Pat Grenier speaks with a reporter outside his transitional housing on Tuesday, May 14, 2024.
AZPM and Arizona Luminaria partnered to tell this local news story. It originally aired on the February 21, 2025 episode of The Buzz
Pat Grenier and his next-door neighbor were going at it again. The kind of dispute that flares up and then is forgotten until something nettlesome sets off another round of bickering. On a bright fall morning in 2019, after Pat had allegedly thrown trash in his neighbor’s mailbox and yard, she called the police.
When police are involved, Pat’s family fears officers may not know that he’s been diagnosed with schizophrenia, and bipolar and anxiety disorders. And that what he often needs most is medical and mental health support.
After interviewing the neighbor, and moving back to his squad car to look into Pat’s history, the responding Tucson police officer saw Pat walk out of his house in his underwear and a black leather jacket.
Pat, then 66, and his neighbor started to scuffle over a broom. Pat fell backward and the officer tried “to detain Mr Grenier who was on the ground on his back,” according to a department case summary report from Nov. 14, 2019 — the same day of the dispute.
The officer rolled Pat from his back to his stomach, secured his left arm and “gave him commands to give me his other hand but he would not,” the report states. The neighbor’s hand, injured as she and Pat had vied for the broom, was bleeding. An officer placed Pat “in a position where he could not get up and just held him there until other officers showed up,” according to the police report.
Police officers and Pat and his family disagree about how Pat was injured.
The first responding officer did not have his body-worn camera on during the scuffle, according to the Office of Professional Standards investigation reviewed by Arizona Luminaria and Arizona Public Media. There’s no police footage of the altercation until another officer arrives.
Home security camera footage shared by the family with the news organizations shows more: Three police officers on top of Pat. Pat screaming in pain. “You threw me on the ground,” he says to an officer in the video. Between prolonged moans and repeated screaming, he says, “You broke my hip.”
One officer asks Pat, “Is there anything else that hurts on you?”
“My heart,” Pat responds, listing his injuries.
Tucson officers would later write about Pat’s conditions. “Mr Grenier had a long history of mental health issues,” according to the report from the day of his arrest. The first officer on the scene contacted Tucson Police Department’s mental health unit.
What happened that day would imperil Pat’s health and his freedom, his family says, sending him to the hospital and forcing him to face an overwhelmed court system in Pima County. He’d eventually spend months inside a jail plagued with a recent history of deaths and widespread complaints of medical neglect.
Pat’s story spotlights both the onerous difficulties of navigating inadequate public health care, court and incarceration systems, and, ultimately, Pima County’s over-reliance on punitive responses for people with mental illness.
Arizona Luminaria and AZPM reviewed hundreds of pages of records from Pima County jail, local courts, Tucson police and medical providers. Reporters also spent a year spanning 2023 and 2024 checking in with Pat and his family to understand complexities that can’t be captured in public records.
Five years have passed since that November day in front of his house. Pat says he hasn’t gotten over what happened.
“I kept wondering if I could survive this agonizing pain,” he says. His voice dips low and turns almost gravelly as his emotions start grinding.
An X-ray would show that Pat’s hip was fractured, according to the Tucson Police Department’s Injured Person Report from the same day of the altercation, which states Pat was hurt when falling in the skirmish with his neighbor.
Pat maintains police knocked him down and left him with a broken bone, an injured bicep and lasting psychological trauma.
“That assault has changed my life forever,” he says.
VIEW LARGER Pat Grenier speaks on the phone with a family member outside his transitional housing on Tuesday, May 14, 2024. In December 2019, Pat filed a complaint that Officer Jose Galvan used excessive force when taking him into custody.
Tucson police general operating procedures include guidelines on proper use of force that require de-escalation tactics and proportionality assessments.
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“Officers should use warnings, verbal persuasion, and other tactics as alternatives to higher levels of force.”
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“Officers shall balance the circumstances known to or perceived by the officer at the time with the severity of the offense committed, the subject’s level of resistance, and the immediacy of the threat.”
Tucson police officers cited Pat for violations that included assault, disorderly conduct and resisting arrest. Officers released him at a hospital, according to the department’s injury report.
Tucson police officials dispute Pat’s account of the incident, saying an internal investigation determined the complaint of excessive force was unfounded.
A few days after his encounter with police, Pat underwent hip surgery and spent a week in the hospital, he and his family say.
A couple months later, in January 2020, Pat missed his first court hearing and Tucson police officers arrested him for failure to appear. On Jan. 20, he was booked into the Pima County jail.
