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PROVO —

Across Utah, nearly 70 mentally ill men and women who are supposed to be receiving mental health treatment are instead trapped in jail cells.

They're getting sicker. They're being released without treatment. They're dying.

They're not supposed to be there.

Charged with crimes but too sick to answer for them in court, they are stuck, waiting for an opening at the only facility in the state that can prepare them to face the legal system — the Utah State Hospital in Provo.

The Deseret News spent three months interviewing families, hospital employees and administrators; examining hundreds of pages of jail reports, injury logs and court records; and found that:

Inmates are being forced to wait five months or more to get into the Utah State Hospital, far exceeding wait times in six other Western states. Some are dying before they get there. And others are being held for so long that the state is forced to release them from jail before they ever set foot in the hospital.

Judges and jailers say they have known for decades about the waitlist for inmates at the Utah State Hospital. But the problem has accelerated in recent years. The wait list has doubled each year between 2012 and 2015 — and the courts keep sending more. Last year, Utah judges sent 148 mentally ill defendants to the Utah State Hospital for treatment, up from 88 in 2011. They also ordered nearly 1,000 mental competency evaluations, up from 745 in 2012.

Today, the state spends 1 in 5 mental health dollars on "competency restoration" — rehabilitating mentally ill inmates until they are at least passably able to participate in their own defense. That translates to $20 million per year spent rescuing mentally ill inmates who have hit their lowest point, instead of catching them when their symptoms were less severe.

The consequences have been devastating, trapping Utah's most vulnerable in a cycle of illness, crime and homelessness.

They are people like James Norman, 39, of Orem, a former Mormon missionary whose bright future turned into a decade of bouncing between jail cells and the state hospital for various crimes, including allegedly killing another mentally ill man at the Utah State Hospital six years ago.

The Utah State Hospital in Provo is seen from the air on Thursday, May 18, 2017. | Spenser Heaps, Deseret News

They are people like Provo resident Diane Prigge, 62, a severely mentally ill inmate who may soon be discharged by the jail back into the community without a trial or treatment because the Utah State Hospital ran out of time to find her a bed.

And they are people like Matthew Hall, a 31-year-old father of two from Ogden who was supposed to be in the Utah State Hospital but instead wasted away in a cell in the Weber County Jail by himself for six months before killing himself by repeatedly smashing his head into the wall of his jail cell.

Without treatment, none of them can face a jury, make a deal, serve their time or be declared innocent. Yet only stopgap measures are being put in place.

In 2015, the Utah State Hospital asked the Utah Legislature for an additional $300,000 a year to send social workers to jails in an attempt to restore some of the inmates back to competency while incarcerated. But those visits are once a week at best, sometimes once a month.

Grid View Nate Hall, center, embraces his son, Gabriel, while standing with Alizea Gobel, 5, bottom left, her sister, Haze Hall, 4, bottom right, and other family members in front of Matt Hall's casket during his funeral at Myers Mortuary in Ogden on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Matt Hall Jr. sits on the steps of Myers Mortuary after the funeral of his father, Matt Hall, in Ogden on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Donna Norman and James Norman Sr. pose for a portrait in the backyard of their house in Orem on Tuesday, April 11, 2017. The couple's son, James Norman Jr., is accused of strangling his roommate while he was a patient at the Utah State Hospital. Due to competency questions he has been waiting six years to stand trial. Nicole Boliaux, Deseret News

The Utah State Hospital in Provo is seen from the air on Thursday, May 18, 2017. Spenser Heaps, Deseret News

Dallas Earnshaw, superintendent of the Utah State Hospital, sits in his office in the administrative building on the hospital's grounds in Provo on Wednesday, May 17, 2017. Nicole Boliaux, Deseret News

Diana Hall kisses her son, Matt Hall, goodbye during his funeral at Myers Mortuary in Ogden on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Excerpt from a letter written by James Norman Sr. asking his son's attorney to talk to 4th District Judge Christine Johnson about his son's condition in Utah County Jail, carried to court on March 23, 2017. Elise Madsen

