Santa Rita Jail. Photo by Scott Morris.

Excessive water consumption killed Santa Rita inmate

Alone in his cell in Santa Rita jail, Jesus Demetrius Dickey drank so much water that he died. Dickey was one of two inmates who died in a week in the jail last June. The Alameda County Sheriff’s Office, which runs the jail in Dublin, revealed little about the two deaths after they were reported, and until now not even Dickey’s name had been publicly released.

But this reporter has obtained investigator’s and coroner’s reports through a public records request, revealing that Dickey, who was facing charges of kidnapping and sexual battery for two incidents in Berkeley, died from water intoxication. Dickey suffered from schizophrenia, which made him compulsively drink water, and he drank and drank until he died.

The other inmate who died in June, 23-year-old Dujuan Armstrong, was restrained. Because of the use of force involved, the case remains under investigation by the Alameda County District Attorney’s Office.

Activists and civil rights attorneys have recently raised concerns about the adequacy of mental health treatment in Santa Rita Jail in Dublin and are pointing to Dickey’s case as the latest example of negligent treatment of inmates suffering from severe mental illnesses. The sheriff’s office considers Dickey’s death an accident, but officials say they are working on ways to improve mental health services in the jails.

Dickey, 45, had a history of schizophrenia and was homeless when he was arrested in Berkeley on April 23. According to UC Berkeley police, Dickey had approached a student in the Durant Food Court at 1:15 a.m. and followed her back to Freeborn Hall, asking for a hug and grabbing her buttock along the way. When he tried to follow her into the dorm, a security guard told him to leave and called university police.

A police officer reviewed the dorm’s surveillance video and recognized Dickey. UCPD arrested him and connected him with another incident under investigation by city police. In that case, which happened about an hour before his arrest, police said that he tried to get into an apartment building on Durant Avenue across from campus and pinned a woman against a wall. When she tried to break free, he allegedly dragged her 20 yards down a hallway, pulled her to the ground in a stairwell, and got on top of her, putting his hand over her mouth to muffle her screams. While she was on the ground, the woman called 911 and Dickey fled.

The woman later picked him out of a lineup. He was charged with kidnapping to commit a sex crime, first-degree burglary, indecent exposure, and sexual battery.

Two days after his arrest, Dickey was brought to Santa Rita, where he was initially assigned to Housing Unit 9, the jail’s behavioral health unit, but two days later was reclassified to a different housing unit. According to the coroner’s report, he was moved to a different pod on June 6, because he was not getting along with other inmates. On June 23, he was placed in a cell alone.

At that point, he was in Housing Unit 8, a special handling unit for inmates who have been segregated because of their gang affiliation, sexual orientation, or charges involving sex crimes.

Sheriff’s Sgt. Ray Kelly said that despite being placed in a cell alone, Dickey was not being held in isolation and participated in normal activities with other inmates, including going to breakfast the morning he died. Another inmate, a friend of Dickey’s, said he played chess with him the night before and saw Dickey at breakfast at about 4 a.m., according to the sheriff’s report.

Dickey had been prescribed Olanzapine, an antipsychotic used to treat mental health issues such as schizophrenia and bipolar disorder, but apparently hadn’t been taking it. During his autopsy, county Chief Pathologist Dr. Michael Ferenc found two Olanzapine pills and two Benadryl pills in a crumpled paper cup stuffed in Dickey’s sock.

Kelly said that as a matter of sheriff’s office policy, deputies at Santa Rita check that inmates have swallowed their pills when they’re given medication. “It’s a system designed to make sure that people are taking their meds appropriately,” Kelly said. “However, if you stash it in your throat or in the back of your mouth somewhere, we can’t see it.”

On June 26 at 8:13 a.m., guards opened the cell doors in Dickey’s pod so the inmates could come out for recreation time. But Dickey didn’t come out. Other inmates noticed him on the cell floor and yelled, “man down.”

