Seriously mentally ill (SMI) refers to untreated people with schizophrenia or
severe bipolar disease. Fifty per cent do not know they are sick so they will not start or
continue medications. These folks cycle between the streets, 72 hour holds, 911 calls,
county jails or prison. There are no safety nets once they cannot be managed at home.
Families learn that long-term locked facilities and conservatorships are virtually non-

The invisible deaths are those already in custody jails. Many are in jail for minor
offenses and die in custody without ever making it to trial. I emphasize that these are
county jails where people are awaiting trial and cannot pay bail and often wait months
for trial.

The topic is particularly well covered in the San Francisco Chronicle as a search
reveals multiple articles of individuals who have met this fate in all the Bay Area
counties. A wrongful death suit against an Alameda county sheriff’s office by the family
of Dujuan Armstrong is reported in the S.F. Chronicle in December 2019. He was a 23
y/o black man. The death was suffocation by “body-wrap.” The video of his death was
made June 23, 2018 but not released until October 2019.
The footage shows the attempt by six deputies and the sheriff to walk Armstrong
down a long hall for transfer to a psych hospital/ward because of psychotic behavior on
the second day of his arrest. A violent struggle ensues with all seven officers attempting
to place Armstrong on the floor eventually cuffing his ankles and handcuffing his hands behind him. Despite this he continues to be out of control. (N.B. I ask myself why not an
IM dose of Thorazine or Ketamine?)

He is crying, asking for help for himself and “for my black brothers.” The body
wrap looks like saran wrap wound around and around the entire body except for his
head and neck. Not shown are the eight minutes it took to place the device. The video
picks up as he is lifted onto a gurney. His head and neck are resting against his chest.
From that point, about three minutes, the prisoner is ominously quiet as he is eventually
rolled into a specialized cell. A nurse is called to take his blood pressure and states “all
good” but moments later he has no pulse and is not breathing. Although not shown on
the video, CPR was started but he was pronounced dead in the jail.
A WAPO article February 2018, is titled: Profound Dehydration: Milwaukee County
Sheriff’s Officers Charged in death of Inmate Denied Water for a Week. Terrill Thomas
was a 38 year-old black male with known schizophrenia. Thomas was arrested because
he shot a gun into the ceiling of a restaurant. He was taken to the county jail clearly in a
mental crisis. He flooded the cell with water by turning on the faucets and overflowing
the toilet. As punishment the water to the sink and toilet were turned off. Death by
dehydration occurred seven days later.

Shali Tilson made such a trip to Hell as seen in excruciating detail as his family
watched their son’s last his last hours on video. The Atlanta Journal-Constitution article
in September 2018 is titled Sarge, I Think He’s Gone: Video Shows the Last Hours before
Rockdale Jail Inmate Died in Cell.

Shali Tilson, a black male aged 22 with schizophrenia, was placed in the Cobb
County jail in Georgia for disorderly conduct in obvious psychotic crisis on March 3 2018.
Despite suicide watch he died nine days later on March 12. Instead of the 15 minute
checks he was left alone by deputies and medical personnel for hours at a time. Records
had been altered as revealed by a video not released until June. The cause of death was
blood clots in the lungs due to dehydration. The description of the footage is heinous.
In February 2011 Carlos Umana, 20, starved to death having gone from 180 to 77
pounds after spending four months in the Salt Lake county jail’s solitary confinement.
There was a water fountain in his cell and meals were brought to him. In October 2010
Umana had stabbed his mother’s boyfriend. Umana died before having gone to trial.
Upon incarceration he had no drugs in his system. His mother brought his psych
medications to the jail but it is not clear if he took them. Because he would not eat he
was about to be transferred to a psychiatric hospital. He was pronounced dead in the

There is a Guardian article by Gloria Olaipo from April 15, 2023 about a man in an
Atlanta, Georgia county jail literally eated by bed bugs. He had been admitted to the
psychiatric ward of the facility …”after determining that he had mental health issues….”
He was described as in good condition upon arrest. Lashawn Thompson, 35 y/o, was at
the Fulton county jail cell in “squalid”conditions after a misdemeanor. Three months
later he was discovered dead. “The cell was so filthy that an employee wore a hazmat
suit upon entering the cell as reported by the Washington Post. The autopsy confirmed
a massive infestation of Thompson’s body and the cell but no cause of death The family lived in Alabama and were not aware Thompson was in Atlanta until notified of his

Addendum: The reader is referred to a six part Reuter’s investigative series of in
custody deaths that appeared October, 2020. The series is titled Dying Inside: The
Hidden Crisis in America’s Jails

Written by paul