Excerpt from a letter dated Feb. 1, 2017, updated 4th District Judge Samuel McVey about competency restoration efforts for Diane Prigge, 62, who had been incarcerated in Utah County Jail since June 2016. Elise Madsen

Excerpt from an Ogden police report about Matthew Hall's final arrest on Nov. 17, 2015. Elise Madsen

This composite image shows James Norman Jr., during college, from before his parents say mental illness set in, left, and on the right in a mugshot from February 2010. Spenser Heaps

A letter sent from James Norman Jr., who was in the Utah State Hospital at the time, to 4th District Judge Christine Johnson in October 2014. Elise Madsen

Nate Hall prints out old photos of his brother, Matt, right, and himself, left, before Matt's funeral at Myers Mortuary in Ogden on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Nate Hall, 34, is pictured in his uncle's trailer in Ogden on Wednesday, May 17, 2017. Hall's brother, Matt Hall, was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Matt Hall Jr. pays his respects to his father, Matt Hall, during his funeral at Myers Mortuary in Ogden on Saturday, April 15, 2017. "I wish you weren’t paralyzed,” he said. "I wish you weren’t dead.” Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Matt Hall lays in his casket at Myers Mortuary in Ogden during his funeral on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Donna Norman is pictured in the backyard of her house in Orem on Tuesday, April 11, 2017. Norman's son, James Norman Jr., is accused of strangling his roommate while he was a patient at the Utah State Hospital. Due to competency questions he has been waiting six years to stand trial. Nicole Boliaux, Deseret News

James Norman Sr. is pictured in the backyard of his house in Orem on Tuesday, April 11, 2017. Norman's son, James Norman Jr., is accused of strangling his roommate while he was a patient at the Utah State Hospital. Due to competency questions he has been waiting six years to stand trial. Nicole Boliaux, Deseret News

Diana Hall receives a hug from a friend during the funeral of her son, Matt Hall, at Myers Mortuary in Ogden on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Diana Hall hugs her grandson, Matt Hall Jr., during his father's funeral at Myers Mortuary in Ogden on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Nate Hall and Matt Hall Jr. speak outside Myers Mortuary after the funeral of Matt Hall in Ogden on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Alizea Gobel, 5, cries while watching a video of Matt Hall, her sister's father, during Hall's funeral at Myers Mortuary in Ogden on Saturday, April 15, 2017. Matt Hall was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nikki Boliaux

Nate Hall, 34, is pictured in his uncle's trailer in Ogden on Wednesday, May 17, 2017. Hall's brother, Matt Hall, was in jail for 15 months until he smashed his head into a wall and jumped off a railing in February. He was paralyzed from the shoulders down until dying from his injuries on April 7. Nicole Boliaux, Deseret News

Dallas Earnshaw, superintendent of the Utah State Hospital, sits in his office in the administrative building on the hospital's grounds in Provo on Wednesday, May 17, 2017. Nicole Boliaux, Deseret News

The Lucy Beth Rampton Adult Services Building on the Utah State Hospital grounds in Provo is pictured on Wednesday, May 17, 2017. Nicole Boliaux, Deseret News

The Utah State Hospital grounds in Provo are pictured on Wednesday, May 17, 2017. Nicole Boliaux, Deseret News

The Mountain Springs Pediatric Center on the Utah State Hospital grounds in Provo is pictured on Wednesday, May 17, 2017. Nicole Boliaux, Deseret News

The Utah State Hospital in Provo is seen from the air on Thursday, May 18, 2017. Spenser Heaps, Deseret News

The Utah State Hospital in Provo is seen from the air on Thursday, May 18, 2017. Spenser Heaps, Deseret News

A still frame from surveillance footage from the Weber County Correctional Facility shows Matt Hall in a cell on Friday, Feb. 24, 2017, just before he smashed his head into the wall and jumped off a railing onto the floor. Hall was paralyzed from the shoulders down until dying from his injuries on April 7. Weber County Correctional Facility

A mug shot of Diane Prigge, 62, when she was booked into the Utah County Jail on June 15, 2016. Utah County Jail

James Norman Jr. poses for a photo in his high school football uniform. Courtesy of Donna Norman

Matt Hall and Brittany Christensen with their daughter Haze Hall and Christensen’s daughter Alizea Gobel. Courtesy of Brittany Christensen

Although this has reduced the waitlist by more than 30 people, even proponents say it's not enough in the long-term.

