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AUGUSTA — Tonia Kigas Porter was freed from state custody Friday for the first time in almost 20 years.

The 49-year-old woman had been committed to the commissioner of the Department of Health & Human Services after being found not criminally responsible for murder for starving her 5-year-old daughter to death in 1993 in Bangor.

A judge in Kennebec County Superior Court ordered Porter discharged after the state, her psychiatrist and the State Forensic Service said they all supported it for Porter, who most recently was diagnosed and treated for cancer.

“She has managed those losses and difficulties with great dignity,” said Ann LeBlanc, director of the State Forensic Service.

Porter has been living in Augusta and doing volunteer work there for years and getting support from people in the community.

Justice Donald Marden asked LeBlanc what Porter’s reaction would be to seeing her photo in the newspaper.

“She’s learned one day your picture shows up on the front page and two days later, people forget about it,” LeBlanc said.

Marden said statements by those testifying on Friday convinced him that Porter has worked hard to recover.

“There’s no question Ms. Porter bears a heavy burden,” Marden said.

J. Mitchell Flick, Porter’s attorney, told the judge Porter is particularly conscientious about taking her medication and “extremely likely to succeed.”

Assistant Attorney General Laura Yustak Smith said that once Porter recovered from her severe psychosis, she was distressed and remorseful about what she had done.

“I think it’s a good thing when a person recognizes how serious it was and has the remorse because that’s the beginning of the recovery and can give the public some comfort that the person knows this was a bad thing,” Yustak Smith said.

Porter was committed to state custody in 1995.

Yustak Smith said she contacted family members of the victim prior to the hearing to discuss Porter’s potential discharge, and learned one was deceased and the other did not want to attend the hearing.

Porter hugged treatment providers and others from Riverview Psychiatric Center and from the hospital’s Assertive Community Treatment Team.

She is expected to continue with community-based treatment.

During a separate hearing in the same court Friday, Kirk T. Lambert also was discharged from the custody of the commissioner.

Lambert, 33, had been committed to state custody in 2000, following a verdict of not criminally responsible for robbery in an incident in which his lawyer said he wheeled a TV out of Walmart.

LeBlanc testified that Lambert was admitted to Riverview “and he stabilized quite quickly on medications.” She also said he has been dealing with an ongoing substance abuse issue.

Lambert has moved several times between the state hospital and the community, and several witnesses said he appeared overly dependent on Riverview and it was time for him to move on now that his mental illness is being treated and there has been no evidence of psychosis.

Instead of readmitting him recently, LeBlanc said, the hospital offered him a list of homeless shelters.

LeBlanc described Lambert, whose head is shaved, as “a good hair cutter,” and a person who is creative and makes beautiful quilts.

She said it appeared unlikely he would injure himself or others and that he plans to move to northern Maine where his father is a registered Maine Guide.

“He has been clean and sober for six months and quite committed to staying clean and sober,” she said.

LeBlanc said Lambert “was compassionate to other people with major mental illness who couldn’t help themselves.”

In March 2013, Lambert was a patient at Riverview when he was credited with rescuing a mental health worker there who was under attack by another patient.

The state, through Assistant District Attorney David Spencer, raised no objection to Lambert’s release.

“You are entitled to be discharged and have worked hard to bring yourself to this position,” Marden told Lambert. “You have some issues that you’re really going to have to stay on top of if you’re going to stay out of trouble.”

Marden warned him that people who don’t address substance issues “become very involved in the criminal justice system. In the final analysis, what happens is entirely up to you.”

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University of New England students have created a program for jail staff and correction officers to help them deal with stress and other wellness issues
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PORTLAND, Maine — Students at the University of New England are spending time at the Cumberland County Jail this week.

The students have created a program for jail staff and correction officers to help them deal with several issues. The biggest one…stress.

They’re doing it not only for class credit, but because they say it’s the right the thing to do.

All week UNE students, studying to be nurses, occupational therapists and trainers, will help the staff with nutrition, exercise and stress management.

In the stress management session there were all kind of sensory activities like making slime and stress balls, by stuffing flour into a balloon.

It’s a  tool that will come in handy for corrections officer Chelsea Moore.

“There’s a lot of stress looking over your shoulder. There’s a lot of not knowing what’s going to happen at any given second. That’s probably the most tiring part of it” Moore says.

This is not the first time UNE students have been in the jail. They were there last year working with inmates, helping them with all kinds of wellness issues.

While there, they noticed the jail staff and correction officers could use some of the same services.

Kelly Pitre, who is studying occupational therapy at UNE, and will graduate next month, is spearheading this program, which is all volunteer.

“I feel like it’s our turn to take care of them” Pitre says. “I’m passionate about it, it’s a great way to put my skills to the test and help implement stress, well being, health and wellness.”

Libby Alvin, who is set to graduate from UNE’s nursing program next month says while she is busy with her school work, she looks forward to getting out in the community.

“It brings you back to why you’re doing school and why you’re working your butt off everyday in the library, to work with people and help make things better.”

A kind gesture that’s greatly appreciated.

“It’s nice to know somebody thought of us. There’s all this work, put into a whole week of them coming in and spending time with all shifts” says Moore.

Last year Cumberland County Sheriff Kevin Joyce awarded UNE students a Volunteer Appreciation Award for their work with inmates.

