DV Journal

(This article first appeared in Broad + Liberty)

Editor’s note: The following story has explicit descriptions of suicide and suicide attempts that may be disturbing for some readers. For anyone who is struggling with suicidal thoughts or ideations, call 988. If it is an emergency, call 911.

For any family, a suicide is a tragedy not only of the death itself, but a tragedy of unanswerable questions that gnaw and corrode.

When that suicide happens in prison, the number of those destructive questions only multiplies.

This is the life now of Janet Owens of Elverson Borough, as she seeks what answers she can gather to the death of her son, Andrew Little, who hanged himself in a prison cell at Delaware County’s George W. Hill Correctional Facility on the first Saturday in June of 2022.

“They called me on Monday and I asked [the chaplain] some questions and she said, ‘Well, I don’t know. I’ll have to get back to you.’ I asked her, ‘Was he on a mental health unit?’ ‘Oh, I don’t know.’ ‘Was he receiving treatment?’ ‘I don’t know.’”

Andrew Wesley Little was born in September of 1987. With Andrew being her second son, Janet remembers him as a much more peaceful baby than her first.

“When he turned fourteen, fifteen, when he went through puberty, that’s when his mental illness kicked in and he took off and went out [to California] and lived on the streets,” Owens said.

Eventually, Owens was able to help get Andrew enrolled in the forestry program at Penn State, Mont Alto, but Andrew’s illness came to dominate again.

Court records show Andrew had numerous contacts with various police departments in Chester, Delaware, and Philadelphia. The dockets show mental illness factored into several of those cases, such as a judge requesting a mental evaluation.

Owen’s frustrations are many, as anyone might imagine. But in particular, she feels as though many medical privacy laws, like the 1996 federal Health Insurance Portability and Accountability Act, or HIPAA, acted as a constant barrier between her and her sick son.

Understandably, a law like HIPAA assumes that it is meant for individual, rational actors. But Owens feels like that’s where the HIPAA and other laws like it are incomplete, and incompatible with mental illness.

“The patient has an inability to recognize their own illness. And that’s why these people think, ‘I don’t need medication.’ And part of their paranoia is they’re [thinking] ‘They’re trying to poison me. They want to give me this medication.’ and that’s why they can’t be medicated or they won’t be medicated because they don’t believe there’s anything wrong with them.”

Owens pointed out that her son’s resistance isn’t just an anecdote, it’s a diagnosis — anosognosia, when “someone is unaware of their own mental health condition or that they can’t perceive their condition accurately,” a webpage from the National Alliance on Mental Illness says.

Retired, with abundant time to just think about her departed son, she wonders how else privacy laws put a wall between her and her son.

For example, Owens says her son was in Chester County months before he was transferred to Delaware County. While there, she says he attempted suicide twice. Owens wonders if a suicide attempt is privileged medical information, and if it is, would Chester County have been prohibited from relaying this safety information to Delaware County?

She says her numerous calls over months and years to jails, prisons, hospitals, all were turned away leaving her with no way to even begin to try and help.

There are other, more straightforward questions as well.

Broad + Liberty showed Owens documents obtained from Delaware County via Pennsylvania’s Right to Know Law.

In an email from April 15, 2022, a sergeant at the GWHCF alerts several other staff members that “On unit 10, we have multiples [sic] doors issues, ranging from broken locks to doors not being able to open or only open with keys,” (emphasis added). The email went on to say that many of those same cells in the unit were frequently subjected to sewage backups.

“Every time a toilet and sink are flushed, a backup of water and sometime [sic] feces into cells and day rooms,” the sergeant wrote.

The timing of the email is important because when it was written, the government had only taken over the management of the prison from a private operator earlier that month. The email represents one of the first alerts that the new management was struggling to deal with broken locks or inoperable doors, a problem that persists to this day.

On May 4, 2022, a work order shows a repair technician worked on cell A210 to replace a wire harness on the door lock, a door lock that is meant to be operated from a remote control room.

One month later in cell A210, Andrew Little hung himself apparently using sheets in the cell. But an incident report shows the door locks were still an obstacle for the officer who was rushing to help.

“Sgt. McDevitt stated that the cell door was inoperable from the Control room, so he quickly proceeded to the main hallway to retrieve the cell key from Officer Kpadeya.”

The documents stunned Owens.

“I was appalled to know that first, some of the letter from the maintenance man was saying that sewage has been seeping into these places. So is it sewage and backup that was making these [lock] systems not work? And then, if somebody should be watched regularly, what are they doing in a unit that locks and they can’t get to the locks in time? My son could still be alive, maybe.”

