1
00:00:00,000 --> 00:00:02,940
Michael Dauphinais: Following is an azpm original production.

2
00:00:09,620 --> 00:01:21,440
Christopher Conover: Welcome to The Buzz. I'm Christopher Conover, this week mental health care in the justice system. When a year long investigation of the Pima County Jail gave the public concrete evidence of crumbling buildings and inadequate health care, many were frustrated. But the county decided a new jail was too expensive. The whole process left those closest to the system with more questions than answers. In particular, how is the county's failing justice infrastructure going to adapt to a community with increasing levels of mental illness and chronic health problems? AZPM partnered with Arizona Luminaria for 18 months to tell the story of one man as he navigates the justice system while struggling with mental illness for over 20 years, Pat's family has spent thousands of dollars and immeasurable amounts of emotional energy supporting him, but in a system that lacks empathy and prioritizes punishment, not prevention. AZPM's Hannah Cree and AZ Luminaria's John Washington take it from here.

3
00:01:21,000 --> 00:01:28,320
Hannah Cree: when mental health makes day to day function difficult, facing eviction from your home can turn a tough situation into a nightmare. 

4
00:01:28,950 --> 00:01:37,770
Pat Grenier: What do I think? I am dismayed. I'm just made homeless by the City of Tucson

5
00:01:38,170 --> 00:02:07,930
John Washington: that was Pat Grenier, a lifelong Tucsonan who lost his house in the middle of a mental health crisis a few years ago. His family believes Pat has frontal temporal dementia, a rare form of the disease that manifests in personality changes and lack of self awareness, although his family is still struggling to get an official diagnosis for dementia, he's battled bipolar disorder and schizoaffective disorder for at least the last decade. His daughter Brianna Grenier says that when things are bad,

6
00:02:08,170 --> 00:02:22,270
Brianna Grenier: The dominant symptom, or tell of his mental illness is he has these very grandiose thoughts. He thinks he's a US Marshal, the cartels out to get him.

7
00:02:21,800 --> 00:02:25,940
John Washington: Brianna says her dad's ups and downs don't define him 

8
00:02:25,690 --> 00:02:31,870
Brianna Grenier: when he is well and stable. He is my most favorite person in the world. But

9
00:02:31,870 --> 00:02:48,550
Hannah Cree: it's important to note that throughout our time with Pat, he repeatedly denied having any of the mental illnesses we described in this piece before his disease deteriorated. Pat had long periods of stability. Brianna told us about his career in one of the many phone calls we had with the family throughout 2024

10
00:02:48,700 --> 00:02:56,770
Brianna Grenier: he was very, very talented woodworker and craftsman, and I know he's very, very proud of that.

11
00:02:56,950 --> 00:03:21,430
Hannah Cree:  One impact of Pat's mental illness is that it makes day to day responsibilities harder. Pat's brother in law, James Baker says Pat was effectively kicked out of his own home in 2022. He missed a few utility payments after he started believing the utility companies were run by oligarchs. In an interview with the both of them in 2023 James says the house was deemed unfit for occupancy after the water and electricity were turned off. 

12
00:03:21,490 --> 00:03:32,410
James Baker: The city says you don't have services. Your house is condemned. No trespassing. You have to get out of your house, no trespassing, unfit for occupancy. So they make someone homeless who owns a home.

13
00:03:32,840 --> 00:04:31,490
John Washington: The city of Tucson denies Pat's claim that they made him homeless. The condemnation report from the city says Pat violated the codes about vegetation overgrowth and debris around his house, as well as letting junk vehicles stay on his property. Christina Pulsgrove, with the city of Tucson Department of Environmental and General Services, said condemning the house was a matter of public safety, and there was a history of problems at his house. She said condemnation isn't a final decision, and occupants can move back in as long as they fix the code violations, restore utilities and receive a certificate of occupancy. Both Tucson electric power and tucson water have payment assistance programs that can help people avoid eviction. But if you think oligarchs control the utilities, it's easy to falter the cracks, and even harder to fix a housing crisis once you're in one. Keith Bentele studies homelessness for the Southwest Institute for Research on Women. He explains how mental illness adds a layer of complication, 

14
00:04:32,630 --> 00:04:50,960
Keith Bentele: but if you think about needing to be really on top of getting in line to maybe get a service, and then you have to meet eligibility criteria and submit paperwork and things like that to get that. Again, if you're experiencing a mental health crisis and you're so depressed you can barely get out of bed, then it's very unlikely you're going to be able to negotiate that system. 

