FOR MOTHER AND STAR ATHLETE DAUGHTER, MENTAL ILLNESS A CRUCIBLE OF PAIN
By: Rachel Riley
Oct. 6, 2018
Alone in a cell for 23 hours a day, gripped by delusions and reluctant to take the medications that would ease the symptoms of her psychosis, Jessica Muñoz-Ciro wanted to end the pain.
She leapt head-first from the top of a bunk bed at the El Paso County jail with enough force to crack her front teeth.
The fall didn’t kill 26-year-old Muñoz-Ciro, once a junior world racquetball champion who’d been arrested this year after she, in the midst of a manic episode, lashed out at law enforcement officers.
Four months later, after stints at two mental health facilities, she again jumped from a top bunk at the jail and survived a second time.
Idali Lawson, her mother, described Muñoz-Ciro’s harrowing experience behind bars and believes it symptomatic of what mental health experts and many law enforcement officials say is a larger struggle: The criminal justice system in Colorado has become a warehouse for people with mental illness.
Those with mental health issues, from addiction to serious psychiatric disorders, often end up in correctional facilities ill-equipped to care for them after an illness-related episode leads to a run-in with law enforcement. If they are released back into the community without proper care, stress can trigger another breakdown, and the process often repeats itself.
Muñoz-Ciro has been through the cycle before. She spent several weeks incarcerated in 2017 on charges she accrued when she left Colorado Springs during another manic episode and drove south on Interstate 25 into New Mexico, where a state trooper caught her topping speeds of 120 mph near Raton, her mother said.
“I don’t know what else to do to help her,” Lawson said. “Every door closes on you.”
Her daughter once had dreams of becoming a professional racquetball player. Muñoz-Ciro won more than 28 national and international junior titles in the sport before moving to Colorado Springs in 2013.
Soon after earning a spot on the national junior racquetball team in 2009, she was diagnosed with Type I bipolar disorder, a severe mental illness that can be managed with a combination of psychiatric medication and psychotherapy.
In the aftermath of the diagnosis, she often refused to take her medications. Her promise and championship aspirations, even normal life, began to fade.
Her January arrest included two felony counts, each normally punishable by two to six years in prison.
She has since been found mentally incompetent. Her criminal case remains on hold. She was transferred in August to the Colorado Mental Health Institute at Pueblo.
Her mother has pleaded with authorities to drop the charges and has consulted countless nonprofits and mental health professionals for help.
“We hear this all the time,” said Andrew Romanoff, president and CEO of the nonprofit Mental Health Colorado and a former speaker of the state House of Representatives. “It’s heartbreaking to hear from families that don’t know where to turn.”
No choice but to call police
Muñoz-Ciro’s face broke her first leap off the top bunk at the jail.
She wanted to die, she told her mother during visitation.
She added that a guard handed her a fragment of her tooth and a tissue, offering no further care, Lawson said.
But Jackie Kirby, a spokeswoman for the Sheriffs’ Office, said that Muñoz-Ciro had fallen from the bed, and the incident was never deemed a suicide attempt. Jail staff administered medical care, to include “five follow-up visits,” Kirby said in an email to The Gazette.
Lawson was able to post bond on March 1, almost a month after Muñoz-Ciro jumped, to seek medical attention for her daughter.
A Colorado Springs dentist found that two of Muñoz-Ciro’s incisors were broken, and the nerve was exposed on one, medical records show. Both teeth required root canals.
Her gums were infected because the teeth had gone untreated, Lawson said.
Muñoz-Ciro then was evaluated at AspenPointe’s Lighthouse, a walk-in crisis stabilization unit in Colorado Springs, and referred to a psychiatric hospital operated by Highlands Behavioral Health System in Littleton, where she stayed until early April.
After her release, she made it about a week at home before another crisis resulted in her mother returning her to the Lighthouse facility. Soon after, a case manager wrote that Muñoz-Ciro hadn’t slept in two days or been eating and was “almost catatonic.”
