Death in Pima County jail shows correctional system’s mental health limitations

Lots of people in the mental health world will tell you that, in this country, jail has become the default psychiatric ward. Pima County’s Restoration to Competency program was meant to break that cycle — and prepare people with mental illness to face trial.

But criminal justice and health care experts are sounding the alarm about the program arguing it’s keeping people with mental illness in jail and not in treatment and it’s putting overwhelmed jail staff in the dangerous position of trying to manage people who don’t understand the criminal justice system.

John Washington is a reporter for Arizona Luminaria in Tucson.

Full conversation

JOHN WASHINGTON: Yeah, so the situation is very complicated, but basically anyone who is facing criminal prosecution needs to be able to understand the court proceedings and even assist in their own defense for trial to proceed. And if there’s a question whether they are competent enough to do that, they can be entered into these programs.

Many other localities throughout the country have set up a restoration to competency program, which assesses whether or not they have achieved a basic level of competency to proceed. Meanwhile, they receive some education. And in the jail, because there is some mental health treatment available, very basic, they’re also receiving that.

So a lot of people say, “Well, it kind of seems like they’re basically in a mental hospital” — and yet they’re very much not. They’re in a carceral setting. And most of the people who they actually have engagement with are not trained to deal with mental health issues, are not trained to do any sort of evaluation.

And that sort of disconnect puts people in many cases in harm’s way or eventually keeps them in jail for longer, actually.

GILGER: Right, right. OK. So let’s talk about a case that you highlight in the story, the case of Stacey Brooks. First of all, just tell us about him, how he ended up in this program.

WASHINGTON: Well, Stacey had been in and out of jail a couple times. They were for relatively minor offenses. He was accused in this last case of assaulting an officer with a metal water bottle. And he started going through the system.

His attorney thought that he was maybe not competent enough to stand trial. And so he’s entered into this program. He was also on court-ordered medication, in which the court makes people actually give him basic medication that he needs hopefully to improve his situation. And he was refusing those meds.

And that is not an uncommon scenario. And yet the people who were administering those meds or helping to administer those meds, again, weren’t really trained to do so. They were trained to respond to crisis or keep people locked up.

So what we saw was when he refused, they came in and they tased him multiple times. They beat the hell out of him, and then they pinned him down and let a nurse come in and give him an injection.

Bear Guerra

GILGER: Yeah. You obtained body cam footage of that incident. And we’re, we’re going to listen to a little bit of audio from that body camera footage. A warning this be appropriate for all audiences.

[AUDIO FROM BODY CAMERA FOOTAGE PLAYS]

GILGER: John, tell us, what does this example and that footage reveal to you about how this program is functioning for folks?

WASHINGTON: Yeah, it’s a really gruesome video. And you know, I’ve actually obtained another video of Stacey getting beat up in an earlier instance as well. The correctional officers and the sheriff’s department say, “Well, look, he was being combative and resisting.” That is clearly true. I mean that you can see that on the video.

And yet there are ways, experts that I talked to explained that there are clearly ways to deescalate, to take time and to engage with him, to try to convince him to take the medication, which wasn’t really done. There was a 30-second video of somebody trying in very basic and sort of meager fashion to get him to take the medication, and it didn’t happen.

What people say is like this basically follows the hammer-nail dynamic. When you have all of these tools and these people who are trained to clamp down, to resist violently, and when someone has some other sort of need, they don’t have the training to provide anything else but that sort of really intense crackdown that we see in this video.

GILGER: Right. And the sheriff in Pima county has talked about this as well and talked about the impact this program has on his staff. What’s he said?

WASHINGTON: Right. Oh, I mean, this presents enormous challenges, unwanted challenges for the sheriff’s department. The sheriff has been very clear that he thinks a lot of the people who are in this program and in other situations where they have mental health crises shouldn’t be in jail.

And yet there just isn’t capacity. Arizona, along with many other states, is at crisis levels of lack of mental health hospital beds. There just aren’t really systems to treat these people. And so we’re relying on the system that is continuing to be flush with money, and that is the jail and the criminal justice system.

GILGER: What does the county have to say about this program and how it’s working? Are they defending it?

WASHINGTON: Well, that’s a little bit complicated. There are many parts. This is one of the things I learned is how really complex the system is. And a lot of the information and a lot of the expertise is rather siloed. So some people have a small window in parts of the program but don’t really understand the whole thing.

And that was a real challenge to report. Some people say their piece of the system is working well. One official told me that it’s working perfectly. And yet we have cases like this where I think anyone would say that it was a huge stretch to call this system perfect right here.

But they also don’t have the money to put in to really try to address this in a more systemic fashion, which is what people who really study this say it needs to happen.

GILGER: Yeah. So last 30 seconds there, John. Give us a sense of what experts say would be better.

WASHINGTON: Well, it’s a slow turnaround of this ship that has been sailing in a certain direction for a long time. You really need to address these underlying crises. There’s mental health, there’s opioid addiction, there’s homelessness. These are all converging and pushing people into the system.

Turning it around is hard, but starting to refund and put more money into objectives that can actually treat these people up front, who can stave this, keep them away from falling down off these sort of critical cliffs in the first place is the only true fix, is what people tell me.