Two days after Little’s death, another work order shows the lock being fixed.

Owens’s theory about moisture is given credence when the technician noted, “Seems that moisture into the inner lock parts…” The rest of the report is obscured for some unknown reason.

Two sources with intimate knowledge of the prison say the run from Little’s cell to the control room and back for the physical keys would have taken at least two minutes, possibly as long as four minutes. Those sources have requested anonymity out of fear of career retaliation.

“He [Sgt. McDevitt] would’ve had to first run downstairs from the top tier (because that cell is on the second level), get buzzed through the 10A block door, secure that door, get buzzed out of the octagon door that connects all four blocks (A, B, C and D), get the cage door buzzed (there is a cage door that secured the control room) and finally get into the control room (which was probably already open because the officer knew he was coming). After retrieving the key you run through the same steps to get back on the unit to the cell,” one source explained.

The second source said other details in the incident report are telling. The report begins by noting that the officer who first became aware of the situation “was conducting chow relief on Unit 10[.]”

“The fact that the Sgt. is ‘conducting chow relief on Unit 10 control room’ is a very clear indicator that the unit was short staffed,” the second source said. “Essentially, the Sergeant had to step in as the Control Room Officer to allow another officer to take a lunch break. The report only mentions one other officer being present at the time of the incident. The information suggests that there was one Control Room Officer and one Block Officer left responsible for a unit that is supposed to have the highest level of security. If the unit were fully staffed it would consist of six total officers.”

The first source confirmed the concern about staffing levels, saying, “At the time of the incident only one officer was assigned to that block.”

The county declined to comment on several questions posed by Broad + Liberty, some of which were not specific to Little’s death.

Owens said she has already been working with local attorneys on a wrongful death lawsuit, prior to seeing the documents provided by Broad + Liberty. While no suit has been filed yet, should it be successful, she hopes to use any monetary awards to work on mental health issues.

“He [Andrew] shouldn’t have been in prison. He should have been in a mental health institute. And because there’s nowhere to go, that’s where he was. And if that’s what they’re going to do, then they need to protect these people, these kids, these children, these young men that should be getting care outside, but they don’t have anymore. And they closed them down. They closed down Brandywine. It was the last one here. He was in Belmont. He was in Brandywine. I can’t even tell you how many places he was.”

The incident makes clear Andrew was in Delaware County’s custody because of a parole violation related to an indecent exposure charge. None of the court dockets available on Pennsylvania’s Unified Judicial System website for Delaware County show charges for indecent exposure. But Owens says her son shouldn’t be thought of as a sexual offender, rather that he was mentally ill and had lost all sense of right and wrong. Supporting that idea is the fact that all of the dockets that are available from Delaware and Chester counties are for nonsexual offenses like disorderly conduct, trespassing, shoplifting, or simple assault.

Owens is estranged from her former husband, and Broad + Liberty was not able to find contact information for Little’s father.

Broad + Liberty has been able to get some answers for Owens. Her son was being housed in the mental health wing according to prison sources who spoke with Broad + Liberty. However, our inquiries did not get any kind of answer as to whether Little and other mentally ill patients were being checked on regularly.

As for whether HIPAA could have acted as a barrier between Little’s time in Chester County versus Delaware, Chester County spokeswoman Rebecca Brain responded to a hypothetical question about inmate privacy that essentially mirrored Little’s situation.

Brain first explained that the county contracts with Primecare for its delivery of medical care for the county’s correctional facility.

“If that inmate is then transferred to another correctional facility that also contracts with Primecare as its medical provider, that information is shared across Primecare’s medical record platform. If the correctional facility does not use Primecare as their medical provider, then Primecare, when aware of a transfer, drafts and sends a document with the patient/transporting authority which includes information regarding the inmate’s suicidal ideology and other basic medical information,” Brain explained.

“According to Primecare, this process falls under continuity of care, where no authorizations are required for the sharing of information between facilities. I would recommend reaching out to Primecare, as they are contracted as the medical provider for a number of prisons and could provide you with more information,” she said.

While this answers some questions, it raises others, such as whether one prison would be able to alert another about known suicide risks even if there were no direct transfer of the inmate, as is used in the hypothetical.

With reform in mind, Owens says she has been following changes in California led by Democrat Gov. Gavin Newsom.

“Governor Gavin Newsom’s Community Assistance, Recovery and Empowerment (CARE) Court initiative would grant more authority to a civil court judge to mandate treatment,” a 2022 report from a CBS affiliate in San Francisco said. “Disability rights groups say that’s a violation of civil liberty. But some family members of the severely mentally ill say it may be the only way for them to survive.”

