At 32, Nathan Pierce was turning his life around. Then he sought help from Texas' mental-health system.

For Nathan Pierce, the crisis came quickly. In July 2012, he began suffering nightmares and feeling increasingly anxious and depressed. At 32, Pierce lived with his mother and two nieces in a mobile home on a hardscrabble road on the edge of Sherman, Texas, in the rural community of Southmayd. Pierce was trying to turn his life around and was studying to become a welder, but his deteriorating mental state made it tough. His symptoms soon worsened. He endured terrifying hallucinations and suicidal urges. So on the morning of July 12, his mother, Barbara Pierce Todd, drove him to the Texoma Community Center, the local mental health clinic, for an evaluation. A caseworker and a supervisor declared that he needed treatment at the North Texas State Hospital, an in-patient facility in Wichita Falls, two hours away. Though Pierce was voluntarily seeking hospitalization, a magistrate issued an emergency detention order that same day and, as is standard practice, the clinic notified the county sheriff’s department to deliver Pierce to the state hospital. He never made it.

Pierce hadn’t been diagnosed with a mental-health disorder, though he had a history of drinking, and getting into trouble, and spent several stints in jail. Since his last release, he had helped Todd raise her daughter’s children, 8-year-old Makaylah and 9-year-old Chealsey. “When I was away at work, he’d help them with their homework and feed them and put them to bed,” Todd says. “He even took them to the father-daughter dance at their school.”

The family traces its roots to southern Oklahoma. Pierce, and his sister and mother carried the ID card known as the CDIB—Certificate of Degree of Indian Blood­—and are proud to be on the tribal rolls and hold a piece of registered land in the Choctaw Nation of Oklahoma. In the summers when he was a kid, Pierce would return to southern Oklahoma to stay with his grandmother and great-grandfather, a Choctaw healer. Pierce built a tree house with his cousin and fished in the stock ponds. “He was always outside,” Todd says. “He loved it over there.”

In his teens, Pierce began drinking, and later on, his drinking led to arrests. He expressed remorse each time, but continued to drink. He was held in the Grayson County Jail on minor charges more than once, and at one point, served a short sentence in prison for an assault that friends described as “a fight between drunks.” After that, Pierce apologized to his mother for causing her worry and vowed to start a new life. The Choctaw tribal government helped out by paying for his treatment in rehab in 2011. After treatment, he stayed sober, enrolled in welding classes and began to imagine a career. “He had had problems, but he’d made up his mind to change,” says Michael West, owner of Fight Time Fitness, where Pierce had learned kickboxing and trained since he was 15. “We had some long heart-to-hearts. … We saw him getting better.”

After dropping Pierce at the clinic on July 12, Todd received a call from a caseworker to notify her of the decision to send her son to the state hospital. She remembers feeling relieved that Pierce had sought help and hopeful he would benefit from treatment.

The Grayson County Sheriff’s office dispatched Corporal Steven Robert Sloan to drive Pierce to the hospital. The national office of the National Alliance on Mental Illness (NAMI) reports that across the country, law-enforcement officers often transport people with mental illness, especially those in crisis.

Sloan, who worked at the county jail, drove to the clinic, where Pierce waited with a crisis worker. Sloan placed Pierce in cuffs and leg irons, and when Pierce asked the reason—since his was a voluntary commitment—Sloan told him that sheriff’s department policy mandated the use of restraints in all transports.

The two-hour drive to Wichita Falls went smoothly until Pierce requested a bathroom break. Sloan pulled over at a picnic area five miles outside Henrietta and un-cuffed one of Pierce’s hands so that he could urinate. What exactly happened next remains unclear. Sloan says that when he started to re-cuff Pierce, Pierce struggled with him, and though still partially restrained, Pierce wound up in possession of the deputy’s Taser.

Sloan would later say that he began backing away to get out of range. He claims Pierce kept coming toward him, aiming the Taser at him. Sloan then shot Pierce in the chest with his 9mm service weapon.

At first, Sloan couldn’t call 9-1-1 because his radio wasn’t functioning and his cell phone had no service. A passerby managed to get through to Clay County deputies, who came to the roadside park. Emergency Medical Technicians (EMTs) arrived at 4:12 p.m. to find Pierce on the ground, “in leg irons and handcuffed, left hand only.”

Pierce was rushed by ambulance to a Wichita Falls hospital, arriving at 4:45 p.m. He was taken into surgery and died on the operating table at 7:13 p.m. During the three hours preceding Pierce’s death, nobody bothered to notify Barbara Todd that her son was in critical condition.