That wasn’t Pat’s first time in the jail — and it wouldn’t be his last.
Inside the jail, Pat says he spent weeks isolated in a cell by himself. He’d spend months incarcerated with mental illness after a judge revoked his bail, deemed him incompetent, and ordered him into a restoration to competency program to see if he’d ever be able to stand trial.
Behind bars, Pat pleaded for help. “Filthy, deplorable. I can’t tell you how horrible it is,” he says, remembering his time in Pima County jail.
‘Where the heck is our behavioral health system?’
The difficulties Pat and his family faced navigating the jail and court systems are not uncommon.
In fiscal year 2023, judges ordered 128 people to Pima County’s restoration to competency program while being held in the jail, the highest number in the preceding five years, according to data provided to Arizona Luminaria and AZPM by Jordan Prather, the county’s restoration to competency manager.
In 2024, an additional 122 people passed through the program.
Someone getting sent to jail because they didn’t show up to court isn’t unusual. In an eight-month period ending in May 2024, about 700 people were held in Pima County jail because they had failed to appear for a court date. Some people detained for failure to appear also had additional offenses.
Many in the jail are pre-trial detainees, meaning they haven’t been convicted of any crimes. And of the 10 people known to have died in the jail in 2022, nine were facing mental health or addiction disorders, according to data from the Pima County Office of the Medical Examiner.
Health and criminal justice workers, as well as some county officials, say that Pat and his loved ones represent the experiences of thousands of others. The stressors for “families are very real and very practical, yet rarely recognized or discussed by academics or policymakers,” according to a 2020 report from the University of Illinois Chicago.
With underfunded and difficult to navigate mental health and addiction treatment programs in Pima County — as well as in much of the country — law enforcement agencies and jails have become the default response for people who need care. Often in ways that fail to address the root causes of their health crises.
The Tucson chapter of the NAACP has raised the alarm about the number of people dying in the jail who were either diagnosed with mental health or addiction disorders. They’ve argued against jailing someone who legally needs medical care.
“This is how our community is dealing with the sickest among us, to keep criminalizing homelessness, criminalizing mental illness and substance use disorder,” said Amelia Cramer, a former chief deputy Pima County attorney and current vice president of the NAACP Tucson branch.
“And where the heck is our behavioral health system? Why are these folks not being leveraged into treatment — instead of through a criminal court proceeding — through some sort of civil proceeding?”
VIEW LARGER Men doze, watch TV, or otherwise kill time in the intake unit of the Pima County jail. September 6, 2024. Other counties in the country are looking for alternatives to jailing people with mental health disorders. In Miami-Dade County, a new treatment center opened to address the estimated 11,000 people with serious mental illnesses booked into the jail annually, “mostly for low-level non-violent offenses,” according to the center’s website. One circuit court judge in the Miami area calculated that the county spent more than $310 million a year to incarcerate people with mental health disorders.
The Vera Institute of Justice, a research organization specializing in criminal justice, found that more than 83% of people in jail with mental illness did not receive mental health care.
Even Pima County Sheriff Chris Nanos has repeatedly criticized the approach to jailing so many people with mental health disorders.
“My opinion is we still have a lot of them in there who shouldn’t be there, that there’s other places for them,” Nanos told Arizona Luminaria and AZPM in an April 2024 interview.
The problem is, as Pat’s family has discovered, “other places” are few and far between.
Pat’s story
Pat is now 71 years old. His family describes him as a jack-of-all-trades and a gifted artist. Speaking with him, you find yourself in the company of a well-read, curious father, brother and grandfather keen on sharing stories and advice.
Pat’s also lived with mental illness for decades.
Despite appeals from his loved ones, he adamantly refutes doctors’ diagnosis of his mental health. He’s faced frequent run-ins with various law enforcement agencies over the past three decades.
Pat has been placed behind bars for alleged offenses that include trespassing, disturbing the peace, domestic violence and failing to show up to court, according to a rap sheet dating back to 1994. The records reviewed by Arizona Luminaria and AZPM span more than 50 alleged violations from the Tucson Police Department.
Still, hundreds of pages of government records don’t tell Pat’s full story. Pat and his family shared his life milestones — and experiences with mental illness — in more than a dozen interviews.
For years they tried to find him help. Pat has held down several jobs to earn a living, but his mental health deteriorated as he aged.
By 2018, Pat’s home was condemned for issues that included occupation of the property without required utilities, trespassing, accumulation of refuse, junked vehicles, and people living in tents, according to a Tucson code enforcement official.
