While he was in prison, Sawyer Letcher hallucinated on a regular basis. He heard voices, banged his head against the walls and cut himself just to “feel good” as the blood ran down.

He was “openly suicidal” and gave repeated warnings of his destructive intent. But still, according to a legal claim filed this month, prison officials and medical providers did not do enough to intervene, allegedly leaving the 19-year-old alone in a cell with the means to kill himself.

And, just after noon on May 26, 2017, that’s exactly what he did.

Now, his mother has launched a federal lawsuit against the Texas prison system and its University of Texas medical provider, saying the state violated the Americans with Disabilities Act by failing to address her teenage son’s “obvious mental disabilities.”

“This is one of the most egregious failures to prevent a suicide that I’ve ever seen,” said Scott Medlock, one of the attorneys representing Letcher’s family in the case. “This poor kid needed help, they knew he needed help and they just put him back in his cell knowing that this is likely to happen.”

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The Texas prison and the University of Texas Medical Branch declined to comment on pending litigation.

In 2017, the Texas prison system saw 34 suicides, the second-highest number in a decade. At the same time, suicide attempts have been on the rise, though previously officials chalked that up to a change in data recording.

Warning signs

The San Angelo teen first ended up in the criminal justice system in eighth grade, when he was sent to juvenile prison and lived on a special unit for kids with severe mental illnesses, according to court filings. While there, he got into an altercation with a guard — and ended up catching an assault charge that landed him in adult prison in 2015.

The day after he set foot on TDCJ grounds, he told medical staff he “felt suicidal,” the suit alleges. In the months that followed, he repeatedly harmed himself and attempted suicide.

He saw “shadows” passing by his cell, ate his own feces, cut his arms in an “openly suicidal fashion” and told a counselor it made him “feel good to feel the blood running down.”

Sometimes, he heard voices telling him to hurt himself, and he’d bang his head against the wall to make them stop.

During his time in prison, according to court filings, he was diagnosed with bipolar disorder, impulse control disorder and borderline intellectual functioning. Medical staff gave him medication, but he thought they were trying to sabotage him and sometimes refused to take it.

Several attempts

Officials put him in the Hodge Unit’s Developmental Disabilities Program, a prison outpatient program for severely mentally ill inmates. The program was designed to help prisoners learn life skills, but Letcher knew that wasn’t enough. He asked to be moved to the more intensive “inpatient” program — but medical staff denied him, according to the lawsuit.

His self-harming behavior continued, as he slit his wrists, tried hanging himself and even ran headfirst into a wall in an effort to break his own neck. Twice in his last 18 months, Letcher was hospitalized after he was found hanging by sheets in his cell.

At one point, psychiatric providers noted his danger to himself when they recorded that, “PATIENT REMAINS A THREAT TO HIS SAFETY.” Though they refused to permanently admit him to the inpatient psychiatric prison next door, officials cycled Letcher in and out of the crisis management program intended to treat acutely suicidal inmates.

Two months before his death, he was discharged for the last time — but he promised one of the counselors he “would be back.”

On May 24, 2017, Letcher was rushed to a local emergency room after he swallowed a handful of Benadryl, a tube of ointment, and a couple weeks’ worth of antidepressants. The next afternoon, he was brought back to Hodge Unit, where a nurse ordered that he see a “psych provider.”

There were no crisis management beds open, so a nurse allegedly told prison officials to keep him under “constant and direct observation.” But apparently prison staff ignored that request, instead putting Letcher in a one-man cell with bars that would work as tie-off points and blankets that could be tied into a noose.

The next day, just after noon, officers found him hanging from a bedsheet in his cell. He was pronounced dead an hour later at a local hospital.

'They let them down'

According to his family’s attorneys — the same duo handling a high-profile class action lawsuit over a lack of air conditioning in sweltering Texas prisons — that all adds up to a violation of the Americans with Disabilities Act because prison officials knew Letcher was mentally ill and allegedly failed to make “reasonable” accommodations.

“Had TDCJ and UTMB reasonably accommodated Sawyer’s disabilities,” Medlock and co-counsel Jeff Edwards wrote, “he would have likely completed his remaining prison term and returned home to live with his mother, the Plaintiff, in just a few short years.”

Officers could have put him under “constant direct observation,” confiscated his bedding, made sure he was in a cell with other people, and put him in a placement without obvious tie-off points, the suits alleges.

“This was a kid with serious mental health problems that did not really belong in prison,” Medlock said. “Every opportunity that there would have been for the state of Texas to help this poor family, they let them down.”

Neither TDCJ nor UTMB has responded to the legal filings yet in court.

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keri.blakinger@chron.com

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