Dying in Jail Cells: No Room In State Hospitals For Jailed Prisoners

mitchell(9-30-15) In a comprehensive front page story in today’s edition, The Washington Post describes how a 24 year old black man with mental illness died in jail after waiting three months to be sent to a Virginia state mental hospital.

I published a blog about Jamycheal Mitchell’s death earlier this month based on a story written by Lisa Suhay in the Christian Science Monitor. Post reporter Justin Jouvenal goes beyond that initial story to expose an ongoing national scandal — the warehousing of persons with mental illnesses in local jails because of a lack of psychiatric beds in state hospitals.

Mitchell should never have been jailed. He was accused of stealing $5.05 worth of food from a convenience store. He should have been diverted into community care and treatment. His death is yet another senseless tragedy caused by our neglect in providing adequate mental health services and reforming our criminal justice system with an emphasis on diversion.

Mitchell’s name can be added to an increasing number of preventible tragedies that have happened because we are using our jails and prisons as defacto mental asylums. What the public needs to understand is that even if Mitchell had been sent to a state hospital, the goal of the doctors there would have been to restore him to competency for trial — not necessarily to treat him!

Kudos to the Post and Reporter Jouvenal for continuing to expose flaws in our mental health system here in Virginia and across the nation and to Mira Signer, NAMI’s executive director in Virginia, for speaking out about this travesty.

Man accused of stealing $5 in snacks died in jail as he waited for space at mental hospital

By Justin Jouvenal   The Washington Post 

Jamycheal Mitchell had stopped taking his schizophrenia medication before he walked into a 7-Eleven near his family’s Portsmouth, Va., home in April and allegedly stole a Mountain Dew, a Snickers bar and a Zebra Cake totaling $5.05.

After the 24-year-old’s arrest, a judge ordered him to a state psychiatric hospital to get help. But like an increasing number of the mentally ill, he sat in jail for months as he waited for a bed to open.

Other inmates said Mitchell paced naked in a cell often covered in his own filth. Family members said they were told he sometimes refused to eat or take medication, and jail records show he manically yelled. He grew gaunt, and by Aug. 19 he was dead, having shed at least 36 pounds.

A state medical examiner has yet to report a cause of death, and police are investigating Mitchell’s case, but his family and civil rights and mental health advocates are outraged that he was allowed to waste away over a $5 misdemeanor. Jail officials denied any wrongdoing, saying Mitchell was fed regularly and was seen by a nurse.

Mentally ill inmates are being warehoused for weeks, months and, in rare cases, years in jails around the nation, waiting to go to state mental hospitals where experts determine whether they are well enough to stand trial and treat those who aren’t. Advocates say the delays are leaving vulnerable defendants to languish, sometimes with tragic results.

In recent years, a defendant with mental illness was raped repeatedly at the Los Angeles jail as he waited eight months for treatment, according to a lawsuit. Three former guards at the Santa Clara County jail in California have been charged with murder for allegedly beating to death a mentally ill inmate who was waiting for a treatment bed. A third inmate in Washington state committed suicide during a wait for treatment.

In Virginia, officials said 89 inmates are waiting in jail for court-ordered mental health treatment. The backlog for Eastern State Hospital in Williamsburg, where Mitchell was to go, is averaging 73 days.

Mitchell’s family was shocked when they saw his body at a funeral home.

“I had to ask again: ‘You sure this is my cousin?’ ” said Jenobia Meads. “It looked like he was 67 years old.”

Virginia officials said Mitchell’s wait was partly an unintended consequence of a move to help the mentally ill in the wake of the 2013 stabbing of state Sen. R. Creigh Deeds (D-Bath) by his mentally ill son, who later committed suicide.

Virginia last year made it easier to commit individuals in the midst of a psychological crisis, but that put more people in line for beds at psychiatric hospitals. Those in crisis get priority.

Hampton Roads Regional Jail (HRRJ) officials said Mitchell was treated like other inmates and did not alert staff to any problems.

“Food was delivered to his cell,” said Lt. Col. Eugene Taylor, assistant superintendent at the HRRJ. “He could have flushed meals.” Taylor said the jail could not say for sure that Mitchell was eating, but he also said Mitchell did not complain that he was losing weight.

