‘She’s breaking down’: Inmates at Bucks County jail decry treatment of suicidal woman with severe mental illness
Kim Stringer went to jail in April. Her parents haven't heard from her since.
Update: As of June 17, Kim has been removed from Bucks County Correctional Facility and taken to Norristown State Hospital, according to Martha Stringer.
(Doylestown) — Because the woman they knew only as “Kimberly” rarely spoke, it took the women at Bucks County Correctional Facility two months to figure out her last name.
Stringer. Her name was Kimberly Stringer.
They were concerned about her. After they learned her name, the inmates started calling: Their parents. Their friends. Anyone who would listen.
WITF Transforming Health profiled Kimberly Stringer in July 2019 as part of a series on problems with mental health services in Pennsylvania. Kimberly has been diagnosed with borderline personality disorder and bipolar disorder, and the story detailed Kim’s parents’ efforts to get her treatment that she legally declined once she turned 18.
After an inmate’s mother found the story online, the collect calls to this reporter started rolling in on Friday evening.
The three inmates told similar stories.
They say Kimberly has been confined to a bare cell, “completely naked,” in full view of male and female guards, with only a soiled blanket and a smock given to patients who are on suicide watch, which she rarely wears.
She urinates and defecates on the floor and on herself.
She has gone without a mattress at times and has no books or possessions.
She is covered with bruises, and at times has hit her head or punched herself.
She hasn’t had a shower in weeks.
“She’s breaking down,” said inmate Courtney Lowe. The 30-year-old, who lives with opioid addiction and is in jail for drug possession and related charges, said she fears repercussions for speaking out, but believes that Kim can’t go on like this much longer.
Thirty-year old Karen Wood—in prison for numerous offenses related to drug possession or delivery, court records show—said Kimberly is incoherent. In one of the few times she spoke to Karen, Kim asked when she was going to get to leave the jail and go to a hospital.
“It hurts me seeing her like that,” Wood said. “I wouldn’t want to go through that.”
Fifty-nine-year old Linda Ennis, in jail for a DUI, said she had been on work release but was moved into Kim’s cell block when the coronavirus hit Pennsylvania.
Three hours into her stay there, Ennis recalls, she was shocked to see several corrections officers enter Kim’s cell.
“They maced her,” Ennis said. “They drug her out of the room. They put her in a cold shower. They strapped her to a chair. She screamed the whole time, ‘Why are you torturing me?’”
Wood and Lowe also separately said they saw something they believe was pepper spray used on Kim.
On Friday evening after Kim’s mother, Martha Stringer, heard what the inmates said they saw, she emailed Bucks County Commissioner Diane Ellis-Marseglia.
Marseglia denied that guards used mace or pepper spray on Kim, saying the county prison never uses pepper spray, a June 13 email shows. However, later that day she told Stringer that it’s possible guards used pepper spray on her daughter and they were “checking the records.”
Other parts of the inmates’ stories were confirmed in a June 12 email between Martha Stringer and Marseglia:
“As you know Kim is extremely ill,” Marseglia wrote. “She needs desperately to be in Norristown and be provided 24 hour medication and support and attendance. She is clearly in need of this…no question. THEY ARE STILL REFUSING TO TAKE ANYONE because of COVID.”
“Kim is in the mental health wing which is 3 or 4 private cells with one guard watching them every single minute,” Marseglia wrote. “She is actively suicidal and we have had suicides with even the tiniest piece of swallowed cloth to plastic shoved down a throat…They have offered her a suicide smock which would give her full body coverage. It is offered every day.”
A “suicide smock,” better known as a safety smock or anti-suicide smock, is a garment designed so that it cannot be used as an aid to death by suicide.
“Every day she urinates on it, spits at the guards/nurse, and when she can, gather [sic] urine and throws it at them,” Marseglia wrote. “The suicide blanket is safe and warm and provides comfort as a weighted blanket does.”
Until the three inmates reached out to draw attention to Kim’s situation, Martha and her husband Paul had been completely unaware of their daughter’s condition at the jail.
They had been trying to find out how Kim was doing. Martha cried upon learning that the two months’ worth of emails between her and county mental health officials had failed to reveal what she called her daughter’s “nightmare” circumstances.
In those emails, reviewed by WITF Transforming Health, county officials told Martha very little other than that her daughter was “safe.”
Kim’s improvement stalls
The setback is the latest in the Stringers’ long effort to get help for their daughter—an effort that shines a light on a system in which people with mental illness are often incarcerated instead of receiving needed treatment.
In June and July of 2019, when Kim participated in a story about her condition, she was living in a metal shed in her yard in Levittown, even though she had an apartment. She drank water out of a stream rather than her tap, pushed a shopping cart full of garbage around town, and was preoccupied with a fear that technology was poisoning her.
Kim’s parents wanted her to be involuntarily committed before she hurt herself or someone else. However, Kim refused treatment.
After that story was published, her parents were successful in getting a judge to sign off on a 90-day involuntary outpatient commitment. Kim was able to live at her apartment, but was told to get a monthly injection of an antipsychotic drug and participate in weekly therapy sessions.
During that time, Kim started to improve.
“She was getting the injections,” Martha said. “She was working with a case manager. She was accomplishing goals. She applied for food stamps. She was able to go to the grocery store. She was able to be social with us again.”
In Pennsylvania, outpatient treatment doesn’t include a provision to force someone to take a medication, and in October, Kim began to refuse her monthly injections.
