San Luis Obispo County Sheriff Ian Parkinson on Tuesday said the county bears some responsibility in the death of a mentally ill man who died after being strapped to a chair for two days in the County Jail.
He said he’s since implemented changes that would have prevented the death.
In one of his few public statements on recent deaths at the jail since April, Parkinson spoke before the County Board of Supervisors about increased medical and mental health needs at the County Jail and changes being implemented to streamline treatment.
“We absolutely have responsibility in the loss of Andrew Holland,” Parkinson said, acknowledging that errors were made between Sheriff’s custody staff and employees of the County Health Agency and that Holland’s death exposed the need for changes.
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“We should have recognized the need for our policy to limit the time an inmate is placed in restraints,” he said. “We should have looked at forcing alternatives, and we did not.”
As a result of the discussion, the board approved a motion by Supervisor Debbie Arnold to have staff identify private companies that could provide medical and mental health services at the jail.
There was insufficient and incomplete communication between the parties involved.
San Luis Obispo County Health Agency director Jeff Hamm
Holland died Jan. 22 of an embolism that began as a blood clot after spending 46 hours in a restraint chair. A judge had ordered Holland be transferred from the jail to the county’s 16-bed in-patient Psychiatric Health Facility (PHF) 12 days before his death, but he was denied a bed despite at least one being available.
The county paid a $5 million settlement to Holland’s family last month.
County officials said Tuesday Holland’s death also exposed a lack of coordination between jail custody staff and county health staff.
“There was insufficient and incomplete communication between the parties involved,” County Health Agency Director Jeff Hamm told the board. “It wouldn’t happen today the way it happened then.”
Since 2012, 11 inmates have died in County Jail custody, and the FBI has confirmed it began an investigation into Holland’s death and alleged civil rights violations at the jail in May. That investigation was ongoing as of Monday, according to an FBI spokeswoman.
Both Parkinson and Hamm said a number of changes have already been implemented at the jail, including:
▪ Restricting amount of time inmates are held in safety cells to 72 hours
▪ Banning the use of restraint chairs
▪ Partnering with the County of Bakersfield and other neighboring agencies to house low-risk patients from the PHF to ensure high-risk County Jail inmates experiencing mental health crisis will have room at the facility
▪ Standardizing protocols to request an involuntary mental health hold that would allow officials to administer anti-psychotic medications
▪ Increasing observation of medically and mentally ill inmates, including daily medical visits to inmates in safety cells
▪ Increasing training for correctional deputies and medical and mental health staff at the jail, including crisis intervention training
The county also formed a mental health task force, an ad hoc oversight committee made up of county staff and representatives from local nonprofits and community organizations.
The county maintains that Holland’s death was the tragic consequence of a series of systematic failures at a time when county jails across the state are overwhelmed with inmates with medical and mental health needs.
About 40 percent of local jail inmates have been diagnosed with some sort of mental illness, a county staff report states, higher than the 30 percent of state prison inmates receiving some sort of mental health treatment.
This was not a systemic problem. You have a problem with staff — you have a human problem.
Tave Holland, cousin of Andrew Holland
More than two dozen people spoke at Tuesday’s meeting, about half of them voicing support for Parkinson, who has received calls for his resignation from the community, including from Holland’s family.
Jeff McKee, whose family member was killed by a schizophrenic man in Santa Margarita in 2010, said he knows what it’s like to lose a family member to mental illness and said he supports Parkinson.
“Instead of blame after the fact, we need to know what there is to learn from this,” McKee said.
Other speakers, however — including 10 members of the Holland family — said the county continues to cover up what led to Holland’s death by not disciplining any employees and refusing to release jail surveillance video that reportedly captured the 46 hours he was strapped to the chair.
Tave Holland, Andrew’s cousin, said the video shows correctional deputies laughed at Holland and failed to help him as he lay dying.
“Andrew was killed; his death was needless. This was not bad policy. This was not a systemic problem. You have a problem with staff — you have a human problem,” Tave Holland said. “What policy is addressing that?”