In his last letter home, Sawyer Letcher was searching for forgiveness.

“You are my hero and my inspiration — I love you more than life,” the 19-year-old prisoner wrote to his mother. “I did a lot of messed up stuff and I am just realizing now. I was just broken, trying to find my way.”

Scrawled in child-like handwriting, the note still sits on the family’s refrigerator in San Angelo, where Keri Womack quietly searches for answers two years after her mentally ill son killed himself in a Texas prison.

Could the prison have done something different? Could she have done something different? Why are so many inmates killing themselves?

Letcher’s death in 2017 came amid a rise in prison suicides, which reached a 20-year high in Texas last year — a troubling shift even as jails across the state have seen suicide figures tumble to the lowest they’ve been in at least a decade.

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Forty inmates killed themselves in the Texas Department of Criminal Justice in 2018, more than twice as many as five years earlier. Jail suicides, conversely, fell by a third over the same time period. Experts credit the downturn in jail deaths to successful reforms in the wake of the Sandra Bland Act, but it’s not as clear what’s driving the increase in prisons.

“We have an epidemic of suicides in prison and no one’s asking why,” said Doug Smith, a policy analyst with the Texas Criminal Justice Coalition. “But if we had independent oversight you damn well better believe they would be getting to the bottom of it. We would know what the problem is.”

Not everyone believes that’s the answer. There’s a pending bill to create independent oversight of the Texas prison system, but state Sen. John Whitmire — the Houston Democrat who chairs the criminal justice committee — questioned whether that would solve the problem.

“The outside oversight would only be as good as whoever appoints the person,” he said. “And there’s just not support for that in the Legislature, in my judgment.”

Rising numbers

The Texas prison population is the lowest it’s been since the early 2000s, with 147,905 people in custody at the end of last year — about 10,000 fewer than a decade ago.

Despite that, the number of suicides is rising. While 2013 saw a 10-year low of 17 deaths ruled suicide, the next year shot up to 31. By 2017, the figure rose to 34 and last year’s total of 40 was the highest recorded in 20 years of state data obtained by the Houston Chronicle.

Just as in the state prison system, Texas jail populations have decreased, too — though not quite as much. In 2018, the state’s lock-ups held about 65,000 inmates, about 3,000 fewer than in 2008. Suicides peaked in 2015 when 35 inmates killed themselves, but generally stayed in the 20s before that. Last year’s low of 17 suicides made for a rate of 2.6 per 10,000 inmates — just below the Texas prison system’s rate of 2.7 per 10,000 prisoners.

According to 2017 Centers for Disease Control data, the age-adjusted suicide rate in the general U.S. population was 1.4 per 10,000 people, also a noticeable uptick in recent years.

‘Line in the sand’

Growing up in San Angelo, Letcher was always a little different from other kids. From a young age, he liked spending time alone, ensconced in books. He wanted to be a preacher when he grew up.

But he took everything too literally and didn’t catch on to social cues, his mother recalled. At Christmas, he couldn’t understand why to tell people thank you when he’d been told not to lie. And over time, his frustration at social interactions spilled over into aggression. He was put into special education classes and diagnosed with Asperger’s, bipolar disorder and borderline personality, according to his mother.

As a single working mom, Womack didn’t know how to handle her son’s escalating behavioral problems and occasional outbursts of violence.

“I just drew a line in the sand with him and said, ‘If you touch me, I’m going to call the police,’” she said. “And I did.”

Letcher didn’t do any better in the juvenile justice system. Instead, the 13-year-old racked up disciplinary violations, then eventually assaulted a guard and caught a new charge — this time as an adult. When he turned 17, officials transferred him to the Texas Department of Criminal Justice.

More mentally ill prisoners

The Texas prison system is grappling with a 24 percent increase in the number of mentally ill prisoners over the last decade; about 19.4 percent of the state’s inmates now have diagnoses requiring mental health treatment behind bars.

In response to the uptick in suicides in 2012, the department boosted suicide prevention awareness efforts among staff, which officials said likely prompted officers to ask more questions and categorize more behaviors as suicide attempts. That, officials said, could explain the sharp rise in the recorded number of prisoners trying to kill themselves.

“We believe that any suicide is one too many,” said prison spokesman Jeremy Desel. “To make sure that we are doing everything possible to keep those numbers as low as possible, it is likely that the agency overcounts the number of attempted suicides.”