‘Physically broken old man’

Sonia Adams, Mitchell’s mother, said her son went by the nickname Weezy. He loved hip-hop artist Lil Boosie and cutting up. “He was always a clown,” Adams said. “He made people laugh.”

But Mitchell also struggled with schizophrenia and bipolar disorder for a decade. Adams said her son had to be hospitalized on a handful of occasions and was unable to hold a job.

Mitchell’s family said he was acting increasingly erratic the week before he showed up at the 7-Eleven and had been off his medication for months. He stole the snacks just after midnight on April 22, according to court records, and was arrested and taken to the Portsmouth jail. His weight was listed as 180 pounds on his arrest warrant. He was around 6 feet tall.

In the days after his arrest, Mitchell waived his right to an attorney and appeared “confused” during an interview, according to court records.

Mitchell’s bond was initially set at $3,000 but was later revoked. The court file doesn’t explain why, but Mitchell’s family members said they were told by court officials it was so he could get help.

Portsmouth General District Court Judge Morton V. Whitlow, who was handling the case, declined to comment.

Court records show that a week later, Whitlow ordered a competency evaluation. Mitchell was also deemed eligible for a diversion program that would have put him in mental health treatment instead of jail, but he was not enrolled because he wanted care in Virginia Beach instead of Portsmouth, according to court records. Mitchell was transferred to the HRRJ on May 11.

Taylor, the jail official, said Mitchell was placed in a unit for inmates with disciplinary or mental health issues, mainly because Mitchell’s psychological state made him a threat to himself and others. Taylor said Mitchell was an “I’m not going to do anything type,” refusing to participate in his care and occasionally becoming combative with staff.

On May 20, a psychologist who evaluated Mitchell wrote that he was manic and psychotic. Mitchell’s “thought processes were so confused” that only snippets of his conversation could be understood, according to the evaluation. Mitchell rapped, twirled around the room and dropped his pants several times.

Whitlow ordered Mitchell to Eastern State Hospital based on the evaluation, but with no beds available, Mitchell remained in jail and spiraled downward.

Roxanne Adams, Mitchell’s aunt, said jail officials told her in May that he was refusing to eat or take his medication.

Family members said they couldn’t visit because Mitchell had not placed them on his list of visitors, probably because he was too impaired. Roxanne Adams said she called the jail approximately 40 times in the coming months, seeking visitation rights and help for her nephew but to little avail. Taylor said he was unaware of the family’s calls and would have to search phone logs to comment further.

Inmates noticed Mitchell’s decline, too.

“I watched a physically healthy young man grow into a physically broken old man in a matter of months,” an inmate on his cellblock wrote in a letter to Mitchell’s family.

‘He looked like a stick’

Justin Dillon, an inmate who delivered food and worked in Mitchell’s cellblock, said his condition had grown alarming by mid-to-late July.

Dillon said he regularly saw Mitchell naked and muttering to himself. Mitchell smeared his feces on the wall of his cell, Dillon said, and one of the inmate’s legs had swelled “elephant like.”

Dillon said Mitchell’s clothing and bedding had been removed because he tried to flush them down the toilet. Jail officials confirmed that Mitchell flushed his clothes but said Mitchell was given a smock to wear.

“He was all skin and bones,” Dillon said. “He looked like a stick.”

Dillon said Mitchell would sometimes eat ravenously, but jail staff also withheld food on occasions because he failed to return his tray after meals — an allegation the jail strongly denied.

Dominique Vaughan, another inmate on Mitchell’s block, wrote in a letter to Mitchell’s family that Mitchell regularly asked for extra food, but most staff would ignore the requests.

Taylor acknowledged that Mitchell soiled his cell and deteriorated during his stay — as do many mentally ill prisoners — but said the jail provided the best care that it could. The jail has a staff of four people who specialize in mental health care for roughly 370 inmates with psychological problems.

“It is quite a challenge at times with the mentally ill,” Taylor said. “Our jail has become a de facto mental health facility in lieu of beds being available in the state.”

Mitchell was taken to the hospital for treatment on July 30, Taylor said. Medical records show he was suffering from edema in both legs and conditions that may have been indicative of liver problems. The hospital listed his weight as 145 pounds.

At a July 31 hearing, Whitlow reiterated his order to transfer Mitchell to Eastern State Hospital, according to court records. Mitchell’s family members said they were disturbed when they saw him in the courtroom — he appeared rail-thin.

