Editor’s note: This story explores suicide, including details of how people died by suicide. If you are at risk, please stop here and contact the National Suicide Prevention Lifeline for support at 1-800-273-8255.
Sasha Putala’s parents knew their son was in a poor mental state when he was arrested on auto burglary charges and sent to Williamson County Jail in June 2012. They told jail employees the 18-year-old had attempted suicide multiple times in the past.
After spending a week in the jail, Putala appeared in court for a hearing, and his distressed mental state was so apparent that, in a rare move, a judge ordered a mental evaluation to determine Putala’s competency to stand trial, according to the family’s attorney, David Raybin.
Within hours of that hearing, Putala was found nonresponsive in his jail cell. He had hanged himself.
“It’s the worst nightmare you could imagine because you wish you could’ve helped your child in some way,” said Putala’s mother, Nakita Click-Putala. “Everybody comes through it differently. There will always be a profound loss.”
Officers responded to 37 suicide attempts between 2015 and 2018 at 408 Century Court — the county jail — according to data obtained by The Tennessean.
While the Williamson County Sheriff’s Office responds to calls about suicide throughout the unincorporated county, deputies responded to calls in their own facility more often than anywhere else in the nearly 200 calls documented during that four-year period.
Research shows inmates in local jails are at a much higher risk for suicide than the general public. The suicide rate there is 46 per 100,000 people. Among the general U.S. population, it’s 13 per 100,000 people.
Suicide is the leading cause of death in local jails.
Putala was the most recent inmate to die by suicide in the jail, department spokeswoman Sharon Puckett confirmed.
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Tennessean archives show two other inmates died by suicide over a three-month period at the Williamson County jail in 2009, and another who died by suicide in 2005.
Gov. Bill Lee said last week he’s proposing more than $11 million in new funding to expand access to mental health services for Tennesseans. The funds would cover more patients through the state’s Behavioral Health Safety Net program and help create permanent housing opportunities for people with mental health issues.
But the funding proposal doesn’t include additional resources for jail or prison inmates. And while at least four people in the Williamson County Jail died by suicide over the past 14 years, the dozens of attempts show the issue isn’t going anywhere.
‘A lack of coordination’
The sheriff’s office staff complete a six-week training academy that includes a two-hour session on suicide prevention, said Jail Administrator Mike Dobbins.
When an inmate threatens suicide or is believed to be a suicide risk, Williamson County Jail medical providers get involved.
Medical staff members are the only ones with the authority to place inmates on or off suicide watch. A guard must physically observe the inmate on suicide watch at least every 15 minutes, Dobbins said.
Medical staff is available 24 hours a day, and a psychiatric nurse works at the jail 40 hours a week.
How do dozens of suicide attempts happen in a facility equipped with more than 400 cameras? Because jail employees aren’t monitoring surveillance footage in real time.
“Cameras are really good to go back and see what happened after the fact. But I’d have to triple my staff to have somebody sitting there and watching the cameras,” Dobbins said. He added that the checks every 15 minutes must be done in person and not via security camera.
In Putala’s case, no footage is available because he was placed in a cell without a camera, Raybin said.
On average, there are more than 128 suicides per day in the United States, attempted by people with and without known mental health conditions. USA TODAY
Williamson County paid the private company Southern Health Partners Inc. more than $588,000 for medical services this fiscal year. Southern Health Partners is the same firm that oversaw Putala’s mental health care before his suicide, Raybin confirmed.
Once an inmate is placed on suicide watch, medical staff notifies Mobile Crisis Services, and one of its partners evaluates the inmate to see if they meet criteria for admission into the Middle Tennessee Mental Health Institute. A second evaluation is done at the Institute, which is one of the state’s four psychiatric hospitals.
But local law enforcement agencies, their contracted health care providers and state mental health partners aren’t always on the same page, Raybin said.
“In my view, you have a lack of coordination, and it leads to a lack of accountability,” he said.
Sometimes, inmates are not deemed to be at substantial risk for self-harm, despite exhibiting troubling behaviors.
For example, a mobile crisis unit determined that one inmate who was smearing and consuming his own feces in his cell did not meet criteria for psychiatric hospitalization, Dobbins said.
“That’s what’s frustrating from our standpoint. I see people that need help, and the system isn’t set up to help them,” he said. “They’re the ones staying with us until their charges are done – then back out on the street they go.”
Officials with the Tennessee Department of Mental Health and Substance Abuse Services see things differently.
“There are behaviors that have a lot of shock value and sound really abhorrent, and are not necessarily secondary to a mental illness,” said Bo Turner, Deputy Commissioner of Operations and Hospital Services.
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‘Jail is not the place for these people’
Dobbins’ biggest concern is what he perceives as a lack of beds at Middle Tennessee Mental Health Institute (MTMHI), which serves 18 counties in the region.
Inmates must sometimes wait days on suicide watch in the jail’s medical unit before a space opens up, Dobbins said.
“If we can’t get a bed, we’ve got to hold them here,” he said. “A jail is not the place for these people.”
Turner said MTMHI has not been at capacity in more than two years.
While there’s sometimes queuing from people awaiting further psychiatric evaluation, “we work aggressively on that waiting list, but that’s just the nature of what’s involved in the evaluation of the region we serve,” Turner said.
Tennessee has worked in recent years to improve its crisis services network, with a focus on preventing a person’s mental health issues from reaching the level where they are arrested or involuntarily admitted to a psychiatric hospital.
Those resources aren’t designed for incarcerated people, though.
“If you’re booked and charged, it’s kind of off the table at that point,” said Matthew Parriott, spokesman for the Department of Mental Health and Substance Abuse Services.
Dobbins said he doesn’t think the number of inmates attempting suicide at the jail is particularly high, considering it houses around 360 inmates daily.
“Can it happen at a moment’s notice? Yes, that’s what’s concerning to me,” he said. “I don’t have staff to sit and watch every single person every second of the day, so you look for ideations. You train on what to look for and be observant, and hope nothing happens.”
Each area of the jail includes a day room with two kiosks, and each kiosk has a button inmates can push if they need medical assistance, including if they’re having suicidal thoughts, Dobbins said.
‘They weren’t kind’
In the days leading up to Putala’s death, a nurse in the jail placed him on suicide watch, then took him off before his court hearing. Putala was then placed in protective custody in a cell by himself, Raybin said.
After his hearing on June 27, 2012, Putala was taken back to his cell, where he was found unresponsive later that day.
He was rushed to Vanderbilt University Medical Center and later pronounced brain dead.
“I’ve handled other suicide cases before, but this was tragic because it was so preventable and so foreseeable,” Raybin said.
Putala’s death made headlines at the time because his parents were initially barred by sheriff’s deputies from seeing their dying son in the hospital. He was still an inmate in the sheriff’s custody and couldn’t have visitors, officials said at the time.
It was only after Putala’s parents called local news outlets that former Sheriff Jeff Long allowed them to see their son. Long is now the commissioner of the Tennessee Department of Safety and Homeland Security.
“They weren’t kind,” Nakita Click-Putala said. “They need to be more compassionate to families because there’s nothing we can do for (loved ones) while they’re incarcerated. They need to realize we love these people, no matter what they’ve done or why they’re there.”
After Putala’s death, his family hired Raybin to file a lawsuit against the county. Raybin and attorneys for the sheriff’s office reached a settlement before a complaint was ever filed. The terms of the settlement are confidential.