Now, though, suicide attempts are more than double what they were five years ago, and completed suicides have gone up as well. Department officials said they are working to find “innovative ways” to treat and track mental health problems.

But Greg Hansch, public policy director for the National Alliance of Mental Illness Texas, stressed that not all suicides are among the mentally ill population, and raised questions about whether prison conditions — especially in uncooled units — could drive up suicide numbers.

“I am certain there have been suicides that directly resulted from the conditions, including the temperature that those facilities are placed at,” he said. “You can just imagine night after night you’re sleeping in highly uncomfortable conditions, at a certain point you might hit your breaking point. And it’s probably worth a look at the extent to which solitary confinement is being used.”

Smith, who once served time in the Texas prison system himself, criticized the department for failing to probe deeper into the reasons for the rise.

“I have no idea why this is happening and neither does TDCJ,” he said. “They just offer one excuse after another.”

Shadows and self-harm

The day after he was sent to the adult prison system, Letcher told medical staff he “felt suicidal,” according to court filings.

As the months wore on, he saw “shadows” passing by his cell, ate his own feces, tried to kill himself repeatedly, and cut his arms in an “openly suicidal fashion,” telling 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. He wouldn’t always agree to take his medication and at one point, mental health providers wrote, “PATIENT REMAINS A THREAT TO HIS SAFETY.”

But they never permanently admitted him to the psychiatric prison and, after a brief emergency room visit for a spring 2017 suicide attempt, officers apparently ignored an order to keep him under direct supervision, instead leaving him alone in a one-man cell with bars that could be used as tie-off points and bedsheets that could be tied into a noose.

The next day, prison guards found him hanging in his cell.

Legislative options

The Sandra Bland Act seems to be having an impact on county jails. Named for the Illinois woman whose suicide in the Waller County jail four years ago sparked national outrage, the legislation emphasized diverting mentally ill inmates, created a fund to pay for more cameras in small jails, and mandated mental health training for jailers statewide.

Despite a string of highly publicized inmate deaths in the Houston lock-up over the past two years, statewide figures hit a decade low last year when 17 inmates killed themselves — and officials said this year’s figures are on track to be even lower.

“A lot of people do not want to be the next Waller County and find themselves part of a viral video,” said Brandon Wood, executive director of the Texas Commission on Jail Standards. “The Sandra Bland Act has to have had a positive impact in terms of bringing to light the issues of inmates with mental health problems in the jail and trying to provide them services they needed all along — but I think it’s also making people aware that we have a long ways to go.”

But to Whitmire, there’s an obvious solution: this legislative session, he filed a bill that would create a compliance monitor appointed by the State Commission to oversee any jails found out of compliance three or more times in 18 months. Last month, the measure was referred to the Senate Criminal Justice Committee.

When it comes to prison oversight, there’s an even more robust legislative fix on the table. A pair of companion bills filed by Houston Democrats Rep. Jarvis Johnson and Sen. Borris Miles seek to create an independent ombudsman to oversee the state prison system.

“We’ve wasted and spent a lot of unnecessary money on things that I think an independent ombudsman would have been able to catch,” Johnson said, touting the measure as a way to both protect inmates and avoid lawsuits. “I think it would have saved the taxpayers money.”

It’s a move advocates have called for repeatedly, citing gaps in medical care, allegations of officers planting contraband in inmates’ cells, evidence of a since-abandoned disciplinary quota system, and various other problems in the state’s 104 facilities.

Michele Deitch, an attorney and criminal justice consultant who teaches at the University of Texas at Austin’s LBJ School of Public Affairs, pointed out that an ombudsman could do preventive monitoring and look into systemic concerns — much as the ombudsman already does in the juvenile prison system.

“There is a critical need for an entity independent of the prison agency to look at these cases as a whole,” she said, “and ask questions about whether there is anything the agency could be doing to better identify prisoners at risk, provide them with treatment, supervise them differently, improve training for staff, or change policies.”

‘I never want this to happen to another boy’

When Womack got the call about her son, she was still at work. She had thought her son was doing better — and it all came as a terrible surprise.

“I just kept thinking he was coming home,” she said. “In his letter, he said he’d be home for his 21st birthday.”

That would have been in February. Now, Womack is suing the prison system in federal court on her son’s behalf.

“I don’t know what the treatment is or what help they need, but I never want this to happen to another boy with similar issues,” she said. “Someone should care.”

keri.blakinger@chron.com