"It's at a crisis point," said Utah County Sheriff's Chief Deputy Darin Durfey, who said he has seen the problem worsen year after year. "A lot of times, we know there's a problem that exists, but we wait until it's a crisis before we address it. And that's where we're at."

Watching and waiting

Nate Hall, 34, had known something was wrong with his brother for years.

The close-knit pair grew up in Weber County, where they were reared by their grandmother and uncle, found the same group of friends and got into the same kind of teenage trouble — shoplifting, breaking into cash registers, dabbling in drugs.

Even back then, Matt Hall had always been loving but volatile, his brother said — playful and gentle with children but quick to anger with strangers and friends.

Matt Hall and Brittany Christensen with their daughter Haze Hall and Christensens daughter Alizea Gobel. | Courtesy of Brittany Christensen

His brother's "episodes," as Nate Hall called them, started around 2009 or 2010, when Matt was about 23. That's when he began noticing moments his brother wouldn't respond to direct questions, days when he would talk about people listening in on his conversations and nights that he could not remember who he had talked to or what he had done earlier in the day.

At first, Nate Hall chalked it up to his brother's intermittent drug use. But it got worse. In November of 2015, at a birthday party for his 4-year-old daughter, Matt Hall frightened his uncle when he told him that sometimes, for reasons even he didn't really understand, he would sleep in his backyard in Ogden in freezing temperatures.

Nate Hall attempted to get his brother to a doctor, but he insisted he wasn't sick. When a doctor eventually diagnosed him with schizophrenia, he refused to take his medication.

Things were unraveling fast when, a week later, a neighbor reported Matt Hall to police for allegedly threatening to beat him up.

Nate Hall was surprised when he heard later that his brother had refused to give the cops his name and tried to run from two Ogden police officers, wrestling a Taser away from one of them in an "explosion of violence."

Nate Hall prints out old photos of his brother, Matt, right, and himself, left, before Matt's funeral at Myers Mortuary in Ogden on Saturday, April 15, 2017. | Nicole Boliaux, Deseret News

His brother hadn't been carrying drugs, weapons or other contraband. The only charges filed in the incident — disarming a police officer of an energy device, a third-degree felony, and other felonies and misdemeanors — were the ones that he got for fighting back.

In jail, Hall's condition worsened. In February of last year, his court-appointed attorney became so concerned that he wrote a petition to the judge. The 31-year-old had long been meticulous about his appearance, keeping his hair cropped short and his body in shape. But now, after just two months in jail, Hall's hair was growing long and stringy.

Even more alarming to his attorney, he appeared to have lost the ability to track their conversations or remember prior conversations at all.

The jail logs corroborate what his attorney witnessed.

In March, inmates warned guards that Hall was "not right in the head." In May, guards noted that "inmate Hall" had simply stopped responding to physical and verbal cues and was "extremely lethargic." In June, guards noted that Hall had spent sunrise to sundown pacing around the day room without stopping or responding to anyone and often gave his food away to other inmates. He was recorded stripping naked and throwing his clothes away multiple times. Once, the guards found him sleeping in a hole in his mattress that he had apparently dug out himself.

By June, Hall's condition had deteriorated to the point that two psychiatrists and a judge decided that he needed to be treated at the Utah State Hospital before his case could proceed. But until a bed at the hospital opened up, he could neither be sentenced for his crimes nor released back into the community.

So Hall waited.

July 20, 2016: Inmate continues to have his "zombie" moments walking naked around his cell.

And he waited.

Nov. 10, 2016: Hall did not have a shirt on and was told to put one on. … Hall then began to run around the day room then jumped on the stair rail and started walking toward his cell.

And he waited.

Feb. 21, 2017: Report of inmate thinking his lungs were collapsing. … Inmate's cellmate started demanding that inmate be seen right now for talking to himself.

