Jamal Sutherland’s death at the Charleston County jail is part of a slow-rolling crisis that has enveloped South Carolina’s detention centers and prisons in a state that has long struggled with caring for those with mental illnesses.
Over the past two decades, the state’s jails and prisons have swelled with inmates grappling with mental illness. It’s part of a national trend that's led some experts to dub these facilities “America’s new asylums.” One Justice Department report noted some 44 percent of inmates surveyed had been previously diagnosed with a mental health disorder.
The shift from psychiatric beds to cellblocks has placed increasing pressure on jail and prison staff, many of whom are ill-equipped to deal with inmates struggling with profound mental illness. But the crisis often plays out behind bars and razor wire, seldom drawing attention until a tragedy, such as Sutherland’s Jan. 5 death after a struggle with detention officers.
Investigators are still trying to determine if criminal charges are warranted in connection with the incident in which Sutherland endured multiple jolts from a stun gun, as well as officers pressing on his back. The 31-year-old Goose Creek man had been transferred to the jail after a fight at a facility where he was being treated for schizophrenia and bipolar disorder.
Experts say the episode demands a larger public conversation about how people with mental illnesses are treated while incarcerated.
“The tragic death of Jamal Sutherland has yet again brought to light the disparities in the lack of proper procedures to ensure the safety of an individual during a mental health crisis,” said Rob Aitcheson, executive director of the National Alliance on Mental Illness’ Charleston office.
South Carolina has been dogged for years with horrific tales about the treatment of people with mental illness in custody. It’s a state where at least five times more people with mental illnesses are housed in jails and prisons than in hospitals, a 2010 study by the nonprofit Treatment Advocacy Center and the National Sheriffs’ Association found.
Since the 1960s, the state's Department of Mental Health and private hospitals have dramatically reduced their inpatient beds and sent patients to their local communities to receive care. The move was lauded as more humane, and potentially cheaper, than lives spent institutionalized. But some question whether it went too far.
The state’s prisons became virtual warehouses for people with mental illnesses after steep cutbacks in funding for care. By 2014, the Department of Mental Health had seen its budget shrink by 40 percent over a decade — the largest drop of any state since 2002.
Despite increases in funding in recent years, South Carolina still currently ranks 45th in the nation for its number of public psychiatric beds, NAMI’s Aitcheson said.
“Unfortunately, mental health seems to only come to the forefront when there are cases of tragedy,” he said.
Such was the case when a class-action lawsuit revealed numerous stories of inmates with mental illness in South Carolina prisons being gassed, locked in solitary confinement for years at a time, denied effective treatment and caged naked in filthy cells.
The suit, filed in 2005, took nearly a decade to wind its way to trial and reach a final ruling that brought about sweeping changes. By that time, eight prisoners with mental illnesses had died, six from suicide. The Corrections Department has since dramatically reduced the use of solitary confinement, expanded mental health screenings and programs, and bolstered training in crisis intervention, among other things, agency spokeswoman Chrysti Shain said.
But the situation has also become more demanding, as the prison system grapples with a doubling in the percentage of inmates identified as having mental health issues, Shain said. That number now stands at more than one in four prisoners.
Charleston County had been hailed in recent years for taking a progressive path in handling offenders with mental illnesses.
A team of five clinicians from the state mental health agency work at the Charleston County jail, where they assess new inmates and check every day on prisoners in the unit where Sutherland was housed. The agency is working to get its staff into detention centers across the state.
Its staff also train law enforcement officers statewide in crisis intervention so they can more effectively deal with people who have mental illnesses, said Jennifer Roberts, executive director of the Charleston Dorchester Mental Health Center.
In Charleston, the center provides one 40-hour training a month, mostly targeted at new officers but also those who want to brush up.
“They like to go. They like to learn how to do a better job working with our patients,” Roberts said.
She wasn’t sure whether the officers who encountered Sutherland had that training.
The agency also has teams of 24-hour mental health professionals that respond to calls in all 46 counties, as well as facilities where law enforcement officers can drop off people who need care.
“We divert a whole bunch of people from going to jail with those units,” Roberts said.
