Maggie Copeland knew she needed help the day she walked into jail.
The 29-year-old mother of a teenage boy told deputies she’d soon be suffering withdrawal from her heroin addiction. In the coming days, her body would be wracked by symptoms such as cramps, vomiting and diarrhea.
The experience, though terrible to endure, could be managed with proper care. But Copeland didn’t get proper care.
She went days without the drugs she needed to help with withdrawal. She became combative with staff, throwing food and screaming. Eventually, she began gurgling in her cell.
When a guard brought her breakfast May 11, 2022, six days after she’d arrived at the Richland County Jail, Copeland had no pulse. She died of dehydration.
“All they had to do,” said her father, Jon Copeland, “was give her a drink of water.”
Like almost everyone else who sets foot in one of Ohio’s county jails, Maggie Copeland didn’t go in facing a death sentence. Copeland started using heroin at age 16 and cycled in and out of jail and prison. This time around, she’d been arrested for holding a “snorting straw” and for a probation violation – offenses that would’ve kept her in jail for several months, at most.
Yet Copeland is among at least 219 Ohioans who died in the past four years in the custody of county jails.Ohio began requiring jails to report deaths and other critical incidents in 2020 but there is no penalty for failing to report. Some deaths in the past four years were not included in the state database.
More than 75% of those who died – 166 people – had yet to be tried for the crime for which they were being held. Some didn’t last 24 hours behind bars.
A Cincinnati Enquirer, Columbus Dispatch and USA TODAY Network Ohio investigation found that jail personnel ignored serious medical conditions and injuries, withheld life-saving medicine and equipment, failed to stop the flow of illicit drugs that inmates later used to overdose, and did not adequately monitor prisoners at risk for suicide.
State officials, inmate advocates and relatives of the dead say the death toll is the product of a justice system that asks Ohio’s county jails to do work they are not properly staffed, prepared or funded to do.
Follow-up story:Gov. Mike DeWine: Jail deaths should be investigated by an outside agency, not sheriffs
Sheriffs and other experts say jails today are the front-line mental health and drug treatment centers in big cities and small towns alike. Most of the 16,000 people in Ohio jails each day suffer from substance abuse, mental illness, or both.
None of this happened by accident. Decades ago, Ohio lawmakers closed state-run psychiatric hospitals but failed to keep a promise to replace them with a robust community-based mental health system.
Instead of getting treatment, thousands of people ended up on the streets and, eventually, in county jails.
“We said we were going to stop warehousing people, deinstitutionalize most of them, and then at the same time build up a local, county-by-county system,” Gov. Mike DeWine said. “We didn’t do it.”
County sheriffs, who run the jails, say they’re doing their best to manage the challenges. But the Enquirer and Dispatch investigation found almost 1 in 3 jails don’t comply with all state standards and that many jails are cited year after year for the same problems.
The consequences of those failures are sometimes measured in lives. Jon Copeland said his daughter struggled for years with opioid addiction, but she was not a hardened criminal or a lost cause. She was hurting and in need of help.
She didn’t get that help, Copeland said, because county jails aren’t equipped to give it. He said state officials, including DeWine, need to act.
“You better do something, because people are dying,” Copeland said. “And their lives are worth something.”
Ohio jails have big political power, weak oversight
For most of the past century, the main job of county jails has been to hold people arrested for low-level offenses while they serve short sentences or await court appearances.
More recently, though, sheriffs say their jails also have functioned as mental health hospitals and drug treatment centers.
“Suicide prevention, overdose prevention within the jail, treatment for your addictions or whatever issues you have, they’re a priority,” said Franklin County Sheriff Dallas Baldwin. “We try desperately to address all that, knowing that the population of the people that come in here are, by and large, unhealthy.”
But state inspections suggest county jails are struggling to provide basic services, not just care related to drug addiction and mental health. In 2022, 28 of 89 jails – 31% − didn’t comply with all 181 state standards.
That means some of the state’s jails don’t provide enough beds, warm showers, toilets, prompt medical care, adequate heat in the winter, and monitoring of inmates suffering from mental, drug and health problems.
