Update (3/6/2021): At the March 4 Jail Oversight Board meeting, Warden Orlando Harper reported to the board about restraint chair use. It was a deviation from what he typically shares at these meetings in response to the board asking for more information on how the jail uses the device following the original PublicSource report below. He said the jail used the restraint chair 18 times in February. He promised that, at the April board meeting, he would provide the March count and include the number of times a person with a mental health condition is placed in the chair. Harper also agreed to show board members the restraint chair forms that are completed each time the chair is used. Jail leadership also provided the board the healthcare queues the board requested following a PublicSource investigation about medical treatment at the facility.

Each time Kimberly Andrews was strapped to a restraint chair, the process was the same. 

Allegheny County Jail staff wheeled the chair up to her cell on the women’s acute mental health unit. They strapped down her arms and legs, fastened her hands and feet. Then they took her to the jail’s intake department, placed a spit hood over her head, and positioned the chair facing the wall, padlocked next to a toilet. “And they leave you there for as long as they want to leave you there,” 21-year-old Andrews remembers.

Andrews estimates she’s been in the restraint chair at least half a dozen times between 2018 and 2020. Once, she was placed in the chair for at least eight hours, according to a court complaint against the jail. Another time, she says she was strapped to the chair naked, save for a stiff green blanket that soon fell down. Unable to pull the blanket up, she was left exposed while staff members and other incarcerated people walked past her cell. “They’re just looking at me naked,” she remembered. “That’s humiliating and devastating and traumatic as fuck.”

Andrews is diagnosed with bipolar disorder, PTSD, anxiety disorder and oppositional defiant disorder and has attempted suicide six times while incarcerated at the jail for misdemeanor charges, according to the complaint. 

According to her, every time she was placed in the chair, it was the result of a mental health crisis. She feels the restraint chair was used as a substitute for adequate mental health services. “That’s mainly all I asked for was to talk. ‘Can I talk to somebody? I have a problem,’” she remembers. “And it always escalated to the chair.” 

Doctors and correctional experts agree that the chair can be a useful tool for keeping people from harming themselves, and the jail’s policy states it is never to be used punitively. Yet according to some former medical employees, people who have been in the chair and three lawsuits against jail officials, the chair is sometimes used as punishment at Allegheny County Jail, with little discretion and without mental health oversight. 

A woman in a black jacket and black face mask with rhinestones leans against a green railing in front of the Allegheny County Jail. A yellow bridge can be seen in the background.
Kimberly Andrews estimates she’s been in the restraint chair at least half a dozen times between 2018 and 2020 at Allegheny County Jail. (Photo by Jay Manning/PublicSource)

According to the interviews and lawsuits, individuals in the chair have had spit hoods pulled over their heads that make it difficult to breathe. They are often denied food or bathroom breaks, sometimes causing them to soil themselves in the chair. Some are pepper-sprayed while in the chair, their skin burning until they are released and decontaminated. Like Andrews, they are sometimes left in the chair with their genitals exposed to passersby. 

The county did not respond to requests for comment. 

Jail reports obtained by PublicSource show the restraint chair is used for a variety of problems, from incarcerated people banging their heads against the wall of their cells to trying to unscrew the lights.

“When they act out, it’s because they have mental health problems. They’re decompensating,” said Chuck Timbers, a seasoned nurse practitioner who says he was terminated from the jail in May 2020 for violating its social media policy. “So what do you do? You strap them to a chair,” he said disapprovingly.

Invented in 1990 as a way to restrain and transport unruly individuals, restraint chairs have been widely used in correctional facilities since then. Studies show they are a safer alternative to four-point restraint, which involves restraining an individual to a bed by both arms and both legs. A 2015 review published in the Journal of Forensic and Legal Medicine found that the restraint chair, when used appropriately, “is a safe and appropriate device for use in restraining violent individuals” and “poses little to no medical risk.” 

Still, the device is controversial. The United Nations Committee Against Torture in 2000 called on the United States to abolish the use of the chairs on people in custody, claiming it “almost invariably” led to breaches of the Convention’s article against Torture and Other Cruel, Inhuman or Degrading Treatment. Amnesty International has been advocating for a federal investigation into their use since 2002.

