The Austin Chronicle

https://www.austinchronicle.com/news/2022-04-01/austin-mans-suicide-in-jail-after-seeking-medical-care-raises-question-why-was-he-there/

Austin Man’s Suicide in Jail After Seeking Medical Care Raises Question: Why Was He There?

Suffering from criminal depression

By Brant Bingamon, April 1, 2022, News

If he had any remaining doubt that JJ needed hospital care, it surely evaporated as Mark Bell chased his brother down the I-35 access road on the evening of Feb. 7. Bell had been driving JJ to the Sobering Center on 12th and Sabine when his brother jumped from the car at a stoplight.

By then, Mark had spent eight hours trying to talk JJ down from a psychotic break. "I showed up to help and he was just out of his mind," Bell said. "He didn't know what was happening in the world. He kept asking me, 'What are we doing? What are we doing here?' He would ask me the same question a hundred times in a row."

Jared JJ "Joker" Bell, a widely loved figure in Austin's EDM scene, would have turned 33 in March. He was an artist and a musician with a gregarious personality who made friends instantaneously. But JJ also had a history of mental illness and drug use, so when Mark drove in from his home in Burnet to check on his brother, he wasn't completely surprised at his condition. As JJ cycled in and out of lucidity, Mark called different rehab facilities. Finally, he decided to try the Sobering Center, and after chasing his brother through Downtown for an hour, he got him there.

"The Sobering Center straight up tells me, 'We won't take him. We only work off of recommendations.'" Bell said. "I was like, 'So what do I got to do?' They said, 'Either the cops got to recommend him here or the hospital does.' So I went and took him to the hospital. And, you know, he was calm the entire time we were in the hospital. He was scared, like a child. He was very timid, but he was fine."

Bell checked his brother into the Dell Seton Medical Center. Before he left he spoke with a nurse. "I said, 'Look, my brother is a schizophrenic. And he is a drug addict.' I said, 'He's been out of touch with reality, probably for a few days now. And he's suicidal. You need to keep him here. You need to detox him. Sedate him, restrain him. Do not let him out of here until he is sober though.' And the nurse said, 'I'll take care of your brother.' I said, 'If you let him go, if he leaves this hospital, you need to let me know immediately. So I can be there.'"

The next morning, Bell received a call from the Travis County Sheriff's Office. He was working in Bastrop and didn't pick up but assumed that his brother had wound up at the jail. And it was true: Dell Seton had called the police, perhaps when they learned that JJ had seven warrants out for his arrest. Bell missed two more calls that day as he worked in an area with poor cell service. The next day, on Feb. 9, he got another call from the sheriff that went through. "And they go, 'Well, we didn't want to tell you this over the phone, but your brother died in custody. We found your brother unresponsive. He killed himself.'

"And I was like, 'How? I left him in the hospital and then he was in jail. Was he on suicide watch?' And they were like, 'We don't have any details at this time.' And I ended up getting information within the week that my brother was in the hospital and apparently they ran his record or whatever, his name, saw he had warrants, and transferred him to jail without helping him. They just sent him to jail instead, while he was in a freaking suicidal drug psychosis. And my brother was out of his mind in there and scared and they said that they found him with his back against the wall, slumped down, with a telephone cord wrapped around his neck."

The Jail

The death in custody report from the Travis County Sheriff's Office states that Jared Bell was admitted to the Downtown jail – as opposed to the larger one in Del Valle – on Feb. 7 at 11:27pm. During booking, he reportedly expressed suicidal ideation and was put on a suicide watch, with deputies visually checking on him every 30 minutes. On the morning of Feb. 9, he asked to make a phone call and was placed in an empty dayroom with a corded telephone at 9:19. An hour later, the corrections officer who had placed him there discovered Bell with the phone cord around his neck. Officers immediately began CPR; paramedics continued it when they arrived. Bell was pronounced dead at 11:07am, 36 hours after entering the jail.

In the last decade, suicide has become the leading cause of death in county jails, which, it's important to note, are different from state prisons: Prisons house inmates who are serving sentences for more serious offenses. County jails mostly contain inmates who have not yet been convicted of anything. Bell's suicide is the fourth in Travis County's jails in the last year. On April 30, 2021, Nicholas Vanwhye killed himself in his cell. On July 11, Alexander McFarland was found asphyxiated. And on Nov. 14, Adan Torres hung himself, was resuscitated, but died days later. Each of these men had coiled a bedsheet into a rope.

