Tuesday, June 26, 2012

Tuesday’s meeting on Jail Concerns

At our local jail, the use of a restraint chair involves an inmate being strapped and kept in an upright position, sometimes for hours, without access to mental health treatment or other normal human interaction. 

The padded isolation room, unlike a regular solitary confinement cell, has no cot or mattress and no sink or commode, only a hole in the floor to be used for a toilet.  Before being placed in the cell, the person is stripped and given only a paper gown to wear. No reading or writing material is provided, and human contact is limited to jail personnel monitoring the cell and bringing in food (with no utensils, for safety reasons) and some strips of toilet paper when requested. 

Someone from the Community Services Board may be called in for assessment, but actual counseling help is normally not available.

Fifteen concerned citizens met at the Family Life Resource Center today as a follow-up to the March 6 forum held at the Massanutten Regional Library to discuss concerns about the above use of restraint chair and padded isolation chair for suicidally depressed inmates in our local jail.

Some helpful things we learned today:

Two representatives of the Harrisonburg-Rockingham Regional Jail reported that our local facility remains seriously overcrowded, currently housing 343 inmates when it was originally designed for 208. Inmates are double bunked, some have mattresses on the floor and an additional 40 are at the Middle River facility. All of this adds stress to inmates and jail personnel alike.

Most of the people who are placed in the restraint chair or in the padded isolation padded cell are incorrigible due to their being highly intoxicated or on drugs (such as bath salts), not because they are at risk for suicide. The group saw the use of restraints as understandable in some such cases but interest was expressed in getting more data on the nature and number of non-substance abuse cases that represent a risk for suicide, and what alternatives there are for their treatment. Records are kept on this and should be available.

There is no actual state regulation forbidding an outside professional (a suicidal inmate’s therapist, for example, where he or she already has one) being brought in to meet with a highly distressed individual, but safety and security concerns are cited as reasons for the jail not permitting this. There seemed to be a consensus in today’s group on having the on-call CSB clinician or whoever on the jail medical staff is doing a risk assessment to exercise the option of at least making a phone call to such a therapist.

The Community Services Board has a contract with the local jail to provide a minimum of necessary mental health services. The director of the CSB kindly expressed his willingness to get more information together on their work which he will discuss first with me and then perhaps also be willing to meet with a representative group of concerned citizens about ways of improving the mental health services they provide.

I was impressed by the level of interest expressed by everyone present, though questions were raised about whether too many concerns for not having trained outside volunteers hurt may get in the way of having more inmates helped. The group recognized the need to balance these concerns.

Another item of interest:

Sam Nickels, who could not be present today, recently returned from a three week trip looking at mental health systems in Central America, and said that hospital personnel he spoke with in Panama said they have a restraint chair, but that it is seldom used, and that the isolation room "went out years ago." In an email to me he suggested, “If Panama can do this, I think we can do it here. At a minimum we should have a protocol that states that if an inmate must be restrained for more than three hours (or whatever time period) in the chair, they must be transferred to the crisis/forensic unit of the state hospital, perhaps after consultation with the on call CSB assessment person.”

Attendees were invited to sign up to pursue one or more of the following:

 1. Investigate practices at other jails and prisons regarding the use of restraint chairs and isolated padded cells (State prisons no longer use the isolated padded cell, and the forensic unit at Western State Hospital uses bed restraints and/or one-on-one monitoring).

2. Consider ways of collaborating with our local Community Services Board in working to improve the treatment of mentally ill and suicidally depressed inmates in our jail.

3. Meet with Sheriff Hutcheson for an inside look at our local facility and to gather more information about actual practices and conditions at HRRJ.

4. Gather information and suggestions from ex-inmates and from concerned family members of mentally ill inmates about how to improve services.

I am also suggesting that each of us express our opinions and concerns directly to our newly-elected sheriff, Bryan Hutcheson, at He has been most open to hearing from his constituents.

A message of concern might go something like:

I sincerely hope that under your leadership the Harrisonburg Rockingham Regional Jail would end its use of the solitary padded cell for mentally ill and suicidally depressed inmates, and that in its place there could be one-on-one monitoring of such persons, utilizing, if necessary, volunteers trained by the Community Services Board or a similar agency.
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