In 2019, the Allegheny County Jail used the restraint chair 339 times — more than double that of any of the other 66 county correctional facilities in Pennsylvania, according to the Pennsylvania Department of Corrections. Twenty facilities, including those in Philadelphia and Delaware, did not use it at all. 

“The [Philadelphia Department of Corrections] did not use the chair in 2019. Please note, the restraint chair is only used when necessary during transport. It is not utilized at any other time,” spokesperson Shawn Hawes wrote in an email to PublicSource. 

During a one-year span between 2018 and 2019, the Allegheny County Jail was one of three Pennsylvania county jails to report restraining pregnant individuals in the chair, which it did three times. 

Restraint chairs are commonplace in correctional settings and are seen by some correctional experts and medical professionals as useful in violent or dangerous situations. As the slogan of one restraint chair manufacturer goes, the chairs are intended for “keeping people safe humanely.” Several people PublicSource spoke to who have worked at the jail said in the most serious cases — for example, if an individual is banging their head against the wall — the restraint chair is necessary. Others said they oppose the chair and view it as a form of cruel and unusual punishment. 

Michelle Lattimer, who worked as a jail mental health nurse from 2017 until 2020 when she was terminated for falsifying an admission document (an incident she feels was due to the jail’s understaffing), said the restraint chair was sometimes necessary but that corrections officers resorted to it too quickly. “It’s understandable when they’re mental health patients, it’s going to happen,” she said. “But I think it happened a little too frequently for my liking.”

Dr. Peter Hauber, a psychiatrist who worked at the jail between 2016 and 2019 and left once his contract expired, said the restraint chair must be used judiciously and can be abused. But he felt that on the acute mental health units where he worked, it was sometimes not used when it should have been. ”When [individuals are] out of control, and you can’t stop them from disassembling the light and trying to cut themselves and swallow things, I think that’s a time when you do need to use the restraint chair, absolutely,” he said.

In correctional facilities across the country, the chairs have resulted in abuse and, in rare cases, death. The Marshall Project found that the chairs have been linked to 20 deaths in the United States in the past six years. Most of the deaths were from overdose or blood clots from being in the same position for an extended period of time.

Jail Oversight Board member Bethany Hallam said she believes the jail should stop using the restraint chair. “People wouldn’t believe that this restraint chair is being used in 2021 unless they saw it for themselves,” Hallam said.

Fellow board members Terri Klein and President Judge Kim Clark declined to comment on the practice. Board members Abass Kamara and Judge Beth Lazzara did not respond to requests for comment.

A black and white line illustration of a man in a restraint chair.
An excerpted illustration of the restraint chair from the device’s 1990 patent document. The illustration has been modified to remove other images.
An excerpted illustration of the restraint chair from the device’s 1990 patent document. The illustration has been modified to remove other images.

Over the course of her two years at the jail, Andrews developed a coping strategy for the long hours she spent in the chair: she sang. 

“They want you to feel like they violated you, like they got over on you. So how I got through it, I would sing,” Andrews said. She mostly sang gospel songs, such as favorites like “Take Me to the King” by Tamela Mann and “Never Would’ve Made It” by Marvin Sapp. “I would sit in the chair for hours and sing out loud,” she remembered.

Now, four months after being released from the jail, Andrews works full time at a fast food restaurant and spends her free time volunteering for the Alliance for Police Accountability, collecting signatures for a petition to end solitary confinement at the jail, which she has experienced firsthand. She is the plaintiff in a lawsuit against jail administration, alleging that being placed in solitary confinement threatened “her life and health” and that uses of force by jail staff violated her rights. 

While she is no longer incarcerated at the jail, she says she carries her experiences in the chair with her. “It’s always fresh in my head like it was yesterday or today, or like somebody’s about to run up in here right now and strap me down to a chair for hours. And not feed me or let me go to the bathroom.”

The restraint chair policy: lacking in transparency and adherence 

Like most of its records, the jail keeps its restraint chair policy buttoned up. PublicSource sought the policy in September through a public records request but the county redacted the entire policy with black lines, claiming that releasing the information “would be reasonably likely to jeopardize or threaten public safety or preparedness or public protection activity.” 

After PublicSource appealed the response to Pennsylvania’s Office of Open Records, the office found that certain redacted portions of the policy were not exempt from disclosure. Rather than provide those portions, the county appealed the decision to the Court of Common Pleas, where the case is still active. (On Feb. 16, the county dropped its appeal.)

