions “absurd.” 

“I can certainly understand the possibility that some specific parts might be redacted,” Dvoskin said, “But all of it, there’s absolutely no possible way that’s reasonable.”

In denying PublicSource’s appeal, Pennsylvania’s Office of Open Records stated in its final determination that “the County met its burden of establishing a substantial risk of actual harm to an individual or the public if the requested policies are disclosed.” The office typically does not review the policies themselves unless requested to do so, instead relying on written statements from officials. “Here, the [Office of Open Records] relied upon the testimony of the warden who is familiar with the security of this facility. No evidence was presented that contested his testimony or indicated that it was inaccurate,” Executive Director Liz Wagenseller later wrote in an email to PublicSource.

Deitch said government bodies have long deferred to correctional institutions for fear of jeopardizing their safety, but that it’s the “lack of critical inquiry” about what information can safely be revealed that puts more people at risk. “You’ve got to shine a light on what’s happening at correctional facilities in order to keep people safe.”

Tierra Bradford, a criminal justice policy advocate for the ACLU of Pennsylvania, agreed. She called the reasons Harper gave for heavily redacting the policies “vague” and noted that the lack of transparency is likely to increase public suspicion of jail leadership, rather than build trust. “At the end of the day, people have a right to know what government officials are doing and making sure there aren’t any secrets being kept, especially for no good reason,” she said.

One of the policies that Allegheny County redacted was made public in the past, as were several other mental health-related policies that PublicSource was not provided, said Bret Grote, legal director of the Abolitionist Law Center, which is currently litigating several lawsuits against the jail. 

Roughly a year before PublicSource’s request, Grote received a number of policies, including the mental health screening and commitments policy, through a public records request. The jail would no longer provide that same policy unredacted in 2020.

PublicSource reached out to all nine Jail Oversight Board members for this story. Brad Korinski, chief legal counsel for Allegheny County Controller and Jail Oversight Board [JOB] member Chelsa Wagner, said he thinks Harper honestly believes disclosing the policies could cause problems. But, Korinski said, the decision should ultimately be made by other leadership, such as the law department or county executive, not Harper. 

“This is where I think that political leadership should say, ok, warden, we hear you … but not ALL of these redactions are needed – give me what you can live with and what you can’t,” Korinski wrote in an email to PublicSource. “I don’t think that conversation is being had.”

JOB member and Allegheny County Council member Bethany Hallam said the redactions show the jail administration’s “clear disdain for any oversight of their policies, procedures and practices whatsoever — the same disdain which I have personally experienced as a member of the Jail Oversight Board when requesting even the most basic information about what goes on in the facility which we have direct statutory authority over.”

President Judge Kim Berkeley Clark, who is also a JOB member, said she believes it is inappropriate for her to comment after PublicSource’s appeal was denied by the Office of Open Records. Sheriff William Mullen, also on the board, said he could not answer questions about the jail’s transparency without consulting with the warden and his staff. “I never had a reason in the past to question the jail’s transparency,” he wrote in an email to PublicSource.

The remaining board members — County Executive Rich Fitzgerald, Judge Beth Lazarra, M. Gayle Moss, Terri Klein and Abass B. Kamara — did not respond to email requests for comment.

When asked about the disparity between Allegheny County and other counties, Wagenseller of the Pennsylvania Office of Open Records said different agencies have different policies and interpretations of what they consider public. Had PublicSource provided the other agencies’ policies, she said, it would not have affected the outcome of the appeal. 

“The release of similar information by different agencies does not preclude the County from withholding the information. In fact, the Right-to-Know Law recognizes that agencies have the discretion to release otherwise exempt records, in whole or in part,” Wagenseller wrote.

The jail has more than 280 policies, according to Harper, and 50 policies are posted on its website. Publishing the remainder, even if redacted, would “jeopardize the safety and security” of the jail, Harper said at the September JOB meeting. Harper previously declined to allow board members to view the unredacted policies, contrary to state law, but reversed his decision in February. 

Much larger agencies have already made similar information public and easy to find online. 

The New York City Department of Correction has many of its policies posted online, including its full suicide prevention policy. Similarly, the Pennsylvania Department of Corrections posts many of its policies on its website, including its almost 300-page policy on accessing mental health care. The Federal Bureau of Prisons also posts its policies in full on its website, including its suicide prevention program policy. 

