No place to die 

Four Missoula County inmates have died of unnatural causes within the last five years. The reasons why may extend beyond the jail.

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Two days after Wasson failed to show up for her June 16 check-in with Lahiff, the Missoula Police arrested her for violating the terms of her release. On the way to the detention center, Wasson hit her head on the Plexiglas cage in the back of the patrol car while screaming and kicking in protest.

When she was booked into the jail, Wasson told guards that for a week and a half she'd been drinking vodka and wine and in the past had experienced alcohol withdrawal symptoms. She was also taking Xanax and the antidepressant Effexor. She said she was "kind of" thinking about killing herself and that she had hit her head the previous night. She added that she didn't want to miss her son's birthday later that week.

"She just kept saying that she wanted to get out of there, that she didn't belong there," detention officer Tonia Turner told law enforcement days later.

Roughly 40 hours after Wasson was booked into the Missoula County Detention Center, she died from cardiac arrest resulting from acute alcohol withdrawals.

In May 2011, Wasson's family filed a lawsuit alleging that Missoula County and detention center contractor Spectrum Medical Services were negligent because they failed to adequately treat Wasson.

"The defendants, and each of them, were negligent in, among other things, failing to make cell checks of Heather, and to provide adequately for her safety," states the complaint filed in Missoula Fourth Judicial District Court. "They knew or had reason to know that she was at risk for severe alcohol/drug withdrawal."

Wasson was left unattended for roughly 90 minutes before jailers discovered her. American Correctional Association guidelines direct guards to check on high- and medium-security inmates personally every 30 minutes. The association, which accredits 1,500 institutions nationally and has more than 20,000 members, advises more stringent oversight of mentally ill inmates.

"More frequent observation is required for those inmates who are mentally disordered or who demonstrate unusual or bizarre behavior. Suicidal inmates are under continuous observation," ACA guidelines state.

On June 19, a guard spoke with Wasson at 7:43 p.m. Roughly 12 minutes later, an unmonitored video surveillance camera in Wasson's cell recorded the woman having what appears to be a seizure. Her right arm stiffens and becomes rigid. The movement-activated camera then shuts off.

Doctor Walter Kemp of the Forensic Science Division determined the cause of death was an alcohol withdrawal seizure from chronic alcohol abuse. Detention Center nurse Judy Munsell testified during the Wasson inquest that her staff was providing Wasson with a half milligram of Xanax twice a day and that benzodiazepines, such as Xanax, are commonly used to ward off the potentially deadly effects of alcohol detoxification.

click to enlarge Danny Wayne Johnston hung himself at the Missoula County Detention Center with jail-issued socks in March 2013. He’s the fourth inmate to die of unnatural causes at the facility since 2009. - PHOTO BY CATHRINE L. WALTERS
  • photo by Cathrine L. Walters
  • Danny Wayne Johnston hung himself at the Missoula County Detention Center with jail-issued socks in March 2013. He’s the fourth inmate to die of unnatural causes at the facility since 2009.

Munsell said Wasson didn't exhibit any obvious signs of withdrawals prior to her death. She was just like so many other inmates that nursing staff treats on a daily basis.

"A lot of people come into the jail and their intake forms are not different from this lady's. It's unfortunate, you know, that she died and I'm really sorry for that," Munsell said. "But there just wasn't anything on that sheet that was a big red flag. It just wasn't for us. We see dozens and dozens of people with similar information."




Missoula social worker Catherine O'Day says it's disheartening to watch detention center inmates get sober and begin planning ways to tackle their addictions, only to watch them fall apart when they leave.

"I see them losing hope," says O'Day, who, in addition to running a mental health program at the jail, teaches social work at the University of Montana.

Staying sober requires support, O'Day says. Offenders become pessimistic when they discover how little support exists for them. Columbia University found that in 2005, federal, state and local governments spent $74 billion on incarceration, court proceedings, probation and parole for substance-involved adult and juvenile offenders. That number dwarfs the $632 million spent on offender prevention and treatment.

Among the biggest problems, O'Day says, stems from the fact that Missoula has no alcohol detoxification facility. Detoxing can be deadly, as it was for Wasson. But the only place to go through a supervised withdrawal is at a hospital emergency room or in jail. And, as O'Day notes, "We're not a detox facility. ... Jail is not treatment."

As with lawsuits filed on behalf of suicidal inmates, addiction-related litigation is costly, too. In 2011, New York City agreed to pay $2 million to settle a lawsuit that alleged a postal worker died in jail because his severe alcohol withdrawal symptoms went untreated.

In Montana, meanwhile, the American Civil Liberties Union filed suit against Lake County jailers for refusing to provide Bethany Cajune medication prescribed to treat opiate addiction. The ACLU alleged Lake County's actions caused Cajune, who was pregnant and jailed for traffic violations, to go into severe withdrawal. Lake County denied wrongdoing, but settled the case out of court in 2011, agreeing in the future to provide medication maintenance therapy to addicted inmates.

click to enlarge Missoula County Sheriff Carl Ibsen says he would welcome more community services for mentally ill and addicted inmates. “There should be better ways of dealing with them than putting them in jail,” he says, “because jail I don’t think is fixing them.” - PHOTO BY CATHRINE L. WALTERS
  • photo by Cathrine L. Walters
  • Missoula County Sheriff Carl Ibsen says he would welcome more community services for mentally ill and addicted inmates. “There should be better ways of dealing with them than putting them in jail,” he says, “because jail I don’t think is fixing them.”

Missoula County Sheriff Carl Ibsen declined to discuss the specifics of local detention center deaths, citing pending litigation. He did note that jailers are consistently working to better manage the rigors of their profession. As an example, he says staff took advantage of new suicide prevention curriculum rolled out two years ago at the Montana Law Enforcement Academy.

The statistics appear to show that increased education and awareness are helping. According to a 2010 report from the National Center on Institutions and Alternatives, the suicide rate in county jails decreased from 107 per 100,000 inmates in 1986 to 38 per 100,000 in 2006.

Despite the progress, Ibsen acknowledges that his officers aren't social workers and overseeing the complex needs of the nearly 400 inmates who live at the Missoula facility on any given day can be tough.

"It's a challenging thing, assessing them, making sure they're housed properly," Ibsen says.

In light of the challenges, Ibsen says he'd welcome more community services. "There should be better ways of dealing with them than putting them in jail," he says, "because jail I don't think is fixing them."

As for O'Day, she bristles when talking about allegations directed at Missoula County jailers. She says it's unfair for detention center staffers to accept blame for an issue that's rooted in policies and laws that extend far beyond their control.

"It's really a systemic failure," she says. "We can't change the world out there from in here."

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