15
00:04:50,990 --> 00:05:04,130
John Washington: During one emergency room visit at Tucson Medical Center, doctors told Brianna that Pat was neither a danger to himself or others, and there was nothing they could do. Let him go home. Brianna implored them that that wasn't true, 

16
00:05:04,250 --> 00:05:24,290
Brianna Grenier: because he is incapable of taking care of himself. He is incapable of usual, routine adult responsibilities, and therefore he is a danger to himself, because he is slowly killing himself. He is killing himself in another way.

17
00:05:24,890 --> 00:05:49,310
Hannah Cree: Housing is just one problem Pat and his family have had to navigate. The other is the justice system. In 2019 Pat was arrested in his driveway after a dispute with a neighbor. During the arrest, Pat, says Tucson Police Department officers broke his hip after tackling him on the concrete. In video footage from the arrest, Pat is screaming in pain.

18
00:05:58,790 --> 00:06:02,240
Pat and his family say he has lasting injuries from the takedown. 

19
00:06:03,170 --> 00:06:19,970
Pat Grenier: I've got new metal rods, horizontal and vertical head along the way there that assault, which changed my life forever. I planned to work as a carpenter until 72.

20
00:06:23,410 --> 00:06:45,400
Hannah Cree: We reached out to TPD about the incident. They said Pat's complaint went through the Office of Professional Standards for an internal review. In an email, Sergeant Richard gretas wrote that the arresting officer, Jose Galvin had seen a physical altercation between Pat and his neighbor, which caused Pat to fall. He then alleges Pat resisted arrest, and that Pat mentioned a recent surgery on his hip.

21
00:06:50,620 --> 00:07:16,060
But Pat's family says that's not true. According to James, Pat's hip had never been broken before that incident, and the injury was caused from what he calls a forceful takedown from behind. The Office of Professional Standards concluded the investigation of Pat's complaint and ruled the allegations they caused Pat's injuries to be unfounded. Today, Pat still wears a back brace from the encounter, but his family has not pursued further legal action. 

22
00:07:24,820 --> 00:07:50,020
John Washington: Law enforcement's response is only one part of the problem. Pat's family says he never quite recovered from the 2019 takedown with TPD and losing his house actually caused more citations to stack up. When he lost his house for the last time in 2022, a major consequence was that Pat could no longer receive mail. When the post office stopped delivering to his house, James says he missed critical notices from his insurance and the courts,

23
00:07:51,280 --> 00:08:00,100
James Baker: they would send notices of your court date to his address, which then ended up going nowhere. It took a period of time before we got realized all that,

24
00:08:02,050 --> 00:08:44,860
John Washington: according to the family's accounts and arrest records, Pat has had at least four warrants out for failure to appear or FTA. An FTA was what prompted Pat's latest stay in the Pima County Jail in March 2023, during a stint of court order treatment at Tucson Medical Center, Pat ran away, and hospital staff called the police to find him. He was arrested and taken to the jail when the police officer found a warrant for failing to show up for a court date. Because of his history of failing to appear to court, Pat's attorney told James that the safest place to keep his brother in law was the jail. He was horrified. We sat down with Brianna and James the day after yet another death was reported at the Pima County Jail in 2023.

25
00:08:44,930 --> 00:09:02,540
James Baker: Because you're seeing in the news another death at the Pima County Adult Detention Center, and then you see another death, and then one death at the mental health unit. So really, and you're telling me that's the best place where he can be right now? Vut what's the alternative?

26
00:09:03,500 --> 00:09:13,160
Unknown: Amelia Cramer, vice president of the NAACP Tucson chapter, says the failure to appear cycle keeps vulnerable people trapped in a traumatic environment. 

27
00:09:13,370 --> 00:09:28,550
Amelia Cramer: The primary reason people to fail fail to appear for the next court hearing is due to poverty, mental illness or substance use disorder, the vast majority of folks have been arrested for low level, nonviolent misdemeanors.

28
00:09:28,730 --> 00:09:56,120
Hannah Cree: Shortly after that arrest, Pat's lawyer filed a Rule 11 petition that's Arizona's legal procedure for determining whether someone is mentally competent to stand trial. In the two months he waited in jail for his Rule 11 hearing, Pat turned 70. Finally, in May 2023, the Arizona Superior Court found that Pat was incompetent. The court ordered him to be held in the jail without bond until his next hearing in October, guaranteeing another four months in the jail.

