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Editor’s note: This story focuses on suicide, self harm and other topics related to psychiatric distress. If you or a loved one is in crisis, resources are available here.

If you met Li’ahnna Mathis, you knew she could sing.

She had been a choir kid at South Kitsap High School, and developed a powerful voice that could be heard belting Beyoncé everywhere from inside the car to inside the DMV.

“[She] would literally sing all day long, even talking to you … she would sing it to you rather than talk it,” said friend Tessa Gilweit.

Mathis, 28, was one of those bright presences in a room — particularly when she performed in drag shows, friends remembered. Among her circle of chosen family in the LGBTQ+ community were friends’ kids who knew her as Auntie Li Li. But Mathis also struggled. As a transgender woman, she had endured violence, homelessness and heartache over the years.

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She died by suicide last December after spending her last conscious moments in a King County Jail cell.

Since Mathis’ death, five more people have died in custody at the King County Jail or after being transferred to the hospital — at least three suicides and one overdose. In the first four months this year, the King County Jail system has seen more people die in custody than all of last year.

The jail has logged 28 suicides, suicide attempts or attempts at self-harm so far this year. The unusual spike in jail deaths has family members, public defenders and advocates asking questions about conditions at the jail, which has seen severe understaffing, new COVID outbreaks and an uptick in its average daily population since the beginning of the year.

But it’s difficult to tell whether the deaths follow a pattern because King County has not complied with a 2021 state law requiring it to review and publicly post analyses of unexpected jail deaths within 120 days — leading to an information void around deaths that occurred last December or earlier.

The jail has not completed and posted any reviews of deaths that occurred inside the jail in 2021 and 2022. Nor have other jails statewide.

LGBTQ+ advocates are also pressuring the jail after a young, homeless transgender person died by suicide in the jail this past March. Damien Ortaga, 25, died less than three months after Mathis, who was being held at the jail on suspicion of violating a protection order.

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“It’s a human rights issue, it’s a humanitarian issue,” said Mahkyra Gaines with the Lavender Rights Project, a legal and social services nonprofit that advocates for Black, trans and gender-diverse peoples. “It’s important to know what happens outside of the community’s eye because so much abuse can happen outside of the public’s view.”

Severe understaffing

Earlier this year, King County public defenders and a union representative for corrections officers — unlikely allies in public safety politics — made a joint case to the King County Council that something at the jail was seriously wrong.

Understaffing had reached crisis levels and COVID cases were rising. This had led to people being locked in their cells for 23 hours a day and attorneys not being able to meet with their clients, public defenders told the council.

Corrections Guild President Dennis Folk said officers working overtime and double shifts were sleeping in empty jail cells because they didn’t have time to go home. They were stressed and sick.

All of this has a trickle-down effect, according to Folk. Delays in medical or psychiatric care were also tied to a lack of corrections staff, he told The Seattle Times.

“We’re unable to provide the very basic care to the inmates in our custody,” Folk told the council in early February. “I have spoken to both incarcerated inmates and to our jail medical staff and psychiatric staff and they feel that we are failing and more needs to be done.”

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In March, King County paid $750,000 to settle a lawsuit filed by the family of a man who killed himself in the King County Jail, which alleged the jail didn’t take adequate suicide prevention measures. Last year, a King County Auditor’s Office report urged the jail to take up more suicide prevention efforts after finding that of four jail suicides between 2017 and 2020, none took place in cells for people at risk of harming themselves.

Before Ortaga’s death this year, a judge had ordered Ortaga be released from jail at 5 p.m. March 9, pending an evaluation from a mental health crisis responder. The jail said it didn’t receive the evaluation by that time, so Ortaga remained in lockup, and was found unresponsive the next day.

Data from the King County Department of Adult and Juvenile Detention show that corrections officer vacancies are higher in 2022 than they have been for the last two years. The jail now has 85 vacant corrections officer positions, compared with 20 vacant positions just a year ago.

The average daily population at the jail has also increased this year. King County data shows that the average daily population as of April 26 was 1,553 — down from pre-pandemic population numbers that hovered around 1,900, but the highest since pandemic restrictions were first put in place.

King County Council Chair Claudia Balducci, former head of the DAJD, said she was uncomfortable putting restrictions on booking certain felonies, which the county’s Department of Public Defense has recommended as a way to cut the jail population.

But Balducci did say that each jail death needed to be thoroughly analyzed for potential trends.

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“I need to see what the jail finds, and then we need to look and see if there are systemic things that need fixing.”

John Diaz, current director of the DAJD, said his department has implemented hiring bonuses — $15,000 for officers with experience, $7,500 for those without — and is hiring a consultant to look at different staffing models to help with vacancies. The jail is also retrofitting bunks that have been used by people in the jail to hang themselves, though that work is not complete, Diaz said.

