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Each of the guards who testified during the inquest said Brilz gave no indication that she intended to kill herself.
In July 2011, a six-member jury that convened for the coroner's inquest unanimously found the county innocent of criminal negligence. That result didn't surprise Datsopoulos. Prior to entering settlement negotiations with the county, he said inquests are typically one-sided affairs, with only prosecuting attorneys—the ones who work for the county—engaging in witness questioning.
"Most coroner's inquests result in the facility being absolved and there's some inherent conflicts there, because it isn't really a fair inquiry," he says. "It's only a one-sided inquiry. There's no real cross examination. Nobody can bring in witnesses that really impeach the people they bring in, or disagree with them. But usually, if the coroner's inquest comes out and says, 'Well, we didn't see anything illegal or improper with the handling of this inmate,' that ends it."
The veteran trial lawyer notes further that inquests weigh criminal liability. There's a significantly lower threshold of proof required to show civil negligence, which Datsopoulos would have to prove if the Brilz case went to court.
Complaints similar to the Brilz family's are often settled out of court. During an 18-month period in 2004 and 2005, for example, four Ravalli County Detention Center inmates killed themselves. According to Ravalli County Sheriff Chris Hoffman, three of those deaths resulted in litigation. All three lawsuits were settled out of court for undisclosed amounts of money.
Hoffman says the series of deaths prompted the jail to overhaul policies governing physical and mental health care. Ravalli County now contracts with an outside company, Spectrum Medical, to provide on-site health care. It also increased training and hired a mental health provider, who is now on call for emergencies.
"It changed the way we did business on so many levels," Hoffman says.
Immediately after being booked into the Fergus County Jail on Jan. 3, 2011, Carl Odell Stacy told guards he intended to commit suicide. Despite the threats and the fact that Stacy attempted suicide while incarcerated at the same facility five years prior, he was left unattended for 46 minutes. During that time, he hung himself with a sheet.
The attorney representing Stacy's family, Torger Oaas, noted during a 2012 trial to debate Fergus County's responsibility that jailers were fully aware of Stacy's suicide risk. "Carl was mentally ill and they knew that," Oaas said, as the Associated Press reported. "Carl had ADHD and depression. It was all over their paperwork."
The jury found Fergus County negligent and awarded Stacy's family $149,000.
Similar precedents dot the legal landscape. Last year, a federal jury awarded the family of a 27-year-old Missouri woman who committed suicide while incarcerated $2.85 million after finding guards exhibited "complete indifference to or conscious disregard" for her health and safety. Despite knowing she was suicidal, jailers failed to remove a string from her hooded sweatshirt. The woman used that string to hang herself.
Since the U.S. Supreme Court in 1976 began spelling out the minimum standards to guide detainee health care, courts have increasingly found that jailers must protect detainees from others and themselves. Ignoring that mandate constitutes a violation of prohibitions against cruel and unusual punishment.
While such standards better ensure prisoners receive humane treatment, jailers can be hard-pressed to satisfy them.
"Counties just don't have adequate funding and resources to provide constitutional levels of care in a lot of situations," says Montana ACLU staff attorney Anna Conley.
Problems meeting those standards are exacerbated by the fact that an increasing number of mentally ill and addicted offenders are flooding jails. According to the National Center for Substance Abuse at Columbia University, one-third of all people detained in local and state detention centers in 2006 had a mental illness. That same report found that of the 2.3 million inmates incarcerated in 2006, 1.5 million, or 65 percent, were addicts.
While the treatment needs of detainees become more complex, the volume of people being housed in jails has increased exponentially. Between 1930 and 1970, incarceration rates in the United States hovered at roughly 100 detainees per 100,000. That number is now 716 per 100,000.
Experts say it's not a coincidence that prison rates started to skyrocket just as lawmakers set to work disassembling the nation's mental health infrastructure. According to the National Association of State Mental Health Program Directors, state funding for psychiatric services in 2006, adjusted for inflation and population growth, amounted to less than 12 percent of the total spent in 1955. In 1955, there was one psychiatric bed available for every 300 Americans. Today, that number is one for every 3,000.
"There's no treatment," says Missoula social worker Catherine O'Day, who oversees a mental health care program at the Missoula County Detention Center. "There's nowhere for them to go."
Meanwhile, while treatment services decrease, prison costs skyrocket. The Missoula County Detention Center's 2014 budget is $11.8 million, a 59-percent increase from 2004.
In May 2009, 31-year-old Heather Wasson seemed more nervous than usual. She didn't like going to the Department of Correction's Missoula Office of Probations and Parole for her regular check-ins, the result of a 2004 conviction on forgery and criminal possession of dangerous drugs charges.
Her probation officer, Kim Lahiff, testified that Wasson normally shook when meeting with her at the office. But that day she seemed even shakier.
Lahiff suspected that something was wrong and so she screened Wasson for illegal drugs. Wasson's 2004 conviction stemmed from methamphetamine use. After finding no contraband in Wasson's system, Lahiff sent her home.