By late February, Hall had been in jail for 15 months, six months of which had been spent alone in a cell that he only got to leave for a few hours every other day. It had been nearly five months since a judge had ordered he be transported to the Utah State Hospital. There was still no bed.

He was at a breaking point.

Shortly before midnight three days later, everything that was supposed to help Hall failed.

A security camera captured what officers would see later: Hall pacing naked around his cell, watching with vacant eyes as a guard left the observation area, then turning to face the wall.

A still frame from surveillance footage from the Weber County Correctional Facility shows Matt Hall in a cell on Friday, Feb. 24, 2017, just before he smashed his head into the wall and jumped off a railing onto the floor. Hall was paralyzed from the shoulders down until dying from his injuries on April 7. | Weber County Correctional Facility

Taking a running start, he rears his head back and smashes it against the concrete with a force that sends him staggering backward.

Pausing briefly, he charges again, slamming his head into the wall, forehead first. He goes a third time before the guard passes momentarily through the office again, oblivious to what has just happened.

As the guard leaves the office, Hall climbs onto a handrail behind the toilet and disappears from view, except for his feet. For a second, he pauses.

Then he jumps.

Eruption point

No one seems to know how Utah got to this point.

Utah State Hospital Director Dallas Earnshaw acknowledges the backlog is a "serious problem" but says it is likely a result of population growth, among other factors.

But out of seven Western states surveyed by the Deseret News, Utah has the longest average wait to get into the state psychiatric hospital — currently 149 days, or about five months.

Arizona has no waiting list. Oregon and Nevada are required to transfer inmates to a psychiatric hospital within seven days. Idaho is about the same. Colorado's wait is 17 days. Even in Wyoming, which has the second-longest wait time in the Intermountain West, it takes an average of 41 days to get defendants into the hospital — several months quicker than in Utah.

Currently, 35 individuals across Utah are vying for one of 100 beds at the Provo facility.

The most recent defendant was added to the list last Wednesday. The person waiting the longest has been there for more than seven months. Another three have been there for more than six months.

Another 29 inmates are already receiving regular visits from social workers through the hospital's outreach program, but they still remain incarcerated in county jails — an environment that even correctional officers themselves say is not therapeutic or helpful.

In waitingCreate your own infographics"We would much prefer them to be in the state hospital," said Lt. Nate Hutchinson, a spokesman for the Weber County Sheriff's Office. “We'd prefer them to be where they're getting the help that they should be getting. We can offer the resources (at the Weber County Jail) that they can send people in to try to work with them and restore their competency, but at the end of the day, we're not the state hospital."

As the sickest inmates get funneled to the top, Utah State Hospital employees are forced to deal with patients who are more complex than ever before.

During the past four years, the number of patients at the hospital's criminal unit who require full-time one-on-one supervision has increased from an average of five to roughly 30.

Despite these concerns, Earnshaw defended his and the Legislature's handling of the situation, noting that the Utah State Hospital is one of many state-owned psychiatric hospitals across the U.S. that have seen their backlogs grow in recent years.

Dallas Earnshaw, superintendent of the Utah State Hospital, sits in his office in the administrative building on the hospital's grounds in Provo on Wednesday, May 17, 2017. | Nicole Boliaux, Deseret News

"We've been able to manage the growth for many years," Earnshaw said. "And the Legislature has been very helpful to us. It just hit us really hard, and that's what's happened in other states. There's been a significant growth over a very short period of time, which doesn't allow you to respond quickly."

Aaron Kinikini, legal director of the Disability Law Center, said Utah is simply seeing the consequences of kicking the can down the road when it comes to mental health care.

In 2015, Kinikini and the Disability Law Center sued the state hospital on behalf of three inmates who had been ordered to receive care at the hospital but instead were kept in jail for six months or more — and, at times, longer than what was legally allowed.

Settlement talks are ongoing, but Kinikini said the state has not been proactive about treating the root cause of the issue and has instead been stuck treating the symptoms.