Critics say those problems persist, in part, because the state's inspection system lacks teeth. It’s set up to coax the sheriffs into compliance, rather than punish bad actors.If sheriffs disagree with an inspector’s findings, they can appeal to the Ohio Jail Advisory Board, which is run by fellow sheriffs.
Another problem is that some sheriffs don’t want to change. They either ignore violations or thumb their noses at critics, including state and local officials, and rarely suffer consequences because they wield so much political power.
When Trumbull County Commissioner Niki Frenchko criticized jail conditions during a 2022 meeting, Sheriff Paul Monroe’s deputies arrested her at a meeting one month later, after Monroe asked her to publicly apologize. They charged her with disrupting a public meeting under a law against outraging "the sensibilities of the group.”
In 2023, Butler County Sheriff Richard K. Jones, whose jail has been cited several times by state inspectors, said he ignores what the state tells him to do.
“They can’t tell me s---,” Jones said.
The state could take a county sheriff to common pleas court to force compliance with the standards, but it never has. DeWine said that would be the "nuclear option."
“My experience in life is that you’re better off trying to work with the community and trying to give them the help that they need,” DeWine said. “You’ll probably get better results.”
Copeland said that approach failed his daughter inside the Richland County Jail.
“What about all the dead?” Copeland asked. “Collateral damage while you sit on your ass and don't do anything about it?”
'Life was gonna start when she got out of jail'
Copeland said he encouraged Maggie to do her jail time before turning her attention to the therapy she needed to address multiple traumas, including the back-to-back overdose deaths of her mother and her partner.
Maggie struggled with addiction, smoking two packs a day, drinking vodka daily and using 2 grams of heroin every day. Over the years, she did bits in the Richland County Jail and the state prison system.
But this time, Copeland felt like his daughter had a chance to get clean and change course. He said he had just guided Maggie through the hellscape of heroin withdrawal in the weeks before she returned to jail.
"Life was gonna start when she got out of jail," he said.
Copeland violated the terms of her probation on another case and had an outstanding arrest warrant. Then she got picked up by Mansfield police for holding a snorting straw. She got 15 days for the straw and 9 months for the probation issues.
Copeland thought his daughter would be safe inside jail, away from the street drugs that held a grip on her. "You go to jail, you're off the street, you're safe," Copeland said. "Damn, were we wrong."
Nationally, 65% of people incarcerated in jails have substance abuse issues. At least 70 deaths in Ohio jails since January 2020 involved drug and or alcohol abuse.
Sometimes people arrive drunk or high. But other times they score illicit drugs from other inmates or even jail employees who smuggle drugs inside for profit.
More than two-thirds of Ohio jails provide medication assisted treatment to help people addicted to opioids with agitation, diarrhea, vomiting and other symptoms. But not everyone who needs that medical assistance, like Maggie Copeland, gets it or gets it in time.
Jailers didn’t start Copeland on medication until three days after she arrived. Medical staff reported that Copeland was uncooperative, which is common for people going through withdrawal, and had lice. They moved her to a medical isolation cell.
The next day, Copeland threw her food tray, screamed, refused to shower and puked all over her bed and jumpsuit. She alternated between taking withdrawal medication and refusing help.
On May 10, she began gurgling. That same night, nurse Madison Hogie claimed that Copeland was “alert and oriented” and “begging” to have her hair cut off. Shortly before midnight, Hogie shaved Copeland’s scalp clean.
Jon Copeland said Maggie took pride in her long hair and would never voluntarily agree to have her head shaved. "There is no way. Absolutely no goddamn way she would part with that hair," he said.
It’s unclear if Hogie lied about Copeland requesting the haircut. But investigators found that Hogie lied about checking on Copeland, noting in logs that she was “alert and oriented” and “muttering to herself.” Surveillance camera footage showed Hogie failed to make the early morning check that she logged. Jail managers later removed Hogie's security clearance, effectively firing her.
Copeland has filed a wrongful death lawsuit against Richland County.
Like Jon Copeland, Victoria Matthews thought her son Cody Bohanan would be safe while in the Butler County Jail in July 2021.
“I knew he was on heroin and he was struggling with it,” she said. “I had a sense of, like, he was safe because he was in jail. I was just thinking this was going to be another chance for him to get clean.”