“I could have at least held his hand,” she says. “I could have seen him once more.”

At 10:30 that night, about 11 hours after leaving Nathan at the clinic, Todd heard a knock on her front door. Seeing a Department of Public Safety trooper standing there, Todd’s first thought was that there had been a wreck. Then another officer, this one wearing the Grayson County Sheriff’s uniform, stepped into view. They asked her to come outside to the porch, and they told her that Nathan was dead, that there had been a struggle and “he had passed away.” Then the Grayson County deputy had a question for her.

“Do you know where you want the body shipped?”

Todd searched for words to describe how it felt to be asked such a question seconds after being told her only son had been shot to death.

“Like dirt,” she says. “They treated me like dirt.”

In Texas, mentally ill patients and their families must navigate a complicated and barely functioning public mental-health system that often interfaces with the criminal justice system. It helps immensely to have money. As one higher-up at the Texas Department of State Health Services says, “If you’re going to have a psychotic break, be sure and have some money.” Big bucks allow you to go to a cushy private clinic in your hometown—unless you have a low IQ or you have a special need, like deafness, or unless you do something too psychotic. The private clinics offer the best treatment and they cherrypick, and Nathan Pierce was no cherry.

There was, however, more than one way to transport him to the nearest state hospital. According to the Texas Health and Safety Code, a mentally ill person can be transported by a relative, friend, mental health administrator, mental health officer, or, if none of those are available, law enforcement officer. That the Texoma Community Center either didn’t know about, or didn’t care to use, one of those first four options points to a large gap between regulations and reality for Texans with mental illness.

As in many states, community mental health clinics in Texas use law enforcement officers to transport patients, according to several clinicians around the state. Shelley Smith, CEO for West Texas Centers, the mental-health agency for a 23-county area, says that during an emergency commitment in her area, patients are always transported by law enforcement officers. “Transports are going on during the day, night, weekends—constantly,” she says, noting that it’s a big drain on Texas counties and sheriffs’ offices.

Sheriffs’ departments and mental health providers shackle everyone during transport, despite another regulation that requires written justification and documentation of use of restraints. Nathan Pierce’s questioning why Sloan needed to restrain him hints at his uneasiness, especially considering his otherwise taciturn and near-somnolent behavior as described by his caseworker at the clinic.

The shackling of patients points to another poorly understood aspect of commitment, which is that when a judge issues an emergency detention order, a voluntary patient becomes an involuntary commitment. So, Pierce may have entered the system voluntarily, but once under that order, he slid over an invisible line into custody. And while technically not a prisoner, he was still treated like one. (Pierce was repeatedly labeled “a prisoner” in some reports and news stories, to the distress of family and friends.)

In large, urban districts, law-enforcement agencies hire specially trained mental health officers to transport patients, but most Texas counties don’t have, or don’t allocate, enough funds for that. So whoever transports your mentally ill loved one may have taken only “Basic Jail Certification Course For Sworn Texas Peace Officers,” a 32-hour course extremely light on the subject of mental illness. The course curriculum includes an introduction by a retired sheriff who warns new jailers about the presence of career criminals and foreigners in Texas jails. He fails to mention the estimated 25 percent of county jail inmates with mental disorders.

“Most officers in all states will spend more of their career dealing with the mentally ill than they will armed, assaultive or fleeing individuals,” says Kevin Elliott, a retired Los Angeles sheriff’s officer who’s now a Ph.D. candidate in criminal justice policy at Texas State University. “Yet most law enforcement officers, including sheriffs’ deputies, receive only a few hours [of training to deal with mentally ill prisoners], compared with more than 150 hours of firearms, self-defense and physical fitness training.”

The transporting of mentally ill patients to hospitals isn’t mentioned in the basic course for Texas jailers. And while the state doesn’t collect statistics on the number of transports, the Texas Department of State Health Services reports there were 14,487 people admitted to state hospitals in 2012. The majority of the admissions were transported by law enforcement officers, according to a staffer who wishes to remain anonymous.

The Grayson County Sheriff’s Office refused to answer questions about the Pierce case or about its policies on transporting mentally ill patients.

The death of Nathan Pierce made little news and has so far resulted in no accountability. The storied Texas Rangers have responsibility for investigating all officer-involved shootings. Ranger Jay Foster was dispatched to investigate the shooting at the roadside park on Highway 82 in Clay County last summer.

By the time Foster got to the scene, Pierce had been taken to the hospital, but Department of Public Safety troopers and Clay County deputies were still there, along with the shooter.

