Recidivism has dropped at the regional jail because of programming implemented to address the problems that send people to jail in the first place, the jail administrator said.
Bryan Brandenburg, administrator of the Northern Oregon Regional Corrections Facility, said recidivism – where people reoffend and end up back in jail – has dropped from 76 percent in 2014, the year before he took over, to just 61 percent today.
Having come from a mental health counseling background in a prison setting, when he got here three years ago he implemented a number of programs to help inmates improve their behavior. Last summer, he opened a small mental health unit.
Today, inmates can take up to six classes: anger management, parenting, substance abuse treatment, medications, criminal thinking, and re-entry into life outside the jail.
The jail has two full-time mental health professionals working there, both paid for with grant money aimed at reducing recidivism, and both employees of the Mid-Columbia Center For Living who are assigned to work at the jail.
When people are booked into the jail, they are medically screened, assessed for their mental health and given a 54-question assessment that rates their risk to reoffend.
The various assessments include questions such as what their current medications are, any medical diagnoses they have, any suicidal history or current plans to hurt themselves, if they associate with criminals, any current drug use, whether they have a job and whether they finished schooling.
The jail does other testing to see if it’s appropriate for them to take programming.
The jail has kept track of inmates who complete the programming as well as those who refuse, drop out or are released before the program finishes.
By a significant margin, those who complete the programs reoffend less. In 2016, 58 percent of those who completed programming reoffended, compared to 69 percent who didn’t.
The next year was even more dramatic, where just 30 percent of those who took treatment reoffended, compared to 52 percent of those who didn’t.
“As a result of this programming, it is not only reducing recidivism for our medium- and high-risk individuals, it is reducing our overall jail population, which saves taxpayer money,” Brandenburg said.
When he got here, Brandenburg realized “we had an extraordinary amount of people who were mentally ill and were receiving psychotropic medication.”
But the jail has been able to move the dial on that population, too. For example, in January 2016, the monthly average severely persistently mentally ill population was 45 inmates. In 2018, that number was just 17 inmates. For the month of March, in 2016 there were 35 mentally ill inmates, compared to 14 this year.
He said the first month he took over, fully one-third of the inmates were chronically mentally ill. Now it’s around 20 percent.
What has allowed this shift in data has been a twofold effort. First, there’s been an increased awareness and emphasis by community partners, including law enforcement, mental health officials, and parole and probation officers, on using best practices to defer the mentally ill from jail and into community placement when possible.
All law officers also received intensive training on crisis intervention.
Second, a federal grant allowed the jail to hire a second mental health professional just over a year ago. That also enabled the jail to open its mental health unit.
The clinicians do intake assessments of inmates, but the real problem is there is no place to put the severely persistently mentally ill.
The hospital doesn’t have a psych hold, and there is no respite center in town to allow people time to settle down, said Brandenburg.
“There are no community placements for these people, but if they are that severe, and they are creating problems for the community, they have no choice but to put them in jail,” Brandenburg said.
“Because of the community effort to provide what alternative placements they could, and our efforts in here, we have seen a dramatic decline in our overall mental health population,” Brandenburg said.
Kathleen Green, lead mental health clinician at the jail, oversees the mental health unit, psychoeducation programs and the triage of people coming in in crisis.
She said the most common diagnoses for those considered severely persistently mentally ill are paranoid schizophrenia and bipolar disorder with psychosis. Most are men in their 20’s to 40’s.
She said most mentally ill inmates are in jail for behavior associated with unmanaged symptoms, often things like disorderly conduct.
She said the biggest offense that gets the mentally ill jailed isn’t a new crime, but just a probation violation. “I would say the biggest one is, they fail to check in. Just … check in.”
That’s because severely mentally ill people often don’t even know what day it is, she said.
They also often have untreated medical issues like diabetes, hypertension, hepatitis C and poor dentition.
The severely mentally ill have, on average, a lifespan shortened by 20 years.
Things were mellow in the unit when a reporter visited recently, with a few men sitting around on chairs in a common area or sleeping in their cell. Green said if a person was in active psychosis, they would be kept in segregation.
Ashford Weston, a mental health specialist at the jail, said, “You think big, scary violent person. But that’s not what we have here. These are your neighbors.”
Green said if a severely mentally ill person is well managed and stabilized on medication, “you’re not going to see the symptoms.”
In the unit, the inmates are in a structured environment with food and medication provided.
Green said the mental health program has been “a fantastic success, I would say.”
She said, “We’ve had some terrific success stories of people who have gone through the regular psycho education programs, and we haven’t seen them again.”
She said in a budget crunch, it can be a kneejerk reaction to say mental health staff aren’t needed. “If we’re lowering recidivism, which has been proven, we’re saving money.”
She added, “We have statistics that show, by offering programming, by having a mental health unit, we are reducing recidivism.”
She felt the jail was fortunate to have Brandenburg at the helm because he brought a background in mental health treatment as well as administrative experience.
Green said 80 percent of inmates accept medications when they are at the jail. But once they leave, even though they have insurance through the Oregon Health Plan, they commonly ditch them. The mental illness then surges, robbing them of the insight that they need the medication in order to function.
Psychosis means a break from reality. A lot of times, the mentally ill can be hearing voices, often derogatory and telling them to do things. If they are paranoid, they are untrusting of people, Green said.
Weston teaches substance abuse and anger management classes and has also taught classes on criminal attitude and men’s parenting. He works to coordinate care with outside partners in the community and even Portland.
The inmates in the classes have homework and are expected to participate in class, which can include role playing.
Weston likes to show his students real-world examples of people losing their cool, and explains why it’s important not to.
With the mentally ill population, a mandatory daily community meeting looks at what they’re feeling, their goal for the day, and what they’re thankful for.
“People who are mentally ill oftentimes can’t say how they’re feeling,” Green said. Marginalized people often feel alone and that they have no one to count on.
They are kept abreast of local current events, to help them feel like they are part of the community. They even get a copy of the Chronicle to read every day.