Delaware County’s prison had been privately managed for nearly 30 years until 2022. Although the formal transition to government management did not take place until April 2022, the county’s hand-picked warden, Laura Williams, started in February.

In the 23 months since then, the GWHCF has witnessed eleven deaths, four of them suicides.

This is a horror story.

It is a story of unmitigated suffering and death from despair. It is the story of our veterans, who are 57 percent more likely to take their own lives than those who haven’t served their country.

Every day in the United States, an average of 17 veterans commit suicide. Those who have served in special combat force units, like Navy SEALS, are a little more likely to die this way than regular forces.

These veterans are suffering and dying in plain sight. Veterans, whether they have seen action or not, are ending lives by their own hands — hands that willingly took up arms to serve.

There is a clear and present crisis in the deaths of those who have borne the battle, heard their country’s call, and who die, often alone in despair.

Around Veterans Day, we remember them, but what do we know of them?

More veterans have taken their own lives in the last 10 years than died in the Vietnam War. Frank Larkin, chairman of Warrior Call, an organization that asks anyone who knows a veteran to call them from time to time and ask, “How are you doing? What do you need? Can I get help for you?” But primarily to convey the comfort of knowing “you are not alone.”

However, the problems are beyond loneliness and the well-known precursors to suicide: drug abuse, alcoholism, joblessness and broken relationships.

New research shows that what ails these sad heroes isn’t just psychological and moral despair but physical brain damage — minute tears in the brain that CT scans don’t pick up.

A leading researcher into brain injury and concussion, Dr. Brian Edlow, professor at Harvard and associate director of the Center for Neurotechnology and Neurorecovery at Massachusetts General Hospital, said these tears are only discovered in postmortems when the brain tissue is put under a powerful microscope.

The cause of these tears, Edlow told guest host Adam Clayton Powell III in a special Veterans Day episode of the television program “White House Chronicle,” are blasts that troops experience on the battlefield and in training — massive concussive blasts, over and over again. Those concerned emphasize that the victim doesn’t have to see combat to suffer damage, it happens in training as well.

Sometimes the tears are a result of a physical head injury like a soldier’s head hitting the inside a tank or a blast throwing a soldier against a wall. Still, mostly it is the shockwave, according to Edlow.

“Just to appreciate the scope of this problem, if you look at the post-9/11 generation, those who answered the call to serve after September 11, 2001, over 30,000 active-duty and veteran military personnel have died by suicide during that time period, which is four times more than the number of active-duty personnel who died in combat,” he said, adding that the “extent of the suicide problem is humbling.”

Larkin said that two-thirds of those who commit suicide have never been to a VA hospital or sought institutional help.

For Larkin, the story is personal. His son Ryan, a decorated Navy SEAL who served for 10 years with four active-duty deployments in Iraq and Afghanistan, was a suicide.

Ryan returned from active duty a changed young man, 29 years old. He was moody, didn’t smile and showed classic signs of depression. His family couldn’t get him out of it, and his brain scans were negative. After a year, he took his own life.

Earlier, Ryan had asked that his body be used for medical research. Postmortem diagnosis at Walter Reed National Military Medical Center revealed substantial brain damage that wasn’t detectable during the year before his death, his father said.

“The system didn’t know what to do and it defaulted toward psychiatric diagnosis,” Larkin said.

Referring to scans and other techniques now in use to examine the brain, Edlow said, “We simply are not accurate enough to detect these sub-concussive blast-related injuries.”

Ryan’s tragedy is repeated 17 times a day — and that figure doesn’t account for those who die in deliberate accidents and are otherwise not reported as suicide, Larkin said.

While medical science and the military catch up, all we can do, as Larkin said, is to check on a veteran, any veteran. You could save a life, bring a man or woman back from the precipice.

In July, two families in Kentucky filed lawsuits against Instagram (whose parent company is Meta, which all of us still think of as Facebook), seeking to hold the company responsible for their daughters’ eating disorders and mental illnesses. This is the tip of a massive iceberg, as in more than 80 current lawsuits, parents are claiming that Facebook and other social media platforms are causing their children irreparable harm.

As these cases continue to pile up, they come as no surprise to those who have closely followed the legal woes of these social media companies. Over the past few years, Facebook has faced a barrage of lawsuits alleging that it failed to protect minors from sexual predators and cyberbullies.