She was released again May 8 and within hours became manic when Lawson refused to hand over the keys to her car.
Lawson said she had no choice but to call the police.
Muñoz-Ciro was arrested on a warrant for failing to appear in court while she was at the Littleton facility.
After the second jumping incident on June 2, the Sheriff’s Office confirmed she was taken off-site to receive medical care, but again did not classify it as a suicide attempt. A deputy who checked on her had noticed blood on her sheets and her face, Kirby said. Jail staff were unsure how she suffered the injuries.
Life behind bars
Jails aren’t appropriate for people with severe mental illness, advocates say, but they’ve become the de-facto mental health system for thousands of Coloradans.
“Jails are not health care facilities. They’re not set up to handle people with diabetes, either. Or cancer,” said Moe Keller, advocacy director of Mental Health Colorado.
The Sheriff’s Office has acknowledged the same.
Mental illness in the jail was highlighted during summer 2017 when the county announced back-to-back record-setting days for the jail’s population. The Sheriff’s Office had in custody nearly 1,800 people — more than half of whom had mental health issues, estimated then-Detention Bureau Chief Mitch Lincoln. At least 30 to 50 inmates didn’t “belong” in the jail because their mental illnesses were so severe, Lincoln said at the time.
Stephanie Gangemi, a behavioral health programs manager for the county Sheriff’s Office, raised the issue again in an interview with The Gazette in June.
“The mental health needs at the jail and in the community are severe,” she said. “I think people underestimate the degree to which the community is sick.”
The Sheriff’s Office has launched a program that partners deputies with a behavioral health specialist who can better recognize and respond to those in mental health crisis. Sheriff’s officials say the goal is to keep them from going to jail — either by working out issues at home or by diverting them to specialized facilities such as the Lighthouse or Cedar Springs Hospital.
It’s difficult for officials to accurately gauge exactly what percentage of the jail’s inmates have mental health problems. The jail relies on inmates to self-report that information during health assessments conducted after they’re booked into the facility, according to sheriff’s spokeswoman Kirby.
However, jail records show that about 3,700 “patients” have had mental health alerts between Jan. 1 and Aug. 31 this year. The alert applies to inmates who are on suicide watch or have a serious mental health diagnosis, history of self-injury or suicide attempts or other cognitive impairments, according to the Sheriff’s Office.
The jail’s mental health team includes behavioral health clinicians, a full-time psychiatric physician’s assistant and a psychiatrist who works eight hours per week to provide medication and help treat the “severely and persistently mentally ill population within the facility,” according to the Sheriff’s Office.
Mental health counselors meet with those inmates on a regular basis, and deputies conduct cell checks at 15-minute intervals, Kirby said.
Lawson said her daughter told her she met with a doctor once regarding her mental health issues and medication following her initial arrest.
“After that, she was just one more person in there,” Lawson said.
Consequences for all
Mentally unstable inmates make a jail more dangerous for everyone. They can hurt themselves, other inmates or jail staff, said Terri Hurst, policy coordinator for the nonprofit Colorado Criminal Justice Reform Coalition.
“There are consequences for every party,” Hurst said. “There’s risk that any sort of treatment progress they’ve been having, any successful recovery they’ve been in, could completely dissipate and go away.”
But alternatives to jail and inpatient psychiatric beds are few. Intermediary centers, group homes and programs to support their re-entry into society aren’t available.
“We just don’t have enough options for people,” Hurst said. “Having a mental illness should not be a criminal sentence in and of itself.”
Muñoz-Ciro is charged with two felony counts of second-degree assault on a peace officer and two misdemeanor counts, harassment and third-degree assault.
On Jan. 30, she was at her mother’s home and had been off her medication for two weeks, an arrest affidavit says. Muñoz-Ciro lunged at Lawson, struck her in the chest twice, hit the deputy in the face twice, and hit a medical responder several times, the deputy said in the affidavit.
But Lawson disputes that account, saying her daughter did not hit her or the medical responder.