"It's coming to a head and doesn't really get noticed until it's erupting," Kinikini said. "These are the people that have been pushed up through pressure toward the eruption point."

"There's just not enough mental health resources in the community," he added later. "And when mental illness goes untreated in the community, it's going to emerge in the backs of our police cars, in the county jails and in the courtrooms."

Catch and release

The system is so dysfunctional that some jails have been forced to release mentally ill inmates back into the community before they ever reach the Utah State Hospital.

They have been waiting so long that the state cannot legally hold them anymore.

In other words, even though a judge and a mental health professional have determined that an inmate is so severely mentally ill that he or she requires a stay at the Utah State Hospital to continue their court proceedings, jails are being told to cut them loose without treatment.

Last June, Prigge was booked into Utah County Jail after police say she tried multiple times to get back into the Provo home she had been evicted from two weeks earlier. Contacted on the doorstep of her parents home in Princeton, N.J., her father declined to talk about the 40-year struggle with a daughter who started showing signs of mental illness in high school, and later became estranged from them when she moved out west.

Two months after her arrest, a Utah State Hospital evaluator met with Prigge for 15 minutes before cutting the evaluation short. He noted Prigge's unkempt appearance, rapid speech, refusal to answer questions and reports from jail guards who said she often appeared to be talking to someone when no one was around. Court records also noted that she likely had psychotic and bipolar disorders.

A mug shot of Diane Prigge, 62, when she was booked into the Utah County Jail on June 15, 2016. | Utah County Jail

The evaluator decided, and a judge later agreed, that Prigge needed treatment from the state hospital in order to proceed in court.

That was eight months ago. Prigge still hasn't set foot in the hospital. In fact, she may never reach it.

That's because Prigge has been held in custody nearly as long as her maximum sentence would be if she were found guilty of the misdemeanors she's charged with. If the state were to hold her any longer, they would be at risk of violating the Constitution.

On April 18, the state hospital asked a judge to "consider the option of releasing Ms. Prigge from the executive director of the Department of Human Services," citing the fact that the hospital is "striving to maximize efficiencies related to the Utah State Hospital bed utilization."

In other words, the hospital asked the judge to release Prigge back into the streets of Provo — a community where she is homeless and unemployed — without ever having treated her.

Jake Summers, the Orem City prosecutor on Prigge's case, says his goal is to get help for the woman. But if the state hospital can't find a bed and county services doesn't agree to take over her mental health care in time for her next hearing on June 8, Prigge will be released and her charges will be dismissed, he said.

That's the reality, Summers says, of being a municipal prosecutor handling misdemeanor cases: Prosecutors like him have the shortest window of time to try to get treatment for an incompetent defendant and the lowest chance of getting them into a hospital full of felony-level offenders.

"We are the lowest on the totem pole as far as access to resources," he said, referring to prosecutors handling misdemeanor cases. “There's just not enough resources for the need that exists within the criminal justice system."

Earnshaw said he doesn't know how many people the Utah State Hospital has had released in this fashion. But they tend to be people with more mild mental illness, he said.

"It doesn't make sense in some cases to admit individuals to (the hospital) who are getting better before admission and have misdemeanor charges," Earnshaw said.

But Prigge's court records suggest she got worse while part of the outreach program, not better.

Just over three months after outreach visits began, Prigge was so agitated and delusional that staff members found it "virtually impossible to interact with her in a meaningful way," according to court records. Today, the 5-foot-7-inch, 62-year-old woman is classified as a "high-risk" inmate who can only be moved under heavy guard.

Excerpt from a letter dated Feb. 1, 2017, that updated 4th District Judge Samuel McVey about competency restoration efforts for Diane Prigge, 62, who had been incarcerated in Utah County Jail since June 2016.

And correctional officers say that when people like Prigge are released into the community, it's usually not very long until they get picked up again by police. Then they begin the process all over again.

Durfey said the worst case he has seen while working at the Utah County Sheriff's Office was an inmate who spent 358 days in 2014 incarcerated at the Utah County Jail waiting for a bed to open up at the Utah State Hospital.