The current lawsuits follow in the steps of an earlier round, filed in 2016 by a coalition of consumer groups and public interest organizations who alleged that Facebook’s policies violated the Children’s Online Privacy Protection Act (COPPA). These suits, which were consolidated into one federal case currently pending before the Ninth Circuit Court of Appeals, all sought class-action status for millions of minors whom they allege suffered emotional distress as a result of their interactions with other children on Facebook or Instagram

In 2017, Facebook was sued in Illinois by the parents of a 14-year-old girl who allegedly died by suicide after being cyber-bullied on the social media platform. The suit, which also named Instagram and the alleged bullies as defendants, claimed that Facebook failed to implement safeguards to protect children from online violence. In seeking $100 million in damages for their daughter’s death, the parents argue that if Facebook had done more to prevent bullying on its platforms and remove offensive content when reported by users or other third parties (such as school authorities), then perhaps their daughter would still be alive today.

In 2018, two other suits were filed in California alleging that Facebook knowingly allowed minors to access its platforms and failed to protect them. One of those cases involved a 13-year-old girl who says she was bullied through Instagram and then sexually assaulted by an adult male. She says that after she reported the incident, Instagram failed to remove the photos posted by her assaulter. In California, minors can sue in civil court without their parents’ permission if they have suffered harm as a result of another’s negligence or carelessness, but only if they’re seeking damages for personal injury. The girls’ lawyers argue that their clients’ suffering qualifies as such an injury because it caused “severe emotional distress.”

Whether Facebook is held liable for a case of anorexia is less important than the collective opening of a very powerful door for families who are filing these lawsuits.

Kila Baldwin, a Philadelphia-based catastrophic injury lawyer who is very familiar with these types of cases, shared a poignant observation with me:

“The collective weight of these ongoing suits bears heavily on the backs of social media companies, which need to individually and collectively appreciate that their platforms, which they often argue were designed to change lives for the better, can also destroy them.”

One thing is eminently clear: These claims aren’t going away anytime soon, nor are other potential legal challenges involving kids’ use of social media platforms. These social media companies have no viable option moving forward than to hold themselves to a higher standard.

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More than two dozen of the nation’s top military heroes are calling on all Americans to save veterans and service members from suicide by connecting with them next month in a nationwide push to reverse the tragedy befalling the men and women in uniform.

Twenty-seven recipients of the Congressional Medal of Honor, the nation’s highest military decoration for valor, have joined forces asking that members of Congress — and every American — take part in National Warrior Call Day on Nov. 13.

“With its simple mission of imploring all Americans to connect with someone who has worn or is currently wearing the uniform and let them know they care — National Warrior Call Day can foster greater connectivity. And greater connection can save lives,” they wrote in a letter to Congress.

National Warrior Call Day is supported by leading veteran organizations, current and former military officials, seven former Veterans Affairs secretaries, and a host of public policy organizations.

Connectivity is key to reversing the tragic suicide trends among military members. Two-thirds of veterans who take their own lives have had no contact with the Department of Veterans Affairs, highlighting the urgent need for greater connection. The ask is that on Nov. 13, every adult American should contact a veteran or service member and ask how they are doing, let them know they are cherished and, if necessary, steer them toward assistance when they might otherwise slip through the cracks.

Suicide is metastasizing among people in the armed forces or who have served. Pentagon figures show the suicide rate for active-duty soldiers last year was the highest it has been in nearly a century. More U.S. veterans have died by suicide in the previous 10 years than service members who died from combat in Vietnam. And after adjusting for sex and age, the rate of veteran suicide is far higher than the rate among all U.S. adults.

Moreover, a large segment of those who are disconnected and die by suicide may have undiagnosed brain injuries from their service that may present as mental illness but require an entirely different approach.

While the latest figures from the Department of Veterans Affairs show a decline in the national suicide rate among veterans, the drop highlights a simmering issue pressed by suicide prevention advocates — the likely undercounting of the data.

For example, the deaths of veterans may not be tallied as suicides in certain instances in which self-harm plays a critical role. These include deaths due to addiction, drug overdoses, alcohol-induced incidents or accidents. While not strictly defined as suicide, they represent a statistical gray area. In addition, much variation permeates how each state accounts for deaths. An officially declared suicide in one state might not be in another.

The group America’s Warrior Partnership recently released an interim report from its multi-year study of suicide deaths across eight states and uncovered significant disparities between state and VA data and a large error rate in how the VA accounts for deaths of vets. The report found that the suicide rate was much greater, at 1.37 times the rate reported by the VA. And when researchers added in veterans whose deaths were from self-injury, including overdose deaths and other behavior closely aligned with self-harm or suicide, the rate of suicide was 2.4 times higher than the rate the VA reports.