The charges against her are typical for someone in her condition, said Lori Jarvis-Steinwert, executive director of the National Alliance on Mental Illness-Colorado Springs.
Psychosis often drives mentally ill people to attack or run from law enforcement officers out of fear or paranoia, Steinwert said.
“This is a very common story,” she said by email. “I would estimate that 30 to 40 percent of the calls to NAMI’s resource and referral line here in the Springs are from family members who have a loved one with mental illness who has ended up in jail because of a crime they committed due to their illness.”
Fourth Judicial District Judge David Gilbert ordered in mid-May that Muñoz-Ciro undergo a mental health assessment.
A staff psychologist for the state’s Court Services Department evaluated her June 13, later writing in a letter to the court that Muñoz-Ciro’s symptoms prevented her from having “a rational understanding” of the court proceedings against her.
On July 10, the court found her “incompetent to proceed” in her case and ordered that she be remanded to the state hospital in Pueblo.
Once a world champion
Muñoz-Ciro was a talkative, energetic child, Lawson said. She was born in Colombia and moved to Washington state with Lawson in 2003. Both have become U.S. citizens.
As an adolescent, Muñoz-Ciro became withdrawn. She would lock herself in her room and cry. Lawson and her then-husband chalked it up to typical teen behavior.
She played racquetball at clubs in the Seattle area, traveling to compete in tournaments.
Wanda Collins, who coached her at a Bellingham club, described her as an “outgoing, warm girl.”
“She never had a temper. She never got in arguments,” Collins told The Gazette by phone. “She just really enjoyed playing racquetball.”
Muñoz-Ciro traveled in 2009 to Santa Domingo, Dominican Republic, to compete in the International Racquetball Federation Junior World Championships as part of the U.S. Junior National Team. She took home a world individual gold medal, and her team won two titles.
But the pressure and stress of regimented training and competition were apparently weighing heavily, her mother said.
A month before the competition, Muñoz-Ciro experienced what her family recognizes as her first manic episode.
She showed up randomly at a classmate’s home and was acting erratically, so Lawson and her then-husband went to pick her up. Muñoz-Ciro jumped into her stepfather’s Chevrolet Tahoe and sped off. She crashed into a tree and was thrown through the windshield, bruising her legs and cutting her face, her mother said.
At Seattle Children’s Hospital, Muñoz-Ciro was diagnosed with bipolar disorder and began the long process of trying to find the right medication.
She started having trouble at her part-time job as a sales associate at Kohl’s. She continued to play racquetball in Colorado Springs, including the downtown YMCA, but her interest in the sport was waning.
An everyday struggle
At Lawson’s southeast Colorado Springs home recently, more than 50 of her daughter’s medals were laid out on the dining room table.
Next to them were piles of paperwork — discharge forms from the hospital, notes from doctors and caseworkers, a letter denying Muñoz-Ciro acceptance into a program that provides support services for people with mental illness. The organization doesn’t accept candidates who become combative or aggressive during breakdowns, Lawson said.
Lawson had not been allowed to visit her for a month. Her psychotic episodes intensified with a urinary tract infection, and she refused to take the antibiotics to cure it.
Then, as Lawson visited with a Gazette reporter, her iPhone rang. It was her daughter’s caseworker at the state mental hospital.
Muñoz-Ciro has been in and out of seclusion and restraint, the caseworker said. She’s been aggressive and lashing out at nurses. She just flipped over a tray of food she was served, he said.
But the hospital got a court order so staff can inject her with antibiotics for the urinary tract infection. That should help, he said.
Lawson rested her head on her hand on the table. She asked about her daughter’s October court date. She was told it probably will be pushed to January, as Muñoz-Ciro likely won’t be in any condition to meet with an evaluator. Four more months in the state hospital.
Lawson apologized to the caseworker for her daughter’s behavior and asked him to express her gratitude to the nurses.
She hung up and began to cry.
“I don’t know if I’m losing my future with my daughter.”
Originally published in the Gazette.