29
00:09:56,480 --> 00:10:14,480
Pat Grenier: It's filthy, just deplorable conditions. And John, I can't tell you how horrible it is, and they put me in there with wife beaters, narcotics dealers and murderers and people who said they were going to kill me.

30
00:10:14,870 --> 00:10:54,110
John Washington: At his hearing. He was also referred to the county's restorative competency program, or RTC. It's specifically for individuals like Pat who have been deemed, quote, incompetent but restorable. According to data from the County's Behavioral Health Department, 128 people passed through the RTC program in 2023, which is the most it has seen in the last five years. The general manager of the RTC program explained to us that those in the program receive the same services as other people in the jail. The main difference is the jail's health care contractor allegedly provides a psychiatrist designated only to people in the program. 

31
00:10:54,470 --> 00:11:18,170
Hannah Cree: But the issue for activists like Kramer is the restoration program happens inside the jail, which is not a restorative place. Eight people died in the jail in 2023 according to the Pima County office of the medical examiner, triggering intense community backlash in 2024 that number dropped to one after the county expanded addiction treatment in the jail. But Cramer says, healing is not a goal of the RTC program. 

32
00:11:18,290 --> 00:11:31,790
Amelia Cramer: Restoration to Competency is not treatment for mental illness, it is simply medication and education to get the person ready to be able to participate in the defense at their trial. This is not to make them better. In

33
00:11:31,790 --> 00:11:55,520
Hannah Cree: September 2023 Pat was beaten up by his cell mate. Jail records documenting the assault report. He had redness and swelling under his left eye. In jail grievance forms we obtained through a public records request. Pat wrote he was hungry, complained of a filthy cell and beatings from corrections officers. He also contracted bronchitis in the jail, and his jail records show multiple transports to the hospital.

34
00:11:55,760 --> 00:12:12,020
Pat Grenier: It don't make sense that I'm denied privileges and roughed up along the way and looked down upon by these so called professionals. I know how to seek help, but when I ask for it, it's not there.

35
00:12:12,540 --> 00:12:31,680
John Washington: The Pima County Sheriff's Department told us that our subject was likely giving us false information when we approached them about Pat's complaints, the county claims its program consisting of medication, legal education and psychological evaluation is more specialized. But Pat said that didn't matter. He was still locked up. 

36
00:12:32,190 --> 00:12:48,780
Pat Grenier: I felt that I had no hope of ever getting out again, to enjoying the fresh air, the breeze on my scalp and looking about the scenery, I didn't think I'd ever see that again. 

37
00:12:52,320 --> 00:13:02,820
John Washington: In a 2023 interview with Brianna and James while Pat was still in jail, they said not being able to visit him in person and only being able to make infrequent video calls with him was heartbreaking.

38
00:13:04,410 --> 00:13:39,240
Brianna Grenier: Oftentimes, I feel numb, if I'm being totally honest, just because the heartbreak and the overwhelm is a lot to realize that, you know, he can't look at the moon, or he can't meet family for coffee or something like that. And so I have not found the best way to be. I am here. That is often my response is that I am here.

39
00:13:43,260 --> 00:13:49,830
John Washington: Cramer says keeping people in jail who are only facing sentences of probation is a mistake. See, someone who's committed

40
00:13:49,830 --> 00:14:09,810
Amelia Cramer: a serious sexual assault should not be released from the jail while they're being restored to competency, but someone who's committed one of these low level misdemeanors have been booked again on a failure to appear, could certainly be released from the jail, to treatment services at a mental health facility in the community, or to supportive housing in the community while They're being restored to competency. But that's not happening.

41
00:14:24,300 --> 00:14:52,830
Hannah Cree: Pat's story is not an anomaly. According to county data, a third of the jail's population was on long term psychiatric medication, and jail workers are performing an average of 400 mental health evaluations a month. The only thing Pima County lawmakers agree on is the problem itself. But everyone has different opinions on what that change should look like. At the top Pima County Sheriff Chris Nanos agrees a lot of the people who have committed low level crimes will be better off somewhere else.

