Part 1: Dying Inside: Why are more deaths happening in Shasta County Jail custody?
Shasta County, jail custody, Death, investigation
By Matthew Brannon
This story was produced as a project for the 2020 California Fellowship.
Other stories in this series include:
What do you want us to know about jails in Northern California?
Analysis reveals disparities among death rates in California county jails
With jail deaths on the rise, California counties look to improve
Shasta County Jail: Two important areas of policy to understand
MATT BRANNON/RECORD SEARCHLIGHT
Every day, the memory of John Adena revisits his sisters. In 31 years of life, he moved from his childhood home in Hawaii to Redding, California, where he played high school football, fought fires and worked as a hospital aide.
In September 2019, he died in Shasta County Jail custody. His sisters don't know how. They said the jail has given no explanation, and nine months after his death, the sheriff's office — which oversees the jail — has yet to release an autopsy report, despite their requests.
"It broke our hearts completely," said one sister, Angelina Odell. "It still doesn't make sense to us. We don't know what happened."
Adena's death in custody is one of 25 reported by the Shasta County Jail since 2006 — a number that one former California jail manager and expert witness described as "way too many, obviously."
A Record Searchlight investigation into the number of jail deaths in Shasta County found:
Shasta County's jail system has been connected to more inmate deaths than most of similar sizes. The county ranks second in total deaths among California's 10 county jail systems with 10,000 to 18,000 annual bookings, based on state data from 2005-2018.
Shasta County Jail deaths have become increasingly common. In the past seven years (2013-2019), the jail has seen 16 in-custody deaths compared to nine in the seven years before that.
In Shasta County, about 65% of jail deaths come from suicides, according to state data. For comparison, that percentage is about 13% in Los Angeles County. Shasta's number is the highest share of any county jail system in the state among those with at least five suicides from 2005-2018.
'No question about it:' Some deaths are preventable
For the last six months, Cpt. Gene Randall has been the sheriff's official tasked with running the jail. He acknowledges that some deaths in custody are ultimately preventable.
"There's no question about it," he said.
Behind the volume of deaths in jail custody, there are autopsies, lawsuits and reports leading some families and outside experts to question how avoidable some deaths may have been.
In 2016, a man found incompetent to stand trial died after developing pneumonia at the jail and not receiving treatment for it, sheriff's records show. The coroner's report stated he likely couldn't "keep food and saliva out of his airway," with heroin and heart disease listed as contributing factors.
In 2018, jail video showed a man "screaming in agony" amid a methamphetamine overdose as guards laughed and insulted him rather than taking him to a hospital, according to a wrongful death lawsuit. Within two days, the overdose killed him.
In 2019, records show a 42-year-old with schizophrenia complained of constipation and died of complications about three weeks later. Despite life-saving attempts, the death became the third in a two-week span.
What are some of the factors behind those numbers? Randall and others with jail experience said many people booked are already part of a vulnerable population. Some inmates are likely to receive better care within the jail than they would outside of it, and certain deaths are difficult to prevent, said Michael Hackett, past president of the Southern California Jail Manager's Association.
Research shows California's efforts to lower the state prison population — known as "realignment" — have thrust an added burden upon jails as they hold more convicted inmates whose longer sentences would before have been served in prison. In some cases, jails are mired in systemic challenges around staffing and funding.
However, most of these challenges are not unique to the Shasta County Jail, whose death rate still exceeds other jail systems of similar sizes.
Mental health issues, inmate suicides are major points of concern
Many county jail inmates suffer from mental health issues, and experts say they're at a disproportionate risk of suicide. In Shasta County, inmates with a documented risk of suicide have been found hanging in their cells within days.
In 2015, Clifford Shaw was booked into the Shasta County Jail for allegedly violating probation in connection to alcohol. When he got to the jail, he told medical staff he had psychiatric problems. His wife said she told jail staff Shaw was suicidal and needed to be watched, records show.
Within five days, an inmate assaulted him. Five days after that, he hanged himself with a jail-issued towel, records show.
A pattern similar to Shaw's took place again in 2018. Perry G. Juarez — a man with mental health issues who previously tried to kill himself — was booked, beaten, and then took his life. He died within three days.
"These inmates are not receiving the individual treatment, attention, empathy or care they need," said Redding defense attorney Matt Izzi. "Our jail just isn't equipped for that, nor is it the appropriate facility for that. It's a detention facility — not a psych ward."
Both Hackett — who previously managed the Imperial County jail system — and Izzi lamented the lack of local facilities dedicated to people with mental health issues.
"Oftentimes, these individuals just end up in the jail," Hackett said. "And they become a real challenge for the sheriff's office."