Sloan showed Ranger Foster the locations of the struggle and shooting, and the ranger examined the officer’s gun and ammunition, and then released it back to him. He took custody of Sloan’s Taser X-26; the safety was in the down or off position, and later tests proved it had never been fired. Sloan told Foster that he had previously transported mental patients on numerous occasions.

Three days later, another Texas Ranger, Brad Oliver, was assigned to the investigation. On July 16, four days after Pierce’s death, Oliver interviewed Sloan and the two Texoma Community Center mental health workers who had assessed Pierce. During the ranger’s 80-minute interview of Sloan, which was videotaped, the deputy sheriff was afforded privileges that most civilians wouldn’t receive when questioned after killing someone.

First of all, the ranger’s respectful and detailed questions about Sloan’s military background, work history and training in law enforcement served to establish his bona fides. Most important, when it came to Sloan’s account of the shooting, the ranger asked leading questions and injected his own editorial comments to support certain conclusions. His most effective technique was to repeat key answers and then elaborate, making Sloan’s largely inarticulate responses into something more substantive.

Oliver: “If that Taser was deployed on you, what were you thinking that could happen to you?”

Sloan: “That I was gone.”

Oliver: “What do you mean, gone?”

Sloan: “Gone as in not here anymore. I was dead.”

Oliver: “OK. ‘The Taser would have incapacitated me so he’d shoot me.’ So this is running through your mind as this happens?”

Sloan agrees, and then describes Nathan advancing on him holding the Taser: “I’m backing up…um, at that time I got to as far as possible that I could back up.”

Oliver: “Why is that?”

Sloan: “I’d a been in the highway.”

Oliver: “What other problems would you have if you’d got into the highway?”

Sloan: “Could have been hit by a car.”

Oliver: “OK, so what’s going through your mind the whole time he’s pointing this Taser at you?”

Sloan: “The things going through my mind are everything—you’re in a situation you got to get out of.”

Oliver: “What kind of situation did you think you was in?”

Sloan: “I was in a life-and-death situation. I mean it was my life or his life …”

That carefully coached testimony by the only witness to the shooting led to this conclusion in the Texas Rangers’ report: “The deputy was forced to shoot Pierce one (1) time.”

The Texas Rangers’ report was completed 39 days after Nathan Pierce’s death, on August 20, 2012. The report noted several unresolved questions, including what exactly happened during the struggle, how Pierce could have gotten the Taser and whether he actually threatened Sloan, and the officer’s possible history with Pierce during prior incarcerations in the county jail. Despite all that, the Rangers’ report exonerates Sloan of any wrongdoing. Since the recommendation of the Texas Rangers is usually followed, it wasn’t surprising that a Clay County grand jury failed to indict Sloan last fall.

There was no indictment, no published reports of investigations or follow-up in the media, and apparently no consequences for the officer, leaving the friends and family of Nathan Pierce with unsettled feelings and unanswered questions. What exactly happened at that rest stop outside Wichita Falls last summer remains a mystery.

“He had voluntarily turned himself in and he was wanting to get help,” said John Sanders, a friend of Pierce’s who had talked to him just days before he was killed. “There’s things about the way it went down that don’t make sense.”

In early 2013, Barbara Todd hired Dallas attorney Jay English to represent her in a lawsuit against the county. “This was a young man who admittedly had some emotional problems,” English said. “But he had his lifetime ahead of him. It’s a terrible tragedy that Nathan Pierce, who wasn’t even under arrest, was killed.” He said that he and Todd were planning a lawsuit in federal court.

However the lawsuit goes, this case illustrates the confusion and lack of coordination within our mental health care system. Shouldn’t anyone transporting of person suffering from mental illness be required to have special training?

Yes, says Gregory Hansch, policy coordinator for Nationial Alliance on Mental Illness and fellow at the Hogg Foundation for Mental Health. He often sees police responding to psychiatric emergencies and says, “That’s why Crisis Intervention Team programs are so important, both for training the police and also for other first responders such as EMTs.”

Meanwhile, every few weeks, Barbara Todd Pierce drives over to the country cemetery near Unger, Oklahoma, to put flowers on a grave. “Now Nathan is buried over there in the old Indian cemetery in the middle of a cow pasture,” she says. “There’s a wrought-iron fence around it—it’s the place where my mom, grandpa and grannie are buried.” Todd says that she wants the rest of us to imagine what it feels like to lose a son. And in her own quiet way, she demands justice.