The mental health policies are not the only jail policies the county has kept secret. After requesting the jail’s restraint chair policy and receiving an almost entirely redacted copy, PublicSource appealed the request to Pennsylvania’s Office of Open Records. The office in that case sided in part with PublicSource and ordered the county to remove some of the redactions. Instead of doing so, the county appealed the decision in the Court of Common Pleas. The county dropped its appeal in February after PublicSource published the policy in full after obtaining it from a different source.

Bradford of the ACLU of Pennsylvania called Allegheny County Jail’s redactions “totally against the spirit of the Right-to-Know law.” With recent heightened interest in criminal justice reform both nationally and locally, she said, it’s time for institutions to be as transparent as possible. “They shouldn’t expect requests to go down any time soon, so I would just get on board.”

Deitch also argued that transparency is essential for effective oversight. “If outsiders cannot get access to these policies,” she said, “then how can the jail ever be held to account to whether it’s even complying with its own policies?”

Juliette Rihl is a reporter for PublicSource. She can be reached at juliette@publicsource.org or on Twitter at @julietterihl.

The post How transparent is Allegheny County Jail compared to other PA jails? We requested their mental health policies to find out. appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.

Christopher West sleeps in two thermal shirts and two pairs of socks. He moved his cot to the center of his cell, on the floor and away from the walls where it’s coldest. Still, West said it’s hard to stay warm in the Allegheny County Jail. On Feb. 8, West asked a friend to post a message on his Instagram: “Somebody tell THEM to turn on the heat in the ACJ we freezing,” the post read. 

Parts of the Allegheny County Jail are plagued with frigid temperatures, according to jail complaints, incarcerated people and their loved ones — a problem that has been raised to jail leadership and the jail board. The county says there is no issue with the heat and that maintenance issues are quickly addressed. Either way, a new heating system is on track to be finished by the end of the year.

PublicSource heard from over a dozen incarcerated people, family members and advocates who complained of inadequate heat at the Uptown facility, which held a daily average of 1,701 individuals in February. Several alleged that while the common areas of the jail are warm, some cells are so cold that individuals can see their breath or have ice on the floor. After receiving repeated complaints about the heat, one grassroots group organized a phone zap to call jail management en masse earlier this month.

“I don’t understand why they don’t have no heat at all blowing into the cells,” said Mike Kiselka on Feb. 22, who is incarcerated at the jail. “They have cool air coming out the vent.”

County spokesperson Amie Downs wrote in a January email to PublicSource that there “has not been any issue with the jail’s heat at all this month.”

“As with all of our homes, there are often smaller VAV boxes that need to be fixed. Those control the heat in a few cells. There is 24/7 maintenance at the facility and as soon as notification is made that there is an issue, it is repaired,” Downs wrote.

Al Caponi, the county’s director of facilities management, said each time the department has received a complaint about temperatures in the jail, it has taken readings on all levels. “Pod temperatures each time have registered at approximately 74 degrees,” he wrote in a Feb. 25 email to PublicSource. Downs confirmed that the readings were taken inside the cells, not just in the recreational areas.

The jail is heated by Pittsburgh Allegheny County Thermal, Ltd., known as PACT, which provides heat to the Downtown business district and the jail via steam that travels from a boiler plant on Fort Duquesne Boulevard through underground pipes.

Timothy O’Brien, PACT’s operations manager, said PACT is not experiencing any system issues and has not received any complaints from the county about steam services to the jail. 

“We provide the Jail a double feed system capable of delivering 2-3 times the actual building requirement,” O’Brien wrote in a Feb. 19 email to PublicSource. He added that once the steam is delivered to the jail’s utility facility, it is then the county’s responsibility to transfer the steam through the complex. “I am sadden[ed] to hear that the inmates are having to deal with these conditions but to me it sounds like a downstream issue after the service is delivered,” O’Brien wrote. 

A new heating system for the facility is on the horizon. The jail will soon be heated by steam heat through an energy plant located on its property, installed by Peoples Natural Gas and owned by the county, per a contract signed in late 2019. A separate energy plant in the County Office Building will supply the jail’s hot water. The jail’s energy plant is expected to be completed by the end of the year, Caponi wrote. 

Warden Orlando Harper has also said there is no issue with the heat at the jail. “As far as the temperatures in the cell blocks, I walk the cell block frequently, and it is very comfortable in the cell block. And if the inmates are complaining, we know the corner cells are colder, we’ll move the inmate from the corner cell,” Harper said at the Jail Oversight Board meeting in January in response to a public comment alleging the facility had no heat or hot water. He said the jail did have a hot water issue but it was fixed immediately, and added that each inmate is given two heavy blankets to keep warm. 

