Sam Rice was always certain of one thing: Police officers were out to kill him.

“I would say, ‘Sam, stop talking like that, you know that’s not going to happen,’” says Susan Adame, a behavioral support specialist with SL Start, an organization that helps people who have developmental disabilities to live independently. Adame worked closely with Rice, a diagnosed paranoid schizophrenic, in 2018.

“But,” she recalls, “he’d always say, ‘No, I’m serious. The government wants to get rid of me and the police will be the ones that take me out.’”

On October 10, 2018, Rice opened a bathroom window in an East Portland motel room that he was sharing with his girlfriend, Talon, who asked the Mercury to only use her first name. From the other room, Talon, who has a developmental disability, heard a loud pop pop. Rice, 30, fell to the room’s tiled floor with a single bullet hole in his head. He had been fatally shot by a Portland police officer outside the motel, who, informed by witnesses’ accounts of an erratic, knife-carrying man, falsely believed Rice was holding Talon hostage.

Because his disease made Rice believe his diagnosis was fictional—a narrative cooked up by a scheming government—Rice refused to take medication or accept mental health treatment. Those who knew him in the year leading up to his death say he was often in a state of psychosis, exacerbated by his use of methamphetamines. Rice’s frequent outbursts and paranoia-induced rage made him a regular on the Portland Police Bureau’s call log; by the time officers surrounded the Del Rancho Motel in October, they had interacted with the tall, 230-pound man on multiple occasions.

In 2012, after a spate of controversial police shootings, a US Department of Justice (DOJ) investigation into the Portland Police Bureau (PPB) found that Portland police officers had a “pattern or practice” of using excessive and unnecessary force against people with mental illness. As a result, the DOJ sued the City of Portland, prompting the city to draft a settlement agreement that detailed a plan to quickly improve officers’ responses.

Seven years later, Portland is still struggling to improve police interactions with mentally ill Portlanders. In the past year, three of the four people fatally shot by PPB officers—including Rice—were in the midst of apparent mental health crises.

Rice’s story is just one example of how police engage with Portlanders who have severe mental illnesses. But Rice’s repeated encounters with police highlight the problems—and the potential—at the intersection of mental health care and criminal justice.

Rice’s first recorded interaction with Portland police was in 2010, when he was arrested on unknown criminal mischief charges that were later dismissed. In 2011, he was arrested for scratching several cars with a pocketknife in a Gresham neighborhood; at the time, he told the arresting officer he had been “training for the Marines for 12 years.” Rice was never in the military.

Several months later, Rice’s neighbor asked him to turn down the volume on music coming from inside Rice’s Gresham apartment. Rice responded by cutting his neighbor with a knife and running off. He was arrested for attempted assault. In his jail intake form, a physician writes that Rice was “talking erratically... about having 100 kids.” The doctor’s diagnosis: “Depression.” In an affidavit penned before Rice’s trial, a Multnomah County prosecutor noted, “It appeared to [the officer] that the defendant was mentally unstable.”

“The police definitely knew who he was. They had the opportunity to help him, and they didn’t.”

Rice’s criminal record doesn’t include the handful of times officers tracked him down after receiving calls related to manic behavior but chose not to arrest him.

“The police definitely knew who he was,” says Adame, who Rice often texted when the police showed up. “They had the opportunity to help him, and they didn’t.”

According to police accounts, PPB officers had repeatedly offered to connect Rice with PPB’s Behavioral Health Unit (BHU). Officers working for the BHU, which was created in response to the DOJ settlement agreement, partner with mental health providers to routinely check in with people in the community whom the police regularly receive calls about—usually for issues related to their mental illness. BHU officers try to keep people out of the criminal justice system by connecting them with mental health services.

But since Rice did not believe he was ill, he refused the officers’ referrals. While BHU was aware he had untreated mental health needs, and while they had the resources to get Rice the health care he needed, they couldn’t force Rice to do anything.

After his second arrest, a judge sentenced Rice to 90 days in prison and three years’ probation, which included mandatory mental health treatment and medication. But once Rice was no longer required to take medication, he stopped.

It’s not uncommon for such requirements to prove difficult, or impossible, to enforce. Mental health experts say tasking police officers—figures synonymous with criminal punishment—with convincing someone to accept help doesn’t make much sense.

“It’s an unrealistic expectation for law enforcement to get people into treatment,” says Chris Bouneff, executive director of Oregon’s National Alliance on Mental Illness (NAMI) branch.

That’s one of the reasons that local officials, including Mayor Ted Wheeler, have begun discussing the creation of a center open 24-7 where officers can drop off people they’ve encountered who might need mental health care. Berk Nelson, Wheeler’s senior advisor, calls it a “triage center”—a place to meet people “where they’re at.” Unlike Unity Center, the city’s emergency hospital for people in the midst of mental health crises, this drop-off space would be more of a navigation center for people seeking resources for mental health treatment.

Sarah Radcliffe, an attorney with Disability Rights Oregon, believes such a program could fill a critical gap—but only if it’s effectively administered.

“It needs to be peer-led by people with lived experiences [of mental illness] to feel like a safe place for people legitimately fearful of hospitals or law enforcement,” Radcliffe says.

Currently, Radcliffe adds, when police officers encounter someone with a mental illness who appears to need help, they often only have two options: Take them to a hospital or jail. “I think if police are committed to diverting people with mental illness from the criminal justice system,” she says, “this could solve a lot of problems.”

The closest Rice got to getting help was last summer, after he threw a cinder block at Ken Hanson’s head.