TCSO spokesperson Kristen Dark stresses that Travis County is not necessarily part of the rising trend of jail suicides. She told us there were four suicides in 2021. In 2020, the jail had none; in 2019, it had two. Meanwhile, from 2018 to 2020, deputies stopped 92 suicide attempts.

"I'm so proud of the men and women I work with here because the vast majority of people who attempt suicide in our jail [survive], thanks to their efforts," Dark said. "We have special housing for people who are suicide risks and their risk is assessed by our counseling and medical team. For some of our inmates, they do visual checks every 30 minutes. Other inmates, it's every 15 minutes. More frequent checks could be due to mental illness, suicide risk, special medical conditions, physical illness, violent behavior, etc. We refer to those as Closed Visuals. It means that inmates are being monitored more frequently than the 30 minute intervals required by the Texas Commission on Jail Standards."*

Attorney Dean Malone, who specializes in bringing civil lawsuits on behalf of families of inmates who kill themselves in jail, said that 30-minute checks, or even 15-minute checks, aren't enough. "It is insufficient to put suicidal people on anything other than a constant or continuous watch," Malone said. "Why is that? Because it literally takes about three minutes, through use of a ligature, to kill yourself. People in cells will use grab bars – in holding cells, they have grab bars by the toilet. They will tie off jail clothing and, literally, all they have to do is lean into the ligature.

"The jails say, 'Hey, we're complying with Texas Commission on Jail Standards requirements and we're seeing these people once every 30 minutes.' Well, somebody can be dead for 25, 27 minutes before a check occurs."

The death in custody report doesn't state whether the officer who placed Bell in the dayroom on Feb. 9 made a visual check between the time he was left alone in the room – 9:19am – and the time he was discovered dead – 10:13am. And Dark said she can't comment on the case in detail, for a variety of reasons, including the rules in the Health Insurance Portability and Account­abil­ity Act.

"I'm not able to speak on the specifics of many, if not all, of our suicide cases because of the fact that I can't reveal HIPAA information," Dark said. "So much of what happens in those situations involves the health and the medical conditions of our inmates. I can't go there, that's private information. I can't give criminal history and I can't talk about anything related to their medical condition. I can't talk about why they were in the hospital or why they were released. And I can't talk about what medical care they received or what the medical team knew, when they're in our custody."

The Hospital

Okay then, what can the hospital tell us about JJ Bell's brief stay at Dell Seton on the evening of Feb. 7? Why did hospital staff call the police on Bell rather than treating him?

The Chronicle tried to get in touch with media reps at Dell Seton. We called six times and left messages four times. But even if they had returned our calls, it's not likely they would have been able to tell us anything, for the same reason that Dark couldn't – HIPAA rules.

Whatever their rationale, Dell Seton's action was not unusual. "This is a real thing that happens to hundreds and hundreds of people," justice advocate Kathy Mitchell said. "People present themselves to the local hospital emergency room, the hospital calls the police, and the police take them to jail. Hospitals are not giving emergency mental health care, hospital-level care, and they're calling the police on people in their own emergency rooms. It is an indictment against our health care system."

This view is more or less the consensus among advocates, health care providers, and even law enforcement. "I could talk about the mechanisms that folks are using to kill themselves and the problems with the use of ligatures," Malone said. "But here's the root of the problem: We are using jails in lieu of mental health treatment facilities to incarcerate generally – not always, but generally – low-level offenders. And these people have serious mental health issues.

"And what do we do? We lock them up in a metal box, with a concrete floor. And I think most sane people – those people without serious mental health issues – if you put them in that situation, it's going to lead to mental health issues."

Of course, mental illness in county jails – and everywhere – is very closely correlated with substance use disorders, because mentally ill people use illegal substances to self-medicate. A 2018 study found that 87% of county jail inmates – almost 9 out of 10 – had some kind of substance use disorder. A large number of these also suffered from mental health issues. Over 40% had experienced a major depressive episode or post-traumatic stress disorder; about a fourth had bipolar disorder; 15% had experienced psychosis.

Mitchell said that the illegality of certain substances has created a class of people who can legally be denied care. "If a person has a heart attack, the hospital isn't going to wait to decide if they also had some alcohol before they went in the front door. The hospital would never decline treatment for that heart attack because the person was also drunk. So we have created these categories of people that we simply don't provide the care for that we would provide under a range of similar circumstances."

Judge Andy Brown, who presides over the Travis County Commissioners Court – and, thus, indirectly, over the jail – is in the early stages of creating a facility that could accept patients like JJ Bell. "I met with the Justice Department folks in Washington, D.C., recently and they cited a diversion center in Miami that they think works pretty well, not just for mental health diversion but also substance use disorder diversion," Brown said. "And their other example was in Tucson, Arizona. So we're going to look at both of those communities, look at how those work, and see if we can implement something similar."