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Kenneth McDonald

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Maine State Prison – Kenneth McDonald – MDOC #114427

807 Cushing Road – Warren, Maine 04864-4600

Well, something’s have been happening in the prison here.  A little while ago we all were locked down  (the entire prison was locked down) and they did what they called “inventory”.  They came through the pods and cleaned everybody out of anything extra that they were not supposed to have.  This went on from Tuesday until Thursday and they wouldn’t even let us out to shower until it was over.  We got out Thursday night.  First thing I did when they let us out was to take a shower and that felt good, too.  For a while now after we leave the chow hall we have been getting patted down and now before we leave the pods we get patted down before we go to chow and we still get patted down after we leave chow.  They have also come up with the idea for separate recs for both the close and medium units.  Guess too many fights have been breaking out for their tastes and they are trying to put a stop to it.  They said that they want us to feel “safe”, but I think that they really don’t want to make out paperwork and the ones that are trying to actually keep safe are the sex offenders and rats (most of which are probably over in medium).  Other than that, everything is just peachy keen.

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Maine State Prison – Kenneth McDonald – MDOC #114427

807 Cushing Road – Warren, Maine 04864-4600

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(We let Kenny know that we would.)

McDonald Plea

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Maine State Prison – Kenneth McDonald – MDOC #114427

807 Cushing Road – Warren, Maine 04864-4600

It’s almost the end of April, and I’m seeing flowers and green grass. A lot of seagulls are flying around as well. I’m doing pretty good in here, and no one’s giving me any problems. Tell old Hawkeye that I said hello and that I’m doing a lot better than I was doing in 2009 and 2010. Was wondering if you could send me any information on a frog species that I read about in the Kennebec Journal. It’s called the “fanged frog” and they have been finding them in Asia. I read about it and would love to find out more about them. They sound kind of cool. Well, I have to go and God bless you.

Who, Who, Who.

Kenneth McDonald, Aka: Owl, Malibu
MDOC #114427, MSP, Warren 

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Maine State Prison – Kenneth McDonald – MDOC #114427

807 Cushing Road – Warren, Maine 04864-4600

Desiree Fischer, a med tech at the Androscoggin County Jail in Auburn, wheels a medication cart down the hall on Wednesday. Between 30 and 61 percent of Maine?s 1,774 county jail inmates were prescribed at least one psychiatric medication, according to a survey conducted by the Bangor Daily News in August (Troy R. Bennett | BDN).

STATEWIDE (BDN) — A Maine judge makes the unprecedented decision to forcibly medicate a murder suspect with antipsychotic drugs. A violent, severely mentally ill patient is shipped to state prison after twice attacking staff members at Riverview Psychiatric Center.

Now Gov. Paul LePage, besieged with troubles at Riverview, has plans to send even more violent patients to prison, and proposes to spend millions to convert the prison facility in Windham to house mentally ill inmates.

These headlines point to a much deeper crisis in Maine. After a well-intentioned move decades ago to shift the care of the mentally ill away from psychiatric institutions, many Mainers can’t find adequate care in their communities. They still end up institutionalized but now it’s behind bars.

The ranks of inmates taking psychiatric medications in Maine’s jails and prisons today once would have filled the state’s largest hospitals for the mentally ill.

Between 30 and 61 percent of Maine’s 1,774 county jail inmates were prescribed at least one psychiatric medication, according to a survey conducted by the Bangor Daily News in August. About a third of the 2,223 inmates in state prisons were taking drugs to manage their mental illness. At the Intensive Mental Health Unit at the state prison in Warren, all inmates were medicated at the time of the survey.

The figures are even higher at Maine’s now consolidated youth corrections facility. More than half of all juvenile offenders, or 79 of the 127, took medications. Many of them are at high risk of returning to the prison system as adults, still in need of mental health treatment.

As high as those percentages are, they underrepresent the real population of inmates with mental illness, because the figure is nearly impossible to nail down.

County jail and corrections officials broadly agree that the rising volume of mentally ill patients is untenable. But counting prescriptions offers only a point-in-time snapshot of the problem. It also fails to account for offenders who are undiagnosed or have mental illnesses that don’t require medication, or varying, facility-to-facility policies for dispensing medications.

Inmate advocates also contend that budget cuts have spurred jails and prisons to crack down on taxpayer-funded prescription drugs, leaving some prisoners unmedicated.

Penobscot County Sheriff Troy Morton said many of the people walking through his jail’s doors are undoubtedly experiencing a mental health crisis, whether they have an official diagnosis or not. The need burdens everyone it touches from the sick individual to the law enforcement official apprehending them, from the jail taking custody to the taxpayer picking up the tab.

“There was a day when if a person was on the street yelling and screaming, [police] didn’t know what to do with them, so they were charged with disorderly conduct, end of problem,” Morton said. “But it wasn’t the end of the problem. It was a temporary delay.”

A moving target

After an arrest, inmates typically are asked about their mental health. Most correctional facilities follow National Commission on Correctional Health Care guidelines for initial screenings, which include a questionnaire that asks about current medications and thoughts of suicide.

Jail and prison staff do not make decisions about medical care, including for mental health problems, Morton said. All correctional facilities contract out for those services.

“We are not doctors,” he said.