Instead of a second chance, Bohanan suffered through withdrawals while in jail, vomiting to the point where he was too weak to stand. A lawsuit filed by his family said Bohanan was so ill he was throwing up blood.
On his fourth day in jail, a guard noticed him slumped over on the cell floor. Paramedics were unable to revive him.
“He asked for help, he begged for help. Even the cellmates asked for help for him. I just don’t get it,” Matthews said.
The coroner ruled that Bohanan died of complication of chronic substance abuse.
Matthews still struggles with the loss of her 24-year-old son who’d fix her flat tire on the side of the road or bring her ice cream at the end of a long day. She said she still pays for his phone to remain active because she “just can’t turn it off.”
“It feels like a part of me is missing and I don’t go a day without thinking of him. I missed talking to him on the phone. I missed his laugh. It’s just so hard. Like when I’m driving home from work and I think, oh, I can’t call Cody.”
Suicides: A leading cause of death in jails
When people are booked into jails, they're supposed to be screened for drug use, suicide risk and intellectual or developmental disabilities. The goal is to alert the jail staff to inmates with medical needs or to those at risk for mental health problems or suicide.
Once they're incarcerated, jail employees are supposed to do regular wellness checks on every inmate. Those on suicide watch are supposed to be monitored more closely.
Isaiah Trammell should have set off several red flags when he arrived at the Montgomery County Jail in the early morning hours of March 13, 2023.
Trammell, 19, had been arrested for a misdemeanor domestic violence warrant on a case filed in 2022. During his booking, Trammell told deputies he had ADHD, autism and said, “I don’t want to live.”
Trammell’s autism spectrum disorder is a developmental disability that can include hypersensitivity to lights and sounds, difficulty with changes in routines and poor social interactions. Jails are places of shouting, chaos and disruptions.
Once locked up, Trammell began banging his head against the walls and door of his cell. He told deputies it was “the only way I know to get rid of the crazy in my head.”
“I just need to know if my life is worth living,” he said.
Jailers put him on suicide watch, which means deputies were supposed to check on him every 15 minutes. They dressed him in a loose-fitting gown and placed him in a cell with no mattress or blanket.
Even if executed perfectly, the conditions of suicide watch in a county jail are focused on preventing a person from being able to kill themselves rather than treating suicidal ideation.
Kerstin Sjoberg, executive director of Disability Rights Ohio, which monitors jails, called the conditions jails impose on inmates under suicide watch “atrocious.” Those conditions can include solitary confinement and cells without sinks or toilets.
“I think when you combine all those factors, that's kind of a perfect storm for someone to either become suicidal if they were not already or to have the opportunity or desire to follow through if they already were,” she said.
By 4:15 a.m., officers had put Trammell in a restraint chair for two hours to keep him from head banging.
They let him out of the restraint chair around 6:15 a.m. Trammell asked for a mat, a blanket and a phone call. Officers refused.
At a video court hearing around 9:30 a.m., Trammell learned he wouldn't get out of jail any time soon. He spiraled out of control. The security camera mounted in the corner of the holding cell captured Trammell pacing, rocking, kicking and crying.
At one point, Trammell dropped to his knees and flopped onto the concrete floor. Then he leaped up and slammed the right side of his head – four rapid blows – against the cinder block wall, knocking himself out for a few seconds.
Jails have restraint chairs and spit hoods but no padded cells.
Five officers rushed in, pinning his legs and handcuffing his wrists. They put him back in the restraint chair, fastening down his arms and feet.
"Please, please, please. I'm shaking," Trammell pleaded as jailers photographed a golf ball-sized lump on his forehead. "Please, I'm in pain."
"You gotta calm down, bud," one man said to Trammell.
"Can I have meds? If I have meds, it'll stop," he cried.
Trammell banged his head against the back of the restraint chair, screaming and tensing. Even once he quieted, Trammell sucked air in and out of his lungs so loudly it could be heard on the surveillance camera.
Paramedics took him to a local hospital where he died three days later. He had six siblings and a dog named Bruce.
Trammell’s death was ruled a suicide. It was one of 64 suicides reported to the state from 2020 to 2023, which accounts for 29% of deaths in Ohio county jails.