On Jan. 13, Richard Arrington, who was incarcerated at the jail, said he was wearing two T-shirts, a thermal shirt and his uniform. “No heat in cells no heat on to be warm and could catch the flu from this treatment,” Arrington wrote in a complaint marked Jan. 2. It was marked “valid” by a correctional officer on Jan. 12. “A maintenance form has been filed for this issue,” the officer wrote.

Still cold, Arrington filed another complaint on Jan. 17. 

Jailbreak PGH, a grassroots group that advocates for people inside the jail, heard in early February from over 10 people at the facility that the vents inside the cells were blowing cold air, according to Nicole, a member who asked that her last name be withheld for privacy concerns. “To be hearing that overwhelmingly, I would imagine it’s affecting everyone in there,” she said. 

The group organized a phone zap to the jail the week of Feb. 8 to demand the issue be addressed. “The phone zap had to happen because there was no awareness of what was going on, and if we don’t advocate for them in these situations, there’s no one who will.” Nicole said jail administrators did not respond to the group’s calls, but that individuals inside the jail have told Jailbreak PGH that the vents were no longer blowing cold air, though they said the heat was still not functioning.

Every holiday season, the jail’s Inmate Welfare Fund buys every incarcerated person a thermal shirt to help keep warm. The purchase cost the fund $6,600 last year, according to the county controller’s office.  

“People are always cold in the jail. They have to know that it’s cold and not a comfortable temperature because that’s why they use the Inmate Welfare Fund to buy thermals and long underwear,” Bethany Hallam, a member of the Jail Oversight Board, told PublicSource in January. 

Some formerly incarcerated people said the jail’s heat has been an issue for years. Levi Molyneaux, who was incarcerated at the jail five times between 2013 and 2020, equated the facility to a “refrigerator.” 

“It’s sad. You see your breath inside. It’s terrible,” he said. 

Barbara Hulcha, who was at the jail from November 2014 to June 2016, agreed. “I was in there freezing. I had to sleep every day with a blanket over my head.” She described people cutting the bottom of their socks to use them as sleeves. Complaints, she said, went unaddressed. “They basically tell you, this is jail. What did you expect to happen?”

Juliette Rihl is a reporter for PublicSource. She can be reached at juliette@publicsource.org or on Twitter @JulietteRihl.

The post ‘No heat in cells’: Incarcerated people, advocates complain of cold temperatures at Allegheny County Jail appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.

Update (3/6/2021): At the March 4 Jail Oversight Board meeting, Warden Orlando Harper reported to the board about restraint chair use. It was a deviation from what he typically shares at these meetings in response to the board asking for more information on how the jail uses the device following the original PublicSource report below. He said the jail used the restraint chair 18 times in February. He promised that, at the April board meeting, he would provide the March count and include the number of times a person with a mental health condition is placed in the chair. Harper also agreed to show board members the restraint chair forms that are completed each time the chair is used. Jail leadership also provided the board the healthcare queues the board requested following a PublicSource investigation about medical treatment at the facility.

Each time Kimberly Andrews was strapped to a restraint chair, the process was the same. 

Allegheny County Jail staff wheeled the chair up to her cell on the women’s acute mental health unit. They strapped down her arms and legs, fastened her hands and feet. Then they took her to the jail’s intake department, placed a spit hood over her head, and positioned the chair facing the wall, padlocked next to a toilet. “And they leave you there for as long as they want to leave you there,” 21-year-old Andrews remembers.

Andrews estimates she’s been in the restraint chair at least half a dozen times between 2018 and 2020. Once, she was placed in the chair for at least eight hours, according to a court complaint against the jail. Another time, she says she was strapped to the chair naked, save for a stiff green blanket that soon fell down. Unable to pull the blanket up, she was left exposed while staff members and other incarcerated people walked past her cell. “They’re just looking at me naked,” she remembered. “That’s humiliating and devastating and traumatic as fuck.”

Andrews is diagnosed with bipolar disorder, PTSD, anxiety disorder and oppositional defiant disorder and has attempted suicide six times while incarcerated at the jail for misdemeanor charges, according to the complaint. 

According to her, every time she was placed in the chair, it was the result of a mental health crisis. She feels the restraint chair was used as a substitute for adequate mental health services. “That’s mainly all I asked for was to talk. ‘Can I talk to somebody? I have a problem,’” she remembers. “And it always escalated to the chair.” 