Screeners review the questionnaire, “triage it, and get them to a provider” if the inmate is on prescription medications when they enter jail, said Geoffrey Archambeau, CEO of Correctional Health Partners, a Denver, Colorado-based company that contracts with the Penobscot County Jail, the Kennebec County Jail and other facilities throughout the country.

If an undiagnosed person is in crisis, they are directed to a medical provider who can prescribe medications, if warranted, according to jail officials from across the state.

“Usually they have committed a crime due to not taking their medication,” Knox County Sheriff Donna Dennison said in an email.

One reason the state has no current count of inmates with mental health diagnoses is because “it’s not a searchable thing” since each jail uses a different computer management system, Archambeau said.

“Here’s the problem: Nobody has real numbers,” Morton said.

While the state has one centralized administrative system for all its facilities, called CORIS, it does not allow prison or Department of Corrections officials to query inmates’ mental health records because of medical privacy laws, according to Deputy Commissioner Jody Breton.

Only the department’s contracted medical provider, Correct Care Solutions, can search those records. John Newby, Correct Care regional vice president, found that in 2015, around 48 percent of juveniles and 34 percent of adult inmates were prescribed psych medications.

“For the State of Maine, we are actually below the national averages on prescribing of psychotropic medication,” Newby said in an email to Breton that she forwarded to the Bangor Daily News.

Many inmates diagnosed with mental illness also have developed drug dependency from “self-medicating,” according to Morton.

That often leaves jails serving as their region’s largest detox and mental illness crisis centers, he said.

“My question is: Is that what corrections is supposed to be about?” said Morton, who started as a corrections officer in 1988. “Is that really how we should be treating people with mental illness and substance abuse? To me, this is really an expensive way to do it.”

Cost pressures

Jails and prisons often fail to identify inmates with mental illness, according to an April 2014 report by two Texas doctors. Published in the American Journal of Public Health, the study examined a nationally representative sample of U.S. prisoners, finding that more than half who were taking medications for mental health conditions upon arrival failed to receive the drugs after incarceration.

“This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison,” the report states. “This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison.”

Joseph Jackson, who formed the Maine Prisoner Advocacy Coalition upon his release from prison two years ago, says many inmates go without drugs they need or receive “cheaper” substitutes.

When he was arrested for shooting another man in 1995 and locked up in county jail, Jackson was taking medication for depression.

“I was on one treatment going in and they got rid of that,” said Jackson, who was the triggerman in a drug-related slaying in Lewiston on Easter morning 20 years ago that left one man dead. “It doesn’t matter if you’ve been on one [prescription] for 20 years and it’s been working well. They say it’s because doctors on the outside are manipulated.”

When he was eventually convicted of manslaughter later that year, Jackson entered the state prison system. Again, his prescription for depression changed.

“They gave me amitriptyline,” Jackson said. “That is how, mostly, they dealt with us. They gave it away back then.”

But today, the cost of medications has changed how correctional facilities dispense them.

“It depends on what those pills cost,” said Jackson, who started a chapter of the NAACP and earned a college degree while behind bars. “They’re going to give you the cheapest pills.”

Providing substitute medications may help county and state pocketbooks, but Jackson describes that approach as an injustice against inmates.

At the Cumberland County Jail in Portland, inmates formerly received psychiatric medications upon request. But in 2011, the jail changed its policy “to only giving the medications when the inmate comes into the jail taking the medications and after being verified,” Cumberland County Sheriff Kevin Joyce said in a recent email. “Or, when the doctors and/or psychologist believes that the medication is necessary.”

That change saved the jail thousands of dollars per year on medication costs, he said. Other jails have instituted the same policy.

For his part, Archambeau, the medical contractor for the Penobscot County Jail, disputes the contention that cost drives decisions on which drugs are dispensed. PCJ spends about $40,000 a year close to 8 percent of its $525,000 annual medical budget on psychotropic medications.

Yet costs can vary by facility. What jail and prison leaders say they have in common is that they’re doing all they can to accommodate inmates with mental illness.

Capt. Jeff Chute, Androscoggin County Jail administrator, said he has witnessed the transformation of county jails over the years. He started in law enforcement in 1984, joining the jail in 1995.

“We are de facto mental health facilities,” Chute said. “Sometimes we’re there to stabilize them. In order to prevent recidivism, we try to get them back on their meds.”

The costs go beyond prescription drugs, according to Dennison, the Knox County sheriff. When hospitals are full, jail officials pull double duty.

“We have to have a guard sit one-on-one with this person,” Dennison said. “Sad situation all around, not only for mental health folks but also for jails and officers.”

Fewer beds

The housing of Maine’s mentally ill in correctional facilities may be making headlines today, but the problem dates back decades, according to Sharon Sprague, superintendent of Dorothea Dix Psychiatric Center in Bangor.

Many of the country’s psychiatric institutions downsized or closed starting in the 1950s, under a process known as deinstitutionalization. States intended to care for psychiatric patients in their local communities, but often failed to set up adequate services.

“When you consider we had 1,200 patients in 1970 and are down to 40 patients today, it says a lot,” Sprague said of Dorothea Dix, which opened in 1901 as the Eastern Maine Insane Hospital. “Our capacity, if we were to fill all the units, is 51. That has been a huge change.”