42
00:14:53,010 --> 00:15:28,110
Chris Nanos: I have no say who can come in there, who gets to come and go, but my opinion is we still have a lot of them in there who shouldn't be there. Know that there's other places for him. The restorative competency program, I think, adds to that problem. I have a guy who who steals a bike at three in the morning, and he comes in, and if he'd had just pled guilty, he'd have been out in two or three days instead, because he's got some real mental health issues, they hold him in my jail till he has his restoration of competency, which is six months down the road for to be evaluated.

43
00:15:28,290 --> 00:15:39,060
Hannah Cree:  But Nanos also thinks that accommodating too much is sending the wrong message, as Nanos told azpm later in 2024 as the county was debating spending $800 million on a new jail,

44
00:15:39,150 --> 00:15:55,260
Chris Nanos: but to build an entire facility around those needs. You're telling your community, those out in the in the world who deal with this, that you want services, you got to be arrested first, and that's the image I want to avoid. 

45
00:15:55,540 --> 00:16:24,820
John Washington: Others suggest starting at the first responder level, often because it's the officer's choice whether to take an individual in crisis to treatment or to jail. Tucson Police Department's Mental Health Service Team, or MHST is a squad of nine police officers who exclusively deal with those calls in the community, but the most severe crises are still left up to regular patrol officers to deal with. Officer Joshua Godfrey explains, the MHST team's most common assignment is serving amendments, as he explains.

46
00:16:25,210 --> 00:16:46,210
Joshua Godfrey: what's called an amendment, and those are people who are already put on a court order treatment plan, but they're either symptomatic or not following their treatment plan, and so their mental health provider will send a form to the court that, again, gets stamped by a judge. It comes to our unit as an order to go pick that person up and take them to a facility get put back on their treatment plan, and that's typically going to be the Crisis Response Center.

47
00:16:46,300 --> 00:16:54,610
Hannah Cree: Sergeant Jason winsky started the team 10 years ago. He says 2023 statistics show that the group doesn't take people into custody often. 

48
00:16:54,880 --> 00:17:03,360
Jason Winskey: We had over 2000 unique engagements with people in crisis in the community, and we only arrested one person the entire year.

49
00:17:03,360 --> 00:17:14,940
Hannah Cree: MHST Officers are trained in de escalation strategies and hostage negotiation, but Godfrey says most of what he knows about mental health treatment comes from his years of working the streets. And mental health

50
00:17:14,940 --> 00:17:26,599
Joshua Godfrey: investigation is not that dissimilar from like a criminal investigation is instead of looking for probable cause to arrest somebody, we're looking for indications that they're a danger to themselves, danger to others, gravely disabled or persistent, acutely disabled.

51
00:17:28,640 --> 00:17:37,610
Hannah Cree: Sergeant Winsky says reform is a slow process, and the system of diversion from jail is far from perfect, due to the limits of the team and challenging situations.

52
00:17:38,690 --> 00:18:00,920
Jason Winskey: Because I think, you know, it boils down to each individual officer or deputy's discretion, right? So every single one of those situations is unique. There's a million ways, unfortunately, that you know, depression and deflection can work, and there's a million ways that it can fall through the cracks.

53
00:18:02,030 --> 00:18:07,850
Hannah Cree: Officers told us there's a significant backlog of cases, and the demand from the community continues.

54
00:18:08,300 --> 00:18:11,810
Jason Winskey: Oh my gosh, we could have five teams, you know, 24/7,

55
00:18:22,040 --> 00:18:26,600
Christopher Conover: you're listening to The Buzz. The story continues after the break. 

56
00:18:27,740 --> 00:18:42,440
NPR promo: We could all use a little help navigating the news these days. The consider this podcast wants to give you a hand six days a week, we'll help you make sense of the day's biggest news story and what it means for you in less than 15 minutes. Listen now to the consider this podcast from NPR. 

57
00:18:43,250 --> 00:19:01,820
Christopher Conover: Welcome back to The Buzz. I'm Christopher Conover. This week's episode features a long running collaboration between AZPM's Hannah Cree and AZ Luminaria's John Washington looking into how mental health issues are treated in the Pima County Jail. John takes us back into the story.

58
00:19:02,560 --> 00:19:28,990
John Washington: In our time with Pat, we were able to see the first hand impacts of a broken system, but at the same time, we barely scratched the surface. Experts told us reform is necessary in almost every area of the cycle that kept Pat stuck, the courts, law enforcement, mental health services in the community, as well as treatment in that jail. Families like Pat's are still looking for solutions. According to Cramer, inertia is the biggest challenge in bureaucracies.

