03-24-2023  2:32 pm   •   PDX and SEA Weather
Police officers pass a fire lit by protesters on Saturday, Sept. 5, 2020, in Portland, Ore. Hundreds of people gathered for rallies and marches against police violence and racial injustice Saturday night in Portland, Oregon, as often violent nightly demonstrations that have happened for 100 days since George Floyd was killed showed no signs of ceasing. (AP Photo/Noah Berger)
Damon M Williams, Portland Resident
Published: 08 September 2020

damon m williams introDamon M. WilliamsDear City Council and Chief of Police (via PPB Public Info Officer),

I have a story to share with you and a couple of questions.

A number of years ago, when I was working at the county hospital in San Francisco, it was decided by the physician and nursing leadership in psychiatry that the department (encompassing several units plus a locked forensic unit and psychiatric ER totaling over a 100 beds) was going to move to a NO RESTRAINT, NO SECLUSION policy.

Mind you, psychiatric practice for decades had relied upon this as a primary tool for managing “escalating” patients, violent patients or patients in acute crisis.  This included using locked seclusion rooms ("padded room"), restraining folks to beds or gurneys and applying straight jackets.  Given the decades these practices had been employed it would have been a completely absurd proposal to move away from restraints/seclusion except for the fact it had been pioneered successfully by Bellevue Hospital in NYC—famous (or notorious) for the severity of illness treated there.

Implementing a change in policy

At the time I was a staff nurse, not green, but certainly not senior.  I heard many of the seasoned, well-respected and frankly, most skilled nurses (as well as sheriff's deputies that supported us during crisis) lamenting the dangers to come with this policy change. “We’ll all be injured regularly…but what about so and so who always requires restraints and has hurt so many nurses and deputies…we won’t be able to manage John Doe anymore…” on and on it went.  However, when Bellevue staff came to our hospital to share best practices in addressing patient crises and this policy change they offered some insights learned during their own implementation:

  1. Paradoxically, fewer staff and patients sustained injuries once the NO SECLUSION, NO RESTRAINT policies were put into place.
  2. The practice change required patients to be formally made aware of it, which offered an opportunity for discussion of past difficulties. 
  3. Nursing and medical staff (like police) are human and it is expected that as a patient enters crisis a process of escalation is induced in staff that creates a negative feedback loop of increasing escalation by all involved parties, especially when coercive means are invoked or in play. Psych leadership acknowledged that by authorizing these tools they were in some ways setting up staff and patients to become injured and create these coercive situations that always led to bad outcomes, including sometimes patient death. 
  4. We all build our approach to situations based upon the tools we have available for our use—SECLUSION and RESTRAINT being available meant that it was used and often threatened by nurses and psychiatrists—why verbally de-escalate, re-direct or offer decreased stimulation when one can just coerce and forcibly alter someone’s behavior?
  5. There is an inherent power discrepancy between patients and staff that contributed to certain outcomes/responses
  6. Both the staff and patients were distressed and upset by having to apply or be placed in restraints.
  7. Policy designers observed that situations are co-created from a behavioral perspective—all of us responding to the cues in our environment. Patients articulated that the expectation of force being applied to them was often enough to begin them escalating. Likewise, if police show up in riot gear, with batons and shields (and tear gas and rubber bullets to boot) at the ready, doesn’t this suggest a visual cue they are “ready to rumble” as well as set their own psyches in a certain orientation?  

I would propose there are mutually reinforcing, coercive dynamics at play in the nightly downtown rumble between police and protesters. Quite frankly, in reviewing some videos taken at night it looks less like a law enforcement attempt to my naïve eyes than a match-up between two opposing gangs or sports teams.

I do not condone violence or destruction of property, and I can understand why the police commissioner and police chief would want our police officers to address these concerns and have all tools at their disposal. However, the police:

  1. purportedly won’t involve themselves when violence is in the offing on at least one recent occasion—due to lack of “resources” which read (perhaps incorrectly) pretty obviously as a dig against their rival gang, the protesters, and the “abolish the police” contingent. ("If you want us abolished and detest us so much, why should we help out?") and
  2. In all of these months there still is not any clear and consistent targeting by police of the protesters engaging in vandalism (if I’m factually incorrect I welcome the correction) or arrests of folks easily recognizable as persons with active warrants (again, please feel free to correct me).

Questioning current tactics

Is it not possible to assign groups of officers to protect certain buildings/businesses (perhaps with support from the National Guard) but otherwise refrain from engaging with the so-called “rioters?” Or somehow alter the gear or formation or tactics that are part and parcel of this nightly enactment? I’m not sure what the fix is (and I acknowledge there must be many facts I don’t have) but from where I sit (and many other Portland neighbors I’ve talked to), it just appears the police selectively enforce the law and escalate the situation at some arbitrary point in the night when "riot" is declared. 

And from what I understand from protesters, this is the point exactly. To concretely, repeatedly demonstrate that policing in this city is both selective in its enforcement, brutish and ineffective. What exactly is the mission of the police on these nightly forays from the perspective of police leadership? And do the chief of police and police commissioner sincerely feel these mission goals (whatever they may be) are being met? Is it accomplishing much beyond demoralizing the police force further and escalating protesters? It doesn't seem to be impacting folks' willingness to go to businesses near the civic center or decreasing vandalism (again, I may be mistaken, please feel free to share the correct facts).

Please do not construe anything in my email as denying the efforts at reform being made by all of you--which are all appreciated--both the aspirational, the provisional and the accomplished.

Thanks for your time and efforts in this challenging time.

Respectfully submitted (with the acknowledgment that leading and protecting a dynamic city with diverse constituencies cannot be an easy job with simple solutions),
Damon M Williams, Portland Resident

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