An Arkansas man died in jail after spending a year in pretrial solitary confinement. The official cause of death was malnutrition and dehydration. But the man, Larry Eugene Price Jr., was also the victim of systemic issues plaguing the American criminal justice system.  

Price, according to a federal lawsuit filed last week, was "a severely mentally ill man, living below the poverty line in Fort Smith, Arkansas." Price suffered from a variety of mental illnesses, including "paranoid schizophrenia, which caused him to experience delusions, visual and auditory hallucinations, disordered thinking, and severe agitation." In addition to his mental illnesses, Price also was diagnosed with "intellectual developmental disorder, a developmental disability that significantly impaired his intellectual and adaptive functioning." His IQ was 55.

As a result of his condition, Price had "a long history of involuntary commitments (or mental health holds) in state and county mental hospitals—where he would be treated by a team of trained professionals." After his health stabilized, Price was released from these facilities into the community. Price "was unmarried, unemployed, homeless, and disabled." 

On August 19, 2020, Price walked into the Fort Smith Police Department. He began yelling and cursing at the officers. At one point, Price "held out his plainly empty hand as if he was holding a gun and used his index finger to pull an imaginary trigger." None of this was out of the ordinary. Price visited the police department on a daily basis and often behaved irrationally. 

When Price refused to immediately leave the police station, an officer decided it would be in Price's “own best interest” to have officers “place him under arrest or otherwise try to calm him.” Price was booked in the Sebastian County Jail and charged with “terroristic threatening in the first degree.” 

Price's bail was set at $1,000. He could not afford to post bond, and jail staff placed him in solitary confinement. He remained in solitary confinement for at least 23 hours a day, seven days a week, for a year. 

Completely isolated, Price's condition rapidly deteriorated. He often refused to take his prescribed anti-psychotic medication and "continued to exhibit increasingly severe symptoms of mental illness." Because of the erratic behavior associated with Price's untreated mental illness, corrections officers routinely denied him his one hour outside of isolation. By November, the jail doctor treating Price "discontinued" Price's medications. According to the lawsuit, after discontinuing Price's medications, the doctor "never made any effort to follow up with Mr. Price or to address his serious mental health needs." 

In December 2020, Price often refused to leave his cell and "began eating and drinking less and less, putting him at risk of life-threatening malnutrition and dehydration." In January 2021, Price requested to see a doctor because he was "sick" and "lost alot [sic] of weigh[t]." His request was not granted because, according to a nurse, Price was "non-compliant."

Things got worse. Price began "eating his own feces and drinking his own urine." Jail staff was instructed to monitor his food and fluid intake but never did so with any consistency. By April 2021, jail staff stopped monitoring Price's food and fluid intake entirely. 

In May 2021, a judge ordered Price "to undergo a psychiatric assessment to determine whether he had the capacity to form the culpable mental state required to prove him guilty of the crime with which he was charged and to determine whether he was mentally fit to proceed to trial." That assessment never occurred, and Price continued to languish in jail. 

By June 2021, Price "was not consuming enough food or drinking enough water to sustain human life." As an inmate in solitary confinement, staff was required to check on his well-being every 15 minutes. According to the lawsuit, "[b]etween August 1 and August 29, 2021, jail guards logged over 4,000 consecutive wellbeing checks." Each of these entries was identical: "Inmate and Cell OK." 

But things were not OK. On August 29, 2021, "Sebastian County Jail corrections officers discovered Mr. Price lying his isolation cell, unresponsive, in a pool of standing water and urine." When EMTs arrived at the scene, they estimated he weighed just 90 pounds — down from 185 pounds when he entered the jail a year earlier. Price's fingers and toes were severely pruned from "being submerged in standing water for a long period of time.” Price was transported to a local hospital, where he was pronounced dead on arrival. 

Price's tragic death is not an aberration. It is a consequence of fundamental problems with the American criminal justice system that impact millions of people. 