When it became clear that the state was getting close to holding him longer than the legal limit — a limit based on the U.S. Supreme Court's Jackson v. Indiana case — the jail was forced to release him.

By 2016, the man had been arrested on new charges and booked back into the Utah County Jail, Durfey said. That time he spent 251 days in jail before a bed opened at the state hospital.

Durfey added it up. Over the course of three years, the inmate had spent 609 days in custody before he got into the state hospital.

Timelapse video of Utah State Hospital in Provo. | Nicole Boliaux, Deseret News

"I don't care who you are," Durfey said. "That's a problem."

John Snook, the executive director of the Treatment Advocacy Center in Arlington, Virginia, said the vicious cycle that Prigge is trapped in can be traced back to the 1960s when the Kennedy administration began a push to "deinstitutionalize"what were commonly called insane asylums.

Disgusted by large-scale abuses at many psychiatric hospitals and encouraged by the invention of new psychotropic drugs, people advocated replacing insane asylums with community mental health services.

But cuts to state mental hospitals were made without increases in funding for community mental health clinics, Snook said. As a result, jails and prisons have become the country's new asylums, and backlogs are growing at alarming rates in state mental hospitals across the country.

"It is a crisis of unimaginable proportions," Snook said. "If more people were aware of just how awful this situation is, people would be up in arms."

Salt Lake County Sheriff Jim Winder said the waitlist crisis in Utah raises important philosophical questions about the purpose of incarceration and punishment — particularly if research shows that jails make mentally ill offenders worse off, not better.

For centuries, "we thought you punished your way to redemption," Winder said. "We're still in the punishment mode."

But multiple studies have shown that mentally ill inmates tend to be victimized in jails, where they are more likely to be physically and sexually assaulted than those who do not have mental illness.

Studies also show that suicide rates are disproportionately high among inmates who are put in isolation — something that jailers say they often order for mentally ill inmates because they have few other tools to manage them.

Winder said roughly 15 percent of Salt Lake County Jail inmates are categorized as seriously and persistently mentally ill, but they take up far more than 15 percent of the jail’s time and resources.

"The jail's not a place for the mentally ill," he said. "And if, as a society, we're going to use (jails) in that way, we better doggone well be ready to pay for them."

Search for solutions

Though James Norman Jr.’s early life was radically different than the unruly path Matthew Hall took growing up, the two found themselves in the same dark world as adults.

This composite image shows James Norman Jr., in college, before his parents said mental illness set in, left, and on the right in a mugshot from February 2010.

Norman grew up in a typical-middle class home in Rigby, Idaho, in the 1970s. He got good grades, played football, and after high school, traveled to Honduras as a missionary for The Church of Jesus Christ of Latter-day Saints. Upon return, Norman graduated from Westminster College, got a job at Fidelity Investments, married, and soon had a baby on the way.

Then in 2001, when Norman was 24, his mother received a phone call from his wife.

"She was crying and she said, 'I don't know what to do. Jim isn't going to work and he's watching C-SPAN on TV and he thinks the senators are talking to him in code,'" said Donna Norman. "And that was the first — that was where it started."

Her son insisted nothing was wrong and refused counseling, treatment and medication for the next several years.

James Norman Jr. poses for a photo in his high school football uniform. | Courtesy of Donna Norman

But his marriage disintegrated. He lost his well-paying finance job and struggled to hold down employment at call centers and construction companies. He moved from Lehi back to his parents' home in Orem, then went through spells living on the street, insisting he was on a mission to combat the same kind of poverty and depravity he had seen in Honduras.

Before he got sick, the most serious offense Norman had been accused of was a traffic ticket. Soon, his rap sheet would grow to include several misdemeanors, a few felonies, and ultimately a murder charge in 2012.

While a patient at the Utah State Hospital in 2011, Norman was accused of strangling his roommate when they were left alone in their room to sleep, though his parents don't believe that's how the fatal encounter played out.

The incident set off six years of torment.

Because he was still clearly mentally ill, Norman stayed in the state hospital until May of last year, when it was determined he was competent enough to proceed toward trial.

