James Tatsch was not charged with any crime. But when he was found unresponsive in an isolation cell at the Alcorn County Jail on Jan. 17, he had been locked up for 12 days. He died at the local hospital.

Tatsch was waiting for mental health treatment through Mississippi’s involuntary commitment process. Every year, hundreds of people going through the process are detained in county jails for days or weeks at a time while they wait for evaluations, hearings and treatment. They are generally treated like criminal defendants and receive little or no mental health care while jailed.

Mississippi Today and ProPublica previously reported that since 2006, at least 14 people have died after being jailed during this process. Tatsch, who was 48 years old, is at least the 15th. No one in the state keeps track of how often people die while jailed for this reason. The news organizations identified the deaths through lawsuits, news clips and Mississippi Bureau of Investigation reports. MBI investigates in-custody deaths only at the request of the local sheriff or district attorney.

Alcorn County Sheriff Ben Caldwell said Tatsch’s cause of death is unclear. It was not a suicide and there were no signs of physical trauma. Medical staff at the jail had recently checked on him and not seen any cause for concern, Caldwell said. Tatsch had been eating normally and had conversations with jail staff.

“Obviously he was going through a mental health crisis and there were times where he was not his normal self, I guess,” Caldwell said.

Caldwell said he doesn’t think people should be sent to his jail solely because they need mental health treatment, but it’s not uncommon. He worries about keeping them isolated, in a bare cell, while they are in crisis. The cell where Tatsch spent his final days had no television.

“If you have a stroke or if you have any other medical issue, you’re in the hospital, or you’re under a doctor’s care, whereas if it’s mental health, if there’s no bed available, then you come to jail,” Caldwell said.

Caldwell said Tatsch was homeless and had come to Alcorn County from the Coast. The sheriff’s department was unable to reach his family, but the Mississippi Bureau of Identification eventually located a former girlfriend of his late father.

Through Facebook, Mississippi Today reached a woman who said she was Tatsch’s niece, but she did not know him personally.

Under Mississippi law, a person going through the commitment process must receive a pre-evaluation by their local community mental health center, and then two more evaluations before having a hearing where a judge decides whether to order them into inpatient treatment.

It isn’t clear whether Tatsch had a hearing during his 12-day incarceration. The Department of Mental Health says the whole process should take no more than seven to 10 days, but it collects no data on whether counties are actually hitting that target. The agency does not know that a person is going through the process until a commitment order is entered by a judge and collects only limited data on the number of people jailed while they await help. 

DMH director Wendy Bailey recently told the Senate public health committee that the average length of wait in jail for a state hospital bed is just under three days, but that figure doesn’t include any time people spend in jail before their hearings.

Thomas Sweat, the new special master who handles commitment hearings in the county, told Mississippi Today that he was appointed to the position “within the last couple of weeks,” has not yet held a hearing and was not familiar with Tatsch.

Polly Tribble, the executive director of Disability Rights Mississippi, said Tatsch’s death illustrates the need for greater oversight of the commitment process.

“It stands to reason that once somebody is booked – and I don’t even like that term, for commitment proceedings – that that’s when DMH needs to get involved, and know about that person,” she said. “Of course we don’t know what happened to this man and if any of that could have been prevented, but it highlights the problem that we have.”

Caldwell said he did not know where in the process Tatsch was.

Alcorn County Chancery Clerk Keith Settlemires, whose office is responsible for coordinating the process, did not respond to calls and an email seeking information. His office eventually told Mississippi Today to stop calling.

Jason Ramey, the executive director of Region IV – the community mental health center that serves Alcorn County and provides initial screenings during the commitment process– said he could not comment on a specific patient.

Lawmakers are currently discussing proposals that would limit the use of jail to detain people during the commitment process, which the Department of Mental Health supports. One measure, sponsored by Rep. Kevin Felsher, R-Biloxi, would allow jail detentions only for protective custody while someone awaits transportation to a medical facility, and only for up to 72 hours.

In an interview, Felsher emphasized that he doesn’t know the specifics of Tatsch’s case and isn’t “pointing the finger at anyone.” But he believes people should not be jailed solely on the basis of mental illness. If jail detentions are necessary, they should be for the shortest amount of time possible.

“Mental illness is a medical condition, not a crime,” he said. “What are you doing in jail for 12 days if you haven’t committed a crime? So there’s some questions to be asked there.”

The Alcorn County Chancery Clerk’s office was in the midst of a transition when Tatsch was booked into the jail. Settlemires, who had no prior experience working in the office, had just been sworn in.

The commitment process can be complicated, requiring clerks and their staff to coordinate evaluations and try to find placements for people in the midst of a mental health crisis.

Deputy Clerk Carolyn James said commitments are currently handled by “whoever in here that can take the commitments.”

“We had a person that did our court work that is no longer here, so we’re just kind of doing the best we can right now,” she said.

When no bed is available at the crisis stabilization unit or the local hospital, people going through the process go to jail, she said.

James said she does not know who runs the crisis stabilization unit.

“We’re trying to do it as right as we can,” she said. “It’s just a bad situation with all this mental health stuff.”

Ramey, the director of Region IV, which operates the Corinth crisis unit, said he was surprised that James did not know Region IV runs that facility.

“I’ll make sure that’s rectified,” he said.

In an email, Department of Mental Health spokesman Adam Moore reiterated that the agency supports legislative proposals to require a pre-evaluation before someone is detained during the commitment process and to restrict jail detentions.

“It is a priority for us this session to work with the Legislature and other stakeholders during the legislative process, and we will continue to do so during the weeks and months ahead in the session,” he said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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