Riverview opened in 2004, replacing the Augusta Mental Health Institute, which began in 1840 as the Maine Insane Hospital. Riverview has dual roles: to treat violent offenders and to assess those charged with crimes to determine whether they understand the charges and are competent to stand trial.

Among the patients housed there today is Leroy Smith, who made headlines earlier this month after Kennebec County Superior Court Justice Donald Marden issued an order authorizing the state to medicate him for six months against his will in an attempt to restore his competency to stand trial.

Smith was charged on May 6, 2014, with killing and dismembering his father, 56-year-old Leroy Smith II, and initially was found not competent to stand trial. He is now receiving psychotropic medication and will return to court in April.

Meanwhile, Riverview is fighting a 2013 decertification for poor patient care, which resulted in $20 million in forfeited federal Medicaid funding.

LePage has said his plan to modify the Windham prison for mental health patients will help get Riverview recertified.

At its peak, Riverview had a capacity of 1,500.

Today, Maine has just a fraction of that number, with about 270 psychiatric beds statewide. Riverview accounts for 92 and Dorothea Dix has 51. The other 127 beds are split between Acadia Hospital in Bangor, Spring Harbor Hospital in Westbrook, and eight community hospitals that all limit patient stays to 30 days.

That’s rarely enough to accommodate the need, experts say, even with Spring Harbor planning to reopen a dozen psychiatric beds after the recent award of $420,000 in state money. Such shortages are a problem in Maine and throughout the country, said Jenna Mehnert, executive director of National Alliance on Mental Illness in Maine, who came to Maine after working in Pennsylvania and New York.

“There aren’t enough psychiatric beds. And sometimes when officers need to divert a person to the hospital there is no room, and they end up back on the streets in jail or the emergency room,” she said.

Just compare the number of people in mental health institutions back in the 1970s to the populations in homeless shelters today, said Shawn Yardley, Bangor’s former director of health and community services.

“It’s an incredible correlation it’s the same number of people. What we’ve done is move the need for that comprehensive service from mental institutions to homeless shelters, not very successfully and not in the best interest of anybody,” he said.

Changing philosophies

In the past, the philosophy in prisons was to keep inmates with mental illness quiet until they completed their sentence, according to Dr. Dan Bannish, a psychologist at the state prison’s Intensive Mental Health Unit. Now prisons are treating the illness, he said at the unit’s opening in February 2014.

“It’s not a hospital. It’s an intensive mental health unit,” Corrections Commissioner Joe Fitzpatrick said in December. “We really did want this for treatment purposes, not for management purposes. It’s a critical piece and it’s probably the most challenging piece.”

A total of 70 inmates 39 from the Department of Corrections, 29 referred by county jails from across the state, and two from Riverview had been treated in the unit as of the end of January.

The number of suicidal behaviors has dropped considerably and self-abusive incidents among inmates in the program have fallen dramatically, he said.

Maine’s county jails also have made changes.

Aroostook County has a mental health nurse practitioner to screen every inmate’s case, said Sheriff Darrell Crandall.

Penobscot County Jail works with Acadia Hospital, which provides clinical services, including two hours of psychiatric services, each week.

Cumberland County Jail has two social workers and Androscoggin County Jail added a full-time social worker who helps inmates transition back into society in an effort to prevent recidivism, Chute said.

“We had to give up some positions for that,” he said. “It was extremely necessary.”

Chute, Crandall and Morton said law enforcement officers also have learned new ways to deal with people suffering from mental health problems.

The Portland Police Department has developed a specialized behavioral health response program, employing a special liaison who goes out on calls whenever mental illness is identified. The liaison also follows up with patients, conducts referrals and serves as a conduit between the department and behavioral health providers.

Mehnert said other departments should follow Portland’s lead.

“We expect [law enforcement] to be social workers, and it’s really not fair, and when they fail we demonize them,” Mehnert said.

The National Alliance on Mental Illness Maine has spent years offering crisis intervention training to law enforcement and emergency responders from all over the state. Every police academy cadet in Maine also goes through that training, along with mental health first aid.

“A lot of this is educating the officers on the street trying to make sure [they can] identify if somebody is in mental health crisis or needs to be incarcerated for a crime,” Mehnert said. “I think that is a crucial thing.”

A smooth transition back into society is key to preventing criminals from reoffending, experts said. But those who are prescribed medication often struggle to pay for their drugs without a job or insurance coverage.

Most jails have transition programs in place, but funding for them often falls short of addressing the multiple factors that affect inmates’ success on the outside, Morton said.

“It’s crucial because if we only set up the mental health part of it, yet they don’t have housing, or they don’t have food or transportation, we’re setting them up for failure,” the Penobscot sheriff said.

“This is not a county jail issue,” Morton said. “It’s a societal issue.”

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Maine State Prison – Kenneth McDonald – MDOC #114427

807 Cushing Road – Warren, Maine 04864-4600

FEBRUARY 26, 2019

The former chief medical officer of New York City jails has just published a remarkable new book about the health risks of incarceration. The book is titled “Life and Death in Rikers Island.” Dr. Homer Venters offers unprecedented insight into what happens inside prison walls to create new health risks for incarcerated men and women, including neglect, blocked access to care, physical and sexual violence, and brutality by corrections officers. Venters further reveals that when prisoners become ill, are injured or even die in custody, the facts of the incident are often obscured. We speak to Dr. Venters and Jennifer Gonnerman, staff writer for The New Yorker magazine.

