Starving the Innocent to Death in Prison

As my friends know, I’ve worn many hats over my career. One of them I am most proud of is my fifteen year experience as a commissioner of Mental Health in my then local county of Washtenaw (Michigan). I was originally appointed as a result of my work for our local chapter of NAMI (National Alliance on Mental Illness) where I served as president in 1992.

My interest in helping people who live with mental illness is life-long. My mother had been diagnosed with a severe mental illness, possibly triggered by a rape, when I was just two years old. In 1958 she spent 10 months in Rockland State Mental Hospital. I was six years old. After trying to place me with foster parents, my father found the right way to handle the situation and I spent the school year in what turned out to be a wonderful place, then named “Green Chimneys Home for Little Folk.”

My mother was released from the hospital that summer, and her illness was controlled through medication fairly well. She was able to work part-time while I was completing grammar school, and full-time thereafter–until I was already in Grad School. At that time she had a mental break from which she never fully recovered.

Her diagnosis varied from Schizo-Effective Disorder to Manic Depression, now more usually referred to as Bipolar Disorder.

All that is an introduction to a terrible tragedy which could just as easily have befallen my mother had I not been there to take care of her.

The New Yorker has a featured article in their edition of April 14, 2025 written by journalist Sarah Stillman and entitled, Starved in Jail. The main subject of the article is woman named Mary Faith Casey. Mary grew up in San Diego, enjoying her early life, marrying, and giving birth to two children whom she reared along with caring for her mother who had developed a serious illness. The stress of it all caused her marriage to deteriorate, and Mary began to experience bouts of depression. In a common consequence of mental illness, Mary began drinking and acting increasingly volatile. She was initially diagnosed as bipolar, subsequently also schizophrenic.

My mother, God bless her, had a very affable personality, and that helped her avoid Mary’s fate. Sadly, the developments for Mary–that volatility, the drinking, the abuse she both received and gave out–all contributed to her distancing herself from her family and becoming homeless. And like many homeless people, she was picked up by the police and charged with various petty crimes. She was released from jail but later a warrant was issued because she had failed to register an address. How could she register an address when she was homeless?

A doorman called the police because he said Mary had become a “nuisance.” The police discovered that there was a warrant for her owing to the lack of an address, and they took her to jail. She remained in jail for four months and stopped eating. She was too emaciated to go to court. The jail had a contract with a private medical practice which did nothing to secure her nutrition. Keep in mind that she was not in jail as convict, she was awaiting trial for the nuisance charge. Eventually, she was taken to court in a wheelchair. The judge dismissed the charges and ordered the staff to take her to the ER. The hospital tried to revive her for a month, but then said she was beyond hope and sent her to hospice, where she died soon after of starvation and neglect.

The family is suing the private medical contractor for failing to provide even a basic standard of care, and while I hope they can get some solace from a settlement, there is a far more important issue at stake here.

The article is about far more than Mary Casey. You see, this is not simply an individual or rare episode. These stories are commonplace. People living with–and in Mary’s case, dying with–mental illness are being subjected to this inhumane standard of care all across America. As I said before, I do not have the slightest doubt that my own mother could have shared Mary’s fate under other circumstances.

If you’re thinking, well, there’s not much we can do about all this, I’m sorry, but that is absolutely wrong. There is a lot we can do about this. To begin with, we can extricate cases of mental illness from the criminal justice system. Cops are not trained to deal with people living with mental illness, and jails are no place for socially vulnerable people. The “crimes” they commit are often trivialities, and even the more serious cases are almost always events that could have been avoided with better care and intervention at an earlier stage of the illness. Back in Washtenaw County, our chapter of NAMI worked on programs of diversion from jail, training officers in how to de-escalate confrontation, and finding appropriate medical and social environments for people living with mental illness. The effects were dramatic, with significant reductions in the need to place people in the criminal justice system. 

But we ran up against institutional problems that eventually led to the discontinuation of the programs. As you can guess, the primary issue was funding. But administrative intransigence, and I’m sorry to say, issues with the police union, also contributed to the problems. You see, in order to provide this training to the officers, some people needed to get paid, and officers needed to receive release time from their duties. When our grant ran out, and when the union objected to the unpaid release time, there went the program.

As I walked around the indoor track at my gym this morning, listening to Sarah Stillman’s story as a podcast, I happened to glance out the window and noticed a person camped next to our gym. I took this picture of him, but made sure he can’t be identified for the sake of his privacy. And I wondered, will he be the next person to die of societal neglect?