Roy Exum: The ‘Inmate X’ Tragedy

  • Thursday, January 12, 2017
  • Roy Exum
Roy Exum
Roy Exum

In early December, a man we’ll call “Inmate X” asked another for a ride in the car, since it was raining. The reply was “No” and “Inmate X” slapped the victim, ending up in the Hamilton County Jail. At his court appearance a week later over the misdemeanor of “simple assault,” a bond of $90,000 was set to assure “Inmate X” would be kept in jail until he had a court-ordered psychiatric evaluation.

In the past month, there is no doubt in anyone’s mind the middle-aged man has severe mental problems. He wears a colostomy bag and has the daily habit of smearing the waste from the bag on himself, the walls of his cell, any jailer he might grab, and – far worse – other jail inmates. Oh, and his colostomy site is so horribly infected he has been hospitalized twice on IV antibiotics.

The first time he was transported from the jail to the hospital his blood had an elevated white count (infection) but within a day or two he physically attacked a doctor and a nurse. He was returned to jail with an even higher white count – that makes sense, right? -- and, had he not been rushed to the hospital on Tuesday of this week, he would now – according to physicians -- be dead in all likelihood.

“Inmate X” has still not been evaluated by a mental health professional. He’s been a prisoner for over a month – requiring hourly care around the clock by jailers – but Moccasin Bend Hospital has got the best excuse in the world and pitches it to the Hamilton County Sheriff’s office at least once a day. As horrifying as this may be, Moccasin Bend Hospital – with a total of 150 psychiatric beds – now serves 52 of Tennessee’s 95 counties.

The only way they will see anyone, regardless of their mental condition or uncertainty, is if said “patient” is an immediate threat to kill themselves or somebody else within the hour. The Crisis Response Team, operated by the Joe Johnson Center, will now respond to calls from the Hamilton County Jail only at shift change due to the number of the jail’s requests.

I am told, on solid authority, there are at least six men among yesterday’s jail population of 562 who are every bit as mentally distraught as “Inmate X” but there is absolutely nowhere else to take these people for the humane treatment that we Americans are certain is available.

Mental Health America lists Tennessee as No. 41 in the nation in overall mental health care but if anyone could see “Inmate X” and his cell at any hour of the day, the only place worse than us would be rural Nairobi. And the finish would be tight. A full 40 percent of the prisoners in the Hamilton County Jail take psychotropic drugs on a daily basis.

What is worst is that once you imprison a person with mental illness, jail and the challenges each day contains only heighten the anguish in almost every case. Most area judges are certain that when they sign a court order it is executed immediately but I can’t name one judge in Hamilton County who can master the mental illness puzzle.

The first judge’s orders that “Inmate X” be evaluated were filled out improperly, which resulted in a lengthy letter from Moccasin Bend to the municipal judge. As of yesterday, the corrected judge’s order had not yet reached the Hamilton County Jail but – remember – “Inmate X” is in the hospital battling sepsis.

Because “Inmate X” – as well as another inmate – are in the hospital, each requires an armed jailer 24 hours a day, which cuts down on the number of jailers at the overcrowded jail. Additionally, anytime Joe Johnson’s Crisis Response Team answers a call anywhere in the county, it is the duty of the Hamilton County Sheriff’s Department to also respond to transport the patient.

In an average month, the Sheriff’s Department will transport as many as 100 people in crisis. If Moccasin Bend has only 140 beds for 52 Tennessee counties, including Knox County and all the way to Bristol, where can the sheriff’s department take these people? They are most certainly not criminals – it is no violation of any kind to have mental illness – yet the county lock-up is the only answer, even if it already has 100 prisoners over its limit.

The sleeping arrangements at the jail are the biggest puzzle. Obviously these severe mental cases must be kept separate, and we must keep the various and many gang members separate, and we have to keep the truly violent – about 20 percent – away from those who quickly become their prey. So where does someone who is bi-polar but off their meds fit it?

No one is sure when “Inmate X” will be ready to appear on his misdemeanor – right now he is almost as physically ill as he is mentally – but it is certain he cannot meet a $90,000 bond for slapping someone else. When he is handed his medicine, he’ll try to put it in his colostomy port. Or he may put it in his colostomy bag. Or stomp on it. Or throw it at the jailer in a handful of infected grime. But he’s mentally ill … he doesn’t realize what he is doing.

The goal of every jailer is to somehow hang on, get enough meds into him to settle him down so he can stand before a judge and somehow move forward. If he is on his medicine – and it is regulated right – he can fare pretty well.

But when he feels good, he quits taking his meds. He gets unruly, acts mean. It is whispered he has a pretty good gun collection so the prognosis is not good at all when he tires of hurling his colostomy waste at others and wants to fight.

The sheriff’s officers have been tending to “Inmate X” every hour for more than a month. All day Christmas, all night as the New Year arrived, and “Inmate X” has not even had his psychiatric evaluation yet. If you have any ideas, or any possible solution, please get in touch with Sheriff Jim Hammond or Chief of Corrections Joe Fowler. They are police officers with virtually no formal training in mental illness and, quite frankly, have no idea what’s the best course for “Inmate X.”

Who was that … the one who just whispered through a veil of tears that death would be a blessing? “That’s no option,” said Chief Fowler. “We need to get him well.”

royexum@aol.com

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