Damning report calls for ban on prone restraints • Virginia Mercury

A recently released report by the DisAbility Law Center of Virginia (dLCV) reveals that the death of Irvo Otieno, the was killed at Central State Hospital in Dinwiddie County during a mental health crisis in police custody last year could have been prevented had deputies and hospital staff not used the prone position, a controversial method of subduing people.

In a presentation of the findings to the House Budget Committee at the state Capitol in Richmond on Tuesday, Colleen Miller, executive director of the dLCV, called on lawmakers to end the criminalization of mental illness, keep law enforcement out of the state’s efforts to treat people with mental disorders and address conditions in Virginia’s prisons, which house thousands of mentally ill people.

“Serious reforms are needed in Virginia because the events that happened to Mr. Otieno led to his death and received a lot of media attention. But people with mental illness face these issues every day in Virginia and we must do something about it,” Miller told the panel.

Otieno, a 28-year-old man with a history of mental health issues, died on March 6, 2023, after being transported from the Henrico County Jail to Central State Hospital. The dLCV confirmed that the use of the prone position – a technique in which a person is restrained face down – by sheriff’s officers and hospital staff was a key factor in Otieno’s death.

“The prone position that led to his death is banned in our state facilities, and yet at Central State Hospital he was laid face down, people piled on top of him, and that’s what killed him. So we really need to think about how to eliminate the prone position,” Miller said.

Ten Henrico County deputies and hospital staff were initially invoiced with second-degree murder in Otieno’s death, which was captured on video. But prosecutors later asked a Dinwiddie Circuit Court judge dismissed the charges against seven of the defendants.

The investigation by dLCV, a nonprofit organization recognized by the federal government as a protection and advocacy organization for people with disabilities in Virginia, also found that during his three-day detention at Henrico Regional Jail West, Otieno was held in an emergency restraint chair for hours, possibly days, after a mental health episode, and that the jail failed to provide him with any mental health treatment.

“A restraint chair alone can be very dangerous. You’re basically slumped in that chair, which makes it hard to breathe. The restraints require that someone be restrained only for as long as necessary while they misbehave,” Miller said.

From Otieno’s first encounters with the police and the hospital emergency room to his arrest and transfer to the Central State Hospital, 27-page report describes “a complete breakdown of Virginia’s mental health crisis system, exacerbated by a culture of criminalization of persons with mental illness, particularly from communities of color.”

The system that was supposed to help Otieno had “completely and utterly failed him,” the investigation concluded.

Del. Mark Sickles, Democrat of Fairfax, the committee’s vice chairman, called the report “troubling.”

“We’re trying to work in this area and police are trained in many places,” Sickles said. “Maybe it’s not consistent, I don’t know what happened in Henrico, but they train police every day to deal with people who have serious mental illness and they need the training.”

Sickles stressed that despite the approval of additional funding by the state legislature, Virginia continues to have difficulty filling positions for mental health workers.

“We don’t have professional staff, we’re trying to fund psychiatric assistant positions, there’s a shortage of all these mental health professionals. We would hire them, we have vacancies,” he said.

Sickles also pointed out that the housing shortage is a significant obstacle, noting that many patients stay in hospitals longer than necessary due to a lack of communal housing options.

“They should not get into such situations and we are working on it,” he added.

Del. Rodney Willett, D-Henrico, called Otieno’s death a “tragedy on every level.”

Willett is a sponsor of Bill 1242also called Irvo’s Law, which the General Assembly passed earlier this year. The measure allows family members and caregivers to have access to loved ones in crisis during the emergency room visit unless the family member’s presence would pose a medical or safety risk or the patient objects to their presence.

“Irvo’s mother never had the opportunity to give that information,” Willett said. “It’s such an unfortunate situation, and it’s also unfortunate that it takes these horrific situations for us to take action. But we were already taking action before Irvo’s horrific death, and we will certainly take more.”

This year, lawmakers also supported Governor Glenn Youngkins “The right help, immediately” The initiative represented a major investment in building alternatives to emergency departments to care for patients in mental health crises, among other efforts to address mental health problems in the state.

But Delores McQuinn, Democrat of Richmond, said Virginia’s prisons, police and sheriff departments are still not prepared to deal with situations involving mental disorders.

“I often talk to my sheriffs in Richmond and Henrico County about these issues and they are overwhelmed with individuals who have mental health issues and they really have no idea what to do with them,” McQuinn said.

“We all need to sit down together and find a more comprehensive solution. But I don’t think it will happen quickly. It will take us several more years to reach our goal.”

The timing of the dLCV investigation shows the importance of keeping law enforcement out of psychiatric treatment, said Miller, the group’s executive director. “Everything law enforcement has been taught to do is contrary to what is necessary for psychiatric treatment. They are trained to be intimidating and tough and never to back down.”

“Legislators and advocates should think carefully about how to protect people and help them get the treatment they need,” Miller concluded.

“We have seen various instances throughout history where it was determined that Mr Otieno needed medical and psychiatric care and he was repeatedly denied it.”