Failing Paul Muskeni

Stuck in Sacramento County’s mental-health system, a local schizophrenic is forced to spend 13 days in the county jail without his meds

Paul Muskeni’s recent stay in a Sacramento County jail underscores difficulties the system is having in dealing with mental-health cases.<br>Photo courtesy Maggie McGurk<i></i>

Paul Muskeni’s recent stay in a Sacramento County jail underscores difficulties the system is having in dealing with mental-health cases.
Photo courtesy Maggie McGurk

Photo Illustration by Don Button

During some of his darker moments, Paul Muskeni considers his birth “ultimately evil” and thinks of suicide as a solution. The only thing stopping him from taking his own life, he said recently, speaking through the fog of his illness, is his belief that his death would cause the awesome power stored in his skull to explode in a nuclear-like blast of destruction.

Muskeni is sick, a diagnosed paranoid schizophrenic. He has threatened to harm himself; he has threatened to kill others. During his stints of quasi-freedom—periods of time in between jail and hospital stays—he likes to treat himself to NyQuil and alcohol cocktails.

The 37-year-old Sacramento man needs help. Instead, while behind bars at the Sacramento County sheriff’s main jail this year, he went without his medications for nearly two weeks. He then was released onto the streets of downtown at 3 a.m.

The episode has Muskeni’s mother, Maggie McGurk, frustrated and worried that if her son lands in the jail again—and the odds say he will—he will not be safe there.

There have been two suicides inside the jail this year. On March 4, 24-year-old Joel Lee Wayne was found dead inside his cell. He’d hanged himself with a bedsheet. Almost one week later, on March 10, Balthazar Nunez Zavala, 46, killed himself in the same manner.

The deaths rekindled the 2-year-old debate over whether the jail is appropriately addressing the mental-health needs of its inmates. Seven of them committed suicide in 2002, prompting the formation of a task force.

The sheriff’s department refused to cooperate with SN&R for this article, evading questions over the course of two weeks and failing to answer even basic inquiries such as “What is the jail’s capacity?”

Other officials within county government could speak only generally, citing medical privacy laws that prevent them from speaking specifically about Muskeni or any inmate.

Muskeni’s 22-day stay provides a glimpse inside the jail and, if anything, raises further questions.

When Muskeni was arrested in late January and booked for a probation violation, he already was known to the jail staff. He’d been there before, having been arrested in November 2002 for setting fire to a hotel room. Jail workers assess an inmate’s mental state during the intake process. But with Muskeni, a record of illness and treatment already existed.

Prior to the arson arrest and during that case, the county was charged with overseeing Muskeni’s mental-health care. While in jail, his competency was questioned, he received psychiatric evaluations, and he was medicated.

In March 2003, Muskeni pleaded no contest to arson. He was put on three years of probation, told to stay away from incendiary devices and ordered to take his medications as prescribed.

But when he returned to the jail this year, he wasn’t able to comply with that order. He wasn’t given his medication for 13 days. And it wasn’t because the jail lacked knowledge of Muskeni’s illness.

The day Muskeni was booked, his mother called the jail and told jail staff which drugs Muskeni was supposed to be taking and their prescribed doses. McGurk then faxed the same information to the jail, as was requested of her.

Muskeni immediately was removed from the general population at the jail and taken to the psychiatric ward, McGurk said. She visited Muskeni there and verified he was being housed where he could be supervised by medical staff.

But Muskeni was not being given his medication.

“If he doesn’t get his meds, he’s like Manson,” said McGurk. “You wouldn’t even recognize him. He does weird things with his face and just looks mean.

“When he’s medicated, he’s sweet and gentle, and very handsome.”

Muskeni sat on a bed in a South Sacramento mental-health facility, absent-mindedly rubbing the palms of his hands across his thighs and rocking back and forth. He was trying to describe his “problems” to his mother.

Diagnosed with schizophrenia 14 years ago, Muskeni was just 23. Since then, he has been in and out of treatment facilities, sometimes living on the streets, where he cannot be properly supervised and often fails to take his medications. For most of the time, the county was assigned to oversee his treatment needs, McGurk said.

But his problems, Muskeni said, are greater than that.

“You need to understand pure math. Some people have religion, but that doesn’t work for me,” he said. “We need to stop the world from expanding—it’s expanding too fast from all these new genetic modifications and surgeries that people really don’t need.”

McGurk looked away from her son and mouthed the words “He’s so sick.”

A soft-spoken, thoughtful person, McGurk is well-known in the capital. She has photographed some of the city’s most prominent and influential citizens and currently works as personal photographer to gubernatorial candidate and State Treasurer Phil Angelides.

When it comes to her son, however, McGurk is vocal. She is a strident advocate for someone who sorely needs one.

“All I’m doing is standing up for my son because he can’t stand up for himself,” McGurk said.

And McGurk is painfully aware that her son is not unique. The county’s mental-health system is full of people fumbling through treatment, toggling in and out of jail and hospitals. Most of them do not have advocates like McGurk.

Instead of being embraced as a mother trying to do what is best for her son, McGurk says she has been blacklisted and labeled a troublemaker.

“It’s because I’m trying to force them to do their jobs,” she said.

So, when her son was arrested in January, McGurk took steps to make sure Muskeni was properly cared for while in the county’s custody.

“When I called the psychiatrist in charge—he only had 16 patients—he didn’t know my son’s name,” McGurk said.

Defense attorney Tommy Clinkenbeard says the jail fails in many areas, not just its mental-health services, and that the 2002 task force caused little change.

“They never really addressed the problem,” he said.

His view of the real problems: The jail employs inexperienced guards, does not provide enough staff to adequately address mental-health issues, and was poorly constructed. Clinkenbeard’s chief concern is the architecture of the county jail, which was built with the intent that inmates would stay there weeks, perhaps months, before finishing sentences or being shipped off to state prisons. However, it’s become common for inmates to stay at the jail longer than a year while awaiting murder trials or federal trials next-door at the U.S. District Court building.

“You cannot stay mentally healthy in that environment for that long,” said Clinkenbeard, who once represented accused killer Nikolai Soltys. After Soltys took his own life inside the prison in February 2002, Clinkenbeard called for an investigation into the jail, taking his complaints to the FBI, a grand jury and the state attorney general. All to little avail.

Muskeni stayed at the jail just 22 days before the district attorney dismissed the charges against him, on February 16.

But then came the next step, at which the county jail failed this one mentally ill man. A Superior Court-employed hearing officer determined that Muskeni could care for himself, and then the jail released him onto the streets of downtown Sacramento. At 3 a.m.

“What good could possibly come from letting someone who is mentally ill roam the streets at that hour?” McGurk asked.

In the short time since his release, Muskeni has been in and out of two different treatment facilities.

McGurk fears for her son’s safety and is worried he will again find himself on the streets and off his meds. But McGurk will do anything to keep her son safe, which may mean getting him out of the Sacramento mental-health system and keeping him from ending up in the county jail again. She is working to convince her son to move in with her in Placer County.

It’s a last resort. Muskeni has, in the past, threatened to kill his mother.

“I’d be afraid when I go to sleep at night,” she said, acknowledging that she fears the disease, not her son. “I won’t turn my back on him.”