In late February, a judge told Kim to follow the advice of her therapist, according to Martha, who has extensively documented her daughter’s interactions with the legal system.
However, Martha said, “She stopped going to therapy, and then COVID happened.”
On April 13—the last time Martha saw her daughter—Kim’s therapist called her on the phone.
“[Kim] was very agitated, did not want to be on the phone, and we sent an email the same day saying we see her deteriorating, and something is going to happen,” Martha said. “And then the next day, it did.”
On April 14, Kim’s neighbor called the Falls Township police. It’s unclear what precipitated the call, but Kim was charged with simple assault, terroristic threats and harassment.
Instead of taking Kim to the hospital, where she could have been involuntarily committed, police took her to county jail, where she was imprisoned on $50,000 bail awaiting trial.
The Stringers could have paid the bail, Paul Stringer noted, but they knew Kim needed to go to the hospital to be committed, and figured that’s where the legal system would soon route her.
“They gave us reassurances she was safe,” he said.
A bureaucratic tangle
Emails show Martha’s unsuccessful efforts to help her daughter over the next two months.
On April 22, Martha requested the police report detailing Kim’s arrest to learn why her daughter wasn’t taken to the hospital. The Falls Township police department wouldn’t give it to her, saying “because it involves an arrest, it is not able to be released.”
The next day, Bucks County Commissioner Marseglia told Martha that she had talked to Falls Township police, who told her that Martha and Paul had said they wanted Kim to go to jail.
Martha told Marseglia that she and Paul had never spoken with police.
In an April 30 email, Martha asked Raymond McManamon, Emergency and Court Services Coordinator/Forensic Liaison, Bucks County Department of MH/DP, if there was a way to get their daughter out of jail.
“At this point, I would wait to hear from probation and/or the jail about a plan to have her come home to make sure she is in the best position to return to the community and willing to accept treatment, whether in the community or some type of treatment facility,” McManamon wrote. “I will be following up with probation and the jail.”
Martha emphasized that her daughter needed treatment and medication. ”What do we need to do to make that happen?” she wrote.
“Given what we’ve discussed so far, getting her stable at the jail or, if she can be released in an inpatient psych setting such as Lower Bucks, might be the best first steps,” McManamon said.
Because of the coronavirus, county prison officials wouldn’t let Martha and Paul visit Kim. They had written letters to their daughter and put money in her prison account so she could call them. They wondered why they never heard from her.
On May 11, Martha sought an update from Marseglia, who asked McManamon to provide one.
“While I cannot speak to her current state of mind or reasons for her not calling, I will continue to collaborate with the correctional MH unit at the jail to make sure they are addressing her needs and working toward re-entry with probation,” McManamon wrote. “She may not be willing to sign the release of information forms presently, and in the case of the Public Defender may not have been willing to speak with or cooperate with her attorney. As soon as either of those parties have a means by which to provide more detail, I will ask that they do so.”
On May 21, Martha reached out to McManamon again, asking for details on Kim’s scheduled court date, set for June 11. He said he was “unable to provide specifics,” but that Kim would “likely” have to receive treatment at a psychiatric facility before she would be able “to proceed with the court process.”
On June 9, two days before Kim’s scheduled court appearance, Stringer checked back in with McManamon.
Martha and Paul were stunned by the reply.
“It appears that the case has been continued and the next scheduled date is 7/22/2020,” McManamon wrote in an email. “As far as next steps, having the jail make a referral to residential treatment would likely be appropriate for Kim. The type of program may be determined by her willingness to participate.”
Martha asked when she and Paul could visit the jail to see Kim. At that point, Marseglia responded.
“I am jumping in here to suggest a few things: First, Kim is safe,” she said. “She will be protected here and, frankly, she is not going to get that much better care if we get her into Norristown [state mental hospital].”
McManamon added that he wasn’t sure when Martha and Paul would be allowed to visit their daughter, and he wasn’t allowed to share more information. “With regard to updates, I don’t think there is any way for the jail or public defender to share information without permission,” he wrote.
‘Brave’ for speaking out
Although county officials repeatedly said they could not relay information about Kim, after Martha sent the June 12 email with an inmate’s account of Kim’s condition, Marseglia provided some details.
She confirmed much of what Wood, Lowe and Ennis said.
And, Marseglia made a promise, one that could cut through the bureaucracy that has kept Kim incarcerated for more than two months.
“Before I typed this I reached out to the staff and we are going to SEE if there is some kind of special court order we can get to move her somewhere,” she wrote.
On June 14, Marseglia agreed to an interview but ended the conversation after a few minutes. McManamon and officials at Bucks County Jail and Falls Township Police Department were not available for comment on Sunday.
Martha Stringer said the inmates were “brave” for speaking up, and she was grateful they were looking out for her daughter.
Paul Stringer said given all the efforts from the experts tasked with helping their daughter, the system set up to help people with mental illness itself has proven to be the problem.
“It’s turned out horribly wrong,” he said, noting that Marseglia has been an advocate for their daughter for years. “We just think she’s inherited a very broken system, and we hope she fixes it.”
Brett Sholtis is a health reporter for WITF/Transforming Health. Sholtis is the 2021-2022 Reveal Benjamin von Sternenfels Rosenthal Grantee for Mental Health Investigative Journalism with the Rosalynn Carter Fellowships for Mental Health Journalism. His award-winning work on problem areas in mental health policy and policing helped to get a woman moved from a county jail to a psychiatric facility. Sholtis is a University of Pittsburgh graduate and a Pennsylvania Army National Guard Kosovo campaign veteran.