Multnomah County Sheriff weighs in on recent spike in overdoses, deaths in jails

Multnomah County leaders say drugs smuggled into the county’s two jails are among the reasons that six people have died in custody in less than three months, the largest spike in at least 15 years. Overdoses are suspected in at least two of the deaths, and the medical examiner ruled that two others were due to suicide. Sheriff Nicole Morrisey O’Donnell has implemented new security measures, including strip searches of people entering the facilities. Sheriff Morrisey O’Donnell joins us to share more about the in-custody deaths and the steps she’s taking to put a stop to them.

This transcript was created by a computer and edited by a volunteer.

Dave Miller:  This is Think Out Loud on OPB. I’m Dave Miller. Six people in custody in Multnomah County jails have died since May. It is the largest spike in at least 15 years. The medical examiner has ruled that two deaths were due to suicide, but drug overdoses are suspected in at least two others. Sheriff Nicole Morrisey O’Donnell has said these deaths are extremely distressing. She’s implemented new security measures as a result. And she joins us now to talk about it. Sheriff, welcome back.

Nicole Morrisey O’Donnell:  Thank you very much for the opportunity to be here this morning.

Miller:  Thanks for joining us. So what happens after an in-custody death at a Multnomah County jail? What kinds of investigations are carried out?

Morrisey O’Donnell:  When an in-custody death occurs, per our policy, the east county major crimes team performs a death investigation. And that is in conjunction with investigators with the Multnomah County medical examiner’s office and the district attorney’s office. And through these investigations, it helps us answer questions about why the event happened, assess our response, as well as looking at policies, practices, and procedures. Those are reviewed throughout that investigation as well.

Miller:  So what do you actually know, without getting into detail about these six individuals? I’m curious broadly what you know at this point about what happened and also what the outstanding questions are that you’re still hoping to learn more about?

Morrisey O’Donnell:  So, as we’re looking at what’s occurred in our jails over the last few months, there are many factors that contribute to a death-in-custody, just as there are for deaths in our community. So, as you mentioned, two of the deaths-in-custody have been related to suicide. And we are currently, and have been working over the last several weeks, to connect with the National Institute of Corrections to provide an assessment, an independent assessment of our facilities, our policies and procedures, our building layouts, and having recommendations on how to move forward. And as these investigations are continuing, we hope to learn more about other resources that we can access that can help us ensure that we are providing the best care in custody to the ever-changing population in our corrections facilities.

Miller:  What policies are already in place to prevent suicide? Obviously in corrections, it’s not like this is an unknown risk. This is something that you all have been very aware of for, I assume actually for centuries, literally, if not longer. So what’s already in place?

Morrisey O’Donnell:  Absolutely. So, when we’re looking at these types of incidents, we have mental health resources in our corrections facilities. We have corrections counselors as well that are available to provide resources to our adults in custody. What we’re seeing also is that people are staying in our custody longer and the severity of charges is higher. And so making sure that we’re providing that access to mental health care and providing that access to our corrections counselors and ensuring that our deputies have the training for suicide prevention and intervention, that they can help assess and make recommendations if they’re in a housing area working with adults in custody where they have a concern.

Miller:  Do you see a connection between longer stays for your adults in custody and more serious charges and suicide?

Morrisey O’Donnell:  I think as you’re looking at people staying in custody longer, that potentially could lead to not being able to connect with family and friends and supports that are in our community that someone might rely on when they aren’t in custody. So I think there are many competing factors on why an individual is feeling that they’re not receiving support. When someone is in our custody for a more lengthy period of time, those connections may have been lost along the way.

Miller:  Are there protocols in place currently for people in custody who corrections officers think may intend to harm themselves?

Morrisey O’Donnell:  Yeah, so when someone is booked into our corrections facilities and they are going to be housed in one of our facilities, they meet with medical staff, corrections health staff, to do an assessment. And that does not involve corrections deputies or sworn members. So that is a private conversation and assessment with medical personnel. And also there’s information on how to access medical [care] through medical request forms as well as mental health. And additionally, as commented before, our deputies attend suicide intervention and prevention training. They have access to connect with medical personnel or mental health personnel if they’re seeing changes in behavior or something that’s concerning. As well, if an adult in custody has made statements that they’re in a really challenging position and they’re concerned or they say that they may harm themselves, we have suicide watch protocols to ensure the safety and security of individuals. And those are also evaluated by medical and mental health staff.

Miller:  You had noted that you are going to be turning to a national organization to get more information about best practices going forward. But do you already have a sense yourself, as the leader of corrections for the County? Do you already have a sense for what went wrong?

Morrisey O’Donnell:  I think it’s really important to continually evaluate our processes, policies, and procedures. The individuals that are coming into our custody… it’s ever changing. So I think it’s extremely important that we are always looking at how to prevent deaths in custody [and] prevent major incidents in our facilities. And I believe that that does require an independent organization to come in that has national experience and expertise on ensuring that, if there’s any challenges or they have recommendations from their work that they’ve done across the nation, that they’re able to provide that to us. So I think we can always improve. And I do think that is one of the most important resources that we can access at this point.

Miller:  I mean, that’s true for all of us in all aspects of our life, hopefully, that we can all improve. I’m just wondering if you, as the leader of the sheriff’s department of Multnomah County, if you yourself, have a sense for what went wrong in these two cases, before we bring in outsiders?

Morrisey O’Donnell:  I believe it’s critically important that we’re training our staff and that we’re listening to our adults in custody. And I think part of the challenges with a very high need, high acute population, I think that is part of what we’re trying to work through right now. So being able to train our staff to ensure that they have that connection, and building those bridges with medical to continue that partnership and help our adults in custody, I think as our population changes, our responses and our policies and procedures and the way we do our everyday work is ever changing as well.