In June, he was then sent to the Utah County Jail to wait as his court hearings resumed. But Norman began to spiral downward almost immediately.

By mid-December, he was again deemed incompetent and ordered back to the state hospital.

Now at the back of the line, Norman spent five more months in jail waiting to get into the same place where he had began.

Like other parents of mentally ill adults refusing pleas to get help, Norman's parents had once hoped the criminal justice system could be the answer. Instead, with each arrest they saw their son snatched up by police and thrown into a jail cell, facing additional charges if he fought back in his confusion.

Only once was the experience different, they said. And it didn't happen in Utah, but in California.

While his parents weren't looking, Norman had packed the family van with food and water, setting out on some imaginary crusade. After his parents filed a missing person's report, police in Los Angeles found him in a construction site, wrapped in the quilt his mother had given him for a wedding present.

He told the officers he was searching for his wife.

"They knew he was mentally ill right away, and what did they do? They didn't throw him in jail for trespassing on a construction site," Donna Norman recalled. "They put him in a mental hospital and called me and said, 'We're going to stabilize him and when he's ready we will put him on a bus. Do you feel like that's safe for him?'

"I was so grateful. Can you imagine? I mean, we never have been treated like that here."

Through the years, the parents say they've considered reaching out for help or campaigning for change in Utah’s criminal justice system. But they fear there is little sympathy for a man who is charged with murder, even a man who is deeply ill.

"I realized very quickly that it would be difficult for me to do that because, I can't, um," Donna Norman says haltingly, "I can't, spin his story in a way that would solicit compassion from people."

James Norman Sr. is pictured in the backyard of his house in Orem on Tuesday, April 11, 2017. Norman's son, James Norman Jr., is accused of strangling his roommate while he was a patient at the Utah State Hospital. Due to competency questions he has been waiting six years to stand trial. | Nicole Boliaux, Deseret News

James Norman Sr. was more critical of Utah’s political leaders, whom he believes have passed over mental health for issues more likely to get them re-elected. Now, he hopes legislators will look outside the state's borders to find solutions.

Utah has already adopted some. In the latest legislative session, the hospital lobbied for and received $3 million to build an off-site restoration facility in what will likely be the Salt Lake County Jail so inmates can start getting competency treatment while in custody.

It’s an idea that states like Colorado, Georgia and Texas have already undertaken, with some success.

But solutions that seem to work at first can soon prove to be a Band-Aid for a gaping wound.

Utah's mental health budgetCreate pie chartsTexas made several piecemeal fixes after being sued for its lengthy waitlist in 2007. The state opened up more forensic beds, contracted with other mental health providers and pumped money into the mental health system.

Yet after dipping between 2012 and 2014, the number of people on the waiting list soared again in recent years, forcing the state to give a number of beds previously reserved for non-offenders to inmates.

According to Snook, the solutions that have shown the most promise have centered around decriminalizing mental illness from the top down and diverting mentally ill offenders into treatment instead of jail.

One of the most well-known mental health reform programs was started in Miami-Dade County 15 years ago by a judge who noticed a startling number of people with mental illness cycling repeatedly through his courtroom.

Under the program, police officers are trained to redirect mentally ill people to crisis units for treatment instead of arresting them. There, patients receive mental health treatment and social support from case managers who monitor them even after they are released.

In addition, the county created an alternative to the psychiatric hospital for low-level offenders: the 16-bed Forensic Alternative Center.

Here's why it works: Rather than going to an expensive hospital, low-risk defendants are diverted to the center, where nurses, case managers, competency instructors and psychiatrists are focused not only on preparing inmates for court but for restoring them to full health with an eye toward permanently rejoining society, according to center director Cindy Schwartz.

Most importantly, after being discharged, providers continue to monitor and help patients access treatment, housing and benefits.

Between 2009 and 2012, people who remained linked to aftercare services after they were discharged demonstrated 75 percent fewer jail bookings and 92 percent fewer jail days compared to those who are no longer linked to services, according to Schwartz.

And as of 2013, the center demonstrated a savings of almost $1 million a year, according to the Palm Beach Post.

