On December 3, 2020, the U.S. Court of Appeals for the Fifth Circuit affirmed the summary judgment dismissal of a federal civil rights lawsuit brought by the estate and children of a woman who committed suicide in the Orange County, Texas, jail 10 hours after arriving.

As she was being booked into the jail for possessing a baggie containing Xanax capsules, a guard who had suicide detection and prevention training used the jail’s intake screening questionnaire to interview Rosa Bonilla. Initially “agitated,” she became more “calm” and “positive,” disclosing that she suffered from bipolar disorder and ADHD and was taking Wellbutrin, Trazodone, and Xanax. She admitted having a history of abusing Xanax and having “taken Xanax and smoked a little bit of weed” that morning. She said she was “depressed” by a friend’s death and had PTSD from childhood sexual abuse but denied having ever attempted suicide or having current suicidal thoughts.

The screening form’s guidance recommended against placing her on suicide watch, but the guard decided to discuss Bonilla’s answers with a supervisor. They decided to keep her in a holding cell and observed her sleeping during subsequent cell checks. There were no other prisoners in the holding cell.

A jail nurse reviewed Bonilla’s intake screening form and emailed a pharmacy to verify her prescriptions but received no reply before her shift ended. The nurse found a possible match for prior treatment at a state mental health facility. Therefore, the nurse emailed an “Inmate Mental Health Condition Report” to a magistrate and to mental health services requesting further evaluation.

Bonilla did not request medication or show any signs of distress until a guard found her hanging from a bed sheet tied around a phone conduit about two hours after delivering her supper. She was declared brain dead two days later.

An investigation by the Texas Commission on Jail Standards found “numerous flags” in the intake form but that jail staff had acted appropriately by notifying the magistrate and mental health services. Bonilla’s estate and children filed a civil rights lawsuit against the sheriff and numerous jail employees. The federal district court granted defendants’ motion for summary judgment and dismissed the case.

On appeal, the Fifth Circuit noted that the guard did not disregard the “red flags” on the intake form. “Her assessment may have proven incorrect, but her response was not indifferent.” It cited numerous cases showing courts’ reluctance to equate generalized evidence of a prisoner’s mental illness with a substantial risk of self-harm. It also noted that plaintiffs had no evidence that Bonilla’s suicidal tendencies were known to anyone.

The court held plaintiffs had not shown a prisoner had a clearly established right to adequate suicide screening or screening by medical professionals or to receive prescription narcotics within hours of intake and before the prescriptions are verified. Further, any causal link between failure to give Bonilla Xanax and her suicide was speculative. The court also found no support for the plaintiffs’ theory that the jail allowed prisoners to self-classify their risk of harm. Therefore, it affirmed the judgment of the district court. See: Bonilla v. Orange County, Texas, No. 19-41039 (5th Cir. 2020)

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