Transcript
This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now! I’m Amy Goodman. His name is synonymous with all that’s wrong with the prison system: Kalief Browder. Kalief spent three years at Rikers Island jail in New York without charge. He was a 16-year-old high school sophomore when he was detained on suspicion of stealing a backpack. Browder never pleaded guilty, was never convicted. He maintained his innocence and requested a trial, but was only offered plea deals while the trial was repeatedly delayed. He was held at Rikers Island jail for three years, beaten by guards and prisoners alike. After enduring nearly 800 days in solitary confinement and abuses, Browder was only released when the case was dismissed. He committed suicide on June 6, 2015, at his home in the Bronx. He was 22 years old. Nearly four years later, the question remains: Why did Kalief have to die? Is there something inherently wrong with incarceration that makes it a health risk, sometimes with deadly consequences?

Well, a remarkable new book attempts to answer those questions as it shines a light on the health risks of imprisonment. The book is titled Life and Death in Rikers Island. Its author, Dr. Homer Venters, the former chief medical officer of New York City jails. He offers unprecedented insight into what happens inside prison walls to create new health risks for incarcerated men and women, including neglect, blocked access to care, physical and sexual violence, and brutality by corrections officers. Venters further reveals that when prisoners become ill or injured, or even die in custody, the facts of the incident are often obscured. He writes, quote, “[W]e work in settings that are designed and operated to keep the truth hidden. Detainees are beaten and threatened to prevent them from telling the truth about how they are injured, health staff are pressured to lie or omit details in their own documentation, and families experience systematic abuse and humiliation during the visitation process,” unquote. The risks of jail are disproportionately harmful for people with behavioral health problems and for people of color, Venters explains. He concludes Rikers Island must close, and suggests how that should be done.

Well, Dr. Homer Venters joins us now, physician and former chief medical officer for New York City’s Correctional Health Services. Again, his book, Life and Death in Rikers Island. He’s currently senior health and justice fellow at Community Oriented Correctional Health Services and associate professor at New York University’s College of Global Public Health. Also with us, Jennifer Gonnerman, staff writer for The New Yorker magazine. Her most recent piece is a review of Dr. Venters’ book. It’s called Life and Death in Rikers Island. “Do Jails Kill People?” is the name of her article.

Welcome you both to Democracy Now! OK, Dr. Venters, start off talking about why you wrote this book and how Kalief Browder’s death relates to all of this.

DR. HOMER VENTERS: Well, early on in my time overseeing the health system in the New York City jails, it became clear that our job was not just to take care of people who were injured or address the medical problems people had, but that this system was conferring new health risks to our patients. So, our patients were getting hurt because of the way the jails were set up and run. And so, it was clear to my team and I that part of our mission had to be to use our tools as public health and epidemiology folks, as well as doctors and nurses, to document just what these health risks were and to report those out. And one of the things that over the years became clear is that those health risks, as you just stated, aren’t meted out in a uniform fashion. People with behavioral health problems, people of color, our data show, were more likely to find themselves on the wrong end of these health risks.

AMY GOODMAN: Talk about why prisons are lethal. Talk about Rikers Island, for example.

DR. HOMER VENTERS: Well, we can start with the first and most serious health risk, which is death. It’s clear that there are many preventable, or what we would call jail-attributable, deaths that happen. We worked hard to document those while I was leading the health service in the New York City jails, but there are many others. So, for instance, people that we know who are coming in with very serious health problems—diabetes or hepatitis C or needing dialysis—who then are denied those services, despite the fact that we have them available; people who are exposed to solitary confinement, not just the isolation, but the brutality and violence associated with it, who do take extreme measures to get away from the distress that that setting causes—those are things that were conferred to those people.

AMY GOODMAN: Tell us the story of Carlos Mercado and Angel Ramirez.

DR. HOMER VENTERS: So, those are two patients who, as have been publicly reported, entered into the jail system with clearly identified health problems, one with diabetes and one undergoing withdrawal. And as has been reported in the press, they both, despite having clearly communicated their problems and even having their problems elicited and understood by quite a few people in the jails, received a punishment response and a neglect response that led to their death, even though they were in a system that was able to provide them the healthcare they needed.

AMY GOODMAN: So what happens to a prisoner when they’re sick? You also talk about the tension between the doctors, the nurses—the health professionals—and the guards.

DR. HOMER VENTERS: In the best of circumstances, the correctional officers, who are with our patients all the time—you know, they see and interact with people much more than we do in the health service—they determine that somebody is ill and they need help, or somebody just reports, “I don’t feel well,” then they’re taken to medical care, and they get the appropriate level of medical care. They’re transferred to the hospital if they need something that the jails can’t provide.

In the worst circumstance—and there are some situations that actually hardwire in this less ideal response—people aren’t able to say that they’re sick or that they feel well, or when they do, they’re not believed, and so they’re kept in a chaotic intake pen, or they’re kept in a solitary confinement cell, even though they’re saying, clearly, “I need insulin,” or “I’m sick,” or “I’ve just swallowed something that could kill me,” and then they’re denied access to healthcare.