Doctors and correctional experts agree that the chair can be a useful tool for keeping people from harming themselves, and the jail’s policy states it is never to be used punitively. Yet according to some former medical employees, people who have been in the chair and three lawsuits against jail officials, the chair is sometimes used as punishment at Allegheny County Jail, with little discretion and without mental health oversight. 

According to the interviews and lawsuits, individuals in the chair have had spit hoods pulled over their heads that make it difficult to breathe. They are often denied food or bathroom breaks, sometimes causing them to soil themselves in the chair. Some are pepper-sprayed while in the chair, their skin burning until they are released and decontaminated. Like Andrews, they are sometimes left in the chair with their genitals exposed to passersby. 

The county did not respond to requests for comment. 

Jail reports obtained by PublicSource show the restraint chair is used for a variety of problems, from incarcerated people banging their heads against the wall of their cells to trying to unscrew the lights.

“When they act out, it’s because they have mental health problems. They’re decompensating,” said Chuck Timbers, a seasoned nurse practitioner who says he was terminated from the jail in May 2020 for violating its social media policy. “So what do you do? You strap them to a chair,” he said disapprovingly.

Invented in 1990 as a way to restrain and transport unruly individuals, restraint chairs have been widely used in correctional facilities since then. Studies show they are a safer alternative to four-point restraint, which involves restraining an individual to a bed by both arms and both legs. A 2015 review published in the Journal of Forensic and Legal Medicine found that the restraint chair, when used appropriately, “is a safe and appropriate device for use in restraining violent individuals” and “poses little to no medical risk.” 

Still, the device is controversial. The United Nations Committee Against Torture in 2000 called on the United States to abolish the use of the chairs on people in custody, claiming it “almost invariably” led to breaches of the Convention’s article against Torture and Other Cruel, Inhuman or Degrading Treatment. Amnesty International has been advocating for a federal investigation into their use since 2002.

In 2019, the Allegheny County Jail used the restraint chair 339 times — more than double that of any of the other 66 county correctional facilities in Pennsylvania, according to the Pennsylvania Department of Corrections. Twenty facilities, including those in Philadelphia and Delaware, did not use it at all. 

“The [Philadelphia Department of Corrections] did not use the chair in 2019. Please note, the restraint chair is only used when necessary during transport. It is not utilized at any other time,” spokesperson Shawn Hawes wrote in an email to PublicSource. 

During a one-year span between 2018 and 2019, the Allegheny County Jail was one of three Pennsylvania county jails to report restraining pregnant individuals in the chair, which it did three times. 

Restraint chairs are commonplace in correctional settings and are seen by some correctional experts and medical professionals as useful in violent or dangerous situations. As the slogan of one restraint chair manufacturer goes, the chairs are intended for “keeping people safe humanely.” Several people PublicSource spoke to who have worked at the jail said in the most serious cases — for example, if an individual is banging their head against the wall — the restraint chair is necessary. Others said they oppose the chair and view it as a form of cruel and unusual punishment. 

Michelle Lattimer, who worked as a jail mental health nurse from 2017 until 2020 when she was terminated for falsifying an admission document (an incident she feels was due to the jail’s understaffing), said the restraint chair was sometimes necessary but that corrections officers resorted to it too quickly. “It’s understandable when they’re mental health patients, it’s going to happen,” she said. “But I think it happened a little too frequently for my liking.”

Dr. Peter Hauber, a psychiatrist who worked at the jail between 2016 and 2019 and left once his contract expired, said the restraint chair must be used judiciously and can be abused. But he felt that on the acute mental health units where he worked, it was sometimes not used when it should have been. ”When [individuals are] out of control, and you can’t stop them from disassembling the light and trying to cut themselves and swallow things, I think that’s a time when you do need to use the restraint chair, absolutely,” he said.

In correctional facilities across the country, the chairs have resulted in abuse and, in rare cases, death. The Marshall Project found that the chairs have been linked to 20 deaths in the United States in the past six years. Most of the deaths were from overdose or blood clots from being in the same position for an extended period of time.

Jail Oversight Board member Bethany Hallam said she believes the jail should stop using the restraint chair. “People wouldn’t believe that this restraint chair is being used in 2021 unless they saw it for themselves,” Hallam said.

Fellow board members Terri Klein and President Judge Kim Clark declined to comment on the practice. Board members Abass Kamara and Judge Beth Lazzara did not respond to requests for comment.

Over the course of her two years at the jail, Andrews developed a coping strategy for the long hours she spent in the chair: she sang. 