Criminalizing poverty

The only reason Price was behind bars for a year was that he was poor. He was never convicted of "terroristic threatening in the first degree." And, due to his mental illness, likely never would have been convicted. But Price's bail was set at $1,000. But Price didn't have any money. 

There are over 440,000 unconvicted people held in local jails every day. Many of them are there because, like Price, they cannot afford to post bail. People with more wealth can engage in the exact same behavior and remain free. 

Proponents of cash bail claim that it is necessary to protect public safety. But the facts don't support that theory. A November 2020 study found reforming cash bail does not negatively impact public safety. Nearly every jurisdiction that reformed cash bail and began releasing more people pending trial saw crime remain flat or decrease. 

In New Mexico, for example, voters approved a "constitutional amendment [that] prohibits judges from imposing bail amounts that people cannot afford" and "enables the release of many low-risk defendants without bond." Between 2017, when the amendment went into effect, and 2020, the percentage of individuals charged with additional crimes pending trial decreased from 26% to 16.8%. This is the result of an increased focus on the pretrial detention of the most dangerous defendants rather than those who simply lack resources. 

Cash bail is also not necessary to ensure that defendants make their court appearances. Jurisdictions that reduce their reliance on cash bail in favor of other methods, such as individualized risk-assessment and electronic monitoring, "experienced no increase in failures to appear for trial." 

Defendants that are detained before trial have more difficulty mounting a successful defense. According to the Brennan Center, "those who are held pretrial are four times more likely to be sentenced to prison than defendants released prior to trial." Further, defendants stuck behind bars are also "are also likely to make hurried decisions to plead guilty to a lower charge."

Other benefits of cash bail reform are more difficult to quantify, including "the safety of individuals who can remain at home instead of in a jail cell, children who are able to stay in their parents’ care, and community members who are spared the health risks… that come from jail churn."

The torture of solitary confinement

In 2021, between 41,000 and 48,000 people were held in solitary confinement in state and federal prisons, according to a study by Yale Law School. Of that group, more than 6,000 have been held in solitary for more than a year. More inmates are held in solitary confinement in jails. 

Studies have shown that solitary confinement "can lead to serious and lasting psychological damage." For people, like Price, who have preexisting mental illnesses, solitary confinement "can exacerbate mental illness and cause people’s mental health to significantly deteriorate."

While people typically associate solitary confinement with violent criminals, the practice "has become a common tool for responding to all levels of misconduct—ranging from serious assaults to minor, nonviolent rule violations." The United Nations considers prolonged solitary confinement a form of "psychological torture." Further, "inflicting solitary confinement on those with mental or physical disabilities is prohibited under international law."

Incarcerating people who need treatment

In the United States, people with mental illnesses are more often incarcerated than given proper treatment. According to the Treatment Advocacy Center, people in the United States with mental illness, like Price,  are “10 times more likely to be incarcerated than they are to be hospitalized.”

While behind bars, people with mental illness are often not provided with the care they need. According to the National Alliance on Mental Illness, around 63% of people with “a history of mental illness do not receive mental health treatment while incarcerated in state and federal prisons.”

Some of this is due to the lack of resources for mental health treatment in the United States.  According to the Association of American Medical Colleges, “more than 150 million people live in federally designated mental health professional shortage areas.” A survey by the Treatment Advocacy Center found that “communities need at least 50 psychiatric hospital beds per 100,000 people in order to provide adequate care.” But instead of investing in treatment centers, taxpayer dollars go toward building more jails and prisons. 

Without adequate mental health resources across the country, many people in mental health crises rely on the police for help. According to the Atlantic, experts estimate that “as many as 40 percent of calls to police concern a mental health emergency.” Many police, however, lack the training to respond to mental health crises. People with mental illness are “sixteen times more likely to be killed in a police encounter than people who are psychiatrically well.” In 2018, “approximately 25% of the victims” of the “roughly 1,000 fatal shootings by police” experienced mental illness.