According to the policy, which PublicSource obtained in full elsewhere, the chair is meant to “prevent harm” to both incarcerated people and employees and “will never be used as a form of punishment.” But former medical employees and people who have been in the chair said in practice, it’s often the go-to when someone is experiencing a mental health crisis. 

The 2015 review in the Journal of Forensic and Legal Medicine found that in lawsuits involving a restraint chair, the problems typically arose from “deviations from set protocols” and “rarely involved issues with the chair itself.”

David Sacks, a psychologist with over 23 years of experience in correctional mental health care, said there are appropriate uses of the restraint chair, such as to prevent self-injury or injury to others when other techniques have been ineffective. But in his brief time at the Allegheny County Jail, he said he saw the chair being used punitively, without proper mental health oversight and without trying any other methods of de-escalation first. “People were placed in the restraint chair without appropriate due diligence by mental health staff. Which is cruel and unusual and therefore a type of punishment,” said Sacks, who resigned after three weeks at the jail.

In one case during Sacks’s short stint at the jail, an individual was placed in the jail for being “belligerent and intoxicated,” according to a nurse’s notes on a jail clearance form. When Sacks assessed the person, he found the individual was “floridly psychotic,” his notes read. “He needed to be sent immediately to the mental health unit,” Sacks later told PublicSource. Despite indicating that on the clearance form, Sacks said the person was still in the chair when his shift ended over two hours later.

A screenshot of a portion of a jail clearance form with responses written in cursive.
A screenshot from a clearance form where David Sacks recommended an individual be sent to the acute mental health unit. According to Sacks, the individual was still in the restraint chair over two hours later.

The jail’s policy states that an individual can be in the chair for no longer than eight hours, unless authorized by the warden. Arizona-based psychologist and correctional mental health expert Joel Dvoskin said the best use of the chair is to transport individuals from one area of the jail to another. “Any jail I’ve been in, that shouldn’t take longer than 15 minutes,” he said.

Several people PublicSource spoke with said they were placed in the chair for eight hours or more, a claim which two lawsuits also allege. “Anybody who puts somebody in there for that length of time should themselves sit in it for that length of time, and then I doubt they would do it again,” Dvoskin said.

Kasi Kovach, a nurse who worked at the jail between August 2019 and January 2020, said people sometimes spent “hours, hours, hours” in the chair. “It’s not a safe practice for anyone,” she said. Kovach was terminated for allegedly attempting to give an individual medication without a guard present, an accusation she denies.

Timbers also described prolonged use of the chair. “Sometimes inmates would urinate on themselves because they’re in the chair so long,” he said.

Hallam of the Jail Oversight Board, who was formerly incarcerated at the jail and has seen the restraint chair used, called the chair “barbaric” and “dehumanizing.” During the board’s September meeting, she asked Warden Orlando Harper to provide the board the jail’s policies in full and post redacted versions of the policies online for the public. Harper denied both requests, claiming that to do so would “jeopardize the safety and security” of the jail.

“Maybe if the jail were willing to provide their policies and procedures to members of the Jail Oversight Board, we could have a better understanding of their excuses for using the restraint chair so we could end that practice immediately,” Hallam later told PublicSource. “But the jail has been anything but transparent.”

The chair as a substitute for mental health services

James Byrd has been strapped to a restraint chair more times than he can count. One time, it was because he was having a panic attack and asked to speak to a mental health provider four times, according to a lawsuit against the jail. Another time, he was put in the restraint chair after having a panic attack and losing consciousness, the lawsuit alleges.

In the best cases, Byrd remembers being released and taken back to his cell after six hours. In the worst case, he says he’s spent up to 26 hours in the chair, his genitals exposed, with no food, water or bathroom breaks. 

 “A lot of times, what’s going through my head is, ‘This is a hopeless situation. This is ridiculous. This is torture,’” said Byrd, who has been incarcerated since 2015 and suffers from anxiety, depression, bipolar disorder and PTSD, according to a lawsuit. His charges include aggravated assault, terroristic threats, rape and stalking.