The family, with help of a few foundations, including the Greater Tucson Fire Foundation, cleaned up the house, paid outstanding bills and fines, and restored his utilities.
James Baker, Pat’s brother-in-law, says that while they were glad to get him in his home again, “what we didn’t cure was the root cause” — Pat’s mental health.
Pat has been in and out of court-ordered treatment since at least 2018. His sister Susan Baker and her husband James share power of attorney over Pat’s affairs.
Soon after the 2019 altercation, Tucson police would arrest Pat again. Again for failing to appear in court. This time, his family says, court officials advised them not to bail Pat out.
His loved ones faced an excruciating decision: Leave Pat in a local jail widely considered unsafe? Or risk him going missing — or worse — on the streets?
To understand why Pat’s family would consider keeping him in Pima County jail, why other options proved unreliable or out of reach and why the county hoped he could be restored to competency in the jail, you have to understand Pat’s story from November of 2019 until March of 2023.
VIEW LARGER Pat Grenier inside his room in transitional housing on Tuesday, May 14, 2024. Back to November
Pat and his family say his experience with Tucson police in 2019 spurred a years-long spiral from which he has yet to break free — as they’ve struggled to find adequate mental health care for their loved one.
Richard Gradillas is a spokesperson for the Tucson Police Department. He replied in July 2024 to detailed questions about officers’ response to the incident with Pat’s neighbor.
Gradillas said Pat filed a complaint after the altercation and the department’s Office of Professional Standards, or OPS, conducted an investigation “given the seriousness of the allegations.”
Tucson police investigators deemed the excessive force allegations “as being unfounded,” he said. “This is based on the information that was provided to OPS investigators, reviewing (body-worn camera) footage, and statements made on scene, including initial supervisor review.”
Arizona Luminaria and AZPM asked about the home security footage Pat’s family provided the news organizations, which showed three Tucson police officers on top of Pat while the then 66-year-old screamed in pain.
“Our investigators do not have any knowledge of surveillance footage and were not provided this during the course of the investigation,” Gradillas said.
The first responding officer did have his body-worn camera on during his initial conversation with Pat’s neighbor. However, upon returning to his vehicle he turned his camera off and did not have it on when he responded to Pat and his neighbor scuffling over the broom, according to the internal police investigation.
Pat told officers that “he had just had surgery on his hip,” the investigation report states. “There was no implication that Ofc. Galvan or officers contributed to the pain in his hip in any way,” investigators wrote, adding that Galvan was no longer with department.
Pat and his family dispute the officers’ accounts and the investigation’s findings, including what they say is incorrect information about Pat telling officers he’d had surgery on his hip. Pat says he was “rammed from behind” and then was “taken down forcefully” by the officer.
Arizona Luminaria and AZPM requested the police body-worn camera footage to review the opposing accounts of police use of force against Pat. Susana Robles, a records specialist with the Tucson Police Department said on Aug. 22 that the department’s current processing time for police body-worn camera requests is at least 14 months.
The footage was requested on Aug. 14, 2024. As of Feb. 26, 2025, the department has not released the public record.
Spiral begins
It’s tough to puzzle together the couple of years after Pat’s experience with police in 2019.
Pat had begun worrying about the “oligarchs” — as he calls them — in control of water and electricity in Arizona, and he stopped paying his utility bills.
Public records show there were at least 39 citations or police reports issued about him in 2020.
In just the first two months of 2021, Pat was the victim of a fire at his house and police transported him twice for mental health treatment, according to Tucson police records and family accounts.
In 2021, his house was condemned again, this time for illegal occupation due to a lack of safe electrical utility, as well as people living in non-occupiable areas, such as a shed, said Laurie Pumphrey, a Tucson Code Enforcement Division inspections supervisor.
Pat would have contact with police, as a suspect, arrestee or victim at least 15 more times in the next 10 months. In April 2021, he was arrested and taken to jail, again, for failure to appear in court, according to a police report.
A mounting mental-health crisis
One 2022 code enforcement inspection made multiple notes of “trash and debris” throughout Pat’s property and obstructing the sidewalk.
“I have a mortgage and a beautiful, glorious home. It’s a beautiful house. It’s perfectly clean,” Pat says. “But the Tucson city government boarded up my windows with security screws.”
Pat’s family says they do not understand why there isn’t a system in place to ensure city officials help people with mental health disorders remain in their home, especially in a county that has experienced some of the highest rates of unsheltered populations in the nation.
“The city made him homeless,” James, Pat’s brother-in-law, says.