“We understand firsthand the challenges that service members and veterans face and the need for their peers, friends and family to lift them up,” the 27 Medal of Honor recipients wrote to Congress.

With the assistance of all Americans — first on Nov. 13 and then throughout the year — National Warrior Call Day can make a difference. It can lift up those who need it and provide hope. It saves lives.

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Military veterans make up roughly 10 percent of the adult population in the United States. Unfortunately, one of the most common causes of death for veterans is suicide. Increases in veteran suicide, especially during COVID, have caused the Troops First Foundation to take action by submitting a letter to Congress.

This letter, signed by the seven living secretaries of Veterans Affairs (VA), introduced an amendment to the National Defense Authorization Act that would make November 21, 2021, the first annual “National Warrior Call Day.”

U.S. Rep. Mary Scanlon (D-Delaware Co.) told Delaware Valley Journal the designation is only part of the solution to the large issue. Warrior Call Day’s goal is for Americans across the country to reach out to their family and friends who have served.

“By creating the day, there’ll start to be resources behind it,” Scanlon said. “There’s an organizing principle, and the various veterans groups can get behind it and community groups can kind of weigh in as well. I think it’s probably in a lot of ways just trying to bring more attention to the issue. I guess in a way that’s deemed to be helpful. One of the issues that we’ve seen over time, and you see the same thing with law enforcement, is that it’s very tough to kind of crack the nut with veterans to make sure that they get the services that are available, how to reach people, and similar to law enforcement, it’s the folks who are used to being the rescuers and not wanting to ask for help. So, trying to get the connections that will actually be helpful is the continuing challenge.”

Mental health issues are not uncommon in the United States, especially among military veterans. According to the VA, more than 1.7 million veterans received services for mental health issues in 2018.

Former VA Sec. David Shulkin, MD said, “Warrior Call Day is important to remind each of us that the sacrifices continue for the brave men and women who defend our country. We want all Americans to be aware of the responsibility to reach out and offer support to our veterans.”

Part of the issue with mental health and military veterans is the stigma that surrounds these issues. Asking for help can often be seen as a weakness for members of the Armed Forces. There is hope that Warrior Call Day will bring more attention to this problem and help break that cycle.

“I think it’s probably part of the whole de-stigmatization issue that we’re dealing with across the board with mental health issues and making sure that people check in with their loved ones and trying to get some traction that way,” Scanlon said. “Because of the escalating issues with suicide there have been a number of different approaches, whether it’s beefing up resources, or trying to find alternative methods of service delivery, making sure that we connect people as they’re leaving the service more strongly so they don’t have to go looking as hard. I think it’s part of a whole menu of efforts to really get a handle on the problem.”

For veterans, the services and resources by federal agencies, particularly the VA, often get mixed reviews. According to a survey by Pew Research, only 46 percent of those veterans surveyed felt the VA was doing a good job. Another survey by Pew Research found 37 percent felt the VA is doing a fair job, while 15 percent felt it is doing a poor job.

“I don’t think [Warrior Call Day] alone is going to bring these changes. I think it’s trying to shine a light on a particular issue and the mental health issues and trying to bring more public attention to it,” Scanlon said. “But being done in conjunction with a whole bunch of different efforts that have been trying to get more services available through the VA and make sure they’re more effective.”

One such way that Congress has moved to help veterans has been the Blue Water Navy Bill passed in 2019. This allows veterans exposed to Agent Orange an automatic presumption, which makes it easier for qualified veterans to receive compensation for conditions resulting from that service-related experience.

Scanlon also mentioned that a similar issue is being explored for post-9/11 veterans and the burn-pits used in the Middle East. About 25 percent of veterans are already experiencing health issues from exposure to these pits.

“We do have more former-service members in Congress now than we’ve had in decades so that is helpful to have people in the mix who are first hand on some of the issues,” Scanlon added.

Former VA Sec. Robert McDonald also urges Americans of the importance of National Warrior Call Day.

“We must get Veterans connected to other Veterans and the qualified care they deserve,” McDonald said. “The Veterans Crisis Line (1-800-273-8255) plays a critically important role in this. They save lives. We know from research that if we can connect Veterans to the VA (and the Crisis Line) we can save lives. Nearly 70 percent of those who take their own lives are not connected to the VA. So, National Warrior Call Day is an opportunity to connect every Veteran to the care they need and deserve.”

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