59
00:19:29,200 --> 00:19:52,990
Amelia Cramer: So what we really need is collaboration between the city and the county, all of the government agencies, along with private, community based providers, to create a new system. And yes, it's work. And you know, the thing I've heard, like you've heard, is it's not my job. Well, it isn't anybody's job, and that's part of the problem. But when people all come together, they can make change happen in a positive way. 

60
00:19:53,380 --> 00:20:28,330
Hannah Cree: Pat was found unrestorable In october 2023 and released from jail. Then it was on to another mental health treatment facility, but he escaped and was missing for almost a week. In the months since, he has bounced around at least nine different boarding houses. His family is doing all they can, but Pat is unpredictable, and they worry about another incident sending him back through the jail system, with the county at a standstill about how to improve its own behavioral health care and those in charge denying responsibility. It seems the only way to survive the system is by having someone in your corner.

61
00:20:28,660 --> 00:20:50,770
John Washington: In Pat's case, James and his wife Susan Baker became his conservators last year, effectively becoming responsible for him. James says much of his life over the last few years has been spent chasing different agencies on the phone, insurance companies, the County's Behavioral Health, social workers, TPD, the court system. It's a full time and emotionally taxing job. 

62
00:20:50,890 --> 00:21:02,290
James Baker: There's an extreme learning curve in all of this, and I've been finding out I'm making, I don't know how, literally, hundreds and hundreds of phone calls and conversations with various people

63
00:21:02,500 --> 00:21:31,570
Hannah Cree: because of his multiple citations, Pat lost his private health care and social security, making it even harder for his family to help him. On top of that, Pat still doesn't have an official dementia diagnosis. Despite the fact that psychiatrists within the RTC program made notes of dementia symptoms, that's only enough to find him unrestorable and doesn't qualify as an official legal diagnosis, which James says they need in order to access much needed financial assistance from the Arizona Health Care Cost Containment System. 

64
00:21:31,720 --> 00:21:39,460
James Baker: This is a tremendous undertaking. Financially, we've expended a little over $5,000 so far just to this point.

65
00:21:39,700 --> 00:21:45,250
John Washington: Brianna says there's no telling where Pat would be right now in the system that seems stacked against the most vulnerable.

66
00:21:45,370 --> 00:22:09,250
Brianna Grenier: He's been allowed to fall through these cracks, where these institutions that he is like designated to and entrusted and care of, have just let him go to the wayside. And again, he has folks in his corner, advocating for him, trying to keep tabs on him, trying to help him, and communicating with these with these entities.

67
00:22:10,540 --> 00:22:11,620
John Washington: You have bread pudding there. 

68
00:22:12,220 --> 00:22:18,910
On a visit to Pat's house last summer, he showed us drawings and notes he wrote on scrap paper during his last day in the jail. 

69
00:22:18,000 --> 00:22:23,700
Pat Grenier: We're gonna go to the right, through this archway. 

70
00:22:24,390 --> 00:22:32,730
Hannah Cree: He said it was hard for him to get writing materials, and he wrote most of his thoughts on jail release pamphlets, medical forms, or whatever else he could get a hold of.

71
00:22:33,300 --> 00:22:47,100
Pat Grenier: This was a pamphlet that was handed out along with this on how to get by on the outside world. That's the this. This is the name of the guidebook, 

72
00:22:47,220 --> 00:22:47,670
Hannah Cree: yeah. 

73
00:22:48,360 --> 00:22:59,610
Pat Grenier: But I took advantage of every single piece of paper. But a lot of this, I had a short stub of a pencil and could barely see what I was writing. 

74
00:22:59,880 --> 00:23:06,090
Hannah Cree: One note reads, the system is flawed. How can I succeed without some sort of aid from the outside? 

75
00:23:06,420 --> 00:23:13,170
John Washington: Now, nearly two years later, Pat's family is still working within the system to try to get in the long term care that he needs.

76
00:23:14,580 --> 00:23:44,100
Christopher Conover: Joining me now in the studio are the reporters who put that story together, AZPM's Hannah Cree and AZ Luminaria's John Washington. Hannah and John, we got some idea of the time scale of this story over the last almost 25 minutes. It's a really long time that you both spent working on this. Are there details about that process that Pat and his family went through that didn't make it into the story, and Hannah will. We'll start with you on that?

