Assisted Suicide

A county psychiatrist's indifferent treatment of a disturbed inmate leads to a courthouse hanging

Cervantes' biggest problem was that he'd allegedly committed that felony while on probation for the drug charge. That potentially meant a longer prison sentence if convicted, and gave prosecutors more leverage when tendering a plea bargain offer.

A Phoenix police officer took Cervantes to the Madison Street Jail for booking. The cop later noted in his report that Cervantes had tried to hang himself in the back seat of the police car during the trip.

"SUICIDE WATCH," the officer noted on a form that he turned over to sheriff's deputies at the jail.

Dr. Joseph Franzetti in deposition, May 11, 2004.
Dr. Joseph Franzetti in deposition, May 11, 2004.
Dr. Joseph Franzetti in deposition, May 11, 2004.
Dr. Joseph Franzetti in deposition, May 11, 2004.

Jailers put the distraught inmate in a restraint chair for several hours. Later, they took him to the sixth floor of the recently closed jail, to the psychiatric unit.

This is what Dr. Pam Drapeau, who has toiled as a county jailhouse shrink since 1997, said in a deposition last year about working at Madison Street:

"It's jail. It's a horrific environment. . . . We run largely a crisis center. It's a MASH unit a lot of the time. Somebody comes up in the [restraint] chair psychotic, screaming, yelling, flailing."

A few months ago, sheriff's deputies moved the 70 or so men from the sixth-floor psych unit to the new county jail on Lower Buckeye Road.

It remains to be seen if employees at the new facility will overcome the chronic lack of staffing, overcrowding, and assorted other problems outlined in a 1997 report to the U.S. Department of Justice.

Despite those long-standing problems, most jailhouse staffers are said by many (including some inmates) to be devoted, competent and kind toward patients.

"The folks who work at the jails aren't there to get rich and famous, believe me," says Dr. Patricia Crellin, who recently resigned as medical director of Correctional Health Services. "If you're not going to help someone on the job, then why take it? It's not an easy place to be. But so many people go above and beyond with the inmates."

But Steve Cervantes would have the misfortune of having Dr. Joe Franzetti as his treating psychiatrist at the jail.

Perhaps Franzetti was overworked at the time, or maybe he was distracted by his other mental-health jobs outside the jail.

Whatever the reason, the psychiatrist clearly would fail his troubled patient.

And that allowed Steve Cervantes to fatally harm himself inside that little cell at the courthouse.

In May 2002, Joe Franzetti was an independent contractor for CHS, assigned to the psych ward at the downtown Phoenix jail.

He said later he also was moonlighting at a therapeutic group home for adolescents in Phoenix, was seeing patients in Guadalupe and was performing competency examinations in criminal cases.

The pay for his jail gig translated to about $130,000 annually based on his hourly wage of $75.

The doctor had taken quite a route to government shrink work.

In his May 2004 deposition, Franzetti described how he'd worked as a professional drummer after earning his undergraduate degree. Later, he went to a medical school in Guadalajara, Mexico, graduating in 1989.

Franzetti eventually turned to psychiatry, and completed a residency at the county hospital in the late 1990s before taking the job at the Madison Street Jail.

"It is very akin to working in an emergency room," Franzetti has said of his work there. "The cases are very acute. The pathology changes on a daily basis, and the men and women that I work with, counselors and nurses alike, are well-trained and they're very good-natured, and it's almost like a family there."

He said a definite advantage for the inmates locked up on the psych unit was that "they are seen more frequently by the [mental-health] providers."

That statement now seems cruelly ironic.

Franzetti was the on-call doctor at the jail on Sunday morning, May 5, 2002.

Cervantes' medical chart shows that Franzetti conducted the intake interview with his new patient in the most restrictive pod of the psych unit's four levels.

There, suicidal inmates are routinely placed in four-point leather restraints or in restraint chairs for everyone's well-being.

Mental-health professionals consider interviews such as the one Franzetti did with Cervantes as crucial to predicting and maybe preventing jail suicides.

An inmate's self-report of substance abuse, suicidal thoughts, or history of suicide attempts often puts psychiatrists and staff on special alert, which has proved to be a lifesaver in many instances.

Franzetti's notes say Cervantes mentioned he'd just tried hanging himself in the police car, and had attempted suicide at the Cook County Jail three years earlier.

The doctor also wrote that Cervantes "is able to tell me he has a family to live for, wants treatment."

Franzetti's initial assessment after the short session was that Cervantes was suffering from major depression -- but not necessarily a psychotic disorder.

Later, the doctor would concede that his diagnosis had been incomplete. He'd never asked Cervantes if he was hearing voices -- a possible sign of a psychotic break, extreme depression or another serious mental illness.

Franzetti continued his new patient on suicide watch, which was supposed to mean extra monitoring by medical staff and detention officers. He also ordered staffers to start Cervantes on antidepressants and anti-anxiety medications.

Despite Dr. Franzetti's testimony, the evidence proves he never saw Cervantes again before the May 14 suicide.

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