A couple of days after the hearing, Roxanne Adams said, she called the jail demanding that Mitchell be taken to the emergency room.

On Aug. 16, Dillon said, he saw Mitchell for the last time. Dillon said Mitchell told him he was sick, but he never stirred from his bed. Dillon said he warned staff members about Mitchell’s condition, but they told him Mitchell was okay. The jail said it has no reports that staff members were warned about Mitchell’s condition.

After Mitchell died, Vaughan wrote that on Aug. 18 he had seen Mitchell slumped over the sink in his cell with his legs sticking out. Vaughan wrote that Mitchell told him: “Get help, I can’t move.”

Mitchell said his legs and body hurt from the way he was dragged to his cell, according to Vaughan’s letter. Mitchell didn’t specify who dragged him or when the incident occurred.

The inmate wrote that he asked jail employees to call for medical help, but they never did. Mitchell didn’t get out of bed that afternoon, grab his dinner tray or answer Vaughan’s calls.

Mitchell was found dead in his cell at 5:44 a.m. the next day. Taylor said there were no signs of foul play.

Mark Krudys, an attorney for Mitchell’s family, said Mitchell’s cell was soaked with urine. Krudys said Mitchell weighed 144 pounds during a post-death examination, about 36 pounds less than when he was arrested.

The attorney said the Hampton Roads Regional Jail had a responsibility to do more to help Mitchell.

“HRRJ cannot be a mere observer to the continuing decompensation and health decline of its mentally ill population,” Krudys wrote in a statement. “What HRRJ cannot do is to do nothing.”

Mitchell’s family said they learned after Mitchell’s death that help had been only days away. They said the jail told them a space had finally opened up at Eastern State and Mitchell would have been transferred at the end of August.

The ‘new asylums’

The number of inmates waiting to be restored to competency like Mitchell is growing. A 2014 survey by the National Association of State Mental Health Program Directors found that 31 of 40 states had waiting lists. The average was 30 days, but three states reported waits of six months to a year.

Half of the states surveyed said they had been threatened with or found in contempt of court for failing to admit patients in a timely manner. Mira Signer, executive director of the National Alliance on Mental Illness in Virginia, said any wait can be dangerous.

“A lot can happen in those 2.5 months,” Signer said of waits like Mitchell’s. “A jail is not a place to be locked out of mental health treatment.”

The increase in wait times is playing out amid an explosion in mentally ill inmates nationwide. The Treatment Advocacy Center calculates there are 10 times as many mentally ill people in jails and prisons as there are in state mental hospitals. They have dubbed jails and prisons the “new asylums.”

Roughly a quarter of inmates in Virginia, or 6,800 prisoners, suffered from mental health issues in 2014, a 39 percent increase since 2008, according to state figures. Jails and prisons are often ill equipped to handle those who are sick.

A 2014 audit by Virginia’s Office of the Inspector General found that treatment with medication in jails was “fragmented and inconsistent” and that jails lacked the capacity to meet the mental health needs of inmates.

Signer said the increase in mentally ill people in jails and prisons has to do with a decades-long decline in psychiatric hospital beds. She said there has been a well-meaning push to treat the mentally ill in community-based care but that new services have not come online as quickly as mental hospitals have downsized.

Jack Barber, interim commissioner for Virginia’s Department of Behavioral Health and Developmental Services, wrote in a statement that privacy laws prohibit him from discussing any specific patient. But he said the agency is “working with system partners to ensure that those on the forensic waiting list are admitted to our hospitals promptly and that those in need of emergency services are identified, triaged and prioritized.”

At Eastern State, the number of people admitted has more than doubled year-over-year, from 304 to 628, since the new laws sparked by the Deeds family tragedy went into effect. Overall, admittances at state mental hospitals have risen 19 percent this year.

Sonia Adams said the family wanted to speak out about her son’s case, so that it doesn’t happen to another inmate. She said her son was conscientious about his grooming and dress. He often got a haircut twice a week and wore the latest sneakers and fashion. She said the family decided Mitchell would be cremated because she felt he would not want his body to be seen in its condition.

“My son died by himself,” Sonia Adams said. “That’s the thing that gets me the most.”


About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.