He was face down inside the cell. There was a cut on his forehead and blood on his face, but otherwise there was no sign that Dickey had been in a fight. Other inmates reported hearing a “boom” or “bang” shortly after breakfast, as if Dickey had fallen on the cell door or kicked it. There was white foam around his mouth and lips. The toilet was full of feces and vomit. Trash and clothes covered the cell floor.

Deputies Sean Reid and James Frye grabbed Dickey by the shirt, pulled him out of the cell, and rolled him onto his back. Paramedics tried to revive him, but he was pronounced dead at 8:58 a.m.

Ferenc conducted an autopsy the next day, but it was inconclusive. On Sept. 7, he determined that Dickey had died from hyponatremia — drinking too much water — due to psychogenic polydipsia associated with schizophrenia. Dickey’s mental illness had apparently made him feel constantly thirsty, even when he’d consumed a dangerous amount of water. He drank so much water it caused the sodium level in his blood to drop fatally low.

While a death in custody from excessive water consumption is unusual, it is not unprecedented in California. In August 2015, Ruben Nunez, 46, died under similar circumstances in a San Diego jail.

Critics say that Dickey’s death is a sign of inattention to mental health treatment in jails. The Alameda County Sheriff’s Office is facing a class action lawsuit filed on Dec. 21 for the treatment of mentally ill inmates. It cites Dickey’s case as an example of the dangers of not providing adequate mental health treatment. “He was allowed to deteriorate to the point where he drank himself to death,” Kara Janssen, one of the attorneys who filed the suit, said. “It should not be happening in our county jails.”

The lawsuit alleges that the sheriff’s office is failing to provide adequate mental health care for inmates, not properly identifying mental health issues at intake, not monitoring medication, not getting complete medical records, and frequently placing inmates suffering from mental health issues in isolation, at times even taking their clothes and leaving them in bare “safety cells.”

“Mental health treatment is virtually nonexistent at the jails, even on the Behavioral Health unit — which is designated as the unit for prisoners with significant psychiatric disabilities,” the lawsuit states. “Jail staff are untrained or otherwise unresponsive to the mental health needs of prisoners and fail to respond to emergency call buttons pressed by prisoners who are mentally ill and in the midst of a crisis.”

The suit points out that failure to monitor inmates can lead to suicide. There have been 33 deaths in Santa Rita over the last five years, including 13 suicides. Such deaths can also be costly for the county, which has paid millions in civil rights payouts in recent years, including $275,000 for the family of Dennis Jimenez, who hanged himself in Santa Rita in 2012.

Amber Piatt, the Health Instead of Punishment program director for Oakland nonprofit Human Impact Partners, has been coordinating with the Ella Baker Center for Human Rights in calling for an audit of the sheriff’s office. “What his story and similar stories coming out of Santa Rita tell us is that people struggling with mental health deserve care and compassion — there are no exceptions for that,” she said. “Jails and prisons exacerbate mental health issues. They do not heal them.”

About 44 percent of the roughly 2,200 inmates in Santa Rita have some interaction with the jail’s mental health services, a higher proportion than most other California counties, according to Kelly. But the jail does not have 24-hour mental health coverage. It has a staff of only five psychiatrists and 12 mental health clinicians, so while jail staff prioritize inmates in crisis, it can take several weeks for inmates to receive mental health treatment, according to the sheriff’s office.

Seeking to improve access, the sheriff’s office plans to construct a new building at Santa Rita that would be devoted to mental health services. The project would be funded partially through state funds allocated from SB 863, a 2014 law that provided funding for jail construction. The sheriff’s office would reallocate bed space in the jail, which has had a declining population and is currently at less than half capacity. Kelly said the project could break ground later this year.

For people suffering mental health issues who land in the jail, Kelly said, “we truly want to reduce their recidivism rate. Where we can save people and get them back to good health, these programs, these buildings, will help us do that.”