And then, finally, I would say that because of the pressure of dual loyalty, this really crushing and very omnipresent ethical problem, human rights problem, in correctional health, that even when they do make it to the health service, sometimes the doctor or nurse or social worker in front of them is acting more as an agent of the security service than as a healthcare provider.

AMY GOODMAN: Talk about your own experiences. You entered the jails in what? 2008?

DR. HOMER VENTERS: Yes.

AMY GOODMAN: About a decade ago?

DR. HOMER VENTERS: Yes.

AMY GOODMAN: What did you find there? What shocked you most?

DR. HOMER VENTERS: I believe that what—one of the things that shocked me the most was the high level of injury and injury associated with violence. Certainly, all physicians and healthcare people, we have experience taking care of injuries. But so many of our patients were coming to us with injuries, and so many of them were saying that these injuries were from things called slip and falls. So, you know, patients that come with a fracture to the jaw, a very—you know, very serious injury, or a fracture of the upper arm or the leg, and then saying that they had slipped and fallen—things that just did not—you know, we didn’t believe. But also, it was clear, when you interacted with these patients, that they were terrified and that they, actually, in that moment, were thinking very clearly about their survival and their preservation. And so, it makes a very difficult proposition for a doctor or nurse.

AMY GOODMAN: So, you set up an injury surveillance system?

DR. HOMER VENTERS: That’s right. Shortly before I arrived, Christopher Robinson, another young man who died in that same jail that Kalief Browder was held in, he had been beaten to death. And so, when I did arrive and started with the Correctional Health Service, we set about understanding how many other people were injured, especially adolescents. And we saw lots of jaw fractures and hand fractures. And so, at first we were dealing with paper records, but then we quickly implemented in the New York City jail system an electronic medical record. But we were able to modify that in really major ways, so that we could capture data not just about the type of injury people had, but about whether or not it was intentional. Did it happen during a use of force? Was there a blow to the head? Then we could use that data to report out to others, not just in the correctional service or the city, but outside parties that might be interested, what the rates of injury were, so that we had empirical data to show that brutality and injury was in fact a real crisis for our patients.

AMY GOODMAN: Describe what would happen when you would send an email to the DOC, to the Department of Corrections, to upgrade an injury, to upgrade what you saw.

DR. HOMER VENTERS: Well, the injury reporting system on the health side, as I mentioned, we built a pretty sophisticated electronic medical record system. On the security side, it required paper, pieces of paper, injury reports, to be updated and amended actually on an individual piece of paper. So, when I would find a patient, as I often would, who had an injury that was more serious than initially reported, or that the circumstances of the injury were different than was originally reported, unlike in healthcare, where we want all information to lead us to the quickest, best outcome for the patient, these paper forms then would be put back in my face, and people would say, “Listen, you have to find the original doctor or go to the original jail. Go find this piece of paper”—that nobody can find. “That’s the proper way to get this addressed, not simply to tell us that, just because you’re a doctor or a health administrator, you think something else happened.”

AMY GOODMAN: Why is there so little transparency? Talk about the silent complicity you describe.

DR. HOMER VENTERS: You know, these are paramilitary settings. And so, the health service, in most of these places, even when we have an independent health authority, we still rely on the correctional staff for our safety and security. And so, as such, because there isn’t a lot of mandated transparency about health outcomes, about the true characteristics of injuries, for instance, at the time we were doing this work, most of the system is designed to keep information on the inside, so that anybody who wants to change the original account, whether it’s a patient or a doctor or a nurse, faces a real gauntlet of challenges, that not only are bureaucratic and administrative, but actually could put their own personal safety at risk.

AMY GOODMAN: We’re going to break and then come back to this discussion and bring in Jennifer Gonnerman, who wrote the review of your piece for The New Yorker—the review of your book. Dr. Homer Venters’ book is called Life and Death in Rikers Island. Stay with us.

[break]

AMY GOODMAN: “Blue Prelude” by Ethel Ennis, Baltimore’s “First Lady of Jazz.” She passed away February 17th at the age of 86. This is Democracy Now!, democracynow.org, The War and Peace Report.

I want to turn to Kalief Browder in his own words. Kalief Browder, of course, is the—well, was 16 when he was arrested and sent to Rikers Island. He ended up being there for three years, much of that time in solitary confinement, without charge. He was arrested when he was a high school sophomore. Police believed—they said that he stole a backpack, but could never come up with the person who made the accusation, who they drove around a neighbor, and the person pointed out Kalief walking on the street. And then that person just disappeared. Kalief would not plead in prison, because he said he was taught not to lie, and he said he was innocent. Held for three years, much of that time in solitary confinement. He said that while he was in solitary confinement at Rikers, the guards often refused to give him his meals.

KALIEF BROWDER: If you say anything that could tick them off any type of way, some of them, which is a lot of them, what they do is they starve you. They won’t feed you. And it’s already hard in there, because if you get the three trays that you get every day, you’re still hungry, because I guess that’s part of the punishment. So, if they starve you one tray, that could really make an impact on you. And—

MARC LAMONT HILL: How much were you starved?

KALIEF BROWDER: I was starved a lot. I can’t even—I can’t even count.

AMY GOODMAN: So, that was Kalief Browder speaking on HuffPost Live, when it was around. He died within two years after this interview. He took his own life. He went on to say he was once starved four times in a row—no breakfast, lunch, dinner or breakfast again. After enduring nearly 800 days in solitary, Browder was only released when the case was dismissed. Browder took his own life June 6, 2015, at his home in the Bronx. He was 22 years old. He was a student at Bronx Community College.