Hanson, the operations director for SL Start, was with a coworker dropping off a new mattress at Rice’s apartment on August 3 when Rice unexpectedly began shouting at him, claiming he was conspiring against him. Rice picked up and threw a nearby cinder block at Hanson. Hanson dodged, and the block smashed through his car window. From a car parked behind Hanson’s, his terrified coworker called 911.

When Rice was picked up by police, officers took him to a hospital’s psychiatric ward, where a doctor placed Rice under involuntary custody—a decision a physician can make if they believe someone’s mental health puts them at immediate risk to themselves or others. It’s often the only instance when a doctor can require someone to take medication to treat mental illness, and it’s the first step toward committing someone in a state psychiatric hospital.

“We were so hopeful,” says Hanson of the intervention. Rice’s family and Talon had also tried to convince Rice to take medication in the past, with no luck.

But the hospital released Rice within a few days, after Rice told his doctor he was just coming down from a meth high.

“It was so frustrating,” says Hanson. “He had been diagnosed as a paranoid schizophrenic, but the doctor didn’t have access to that information. So they let him go.”

It’s equally frustrating for those tasked with choosing to commit a patient to mental health care. Psychiatric doctors are paired with county mental health experts and are only given a five-day window to diagnose a patient before they must prove to a judge why a person should be committed—otherwise, they’re required to release the patient. With such a short timeframe, doctors and state investigators can miss clues that signal serious mental illness.

“Oregon views civil commitment as a removal of your civil rights, and they clearly and understandably take that seriously,” says Bill Osborne, who has worked for Multnomah County’s involuntary commitment program for years. “But the burden of proof is so high, it sometimes keeps people from receiving the treatment they need.”

In Oregon, a judge can only approve a commitment case if county investigators can prove a patient is at imminent risk of dying, either by suicide or by lacking the mental capacity to care for themselves. This can be an impossible task; Osborne says his investigators end up only taking about 8 percent of all patients placed on involuntary hold before a judge. The rest are allowed to leave the hospital.

It’s not unusual for people to be placed under involuntary custody, analyzed, and then released again and again—never deemed ill enough to be committed, and never connected to mental health services.

Osborne says this cycle is “hard to watch.”

Oregon’s state legislature may be able to help. Senator Floyd Prozanski is currently drafting a bill for the 2019 legislature that would expand the number of days a state investigator has to analyze someone in involuntary custody.

Rice’s final arrest was last August, when he was accused of damaging bank property on Southeast Powell. After Rice failed to appear for a related court hearing, a judge sent out a warrant for his arrest. Around the same time, Rice moved into Room 106 at the Del Rancho Motel. Rice and Talon had recently been evicted for having the police called to their apartment too frequently, according to Hanson.

Officers were called to the 82nd Avenue motel after a 7-Eleven employee called 911, claiming Rice had threatened another customer with a knife. Talon, who was with Rice at the convenience store across the street from the Del Rancho, says she and Rice headed back to their motel room when the employee called the police. At least one person who saw Rice and Talon enter the room was under the impression that Talon had been brought there against her will, telling officers as much when they arrived at the scene.

In police reports, officers said Rice yelled at them from behind the door of Room 16 that if they came inside, “she will die.”

Talon told the Mercury that Rice also believed the police wanted to kill her—and considered it his job to protect her. “I always felt safe with Sam,” she said. “He never tried to hurt me.”

But in the eyes of PPB, this was a hostage scenario. Snipers trained in active shooter and hostage situations surrounded the motel. When Rice opened a bathroom window, PPB Officer Kelly VanBlokland fired one shot, striking Rice in the head.

Talon’s recollection of the morning doesn’t align with the scant information PPB officers have made public about Rice’s death. Talon says that, until Rice was shot, she was oblivious to the fact that there were police outside the motel. She remembers taking a shower that morning, getting dressed in the bedroom, and hearing Rice complain that her shower had fogged up the mirror. Then he opened the bathroom window.

There are many ways Rice’s story could have ended.

En route to the Del Rancho Motel, officers contacted Project Respond, a team of 20 mental health clinicians with Cascadia Behavioral Health. PPB often calls Project Respond to assist in situations that involve someone who might be having a mental health crisis, with the aim of connecting them to community resources. Officers regularly show up at a scene and wait for Project Respond to arrive before engaging with a person in crisis. In Rice’s case, however, officers didn’t wait to shoot a man they believed was homicidal.

According to SL Start’s Hanson, who picked Talon up after the shooting, Rice was dead by the time Project Respond staff arrived at the motel.

That disconnect is part of why City Commissioner Jo Ann Hardesty has prioritized an overhaul to Portland’s 911 call center in her first year in office.

“There’s a role for police in our community, but that’s not addressing people with mental health issues.”

Hardesty, the newest commissioner in charge of Portland’s Bureau of Emergency Communications, wants to rework the city’s 911 call center to reroute any calls related to a mental health crisis to a clinician like those with Project Respond. Instead of treating someone in crisis like a criminal, these responders would treat them like a patient in an emergency room.

“We have to step back and realize that our emergency response system includes much more than police officers,” Hardesty says. “There’s a role for police in our community, but that’s not addressing people with mental health issues.”

A failed police intervention with a mentally ill person also fails those left behind. Following Rice’s death, Talon, who has since moved into her own apartment, has been hesitant to return to her job. Her experience testifying in the grand jury trial against VanBlokland was frightening, she says, especially since it meant sitting in a room with the officers involved in Rice’s death.

“She said she doesn’t want to talk about it anymore. She said nobody cares,” says ST Starts’ Adame, who tries to check in with Talon on a daily basis. “To be honest, I have a hard time changing her mind.”

Asked if she was surprised that VanBlokland was cleared of any criminal charges, Talon answers bluntly: “No.”