Montgomery County Sheriff Rob Streck said Trammell probably shouldn't have been in jail, given he was in the throes of an extreme mental health crisis.
"When he came in, everything seemed fine. He began banging − once again, I don't like being on the record for this because my attorneys don't want −but as soon as he started banging his head, he was taken, secured, calmed down, (let) out, (put) back in his cell (with) people watching him," Streck said. "And out of the blue, he does the same thing."
He added "All of that happened within seconds. So, staff was there. Staff quickly figured out that he had an issue."
Streck’s investigators determined the jail staff did nothing wrong and provided Trammell with appropriate care.
'It's very hard to know': Suicide prevention efforts in Ohio jails aren't fail-safe
Sheriffs say suicide prevention efforts are in place in county jails, but they're not fail-safe.
“There are people who are intent on taking their own life, and they don't want anyone to know about it. It's very hard to know," said Hamilton County Sheriff Charmaine McGuffey. “Our officers are trained to interact, to talk, to hear, to be out there, and hopefully be able to catch any of those behaviors that indicate somebody's going to commit suicide.”
Jail inspection records, lawsuits and other documents point to multiple instances in which wellness checks weren’t done. But it’s not known how many of the 64 inmates who died by suicide were on suicide watch. State officials redacted that information from data obtained through a public records request.
At the Ross County Jail, on Nov. 5, 2021, jailers put 21-year-old Malcolm Willis in a cell by himself. Willis told staff he was withdrawing from fentanyl, but his requests for medical attention went largely unanswered.
After passing out meal trays around 4:20 p.m., no one checked on Willis until he was found hanging from an air vent at 9:40 p.m., a bed sheet around his neck. During that five-hour, 20-minute window, guards were supposed to be making hourly wellness checks.
Ross County investigators found numerous problems: Guards didn’t make in-person checks or turn on their body cameras, one deputy relied on a surveillance camera to look in on Willis, another deputy failed to pick up his dinner tray – missing an opportunity to check on him.
During the emergency response to Willis’ cell, no one thought to bring the AED, a device used to jump start a patient’s heart, or the hand tool used to cut someone down while they’re hanging.
Willis left behind an infant son and a 3-year-old daughter. His family is suing jail officials. Willis’ mother, Victoria Bristow, said her son had not been suicidal before entering jail and blamed conditions there for his rapid deterioration. She described her son as “a beautiful soul” who loved to cook, sing and dance.
“I don’t want there to be no more Malcolms. I don’t want no more families broken,” Bristow said. “When you go to jail, it’s not a death sentence. And when you go to jail, you’re not just an inmate with a number. You’re a person there. You have a family and a life on the outside of this.”
Some families are still waiting for jail officials to explain how and why their loved ones died.
Patty Wolf, of Lancaster, felt relieved when her daughter, Gierra Perdue, went to jail. It was, she thought, a place where she’d be safe and away from the street drugs she’d used for years.
Perdue quit school in 10th grade, ran with the wrong crowd and started using drugs. That was years ago.
In 2021, after being sentenced to three years probation for felony drug possession, she failed to show up for mandatory drug testing. Authorities issued an arrest warrant. She flew under the radar until 2023 when Perdue, 33, got picked up on a traffic stop and taken to the Franklin County Jail on Jackson Pike.
Nine days later, on March 17, she was dead.
Wolf is tormented by the thought of her child dying alone. She knows only a few details of what happened.
"I just want to know how, why. If she was that sick, why didn't they take her to the hospital? So now her kids won't see their mom again. I won't see my baby again,” Wolf said. “I just want to know what happened.”
More than a year later, Franklin County released its investigative report to the USA TODAY Network Ohio bureau in response to a records request made in July 2023.
Officers and medical staff failed to make the required checks every 10 minutes on Perdue, investigators found. One medical assistant wrote in the logs that she made four checks and after Perdue was discovered cold and stiff in her cell, the employee asked a co-worker if they could "white out" her initials on the falsified logs.
Medical staff had a practice of pre-filling out the logs and then initialing them later. The log for 2 a.m. to 5 a.m. had been pre-filled but a medical assistant and the charge nurse, Annessa Moore, decided to put that document in the medical shredder bin and create a new one, investigators said.
