Marino had slit his wrists, swallowed wet toilet paper, and tried to hang himself with a sheet, Joe Marino and attorney Alfred Farese Jr. told the Globe. He had been on suicide watch when prison officials found him unresponsive in his cell at 7:35 p.m. on April 8, according to Joe Marino and Farese. He died an hour later at Morton Hospital in Taunton, officials said.

In the weeks leading up to his death, Leo Marino, an inmate at Bridgewater State Hospital, tried to kill himself three times, according to his brother and attorney.

Joe Marino wants to know why his suicidal, mentally ill 43-year-old brother wasn’t monitored more closely; meanwhile, Marino’s death has led mental health advocates to renew calls to reform Bridgewater State Hospital and ask what happened to plans to revamp the troubled facility.


“Leo should be alive right now,” Joe Marino, 54, of Saugus said in an interview. “This should have never happened. Who was watching him?”

The state Department of Correction repeatedly refused to say whether Marino was under supervision at the time of his death. State Police assigned to the Plymouth district attorney’s office are investigating, but said it could not comment. The Disability Law Center, which advocates for the rights of people with disabilities, has launched its own investigation.

The state medical examiner’s office on Thursday ruled Marino’s death a suicide caused by asphyxia due to upper airway obstruction. There was no further information on how the asphyxiation occurred.

Marino, a father of two teenage boys, suffered from mental illness, his brother said. Court records show he was diagnosed with bipolar disorder and struggled with substance abuse that included cocaine and prescription drugs. He also had a history of suicide attempts, according to court documents.

In 2011, Marino told a doctor that he had religious visions and that God spoke to him.


In the fall of 2015, while being held in Essex County Correctional Facility in Middleton on charges that he assaulted his fiancee, Marino tried to kill himself several times, his brother said. He was admitted to Bridgewater State Hospital on Oct. 13 for observation, according to correction officials.

Marino was then civilly committed to Bridgewater, a medium security prison that houses mentally ill inmates, on Jan. 28, after he was found incompetent to stand trial on the assault charges. He was also facing charges in Newburyport District Court of driving under the influence of drugs and possession of a controlled substance.

By the time he was sent to Bridgewater State Hospital in the fall, his mental health had badly deteriorated, according to his brother. Jail officials in Middleton had refused to allow Marino to take Klonopin, a drug he had been prescribed to treat panic disorders and anxiety. Officials at the Essex County Sheriff’s Department, which runs the jail, could not be reached Thursday.

“We’d go see him and he was fully depressed,” Joe Marino said. “He couldn’t think, eat . . . he felt absolutely terrible.”

In March, Marino spent more than 250 hours in seclusion at Bridgewater, according to Roderick MacLeish Jr., an attorney who filed a class-action lawsuit on behalf of Bridgewater inmates in 2014.

At the time of his death, according to his brother, Marino was being held in the Intensive Treatment Unit, which, according to the Department of Correction, includes 14 cells, a dorm room with a restraint bed, and office space for nurses, the unit director, and security.


Officials said the cells include a bed, a toilet-and-sink combination, and a table with a fixed stool. During the first hour of being in the Intensive Treatment Unit, inmates are watched continuously, officials said. After that, mental health staff conduct checks every 10 minutes. Correction staff check on inmates every 30 minutes, according to the department.

Officials at Bridgewater had allowed Marino to again take Klonopin, but his mental state continued to deteriorate, Joe Marino said. According to Farese, Marino’s lawyer, his client was preparing to receive electroconvulsive therapy and was not taking Klonopin at the time of his death.

A spokesman said the Department of Correction does not administer electroconvulsive therapy, but if a doctor prescribed the treatment, the inmate would be taken to an outside facility.

Correction officials declined to answer questions about Marino’s specific medication, saying such information cannot be disseminated under state confidentiality laws.

Hours before Marino’s death, he sat across from his brother and his attorney. Joe Marino told his brother that his family loved him and they needed him to be strong.

“I can’t take it anymore,” Joe Marino said his brother told him. “The pain is too great.”

Before he left, Joe Marino said, he begged prison officials to keep an eye on his brother.

Marino’s death has reignited discussions about mental health treatment for inmates at Bridgewater. Mental health advocates, who pushed for sweeping changes following the deaths of three men at the facility between 2009 and 2013, say legislators punted on proposed reforms two years ago and have done nothing since.


Governor Deval Patrick’s $12.3 million plan called for increased staffing, including 130 full-time mental health clinicians and a new facility where potentially violent inmates be treated in a secure setting.

Correction officials had sought $10 million to boost staffing and enhance training, but lawmakers approved only $1.8 million in new funding and said they needed to study the issue further, according to the Executive Office of Public Safety and Security.

“In the end nothing was done,” said Christine M. Griffin, executive director of the Disability Law Center Inc. “There’s been a lot of silence.”

Mental health advocates said they plan to take their fight to improve Bridgewater to Governor Charlie Baker’s office.

“The Baker-Polito Administration recognizes the challenges at Bridgewater State Hospital and is working on a strategy to ensure that the quality of care and level of safety patients receive there matches what they would receive at any mental health facility,” said Felix Browne, spokesman for the Executive Office of Public Safety and Security.

MacLeish said he met with Baker’s chief legal counsel in May to discuss Bridgewater. That same month, he sent a letter to Attorney General Maura Healey stating that “the rights of the severely mentally ill continue to be abused,” he said.

“The state locks up someone without meds, without the proper therapy and counseling, and puts them in solitude and doesn’t realize that’s going to kill them,” said Joe Marino, who was planning his brother’s funeral. “The system failed him. He should have got the help he needed so he could live.”


Jan Ransom can be reached

at jan.ransom@globe.com. Follow her on Twitter at @Jan_Ransom.