Byrd is one of five plaintiffs in an ongoing lawsuit against the jail for alleged mistreatment of incarcerated people with psychiatric disabilities. According to the federal class-action lawsuit, which was filed in September by Schnader Harrison Segal & Lewis, the Pennsylvania Institutional Law Project and the Abolitionist Law Center, individuals with psychiatric disabilities are placed in the restraint chair for “nearly any issue,” including as a substitute for mental health care. The chair, the complaint alleges, is often used in tandem with chemical irritants, tasers, forced nudity and physical force.

In 2019, the Allegheny County Jail had the sixth-highest per capita rate of restraint chair use in Pennsylvania, according to Pennsylvania Department of Corrections data. The jail was behind McKean, Crawford, Lawrence, Bucks and Northumberland counties, all of which used the chair fewer times than Allegheny County but also housed significantly fewer people. The jail ranked eighth in the state for its overall use-of-force rate, which includes handcuffs, stun devices, chemical agents and other restraints. Philadelphia correctional facilities used other types of force, such as handcuffs, chemical agents and other restraints, but at lower rates than Allegheny County Jail. 

Records indicate the chair has been used at Allegheny County Jail as the solution to an array of problems, ranging from resisting officers to refusing to leave a police car. In some cases, the individuals were on the acute mental health unit or told jail staff they were suicidal.

“[Individual] stated he wanted to die and for Sgt. Greenawalt to ‘kill him,’” read one misconduct report from Nov. 5, 2020. After being placed in a suicide gown and handcuffs, the person called the corrections officer a derogatory name, began resisting officers and tried hitting his head against the wall. Officers attempted to secure the individual in a restraint chair, but he resisted. An officer stunned him with a stun gun in the shoulder. “The restraints were secured and [individual] was secured in cell H-9,” the report reads. 

On the same day, another individual was placed in the chair after arriving at the jail and refusing to leave the police car. When she resisted the restraints, she was also stunned with a stun gun, according to the report.

A screenshot of a jail misconduct report where one individual was placed in the restraint chair.
A screenshot of a jail misconduct report detailing an incident where one individual was placed in the restraint chair.

People who have been restrained almost always feel negatively about the experience, a review by Maine Medical Center in 2010 found. Some reported feeling “retraumatized,” having “the sensation of a broken spirit” and felt the restraint process was unethical. Research shows most nurses have more mixed feelings about using restraints, disliking them but believing they are necessary in instances of violence. 

Having better mental health treatment at the jail could prevent the need for the restraint chair, Lattimer said. ”We had some really awful stuff happen. But there’s something going on in their head to make them think that, ‘This is what I need to do to get attention,’” she said. “That’s the part that needs to be addressed, not, ‘Let’s throw them in a restraint chair.’”

Hallam of the Jail Oversight Board agreed. “Folks are placed in solitary confinement, placed in a restraint chair … as opposed to being given adequate health care,” she said.

Andrews said she hopes one day, the jail will be able to provide acceptable medical and mental health treatment to the individuals in its custody. “If they can’t provide that, then they need to start putting people with mental health issues in a different facility,” she said. “Because Allegheny County [Jail] is not the place.”

This story was updated with information about a county lawsuit on Feb. 17, 2021.

Juliette Rihl is a reporter for PublicSource. She can be reached at juliette@publicsource.org or on Twitter @JulietteRihl.

This story was fact-checked by Matt Maielli.

Mental health reporting has been made possible with funding by the Staunton Farm Foundation, but news decisions are made independently by PublicSource and not on the basis of donor support.

We don't have paywalls — but your support helps us bridge crucial information gaps.

Readers tell us they can't find the information they get from our reporting anywhere else, and we're glad to provide this important service for our community. We work hard to produce accurate, timely, impactful journalism without paywalls that keeps our region informed and moving forward.

However, only about .1% of the people who read our stories contribute to our work financially. Our newsroom depends on the generosity of readers like yourself to make our high-quality local journalism possible, and the costs of the resources it takes to produce it have been rising, so each member means a lot to us.

Your donation to our nonprofit newsroom helps ensure everyone in Allegheny County can stay up-to-date about decisions and events that affect them. Please make your gift of support now.

Juliette Rihl reports on criminal justice, public safety and mental health for PublicSource. Her 2020 series on how court debt impacts low-income Allegheny County residents prompted the county to join...