Earnshaw said the Utah State Hospital will be working with consultants to project forensic needs over the next five to 10 years and said that he wants to look into a diversion program that would be more similar to Miami-Dade's.

"I don't fault anybody," he said. "I think everybody's been talking about this and trying to find solutions for a few years now. Legislators, department heads, division heads, county commissioners, mental health centers — we do need to have further discussion. I think there are still systems issues that need to be addressed. But we're having those discussions."

James Norman Sr. just wishes they would hurry.

It took four months for his son to make it back into the state hospital, and that was only after he walked into a courtroom and hand-delivered a letter to the judge begging her to force the hospital to make room. Attorneys on both sides echoed the father's concerns, as did the judge.

Excerpt from a letter written by James Norman Sr. asking his son's attorney to talk to 4th District Judge Christine Johnson about his son's condition in Utah County Jail, carried to court on March 23, 2017.

Even then, James Norman Sr. wasn’t sure how long it would be before the hospital would send his son back.

"Even though we're very very glad to get him back in the state hospital, there is no guarantee that this cycle won't repeat itself all over again," the father said. "Even though this has been going on for well over five years — or eight years depending on how far you want to go back to his first incarceration — you know there's no long-term solution."

Case dismissed

As it stands now, Diane Prigge is still in jail. James Norman Jr. is in the state hospital. And Matthew Hall is dead.

The 31-year-old clung to life for more than a month after his suicide attempt, paralyzed from the neck down in a hospital bed at Promise Hospital in the Avenues and unable to do more than whisper and shrug his shoulders.

Throughout March and April, Nate Hall visited his brother nearly every day, spinning dreams of finding experimental trials for him to participate in that might cure his paralysis and making preparations to move him to a long-term care facility in Clearfield.

It wasn't to be. His brother’s heart gave out on the night of April 5. Doctors resuscitated him twice with epinephrine, but there was no way to save him: The drug was the only thing keeping his brother’s heart beating.

He died in the early hours of the morning, two days later.

On April 15, Nate Hall joined the rest of his family at Myers Mortuary in Ogden.

Nate Hall spent most of it outside, talking to friends and smoking. To his surprise, many people who had clashed with his brother in recent years over his erratic and compulsive behavior still showed up. It was behavior he now understood to be the underpinnings of a severe mental illness.

Inside the funeral home, his mom gripped the door frame, unable to bring herself to walk into the viewing room. "I don't want to go in there," she gasped. "I'll never see him again after this."

A 5-year-old girl, the half-sister of Matt Hall’s youngest daughter, ran toward the casket. "Is he in heaven?" she asked her mom.

Matt Hall Jr. pays his respects to his father during his funeral at the Myers Mortuary in Ogden on Saturday, April 15, 2017. "I wish you weren't paralyzed," Matt Hall Jr. told his father. "I wish you weren't dead." | Nicole Boliaux, Deseret News

Matt Hall’s oldest child, 9-year-old Matthew Jr., spoke hardly at all. The little boy gazed into the casket silently, wiping his eyes with the sleeves of a gray suit several sizes too big.

"I wish you weren't paralyzed," he said. "I wish you weren't dead."

To this day, Nate Hall hasn't been able to bring himself to watch the security footage of his brother's suicide attempt. He can barely bring himself to read the jail logs.

He never found out why his brother did what he did on that pivotal February night. For all the times he asked him, his brother never gave him a reason.

"He just kept saying he messed up," Nate Hall said. "That he wished he wouldn't have done it."

From his place in Farr West, the days stretch before him, long and empty, blank spaces to fill with memories of Matt.

"He didn't have anything other than the charges he got from them arresting him," Nate Hall said, his voice shaking.

"He didn't have drugs on him, he didn't have weapons, he didn't do nothing. All this because a cop wanted his name and he didn't want to tell him. … It all started just from that."

Matt Hall Jr. sits on the steps of Myers Mortuary after the funeral of his father, Matt Hall, in Ogden on Saturday, April 15, 2017. | Nicole Boliaux, Deseret News

Contributing: Mariana Chrisney