Cristina Polsgrove, spokesperson for the Tucson Environmental Services Department, said last August that there was a history of problems at Pat’s house. Condemning it was “a matter of public health and safety,” she said. Polsgrove added that condemning a house is “not a final decision,” and that if the family fixed everything, restored the utilities and received a certificate of occupancy, they could move back in.
One of the consequences of the city condemning Pat’s home was that he could no longer receive mail. In October 2022, mail sent by code enforcement officials to his house was returned, according to public property records. And despite being homeless, Pat says he still had to pay his mortgage.
Because he wasn’t getting mail, Pat says he didn’t receive correspondence from the courts and his insurance company. James says that turned into yet more citations for “failure to appear” in court, as well as a gap in insurance coverage.
“I know how to seek help,” Pat says. “But when I ask for it, it’s not there.”
After Pat’s house was condemned, he and family members say — and police reports and city public property records from about 2021 through 2023 confirm — people broke in multiple times, stealing about everything they could take, including his prized carpentry tools. Pat’s beloved mitre saw was a particularly stinging loss.
At least one fire was set inside his home.
VIEW LARGER Brianna Grenier, Pat’s daughter, on Tuesday, May 14, 2024. ‘They begged us not to put up bail’
On and off for years, Pat was a patient with CODAC, a community health organization focused on mental health and substance abuse disorders. The treatment center is among the medical facilities Pima County courts can divert people to rather than jailing them.
Pat went missing in early 2023, while under the center’s in-patient care, James says. Officials with CODAC told the news organizations they wouldn’t comment on details about individual clients.
Then in March 2023, Pat’s family says trouble rekindled again after Pat absconded from a different treatment facility near Tucson Medical Center. An officer saw Pat in the hospital’s emergency room, and a warrant popped up, according to a March 11, 2023 arrest report. The officer arrested Pat for disorderly conduct and trespassing.
The officer took him to the Pima County jail, according to both police and jail records. Once again, Pat also was wanted for failure to appear in court.
That’s when Pat’s family says his public defender, a judge and the then-manager of the restoration to competency program, counseled them against bailing him out.
“They begged us not to put up bail because otherwise he would be running in the wind,” Susan, Pat’s sister, says. She says the court and county officials told the family: “Please let us hang on to him, get him the help he needs.”
Arizona Luminaria reached out to the officials for comment. The public defender told Arizona Luminaria last June that he would not comment on the case. Court officials and the restoration program manager did not respond.
The concern was that letting Pat out, the family says, would result in another cycle of crisis, citation, failing to show up to court, and getting thrown back in jail.
The family hoped a judge would rule he could not be restored to competency — that he was unable to understand the court proceedings — so his criminal charges would be dropped. The family struggled with the idea that they would willingly let Pat stay in a dangerous jail where people were dying. But the alternative was losing Pat on the streets with dangers of their own, ones especially perilous for older people with mental health illness.
“These are not proper places for individuals to be, they’re not healing,” says Brianna Grenier, Pat’s daughter, of the family’s painful decision to leave her dad in Pima County jail.
Pat puts the problem of relying on jail for treatment in his own way: “There are many ways to rehabilitate without a stick and a sword.”
Cramer, the former chief deputy Pima County attorney and current vice president of the NAACP Tucson chapter, stressed the harms that come with sending people to jail for failing to appear at their court date.
“The primary reason people fail to appear for the next court hearing is due to poverty, mental illness or substance use disorder,” she said.
“The vast majority are folks who cannot keep a calendar. They just don’t have the capacity because they’re suffering from an illness, whether it be schizophrenia, or severe depression, or fentanyl or methamphetamine or heroin addiction,” Cramer said. “Because of their medical condition, their mental and behavioral health disorders, they are unable to get themselves to that court hearing.”
That’s what happened with Pat, his family says.
“He didn’t show up for court dates primarily because when your house is condemned the post office no longer delivers mail to your address,” James says.
Shortly after Pat was booked in the Pima County jail in March 2023, he was placed in the mental-health housing unit, his family says.
After his initial hearing that same month, his public defender requested a mental competency evaluation to assess if he was capable of following and understanding the court proceedings.
“This idiot they supplied me with, pleaded for Rule 11,” Pat says.
Rule 11 triggers a competency determination, a multi-step process to assess a person’s mental health. According to Arizona law, any party or the court itself may request that a “defendant be examined to determine the defendant’s competency to stand trial, to enter a plea or to assist the defendant’s attorney.”