In addition, the county’s Criminal Justice Coordinating Council brought authorities and advocates together to devise ways to improve public safety and community well-being.
Among other things, they pushed for alternatives to jail for people who have mental illnesses, are homeless or are substance abusers — a process they called “diverting and deflecting.” It focused on providing assistance and issuing warnings or tickets rather than arrests that put these folks in jail.
Sutherland’s experience seemed to cut against that grain.
His parents said he had struggled with mental health issues as an adult. Those problems landed him at Palmetto Behavioral Health, a North Charleston psychiatric facility. But a fight that occurred there on Jan. 4 led to his arrest on a misdemeanor assault charge and a transfer to the county jail, authorities said.
Video footage of his arrival show a man who was clearly in the throes of a delusional episode, cursing and loudly proclaiming that the Illuminati were after him. But things didn’t turn violent until two detention deputies tried to remove him from his cell to attend a bond hearing the next morning.
That’s when he ended up on the floor, repeatedly shocked with a stun gun, a knee pressed on his back, as deputies tried to cuff him. He howled in pain until he spoke no more. He appeared unresponsive as deputies dragged from his cell face down.
His cause of death was ruled “excited state” with adverse effects caused by prescription medications as he was being subdued.
Once people with mental illnesses land in the country's jails, they encounter officers who often have scant training in dealing with them, according to a 2016 report by Public Citizen’s Health Research Group and The Treatment Advocacy Center.
Nationwide, almost half of jails devote a mere 2 percent or less of their initial training to teach staff and sheriff’s deputies to deal with seriously ill inmates. And almost two-thirds reported devoting two hours or less of their annual training to the unique needs of these inmates.
But that doesn’t appear to be the case here.
One of the deputies involved in the extraction was Sgt. Lindsey Fickett, who as recently as September was a member of the jail's 12-member Special Operations Team. Under former Sheriff Al Cannon, the team was assigned to the jail full time and was similar to a SWAT team.
In years past, Fickett and other members of the team received training in dealing with inmates with mental illnesses and in so-called "Dynamic Cell Extraction," Sheriff's Office records show. According to other agency records, profits generated from inmate purchases in the jail's commissary paid for stun guns, uniforms and overtime for the team.
Deputies in the unit responded to requests to restrain inmates along with other incidents, including assaults and suicide attempts, records show.
In an interview last year, then-Assistant Sheriff Mitch Lucas, said the team deterred law-breaking behavior just by their presence and had made the jail safer.
“It more than paid for itself, as far as I’m concerned,” Lucas said of the team.
It is unclear if the group’s activities continued under Sheriff Kristin Graziano. Sutherland died on Graziano's first full day on the job.
Need for understanding
At a May 14 news conference, Charleston Mayor John Tecklenburg, Police Chief Luther Reynolds, City Council members and faith leaders said the video of Sutherland’s treatment as an inmate with mental illness was disturbing and inappropriate.
“Jamal Sutherland deserved the mental health treatment he sought,” Tecklenburg said. “Mental illness is not a crime."
Sutherland had no previous arrest record, according to a state criminal background check.
Reynolds noted that someone struggling with a psychiatric diagnosis often encounters police only after a multitude of preceding failures. By that point, they may be belligerent, with no easy access to care. And the police are often least qualified to deal with them, he said.
Paton Blough, a Greenville man and mental health advocate who lives with bipolar disorder, has had his share of interactions with police.
It's been 15 years since one occasion when officers tried to transport Blough from a hospital in a patrol car during a mental health crisis. Blough said he believed the car would explode, so he was fighting, in spite of the hand and leg cuffs he was wearing. Officers jolted him three times with a stun gun.
In contrast, Blough recalled another situation when a bartender called the police during one of his episodes. The officer who responded "took his time with me," Blough said, and waited while a family member brought medication.
"The difference was the way the officers responded to me. The condition I was in was the same," Blough said. "When you're in that tense situation, an understanding person can make a big difference."
Blough's advocacy today focuses on crisis intervention training. Through that kind of training, police and jail officers can get a better grasp on the experience of psychosis and how to respond to it.
But too often, such training comes too late.
Stephen Hobbs contributed reporting.