Jennifer Gonnerman wrote a lot about his case for The New Yorker and exposed videos that were gotten from the inside of Rikers showing him being beaten by guards and prisoners alike.

Jennifer, you have covered the prison system a lot. And you were really taken with this book, Life and Death in Rikers Island, and wrote a review of it for The New Yorker.

JENNIFER GONNERMAN: Yeah, you know, I saw an early copy of this book in December. And a lot of books come in. You know, as a reporter, you get a lot of—often get a lot of books and people who want publicity. I started reading this book, and I really couldn’t put it down. I thought it was so important, crucially important. And I feel like it covers one of the most overlooked aspects of mass incarceration. I mean, mass incarceration has gotten a lot of attention in recent years. But what—the health risks that folks endure when they go inside is something that I feel needs much more attention. And I think, as a society, we’ve sort of grown numb to these headlines, like an individual died in prison or jail, and we don’t really follow up with the necessary questions. And what Dr. Venters’ book does is really pushes us to ask those harder questions, like: Did this death have to happen? Was it preventable? Did something happen in the jail that led to this individual’s death? And those are the kind of questions the public—and journalists, in particular—really need to be asking.

AMY GOODMAN: Tell us the case of Ronald Spear.

JENNIFER GONNERMAN: Ronald Spear is one of the gentlemen in the book. He was in Rikers Island. He was in his fifties. He was a kidney dialysis patient. In 2012, one night, he felt very ill and tried to get the attention of the doctor. He was housed in the infirmary on Rikers Island. There was a medical office next door to his dorm. He snuck out of the dorm to get into the hall to get to the medical office, and the doctor told him—you know, a guard stopped him, and the doctor said, “You have to keep waiting.” He had been waiting for hours. The officer, the correction officer, and Mr. Spear got into an altercation, which ended with two other guards coming in and restraining him on the floor. And that would have been the end of the situation, but then the first officer, whose name is Brian Coll, came in and kicked Mr. Spear in the head repeatedly, and he died right there on the floor. This case was covered up, lied about for years, until, finally, federal prosecutors in the Southern District in Manhattan brought a prosecution against the officer. And he went on trial in 2016. So I sat through the trial. And obviously the focus was on what this officer did and didn’t do.

But one of the subtexts of that court case was what the medical staff was doing at the time. So, this crime took place in the hallway right outside the medical offices, and the nurse got on the stand and said, when she heard the altercation in the hallway, she opened her door, and then she shut her door, and that she had sort of been taught to do that. It’s almost like an unofficial rule on Rikers Island. And the doctor who was on duty and hears all of this commotion going on in the hallway, he was sitting in his office and never looked out the window, never opened the door, testified to all of this, and only opened his door after the whole thing was over, and somebody knocked on the door—I believe it was a captain—and said, “Can you come out here and, you know, help?” And at that point, Mr. Spear is on the floor, in handcuffs, face down and no pulse. And so, essentially, this homicide took place within feet of the medical staff. And that always stuck with me. And, you know, this idea of an unofficial rule of averting your eyes when there’s an altercation between correction officers and inmates is something that actually shows up in Dr. Venters’ book also.

AMY GOODMAN: You say that 112 people died in New York City jails between 2010 and 2016. That’s like almost what? Twenty a year.

JENNIFER GONNERMAN: More, probably, in some years, right? Yeah.

DR. HOMER VENTERS: Some years, yes.

AMY GOODMAN: So, what is society’s responsibility here?

DR. HOMER VENTERS: I think that there are really very large policy decisions that have been made to keep these deaths and injuries hidden. And so, to undo these problems is not simply a matter of a little bit of training for one group of staff or another. It is that we have to establish medical systems that work not only to care for the patients and their health problems, but also to collect the data we do in the rest of the country, and report it out. We also need independent oversight. We’re fortunate in New York City to have the Board of Correction, an incredibly vital institution that really doesn’t exist in most of the other 3,000 counties in the States. But they need to be supported and the independence to make sure that the health service and the correctional service adhere to rules.

AMY GOODMAN: Dr. Venters, you also say Rikers should be closed.

DR. HOMER VENTERS: Absolutely.

AMY GOODMAN: Is it happening fast enough?

DR. HOMER VENTERS: Well, so, the Mayor’s Office of Criminal Justice, led by Liz Glazer, is doing an amazing amount of work to come up with the actual planning that can make it happen. But this is a political question. To close Rikers Island, one of the—

AMY GOODMAN: How many people does it imprison?

DR. HOMER VENTERS: The jail system today has about—has under 9,000. But we really need to get down to 5,000 or so, which means building at least another borough jail.

AMY GOODMAN: You write, the health risks that are faced, particularly by people with behavioral problems, in prison—talk about that.