“They want you to feel like they violated you, like they got over on you. So how I got through it, I would sing,” Andrews said. She mostly sang gospel songs, such as favorites like “Take Me to the King” by Tamela Mann and “Never Would’ve Made It” by Marvin Sapp. “I would sit in the chair for hours and sing out loud,” she remembered.

Now, four months after being released from the jail, Andrews works full time at a fast food restaurant and spends her free time volunteering for the Alliance for Police Accountability, collecting signatures for a petition to end solitary confinement at the jail, which she has experienced firsthand. She is the plaintiff in a lawsuit against jail administration, alleging that being placed in solitary confinement threatened “her life and health” and that uses of force by jail staff violated her rights. 

While she is no longer incarcerated at the jail, she says she carries her experiences in the chair with her. “It’s always fresh in my head like it was yesterday or today, or like somebody’s about to run up in here right now and strap me down to a chair for hours. And not feed me or let me go to the bathroom.”

The restraint chair policy: lacking in transparency and adherence 

Like most of its records, the jail keeps its restraint chair policy buttoned up. PublicSource sought the policy in September through a public records request but the county redacted the entire policy with black lines, claiming that releasing the information “would be reasonably likely to jeopardize or threaten public safety or preparedness or public protection activity.” 

After PublicSource appealed the response to Pennsylvania’s Office of Open Records, the office found that certain redacted portions of the policy were not exempt from disclosure. Rather than provide those portions, the county appealed the decision to the Court of Common Pleas, where the case is still active. (On Feb. 16, the county dropped its appeal.)

According to the policy, which PublicSource obtained in full elsewhere, the chair is meant to “prevent harm” to both incarcerated people and employees and “will never be used as a form of punishment.” But former medical employees and people who have been in the chair said in practice, it’s often the go-to when someone is experiencing a mental health crisis. 

The 2015 review in the Journal of Forensic and Legal Medicine found that in lawsuits involving a restraint chair, the problems typically arose from “deviations from set protocols” and “rarely involved issues with the chair itself.”

David Sacks, a psychologist with over 23 years of experience in correctional mental health care, said there are appropriate uses of the restraint chair, such as to prevent self-injury or injury to others when other techniques have been ineffective. But in his brief time at the Allegheny County Jail, he said he saw the chair being used punitively, without proper mental health oversight and without trying any other methods of de-escalation first. “People were placed in the restraint chair without appropriate due diligence by mental health staff. Which is cruel and unusual and therefore a type of punishment,” said Sacks, who resigned after three weeks at the jail.

In one case during Sacks’s short stint at the jail, an individual was placed in the jail for being “belligerent and intoxicated,” according to a nurse’s notes on a jail clearance form. When Sacks assessed the person, he found the individual was “floridly psychotic,” his notes read. “He needed to be sent immediately to the mental health unit,” Sacks later told PublicSource. Despite indicating that on the clearance form, Sacks said the person was still in the chair when his shift ended over two hours later.

The jail’s policy states that an individual can be in the chair for no longer than eight hours, unless authorized by the warden. Arizona-based psychologist and correctional mental health expert Joel Dvoskin said the best use of the chair is to transport individuals from one area of the jail to another. “Any jail I’ve been in, that shouldn’t take longer than 15 minutes,” he said.

Several people PublicSource spoke with said they were placed in the chair for eight hours or more, a claim which two lawsuits also allege. “Anybody who puts somebody in there for that length of time should themselves sit in it for that length of time, and then I doubt they would do it again,” Dvoskin said.

Kasi Kovach, a nurse who worked at the jail between August 2019 and January 2020, said people sometimes spent “hours, hours, hours” in the chair. “It’s not a safe practice for anyone,” she said. Kovach was terminated for allegedly attempting to give an individual medication without a guard present, an accusation she denies.

Timbers also described prolonged use of the chair. “Sometimes inmates would urinate on themselves because they’re in the chair so long,” he said.

Hallam of the Jail Oversight Board, who was formerly incarcerated at the jail and has seen the restraint chair used, called the chair “barbaric” and “dehumanizing.” During the board’s September meeting, she asked Warden Orlando Harper to provide the board the jail’s policies in full and post redacted versions of the policies online for the public. Harper denied both requests, claiming that to do so would “jeopardize the safety and security” of the jail.

“Maybe if the jail were willing to provide their policies and procedures to members of the Jail Oversight Board, we could have a better understanding of their excuses for using the restraint chair so we could end that practice immediately,” Hallam later told PublicSource. “But the jail has been anything but transparent.”