Brown was instrumental in the creation of the Sobering Center, which, you will recall, was the first place Mark Bell took JJ. But it was a four-year process for Brown and his allies to establish the Sobering Center, so a diversion facility for those with substance use disorder won't be here anytime soon.

JJ

"When he moved to Austin, my brother got into the music scene, the EDM and all that," Mark Bell said. "And he made more friends than I ever knew you could make. When he died and all these people were telling me their condolences, I said, 'I've never even seen this many people. And he knows this many people?'"

On a Saturday in late March, hundreds of JJ Bell's friends came together at Indra's Awarehouse to share their memories of him. Indra's is an old warehouse on the eastern edge of the city dedicated to art, music, dance, and expanded consciousness. It sits on an acre of scrubland and hosts EDM festivals and psytrance campouts.

As such, Indra's is a home base for Melanie Maxwell. Maxwell helped organize the memorial for JJ, whom she met running coffee and snack concessions at festivals across the state. "It can be really stressful, catering and getting set up to do festivals," Maxwell said. "I'm usually running late, I'm just not really present in the space yet. And he's someone that the second we would see him and connect with him, it was like, 'Okay, we're home. We're here, we're present.' He really helped to remind me, hey, we're in this community together. We're so fortunate to be together."

Dixon Stovall knew JJ for eight years and thought of him as his best friend. "JJ was this person that could show up wherever he was and have people ... laughing, singing, you know, playing card games. He was a joker. He was a jester, he was a modern-day jester. He stirred the pot in the most loving way. Everywhere he went, he just radiated that to people."

Like most, Stovall met JJ at a music festival. They became closer as Stovall went through a painful divorce, when JJ dropped by Stovall's home and found him in a deep depression. "He said, 'I'm going to help you.' I said okay and he said, 'Sit your ass down on the couch.' And I was like, all right, and he comes back with a chiminea, which is like an outdoor wood burning thing. And he said, 'Are you okay with me getting rid of some of this stuff,' like pictures of my wife? And this dude is probably the only person I would allow to go in my home like that. And he burned every single thing. He took it and he put it outside in a chiminea and set it on fire.

"And as crazy as it sounds, that was the best thing anybody could have ever done for me at the time."

Story after story on Saturday made the point that JJ was there for his friends, but Stovall and others saw that he did not take care of himself, especially in the last months of his life. Stovall wept as he described those days. "I was trying to help JJ get clean. I knew he was sick and I knew he was going in a bad direction. And I feel bad because I kind of put my foot in his ass a week before he died. I was like, 'Man, I can't be your friend anymore if you don't get sober. You're hurting people around you, you're hurting yourself.' I was like, 'I love you but you gotta get some help, dude.' And next thing I know, I get a phone call and he's dead."

Maxwell has lost other friends to mental illness and drugs and says the criminal justice and health care systems need to find ways to save people like JJ Bell. "His brother and Dixon and other friends were really there for him in all these ways but you can't stop somebody from doing their vices if they're not wanting to and especially if they're thinking this is the only thing managing their situation. And I feel like the jail system and the halfway house system, they're not equipped to handle people having these mental breaks. I think there needs to be a lot more resources put towards that."

Mark Bell wants to see the Travis County Jail held accountable. "What I want to know is, how is my brother, who was on suicide watch, left alone with access to a telephone cord? Why wasn't he in a cell where he didn't have anything to hurt himself? How are you gonna leave someone on suicide watch alone with a telephone cord? How long did he have to have been laying there with the telephone cord around his neck, to not just suffocate but to be unable for them to resuscitate him?"

Stovall says the Austin community should be able to handle crises like the one JJ experienced with delicacy and compassion. "What sucks about these situations is that society, law enforcement – whatever, the system, the social structure we live under – it's very black and white. You're either good or bad. And JJ was truly good. But I think the main lesson to be learned here is that, when someone's questioning their sanity and coming off drugs, how dare you go put him in a jail cell? And how dare you judge him as some criminal or some person that's harmful? It's just not fair. And it cost him his life. He's dead. I'll never get to talk to my buddy again."


The National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 800/273-8255.


Crisis Text Line is a texting service for emotional crisis support. To speak with a trained listener, text “HOME” to 741741. Both are free, available 24/7, and confidential.

* Editor's note Thursday 3-31 2:34 pm: This story has been updated to include more information about the Travis County Sheriff’s Office policy on visual checks for inmates in crisis.

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