Lingering questions around the death earlier this year of a man held at the Alaska Psychiatric Institute have renewed scrutiny of Alaska's only state-run mental hospital.
Duop Tharjiath was 29 when he died at API in March. Tharjiath had been held there for more than five years, longer than just about any other patient, and his was the first death at the facility in more than 10 years.
That's according to an Anchorage Daily News story that examined Tharjiath's life, at the intersection of Alaska's criminal justice and psychiatric systems, and his still-unexplained death.
ADN reporter Michelle Theriault Boots says Tharjiath ended up at API after he was charged with manslaughter.
Below is the transcript of an interview with Theriault Boots on Alaska News Nightly. It has been lightly edited for length and clarity.
MTB: He was held in API and continued to be seen as this highly dangerous, violent person, and he could never manage to kind of do what they wanted him to, to move closer to being released. And people are not really supposed to be held indefinitely at state psychiatric hospitals such as API. They legally are supposed to work towards the person living in the least restrictive setting possible. And then he ended up, you know, suddenly dying with really no explanation of what killed him. An autopsy found no anatomic or toxiological cause of death.
CG: You mentioned that there was this perception that he was this dangerous, violent person, some people thought. And I think you wrote that, you know, some others disagreed with that.
MTB: Yeah, I mean, I think it's clear, the record shows, that that he did injure people. He did injure workers at API at some points while he was there. But I think the what his family and what some of the people who worked with him saw was that this was a person who was suffering from a severe mental illness, who had been diagnosed with schizophrenia and who sometimes lashed out and acted out, but that he was sometimes perceived, according to his family and some of these people, as being extraordinarily dangerous, in part, because he was Black, he was Sudanese, and he was a very large person, physically. And those people contend that those factors kind of had something to do with how he was treated, and why he was never able to progress in his treatment, and why he was never able to leave API, a place that both, you know, contained him and feared him at the same time.
CG: Now, if I understand this correctly, the autopsy found kind of a variety of anti-psychotic medications in his system, but that the autopsy does not point to that as the cause of death. Is that right?
MTB: Yeah, I don't think it's a rare finding, but it's a confounding finding. It's, you know, there is no evidence of what physically killed him, so we don't know, though there are things that can, speculatively, cause a person to die but not show up on an autopsy, including certain types of heart issues that don't have a physical signature to them, seizures. It's not always possible to tell in an autopsy what killed someone.
He died at age 29 in the custody of the state of Alaska. People, in general, are not supposed to die in psychiatric hospitals. It's a rare thing, and it's considered what, in the medical world, is called a "sentinel event," which is where something goes so wrong that the institution needs to take a close look at what happened and why it happened.
CG: What did the federal investigators find when they looked at this?
MTB: They found several problems that needed remedy, ranging from issues with his, the patient's, right to have medication administered orally before an injection. Issues related to when checks were done. They found a bunch of issues, and API submitted a plan to correct those issues, and it sounds like at this point, API is back in the good graces of their federal licensing authorities for the moment.
But they also said in a Board of Governors meeting that I listened to that they, you know, that they want to make a lot of changes. They're going to do a bunch of trainings for staff. And the CEO even said in that meeting that he thought that there was a culture problem. And he even said that he thought that, you know, while the employees there are extraordinarily hard working and do a very hard job, that some of them were not meeting expectations and that they needed to, that API needed to, you know, make sure that people were acting with compassion and empathy at all times.
And, you know, I think that some of the people I spoke with for the article would say that's API blaming the floor staff, the least-senior, least-paid employees who interface with the patients the most. And that they would say that, you know, problems like this that lead to an event where a patient dies under these kind of circumstances start much higher up.
CG: As somebody who has reported on these issues for years, and specifically on the Alaska Psychiatric Institute, how does this case play into, you know, the larger questions about API and I guess also, you know, the State's role in caring for mentally ill Alaskans?
MTB: Yeah, I think it really puts into stark relief just the state's struggle to care for some of its most vulnerable citizens and how it, you know, it aims through the courts and through psychiatric hospitals to heal, but at times it succeeds only in institutionalizing.
And to me, it was also a clash between this family that saw their son and brother as a person who was different, but not irrevocably ill, and this establishment, this psychiatric establishment, that viewed him as so profoundly mentally ill and dangerous that maybe they couldn't get beyond that conception of him.
CG: So you went to his burial here in Anchorage, and I just wondered, what was that like? How would you describe that?
MTB: Yeah, I went to his burial. It was in May. A lot of people from the family from all over came. I actually, I recorded a little clip of the audio of singing from the burial. They were singing in the Nuer language.
[singing]
It was moving. It was really moving. I also went to Mr. Tharjiath's father's home and spoke with several family members, and spoke quite a lot to his sisters, and they invited me to his burial. And there were family members who had traveled from all over. It was really moving and beautiful.
This was this person that, during his lifetime, lived such a short and hard life, and a life where he was seen by many as being so dangerous and violent and scary, but no, he had a family and an extended family that adored him and that was very apparent at his burial.
