Pacific Gateway Hospital security may be inadequate

From the Portland Tribune, April 13, 2001

Sources say the facility where Mejia died had no dedicated security staff

The April 1 police shooting of Jose Santos Victor Mejia Poot at BHC-Pacific Gateway Hospital has raised dozens of questions about the quality of security at the hospital, which is considered a backup provider for Multnomah County.

Former workers at the Sellwood psychiatric facility, county mental health workers and residents have expressed concerns including: the point at which the hospital calls police to assist with patients, whether staff allows police to bring weapons onto psychiatric wards, the types of security staff available in an emergency and what kinds of actions are taken to calm and control patients.

“Questions abound here,” said Bob Joondeph, director of the Oregon Advocacy Center, a nonprofit legal service for the mentally ill. “You can correct problems if your patient is alive.”

Mejia had been brought to the Sellwood psychiatric hospital March 30, about 15 hours after being arrested on a Tri-Met bus in Northeast Portland for harassment and resisting arrest.

Sunday evening, April 1, Pacific Gateway staff called officers for assistance, saying he was threatening hospital personnel with pencils. Officers helped place Mejia in a seclusion room and left. Half an hour later, the hospital called police again.

Police said Mejia was out of the seclusion room and wielding a metal bar apparently ripped from a door. Officers used pepper spray and beanbag rounds before one of the officers fired two bullets. Mejia died of gunshot wounds to the head and chest. The three officers at the scene have been placed on leave.

Karl Brady, chief executive officer of Pacific Gateway, did not immediately respond to a certified letter sent by the Portland Tribune, which asked several questions about the hospital’s security.

Strict procedures, including the use of restraints and medication at all of the hospitals contracted by Multmomah County are dictated by the Oregon Administrative Rules, the Joint Commision on Accreditation of Hospitals and the Health Care Financing Administration, Joondeph said.

Standardized policies

Besides Pacific Gateway, Oregon Health Sciences University, Providence Health Systems, Legacy Health Systems and Woodlawn Park Hospital also are contracted by Multnomah County as adult (nonadolescent, nongeriatric) providers. Their psychiatric units’ security policies are similar.

All have trained security staffs that do not carry guns and are able to respond to emergency situations around the clock. Sometimes other personnel on staff also respond to the crisis. “We page them and they come,” said Robin Blair-Henderson, director of behavior and health services at Woodland Park, a 15-bed facility on Northeast Hancock Street.

All say police are rarely called to assist in controlling patients. At OHSU, it’s happened only twice in 15 years, said Jim Newman, a hospital spokesman.

“First, staff in the ward tries to control the situation. If they feel it’s past their ability, they call OHSU’s public safety force,” he said.

And all have policies that ask police to check their weapons at the door for routine visits, such as patient drop-offs.

However, in a crisis situation, they say police are allowed to bring weapons in. “We have no control over whether guns are brought onto the unit,” said Tracy Barnett, spokeswoman for Legacy Hospital, which has three facilities with beds reserved for psychiatric patients: Legacy Adventist, Legacy Emanual and Legacy Good Samaritan. “Once they get here, they are to respond as they do to any of their calls.”

All of these hospitals have strict policies for controlling patients’ behavior, including techniques such as one-on-one therapy, timeouts in an unlocked room, seclusion in a locked room while a patient is monitored, and the use of medication if it will lower a patient’s anxiety.

Blair-Henderson said that seclusion and restraints are used from three to four times a month at Woodland Park, “which is relatively low,” she said. The staff also takes pride in the fact that it rarely uses sedating medication, she said: “You can’t just give someone medication to rest them, just to knock them out. The medication has to have a purpose. If you don’t need it, you can’t give it.”

At Pacific Gateway, however, several mental health workers familiar with the hospital say there is no dedicated security staff.

County investigation

Joondeph, among others, wonders about the county’s ability to review conduct at Pacific Gateway when the county could risk losing access to 66 adult beds for psychiatric patients if it decided to end its contract with the hospital.

Janice Gratton, senior manager of Multnomah County’s Department of Family Services’ Behavioral Health Division, points out that only three to four beds at any given time are being contracted by the county. The rest of the patients are being paid for by other providers. “It’s not really only our business they’re depending on,” she said.

“Ultimately our responsibility is to have safe places for people,” she said. “If that hospital isn’t a safe place, we’re compelled to look for other places. It’s not easy, but it’s part of our responsibility.”

The county is conducting two investigations, which it launched after the shooting incident, into the hospital. One looks into whether abuse or neglect occurred and must be completed in 45 days, she said. Gratton said she hopes it will be completed before that.

Gratton hopes a separate investigation into the pattern of care at the hospital will be complete in two weeks. Investigators have begun interviewing staff members at the hospital and will look at medical records in coming days.