Investigators noted that surveillance video captured “moaning” sound from Perdue’s cell around 9:42 p.m., loud enough that an officer turned his head toward it. They noted that was the last sound coming from her cell. She was found dead shortly after 2 a.m.
Paramedics called to the scene said she had “been down for hours.”
Armor Health, the contracting agency that provides medical care at the jail, said it "terminated the clinicians, removed their access to the detention facility, and reported each to their corresponding medical boards. Armor has a zero tolerance policy for any employee who violates company protocols."
'I'm in this place dying': Lack of medical care also a problem in Ohio jails
Sometimes, jails fail to provide basic medical care, either because they ignore ailments or don’t recognize their severity. That matters because the inmate population tends to be unhealthy.
On Nov. 11, 2020, Alfonso Askew called his wife, Stacey, from inside the Trumbull County Jail and begged for help.
“I’m dying ... my stomach is killing me,” he told her. “Oh, my God, I’m in so much pain.”
At the time, he’d been locked up for five days on a probation violation related to a drug charge. After getting the call, Stacey Askew left urgent messages with jail officials about her husband’s condition, but no one called her back, according to a federal lawsuit her family filed against the jail.
Her husband also told guards about his worsening condition. When he reported that he had blood in his urine, the medical staff told him to drink fluids.
He was sweating profusely, breathing sharply and doubled over in pain. He called Stacey again. Both husband and wife feared for his life.
Around 3:30 a.m. Nov. 12, Askew called for help from guards and collapsed on his cell floor. Medical staff checked on him, offered him over-the-counter antacid and promised a doctor would see him in the morning.
Throughout the ordeal, the jail medical staff failed to take his complaints seriously, according to his family’s lawsuit. He had symptoms of a perforated peptic ulcer, including severe abdominal pain, vomiting blood and trouble breathing.
Just after 10 a.m., officer John Greene stopped at Askew’s cell to offer him a shower and a phone call. Instead, Greene found Askew not moving or breathing. Staff, including Sheriff Paul Monroe, rushed in to help.
Askew died of a ruptured peptic ulcer the next day in a hospital. The family’s lawsuit said he most likely would still be alive if he’d received proper medical care.
The 48-year-old father left behind seven children.
Jails have a 'duty of care' to those in custody
Jails aren’t supposed to be five-star hotels, but courts have found incarcerated people have a constitutional right to health care while in custody. Jails are expected to meet minimum standards and owe a “duty of care” to those in custody.
But again and again, Ohio jails fall short of those basic expectations, according to inspection reports,investigative documents, lawsuits and interviews.
Joel Pruce, a human rights professor at the University of Dayton and a member of the Montgomery County Jail Coalition, doesn't believe jails can ever care well for people in custody.
"Jails are places of harm. They're places of punishment. They're not places of health care," he said. "They should be in hospitals, community health facilities, places where they might actually do better.”
Chavis Martinez, 28, wasn’t having a health crisis when he arrived in February 2021 at the Corrections Center of Northwest Ohio in Williams County. But he needed some basic care to stay healthy.
Martinez told jailers he relied on insulin to control his Type 1 diabetes. The medication is essential for many diabetics to stay alive.But while locked up for a week, Martinez only got insulin once, according to a lawsuit later filed by his family.
In the early morning hours of Feb. 11, Martinez was shaking from tremors. His teeth clenched and eyes rolled back. An ambulance crew took him to the hospital.
Martinez never woke up.
His family filed a wrongful death and civil rights lawsuit in federal court, but the legal team dropped the case after Martinez's family lost contact with the law firm.
Criminal charges against jailers
Civil lawsuits against county jails are common. Criminal cases against jail staff are rarer.
But a guard was criminally charged following the death of David McKain at the Stark County Jail on Nov. 24, 2023. Placed on suicide watch, McKain was supposed to be checked every 15 minutes.
Five days later, he hanged himself. He died in the hospital Dec. 3.
In January, one of the officers assigned to check on McKain the day he hanged himself was placed on leave and charged with tampering with records. Court records provide few details about the nature of that charge, and Sheriff George Maier declined to comment.