DR. HOMER VENTERS: Yeah, I think that the most extreme example, that’s really an obscenity, is the notion that people who exhibit symptoms of mental health problems would be then put into solitary confinement, where we know that they’ll get worse and often die. And so, the idea that we had a solitary confinement unit for people with mental illness in the New York City jails until 2014 is horrific. It’s not—that’s not a lack of resources. That’s not a lack of thought. Thought went into it. And so, where Jason Echevarria and others died, you know, that was an affirmative decision. So, undoing those bad decisions, coming up with a more clinically appropriate, a therapeutic model, in most cases, means not having people in jail. It means having people in a community setting, that’s an actual healthcare setting. We built alternative models in the New York City jails, these units, the CAPS and PACEunits, these very therapeutic units, but they’re incredibly expensive—couple million dollars a year for 20 patients. And every aspect of those units would be more effective if they were not in the jails.

AMY GOODMAN: Mass incarceration in this country has been taken on by grassroots activists now for years. And it’s certainly reading, I think, a—reaching a tipping point, where you have people across the political spectrum saying we have the largest prison population in the world. How can this be changed?

DR. HOMER VENTERS: I think that one of—there’s an important voice that needs to be brought to this, which is healthcare systems, health insurance companies, because keep in mind that while most people don’t die in jail or prison, many people are coming home with physical and psychological damage from these settings. And the care they need—which they may have struggle to access, but the care they need is going to be provided by community hospitals. Just take the example of traumatic brain injury. We documented all of the hidden traumatic brain injury just in the New York City jail systems. That increases the risk of those people for dementia and CTEdown the road, that is incredibly costly to them and their families.

AMY GOODMAN: How do people on the outside get access to this information on the inside, particularly families of people who are in prison?

DR. HOMER VENTERS: So, I think that it is—these systems are designed to keep the truth from—certainly from families, who are, you know, lied to all the time. And from—but I think that it’s incredibly important to have aggressive journalism. But also, I think that some of the structures that exist in New York City should be replicated elsewhere, so having a board of correction or an oversight agency that demands data. Having investigative journalists that dig into individual deaths is incredibly important.

AMY GOODMAN: Steve Coll just wrote a new piece in The New Yorker, “The Jail Health-Care Crisis,” talking about the opioid epidemic, among other things.

DR. HOMER VENTERS: Yeah, I think that that’s a—that is also a very good example, that most jails and prisons, people don’t have access to evidence-based addiction care. So, many people end up incarcerated because of an addiction problem. Then, because they’re denied access to buprenorphine and methadone, they leave, and, we know—we have documented, here in New York City—their risk of death when they leave is much higher. Now, in New York City, we have a methadone program and a buprenorphine program for people who are incarcerated, but very few jails around the country have that.

AMY GOODMAN: And, Jennifer Gonnerman, what gives you the most hope as you continue to cover the prison-industrial complex?

JENNIFER GONNERMAN: Well, you know, as you were mentioning, there’s a lot of activists that have taken up this cause, which is fantastic, because, you know, back in the ’90s, the 2000s, you just didn’t see that level of interest or enthusiasm in activism for taking on these really challenging topics. That gives me hope. And also folks like Dr. Venters, people who have been on the inside, who have witnessed horrific things, and then have the wherewithal and the courage and take the time to really record them, so the rest of us can really, truly get a much better understanding of what’s going on behind bars.

AMY GOODMAN: And the access to information you, as a journalist, have, getting—for example, you leaked these videos of what was taking place with Kalief being beaten, the videos that are taken, the surveillance system within prison?

JENNIFER GONNERMAN: Right. You know, that was very unusual. You know, there is very little video footage that has come out of—from prisons around the country, despite there being a number of surveillance cameras. You know, like Dr. Venters said, the truth is hidden. It’s intentionally hidden. It’s very difficult—you know, reporting on what’s going on inside of jails and prisons is very difficult. But, obviously, the more journalists who are taking on the challenge, the more we’re going to get to the heart of what the truth is.

AMY GOODMAN: I want to thank you both for being with us. Dr. Homer Venters, former chief medical officer for New York City’s Correctional Health Services. His new book, Life and Death in Rikers Island. And Jennifer Gonnerman, staff writer for The New Yorker magazine. We’ll link to her piece, “Do Jails Kill People?”

 

Image result for Criminal Justice Academy in VassalboroVassalboro,  Maine — A sheriff in Maine says two corrections officers have been placed on paid leave after a fellow officer was shot in an apparent accident at a police training academy.

Matthew Morrison of the Aroostook County Sheriff’s Department was shot in the leg in a parking lot at the Criminal Justice Academy in Vassalboro on Monday. He was taken by ambulance to MaineGeneral in Augusta and then flown by the Lifeflight helicopter to Maine Medical, according to CBS affiliate WAGM-TV,  and is recovering.

Police say 24-year-old Cumberland County corrections officer Matthew Begner shot Morrison. Police say the shooting took place inside a pickup truck owned by by another Cumberland County officer, 25-year-old Cody Gillis, of Brunswick.

 

Police say the 9mm gun is owned by Gillis.

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The shooting took place as the three men were leaving the academy grounds for the evening around 8 p.m. The gun had been stored in the console of Gillis’ truck.

The director of the academy says he will also review the shooting and is awaiting the final investigative report from Maine State Police. WGME-TV reports ( http://bit.ly/2sy9dWR ) that the academy director says corrections officers aren’t supposed to have guns on campus.

The Kennebec County District Attorney’s Office will also receive a copy of that report, the station reports.

State police and the Cumberland County sheriff are both investigating.

 

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Political Prisoners

Welcome to the blog from inmates of Maine's jails and prisons.

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