The chair as a substitute for mental health services

James Byrd has been strapped to a restraint chair more times than he can count. One time, it was because he was having a panic attack and asked to speak to a mental health provider four times, according to a lawsuit against the jail. Another time, he was put in the restraint chair after having a panic attack and losing consciousness, the lawsuit alleges.

In the best cases, Byrd remembers being released and taken back to his cell after six hours. In the worst case, he says he’s spent up to 26 hours in the chair, his genitals exposed, with no food, water or bathroom breaks. 

 “A lot of times, what’s going through my head is, ‘This is a hopeless situation. This is ridiculous. This is torture,’” said Byrd, who has been incarcerated since 2015 and suffers from anxiety, depression, bipolar disorder and PTSD, according to a lawsuit. His charges include aggravated assault, terroristic threats, rape and stalking.

Byrd is one of five plaintiffs in an ongoing lawsuit against the jail for alleged mistreatment of incarcerated people with psychiatric disabilities. According to the federal class-action lawsuit, which was filed in September by Schnader Harrison Segal & Lewis, the Pennsylvania Institutional Law Project and the Abolitionist Law Center, individuals with psychiatric disabilities are placed in the restraint chair for “nearly any issue,” including as a substitute for mental health care. The chair, the complaint alleges, is often used in tandem with chemical irritants, tasers, forced nudity and physical force.

In 2019, the Allegheny County Jail had the sixth-highest per capita rate of restraint chair use in Pennsylvania, according to Pennsylvania Department of Corrections data. The jail was behind McKean, Crawford, Lawrence, Bucks and Northumberland counties, all of which used the chair fewer times than Allegheny County but also housed significantly fewer people. The jail ranked eighth in the state for its overall use-of-force rate, which includes handcuffs, stun devices, chemical agents and other restraints. Philadelphia correctional facilities used other types of force, such as handcuffs, chemical agents and other restraints, but at lower rates than Allegheny County Jail. 

Records indicate the chair has been used at Allegheny County Jail as the solution to an array of problems, ranging from resisting officers to refusing to leave a police car. In some cases, the individuals were on the acute mental health unit or told jail staff they were suicidal.

“[Individual] stated he wanted to die and for Sgt. Greenawalt to ‘kill him,’” read one misconduct report from Nov. 5, 2020. After being placed in a suicide gown and handcuffs, the person called the corrections officer a derogatory name, began resisting officers and tried hitting his head against the wall. Officers attempted to secure the individual in a restraint chair, but he resisted. An officer stunned him with a stun gun in the shoulder. “The restraints were secured and [individual] was secured in cell H-9,” the report reads. 

On the same day, another individual was placed in the chair after arriving at the jail and refusing to leave the police car. When she resisted the restraints, she was also stunned with a stun gun, according to the report.

People who have been restrained almost always feel negatively about the experience, a review by Maine Medical Center in 2010 found. Some reported feeling “retraumatized,” having “the sensation of a broken spirit” and felt the restraint process was unethical. Research shows most nurses have more mixed feelings about using restraints, disliking them but believing they are necessary in instances of violence. 

Having better mental health treatment at the jail could prevent the need for the restraint chair, Lattimer said. ”We had some really awful stuff happen. But there’s something going on in their head to make them think that, ‘This is what I need to do to get attention,’” she said. “That’s the part that needs to be addressed, not, ‘Let’s throw them in a restraint chair.’”

Hallam of the Jail Oversight Board agreed. “Folks are placed in solitary confinement, placed in a restraint chair … as opposed to being given adequate health care,” she said.

Andrews said she hopes one day, the jail will be able to provide acceptable medical and mental health treatment to the individuals in its custody. “If they can’t provide that, then they need to start putting people with mental health issues in a different facility,” she said. “Because Allegheny County [Jail] is not the place.”

This story was updated with information about a county lawsuit on Feb. 17, 2021.

Juliette Rihl is a reporter for PublicSource. She can be reached at juliette@publicsource.org or on Twitter @JulietteRihl.

This story was fact-checked by Matt Maielli.

Mental health reporting has been made possible with funding by the Staunton Farm Foundation, but news decisions are made independently by PublicSource and not on the basis of donor support.

The post ‘It always escalated to the chair’: Allegheny County Jail used the restraint chair more than any other county jail in PA. appeared first on PublicSource. PublicSource is a nonprofit news organization serving the Pittsburgh region. Visit www.publicsource.org to read more.