But evidence in the case against the officer, Jason Rohr, includes logs related to McKain’s suicide watch. Rohr has pleaded not guilty.
State officials initially said the jail failed to perform and properly log wellness checks on McKain. But later, after reviewing information from the sheriff's office, state investigators determined the jail complied with state standards.
McKain left behind his three children, his parents and his sister.
After an incident at the Scioto County Jail, Ohio Attorney General Dave Yost brought murder, reckless homicide and voluntary manslaughter charges against guard Billy Thompson for his role in the death of Kevin Bailey.
Thompson was accused of slamming Bailey to the ground as guards tried to move the 56-year-old within the jail. Bailey died of blunt force trauma June 1, 2020, a few days after the struggle.
Thompson was acquitted of all charges.
A 2023 trial against former Richland County Jail guard, Mark Cooper, ended in a hung jury over his role in Alexander Rios' death. A second trial in April ended in an acquittal. In 2019, Rios was forcefully subdued and tasered until he lost consciousness and died in a hospital eight days later. He was 28.
More recently, in March of this year, a former Pike County deputy was sentenced to eight years in prison. Jeremy C. Mooney was accused of using pepper spray on an inmate in a restraint chair twice and punching the inmate 11 times. Prosecutors said Mooney struck the inmate so hard he broke his hand.
Not all problems identified by state inspectors or lawsuits involve death or serious injury. Some flag abusive treatment or lousy conditions.
Men incarcerated in the Franklin County Jail on Jackson Pike said it’s so overcrowded that people are sleeping on the concrete floor and there is just one toilet and sink for 30 people. The walls are marked with dried feces and the air vents are clogged with dirt, they said.
"If people would see how we're living in here, man, like they would definitely shut this b---- down," said Durell Ware from inside the jail. He added, "I would rather go back to prison than be here. Prison is way cleaner than here."
Jayson Wilmot, a former inmate in the Butler County Jail, said in a lawsuit that an officer moved him to a cell with no bedding, toilet paper or running water. When he complained, he said the officer started reading his mail from his girlfriend over the intercom to taunt him. The Butler County Sheriff's Office declined to comment on the allegations.
A call for reforms from the families of dead inmates
Families of the dead and injured say the problems in county jails run deeper than the day-to-day conditions inside. Incarcerated people need to be treated as human beings, the state needs to enforce the jail standards already in place, and Ohio needs more mental health and drug treatment options.
Until those things happen, they say, nothing will change. Inmates will continue to die. Families will continue to sue. And taxpayers will continue to pay tens of millions of dollars in legal settlements.
The state doesn’t track how much counties pay in legal claims. But Montgomery County alone has paid more than $9.5 million since 2018 for lawsuits related to jail conditions. Cuyahoga County has paid at least $7 million.Richland County settled with the Rios family for $4 million.
Sjoberg, the disability rights advocate, said the state’s inability or unwillingness to change the way it oversees county jails means more human and financial costs are in Ohio’s future.
"We need some kind of effective oversight of our jails, to ensure that there’s at least a baseline minimum standard that is going to prevent some of the really atrocious things that happen in the jails," Sjoberg said.
Ohio Rep. Phil Plummer, R-Dayton, worked for years in the Montgomery County Sheriff’s office, including a decade as sheriff when the county was sued over multiple, high-profile abuse cases. He said Ohioans don’t understand how complicated the job has become.
Jails no longer are places where sheriffs lock the doors and wait for inmates to finish serving their sentences.
“Everybody thinks just arrest them and throw them in jail. The problem is over,” Plummer said. “Well, it’s not. The problem has just begun.”
Austin Bristow, the brother of Malcolm Willis, said state officials bear some responsibility for his brother’s death by suicide in the Ross County Jail. They know jails are more dangerous than they should be, he said, but they’re not doing anything about it.
"You're watching all this bad stuff happen all over the state and it's your job to run that,” he said. “You're just completely failing.”
Ohio Politics Explained: Dying Behind Bars
Laura Bischoff and Erin Glynn are reporters for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.
Canton Repository reporter Nancy Molnar contributed to this report.