77
00:23:44,360 --> 00:24:17,750
Hannah Cree: definitely things that we wanted to include but didn't for time constraints, couldn't make it in. One of those that is really top of mind for me was the fact that Pat and his family really struggled to get him glasses inside the jail. Day to day function is more difficult when you can't see and they didn't let him bring his existing glasses in. And, you know, that's a the jail bureaucracy is a whole nother. That's a phone tree, that's maybe you're running into a corrections officer that's been on the job for six months, and they don't quite, you know, get how things worked. James was describing that was a big barrier

78
00:24:18,140 --> 00:25:27,620
John Washington: To underscore, sort of the, probably the principal takeaway for a lot of people is the difficulty throughout this entire process. It was it was a hard story to report. It was a hard story to live through. And there is so many challenges, so many hurdles, so many speed bumps, so many dead ends that Pat, his family and so many other people who are in a similar situation or even brushing into the system briefly, have to try to navigate and it is really, each of the systems is complex in its own right, and when you put them all together, it gets even more complex. And I think the level of difficulty in trying to wrap our heads around this problem is why the problem exists in some regards. And a lot of the public officials and experts that we spoke with say like, Look, nobody is really claiming responsibility, because they've all been able to point to another agency, and the agencies and the different systems just aren't working together very well, and that's something that I think about a lot.

79
00:25:27,890 --> 00:25:59,750
Christopher Conover: One of the things that really struck me as I've talked with you both over the last 18 months, as you've been looking at this and listening to the multiple versions that became what is this show, that came through, but there's so much more to it. Is the impact on Pat's family. We focus on Pat, but so much was going on with his family also that was caused by all of this. 

80
00:25:59,750 --> 00:26:47,780
John Washington: Yeah, I don't know if they gave us a final dollar amount, but this cost them just trying to understand the system. I mean, thousands and thousands of dollars. Pat has a sister and brother in law and other family members who worked effectively, full time jobs at various points, trying to get him insurance back, trying to understand the best process of getting him out of the jail, or deciding to keep him in the jail, as we reported, trying to find him any sort of services, mental health services when he was on the outside. And they readily acknowledge that they are relatively privileged. They have some means, and they have, you know, like very high literacy in navigating these things. But not everyone has the time or the means to dedicate what they have, so they're lucky in many regards.

81
00:26:47,000 --> 00:27:32,390
Hannah Cree: That was the biggest personal impact that I felt reporting this story is the sacrifice that a family makes when just one member of that family becomes incapable of caring for themselves. When you're working full time, I know Brianna was working full time, and honestly, just making one phone call to an insurance company to make to make it so you can pay a singular bill, that can take, I mean, an uncalculable amount of mental energy and to deal with that for years and years on end with, I mean, insurance is just one example, but bureaucracy of the jail, you know, all the systems that we're describing in this piece, it's, it's overwhelming just for a reporter to witness it from the outside,

82
00:27:32,630 --> 00:27:34,580
John Washington: mental and emotional energy, 

83
00:27:34,580 --> 00:27:34,970
Hannah Cree: absolutely 

84
00:27:34,970 --> 00:28:01,370
John Washington: The emotional weight that they carried when numerous different people in city and county counseled them to leave Pat in jail, and they knew he was there, and they knew that it was in part their decision to do that, and it was very hard for them. I mean, or the first time we interviewed them together, he was still in jail, and they it was very, very apparent that that was weighing very heavily on them. 

85
00:28:01,820 --> 00:28:50,570
Christopher Conover: I remember that interview. It was in the studio right across the hall from us, and that was what we often refer to as an intense interview. But it wasn't intense anger. It was just you could feel the emotion coming through the glass and through the walls for them, it was, yeah, quite the experience to say the least. John, you touched on this a little bit a minute ago about the difficulties that you two had, of course, just dealing with the emotional part of it, but the practical part of reporting something like this with so many different moving parts, that's something we as listeners don't always get to hear about.