When they resort to suicide, the timing is unsettlingly predictable.
Usually, the first few days after booking are critical because inmates are scared and in shock, said Lenard Vare, the former director of Napa County's jail system.
Of 10 suicides in Shasta jail custody from 2012-2018, half came within the inmate's first five days of incarceration, seven in the first two weeks, the Record Searchlight's analysis shows.
Randall, who has been running the Shasta County Jail since January, suggested the county's overall suicide rate is a factor. He said he believes the jail is equipped to look after inmates with mental health issues, but "quite frankly, there's going to be room for improvement as better treatments are identified."
As of January, about 30% of the jail's population was on psychiatric medication, records show.
Slowing jail deaths can be a challenge in a 'depressing environment'
Even with good intentions, officials looking to curb jail deaths can run into obstacles with funding, staffing and certain jail residents who present special challenges.
"We house inmates that are in a high-risk population at times, whether that be alcoholism, drug use or just overall not having the ability to care for their health," Randall said. "Obviously (deaths are) tragic and we don't ever want to see that happen."
Randall said one of the main focuses of the sheriff's office, which oversees the jail, is the protection of life.
Still, administrators say some deaths are difficult to prevent.
In Hackett's experience as a jail administrator, he has seen cases where people refuse life-saving medication or find unexpected ways to kill themselves. But instances like those are a minority.
Suicides, overdoses, illnesses — "as a general statement, most of those kinds of deaths can be prevented with really intensive, good supervision," Hackett said.
But intensive supervision can require an intensive investment.
"(Let's say a) hypothetical jail requires that we have to change the vent system, so that people don't use that to hang a bed sheet around and hang themselves," Vare said. "Just that project alone could cost a million dollars — just to retrofit that. And where is that money coming from?"
Aside from the structure of the facilities themselves, Vare has also seen jails struggle to recruit and retain jail workers.
"You could do a whole story on corrections burnout," he said. "It can be a very depressing environment to work in."
A 2013 Shasta County grand jury report described the jail's hiring process as "lengthy and cumbersome" but said revising it could result in hiring less qualified officers.
Randall said jail employees work 12-hour shifts and sometimes work mandatory overtime on their days off.
"They do a good job," he said, "and this is a real tough job to do."
'No one deserves to die this way'
Beyond the statistics around in-custody deaths, there are real families coping with loss. Take the case of Adena, the 31-year-old who died in jail custody on Sept. 22, 2019.
In August, following the loss of his longtime job, Adena showed up in the hospital with a leg injury. A police report stated he appeared to be confused and not know where he was. He was accused of shoulder-checking a medical worker, who did not fall over, and charged with battery.
For his sisters, Odell and Michelle Gallagher, their brother being arrested was unimaginable. They described him as a quiet and quirky young adult who cared about helping others.
"Instead of being thrown into jail for five weeks, I feel like he needed mental health help," Odell said.
Once in jail, they figured he would get the mental health treatment he seemed to need. He was acting way out of character, rejecting family visits, getting into fights and losing jail privileges as punishment, they said. A judge even paused Adena's court proceedings so he could have a mental health evaluation.
"After that hearing, I remember walking away just feeling really relieved," Gallagher said. "We're going to get answers and we're going to be able to help him get through this."
Instead, he died.
Nine months later, they feel stuck in a nightmare. Without the autopsy and death reports, Adena's sisters feel no closure and see no end in sight.
"It is incredibly frustrating," Gallagher said. "My parents have been calling and trying to get some updates and answers and apparently they don't even take their calls anymore and they're not responding and calling them back with any updates. We're just left in the dark."
They saw their brother's death mocked online by local residents, who cheered on a perceived saving of tax dollars.
The absence of an explanation hasn't helped. With no evidence to the contrary, Odell said she believes her brother would still be alive had he not been in jail custody.
And while they can't change what happened, Odell and Gallagher said they hope their brother's story can bring more attention to the need for transparency, mental health services and urgency for preventing deaths in lockup.
"It doesn't seem right," Gallagher said. "There were never death sentences issued ... they weren't supposed to die when they did."
This article is the first in a three-part series. Matt Brannon wrote this story while participating in the USC Center for Health Journalism's California Fellowship. To share how county jail incarceration has affected you or a loved one, email jails.recordsearchlight@gmail.com.
He covers politics, the criminal justice system and breaking news for the Record Searchlight. Follow him on Twitter @MattBrannon_RS. Support local coverage and keep up with the North State for as little as $1 a month. Subscribe today.
[This article was originally published on Record Searchlight.]