Dying in custody at St. Louis region's jails
Courtney Curtis
St. Louis Post-Dispatch
February 5, 2025
The recent death of 26-year-old Aaron Sarles at the Jefferson County Jail is a tragic reminder of the critical need for comprehensive medical care within our correctional facilities.
Sarles, arrested Saturday on a drug possession charge during a traffic stop, fell ill shortly after intake. Despite being evaluated at a hospital and monitored upon his return to the jail, he ultimately succumbed to his condition on Monday.
This incident is not isolated. In October 2024, another individual, 39-year-old Patrick D. Watz of House Springs, died while in custody at the same facility under circumstances that also raised concerns about the adequacy of inmate health care.
These cases highlight a systemic issue within the region’s correctional facilities, where jails often operate on cost-saving measures that prioritize efficiency over the well-being of those in their custody.
The Jefferson County Jail has faced a continual rise in inmate medical costs, with expenditures totaling approximately $3.687 million since 2021. Yet, despite these investments, the adequacy of medical care remains questionable. Increasing budgets do not automatically translate into improved outcomes, particularly when care is limited to the legally required minimum, rather than being structured to ensure that incarcerated individuals receive appropriate and proactive medical attention.
The intake process is a critical juncture where thorough medical evaluations should be conducted to detect underlying conditions and ensure proper care. According to the Missouri Department of Corrections, all offenders are evaluated during the intake process at reception and diagnostic centers, with mental health screenings and medical assessments determining the necessary treatment.
However, the effectiveness of these evaluations is contingent upon the thoroughness of the procedures and the training of the staff involved. A mere body scan does not constitute a comprehensive medical assessment, yet it was cited as the primary tool used to determine Sarles’ condition upon entry.
In Sarles’ case, after being medically cleared at a hospital, he continued to exhibit signs of illness while in custody. His deterioration raises serious concerns about the adequacy of his initial assessment and the effectiveness of subsequent monitoring. He was moved to a different housing location to be observed by medical staff, yet by the time he suffered a medical emergency Monday, it was too late to save him.
This underscores the need for a comprehensive review of intake and evaluation procedures to ensure that they go beyond bare minimum standards and truly safeguard the health and well-being of those in custody.
Individuals in custody do not have the autonomy to choose their medical care providers and are entirely dependent on the institution for their health needs. This dependency necessitates a higher standard of care, as many incarcerated individuals have pre-existing health conditions, mental health disorders, or substance use histories that require specialized attention.
The Missouri Department of Corrections recognizes this need, offering programming for offenders with severe mental illnesses and developmental disabilities. However, these programs mean little if jails fail to conduct comprehensive evaluations or intervene when an individual exhibits distressing symptoms.
Cost-saving measures should never come at the expense of human life. It is imperative that correctional facilities implement robust intake assessments, continuous monitoring, and timely medical interventions. Regular audits and increased transparency in reporting will help ensure accountability and adherence to established healthcare standards.
F.A.I.R. Society (Formerly Adjudicated Individual Reentry) urges Jefferson County and other jurisdictions to conduct comprehensive reviews of their jail medical procedures, invest in adequate healthcare services, and ensure that all staff members are properly trained to recognize and respond to medical emergencies.
The loss of life within our correctional facilities is a preventable tragedy that demands immediate and sustained action. If we continue to tolerate a system where inmates are given only the bare minimum required care, we must also accept the reality that more individuals like Aaron Sarles and Patrick Watz will die in custody. That is a reality we cannot, and should not, accept.
Curtis is the criminal justice committee chair of St. Louis City NAACP. This was written on behalf of F.A.I.R. Society (Formerly Adjudicated Individual Reentry).
https://www.stltoday.com/opinion/column/opinion-dying-in-custody-at-st-louis-regions-jails/article_b1d713d4-e30f-11ef-80c8-030f4f7c6ccb.html (paywall)