Diaz, who is retiring in June, suggested that some of the increase in deaths could be due to mental health issues exacerbated by the pandemic. The isolation of a single bunk during COVID could also be a risk factor, he said.

“It’s not a surprise to anybody that we have a lot of people in our community, not just here, but throughout the country that’s really suffered from issues of mental health, addiction, homelessness,” Diaz said. “Frankly, there’s a lot of these safety nets that just had not worked for many people and those are the people that we’re seeing here.”

Mental health resources from The Seattle Times

New law, no teeth

Until very recently, Washington jails were never required to make information about in-custody deaths public.

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Instead, jails voluntarily provided information to the federal government, which then published statewide statistics. Jails across the state defined in-custody deaths differently, leading to inconsistent measures of statewide mortality rates.

Much of the information about people who have died in jails has come out in civil lawsuits or the occasional federal intervention.

In 2006, a federal Department of Justice investigation into conditions at the King County Jail found that it had failed to protect people inside from self-harm and provide adequate medical care, which likely contributed to at least one death. The investigation also criticized the jail’s internal investigations.

The Justice Department settled with the county in 2009, but deaths in King County facilities have persisted.

A 2019 investigation by Oregon Public Broadcasting, the Northwest News Network and radio station KUOW found that at least 70% of people who died in jail custody in Washington and Oregon jails since 2008 were awaiting trial and hadn’t been convicted of a crime.

Suicide comprised more than half of the deaths with known causes, and a third of all deaths occurred within the first three days of lockup, according to the investigation. Another report from Columbia Legal Services found that more than 200 people had died in Washington jails between 2005 and 2016.

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Following the reports, state legislators in 2021 required fatality reviews within 120 days of unexpected deaths in jail custody. But nearly a year later, the King County Jail has still not completed and posted a single fatality review, even as seven people, including Mathis, have died of suicide, overdose or undetermined causes in the jail since then.

Diaz said he was not aware of the new law’s requirements until The Seattle Times notified him.

“I was not aware of the law about posting,” Diaz said, though he insisted that the jail was conducting fatality reviews.

“I want to know why and how she was even able to [kill] herself,” Mathis’ friend Jennifer Titterness told The Seattle Times. “Why and how? You shouldn’t be able to do that.”

It’s also unclear whether other jails across the state are conducting or completing the required fatality reviews. As of early May, the Department of Health said it had not received any reviews from any jail within the state.

“My initial reaction is this is a problem,” said Sen. Rebecca Saldaña, D-Seattle, one of the co-sponsors of the new law. “Is that because there’s no enforcement?”

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No outside review

A decade ago, the Snohomish County Jail saw a rash of deaths in custody — eight in three years. The Snohomish County Sheriff’s Office asked the federal government through the National Institute of Corrections to come in and review its jail procedures, leading to reforms around staffing and medical care.

“Once this pattern [of deaths] starts to develop I think there’s a symptom that there’s something broken,” said Cheryl Snow, a civil rights lawyer who sued Snohomish County over three jail deaths, winning settlements worth at least $5.5 million.

King County has not requested a similar review. Instead, it relies on its own staff, the Seattle and Kent police departments and public health officials to investigate individual deaths.

“You wonder why here they’re not doing it,” Snow said. “You’d like to see them take that step and somebody explain why they’re not asking for outside review.”

While Diaz said his department reviews in-custody deaths thoroughly, not only has his department not complied with the new law it hasn’t asked for outside help. Li’ahnna Mathis’ 120-day fatality review deadline came and went in April, with no review published.

“It’s infuriating,” Titterness, Mathis’ friend, said. “She doesn’t deserve to be lost. She was a valuable human and this world is darker because of it.”

News researcher Miyoko Wolf contributed to this story.

How to find help if you are experiencing suicidal thoughts

If you are experiencing suicidal thoughts or have concerns about someone else who may be, call the 988 Suicide & Crisis Lifeline at 988; you will be routed to a local crisis center where professionals can talk you through a risk assessment and provide resources in your community. More info: suicidepreventionlifeline.org. Or reach out to Crisis Text Line by texting HOME to 741741 for free, 24/7 crisis counseling. More info: crisistextline.org.

Help for domestic-violence survivors

If you are in immediate danger, call 911.

If you have been abused by an intimate partner, you can call the 24-hour National Domestic Violence Hotline at 800-799-7233 or 800-787-3224 (TTY).

A variety of agencies in the area offer assistance, including confidential shelters, counseling, child therapy and legal help. For a list of resources, visit the Washington State Coalition Against Domestic Violence’s website.