Miller:   Let’s turn to at least two of the other deaths. Maybe something has changed, but as of last week, the news was that at least two of the other four deaths were suspected drug overdoses. Is that still the number or is there more clarity about the remaining four deaths?

Morrisey O’Donnell:  That is the clarity I have at this point. And to go into some of the changes that we’ve made to address this situation, again, reiterating that the lethality and the addictiveness of what we’re seeing in our community and in our facilities with fentanyl is devastating. And it’s extremely sad to see individuals that are struggling with addiction. The fentanyl can be deadly in very small quantities, in one pill. It’s easily available and a recent report indicated that it could be purchased for less than a dollar. So as we’re looking at strategies to ensure that this is not present in our facilities, we recognize that technology that has been in place may not be able to detect such small quantities because of the density.

Miller:  So I think people need to understand what you’re talking about here. What’s the technology that had been used in terms of assessing what people were bringing into jails?

Morrisey O’Donnell:  Yes, it’s a body scanner technology, which would be able to highlight if there was, potentially, an object that someone either had ingested or was present in their body, when they’re coming into our facility.

Miller:   Okay. Ingested or put in some orifice and then there was some, like a scanner at an airport?

Morrisey O’Donnell:  Exactly. That was going to be my next statement. Thank you.

Miller:  Okay. So, but you’re saying that because of, just literally, the density or size of fentanyl pills, you don’t think they were being picked up by these scans?

Morrisey O’Donnell:  Correct, and/or fentanyl powder that is extremely light and the quantity is so small and it could be lethal, a lethal dose that is just a very small quantity.

Miller:  So, what is the plan going forward?

Morrisey O’Donnell:  So, we have begun and returned to an unclothed body search to ensure that we’re able to put one more measure in place to identify if someone is bringing controlled substances and drugs into our facilities. We have also, over the last several days and continuing, brought in our specialized teams working collaboratively across the agency to work in our facilities, both facilities, and search all areas to ensure that we are able to identify if it is currently in our facilities and really determine how it is entering into our facilities.

Miller:  Is unclothed body search a euphemistic way to say that you’re gonna be searching the body cavities of people as they enter?

Morrisey O’Donnell:  It’s a visual search. Just for an example, since this policy has been in place, we have recognized an individual that was concealing an amount of drugs in the back of their mouth. And that would not have been picked up by a body scanning system.

Miller:  Purely visual?

Morrisey O’Donnell:  Correct.

Miller:  It does seem like that could still leave open the possibility that people could be smuggling drugs in, especially tiny pills, inside body cavities?

Morrisey O’Donnell:  Absolutely. I think, again, we’re looking at any and all strategies to eliminate this from our facilities. And every time that we’re putting measures in place, we are always being tested. So, as we’re hearing from our investigators that do this work in our community, there are individuals that have relayed to them that if someone believes they might be going to jail, that there’s a possibility that they may be concealing it in a way that, if they’ve had previous experience in our jail, that they’re using a different method. So, we’re continually looking at our practices to ensure that we’re trying to stay ahead of that as we can.

Miller:  And what about corrections officers, you know, corrections deputies or vendors or staff? There are a lot of people who are going in and out of these facilities on a daily basis. I don’t imagine all of them are taking their clothes off and opening their mouths?

Morrisey O’Donnell:  Correct. And again, what we have heard from other adults in custody, as well as our investigators that are doing this work in our community, indicates that individuals are concealing the drugs on their bodies as they’re coming into our facility.

Miller:  You mean the adults in custody are concealing them? You’re saying from the investigation you’ve done so far, you don’t think it’s anyone but the people in custody?

Morrisey O’Donnell:  I do not. And we’re also hearing information from adults in custody on ways that adults in custody that are coming into our facility are potentially concealing drugs.

Miller:  What about after the fact? Let’s say that somebody is in the middle of an overdose. What is the availability of Narcan right now?

Morrisey O’Donnell:  We’ve expanded our use of Narcan over the last several months. We’ve been collaborating with our corrections health partners. That has been accessible in many areas of our facilities, and we have worked with our corrections health partners to ensure that it is in close proximity to ensure access for our deputies and our medical staff, if we have an incident that’s suspected overdose.

Miller:  Do you have an estimate for the number of people who are brought in, in custody, who use fentanyl or other opioids regularly? Who are in active use of fentanyl?

Morrisey O’Donnell:  I do not have that. Corrections health or the health department would be a better resource for that information.

Miller:  But is it fair to say that it’s not uncommon?

Morrisey O’Donnell:  From the information that adults in custody are providing. But again, I think that’s a question that’s more directed to our health partners.

Miller:  The reason I’m asking is because I’m just wondering, assuming that they’re not all smuggling drugs in, I imagine that many people in custody would be going through serious withdrawal while they’re in county lockup. And I’m curious what that means for you?

Morrisey O’Donnell:  So, as we talked about briefly, when someone is brought into our custody and they are staying and going to a housing area, our corrections health, our medical partners, do that assessment. And they help people if there is a situation where they’re admitting that they have been using. And that is purely a corrections health, that is part of their function to ensure that they are providing care based on what the adult in custody, what information they’re providing to them at the time of booking. And then there is also, as mentioned, request forms and other ways for our adults in custody to contact medical for additional services, if that’s the case.

Miller:  Nicole Morrisey O’Donnell. Thanks very much.

Morrisey O’Donnell:  Thank you. I appreciate the opportunity to be here today.

Miller:  Nicole Morrissey O’Donnell is the Multnomah County sheriff. She joined us to talk about a recent spike in, in-custody deaths in Multnomah County jails. There have been six since May.

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