86
00:28:50,000 --> 00:30:23,570
John Washington: Yeah, there really are a lot of moving parts, and a lot of people right now, when they're entering to Department of Corrections in Arizona or sometimes at jail, their insurance basically suspended for a short time. And I've been talking with people recently as well, and that is not always reinstated immediately upon leaving. And that is one of myriad difficulties trying to make sure that people have continuity of care. And when you're dealing with mental health, when you're dealing with substance abuse, that continuity of care can be a life or death situation. So making sure that people have insurance, and that is, I'm cherry picking here one of the dozens and dozens and dozens of things that we encountered, saying like, Oh my gosh. How do you this is, you know, the questions that Pat's family was asking themselves. How do we make sure that his insurance is reinstated? After his house was condemned, how do we make sure that he's able to get mail from the insurance company because we didn't even know that their insurance was cut off? How do we try to understand what sort of mental health or basic medical care he has access to? In the jail, and these are all different systems, not to mention the courts that that they have to try to figure out. And they don't, as you said recently, they don't all intersect in proper ways. And this is why, as Sheriff Nanos has repeatedly called out, our jail has now become, effectively the largest mental health institution that we have locally. 

87
00:30:23,870 --> 00:30:31,460
Christopher Conover: Hannah, anything that's stuck out to you, difficulties in the reporting of all of this?

88
00:30:31,520 --> 00:31:07,860
Hannah Cree: on a smaller level, we basically had to navigate Pat's mental health issues from a removed perspective, but the same ups and downs that his family is also going through because at one point he went missing for at least a month and he wasn't answering phone calls, but his also, his family also didn't know where he was, either. So navigating those family dynamics, trying to practice empathy, but also this story is really important, and his story was such a great example, like, I think, in editing, we brought up almost all agencies in Pima County, they were all mentioned in one capacity or the other. I learned so much over the past 18 months

89
00:31:08,320 --> 00:31:57,490
John Washington: To explain what the consequences are for going missing for someone like Pat, it's not just that the family is worried or that he himself might be out in the streets or potentially extra vulnerable. But the reason he went into the jail for the last time is because he couldn't make his court date because he was missing for a little bit. He left the hospital where he was supposed to be receiving treatment, and he didn't show up for court. That is a felony, and that is why he was in jail for the last time. And this is happening to hundreds of people a year, where just the mere fact of not being able to make a court date, and a lot of that stems from having a mental illness, they are punished for it. And that is one of the things I think, was readily and very poignantly apparent in reporting this story. 

90
00:31:58,420 --> 00:32:21,580
Christopher Conover: Yeah, it goes back to what we were talking about a minute ago. It's that intersection of things that should be intersecting but don't. And then you have to navigate not just one bureaucracy, but the bureaucracy of insurance, of city government of county government, of banking, of healthcare, all those things. 

91
00:32:21,610 --> 00:32:24,250
Hannah Cree: How can anyone do it without a family like Pat's? 

92
00:32:24,610 --> 00:32:25,030
John Washington: Yeah, 

93
00:32:25,270 --> 00:32:26,320
Hannah Cree: That was my takeaway.

94
00:32:26,000 --> 00:32:58,280
John Washington: An interesting definition from Hannah Arendt is bureaucracy is really ruled by no one. And I think that is something that the family sort of felt. It's so dissipated who can respond to some of their basic questions that they are given the runaround such that they never get an answer, never get a proper answer. And this is not over. I mean, Pat is is still needing services. You know, he still could have another run in with the law, and he could end up back in jail. And that's something that is, I think, a present concern for for the family. 

95
00:32:58,430 --> 00:33:16,910
Christopher Conover: All right. Well. Hannah, John, thank you for year and a half of reporting. As you said, John, this isn't over. It's the end of our story for today, but it is not the end of Pat's story or anybody else's story who is in a similar situation. Thank you both for your time. 

96
00:33:16,940 --> 00:33:17,600
Hannah Cree: Thank you. 

97
00:33:17,630 --> 00:33:18,080
John Washington: Thanks

98
00:33:18,650 --> 00:33:20,480
Christopher Conover: And that's the buzz for this week. You suite.

99
00:33:29,360 --> 00:33:49,940
You can find all our episodes online at azpm.org and subscribe to our show wherever you get your podcast, just search for The Buzz Arizona. We're also on the NPR app. Zac Ziegler is our producer, with production help from Maggie Farmer, Our music is by Enter the Haggis. I'm Christopher Conover, thanks for listening.

100
00:33:58,610 --> 00:34:07,640
Nicole Cox: Like this podcast? Your support makes acpm original productions like this, one possible donate at azpm.org/give