When Pat was escorted from the jail to court to decide whether or not he could stand trial, he says he was shackled “in three-point manacles” — ankles, waist and wrists.
“The competency hearing was conducted slam-bam-thank-you-ma’am,” he says. He felt the only outcomes available to him were: “He’s guilty or he’s incompetent.”
The courts would take two more months to rule if Pat was fit to stand trial.
‘Lonely, desperate,’ and a birthday in jail
In April 2023 – still in the jail – Pat turned 70 years old.
On April 20, Pat filed a grievance while still incarcerated in Pima County jail, writing to staff: “This detention which is a false detention has been arduous because I’m hungry all the time but also painful because my body has been racked (wrecked) from the numerous beatings, strappings, and illegal injections,” according to a copy shared with the news organizations.
Pat described himself as “Lonely, desperate.” He wrote, “This cell was FILTHY!”
According to the grievance resolution, a correctional officer wrote that Pat was given a medical request form. A jail officer wrote: “This grievance dismissed.”
In 2023, Arizona Luminaria obtained, via a public records request, medical grievances from the same month Pat was booked into the jail. At least 111 grievances were filed that month from people who were detained inside. Officials with the sheriff’s department redacted names from the public records request.
One grievance from days before Pat was incarcerated read: “I’ve put in several mental health request and still haven’t been seen. I’m SMI and need my Meds,” the person wrote, using an acronym for severe mental illness.
They said they had been in the jail for more than a month, “and I still have not been seen by the provider or started my medication regiment that works for me. I’m now exhausting my administrative remittance. Next will be law suits.”
VIEW LARGER Grievances filed by people detained in the Pima County jail received by Arizona Luminaria via a public records request. The grievances detail problems people in the jail have had receiving medical care and other issues. Incompetent to stand trial
Two months after Pat was booked into the jail in 2023, the court took any further decisions about bail and leaving their loved one behind bars out of his family’s hands.
On May 30, 2023, the Arizona Superior Court ruled that Pat is “unable to understand the nature of the proceedings and is unable to assist counsel in his defense, and is therefore incompetent.” A week later, on June 6, the court ordered him held without bond and set his next hearing for four months later — Oct. 2.
Pima County Superior Court placed Pat in the county’s restoration to competency program. The program contends that consistent oversight, evaluation and access to mandated medication — even under the conditions of confinement — will help stabilize people.
Some criminal justice and medical experts say that any time spent in jail has the opposite effect, especially for people experiencing mental illness. A study from Mental Health America calculated that “on any given day between 300,000 and 400,000 people with mental illnesses are incarcerated in jails and prisons across the United States.” The study notes that incarceration can increase people’s “vulnerability and exacerbate mental illnesses.”
The negative effects of incarceration on mental health are detailed in research compiled from Prison Policy Initiative, a nonpartisan nonprofit organization that has studied mass incarceration and its effects on society since 2001.
“The carceral environment can be inherently damaging to mental health by removing people from society and eliminating meaning and purpose from their lives,” according to the research.
Prison and jail experts have said incarceration can lead to Post-Incarceration Syndrome, which the Prison Policy Initiative defines as “a syndrome similar to PTSD, meaning that even after serving their official sentences, many people continue to suffer the mental effects.”
After already having been detained since March, and now placed into the restoration to competency program in May, Pat would remain locked up.
He called the jail, “a dungeon.”
Dueling crises
Pat was behind bars at the same time Pima County jail was facing criticism for dangerous conditions and deaths.
While there have only been two deaths in the jail between September 2023 and early February 2025, in 2022 Pima County’s Adult Detention Center had one of the highest per capita mortality rates of any jail in the nation. At least 10 people died that year. That was a per capita mortality rate over four times the national average, and higher than New York City’s notorious Rikers Island jail, which saw 19 deaths in 2022. In 2023, eight people died in the Pima County jail.
In 2023, in addition to the eight people who died in custody, another 12 people died within 30 days of being released, according to information shared by the medical examiner. In 2024, eight people died within 30 days of their release from jail: six of them from complications involving opioid addiction and one from a gunshot wound to the head.
The county itself found medical and mental health care at the jail to be chronically deficient. A 2023 Arizona Luminaria investigation found that Pima County docked the for-profit medical provider at the jail at least $3.1 million in a 14-month period from February 2022 to April 2023.
“I dream of freedom from this box and close quarters with men I don’t know,” Pat wrote in a personal journal chronicling his days in jail. The entry came in September 2023.
“I have a strong anger at being held here, almost seven months, innocent, no arraignment,” he wrote.
His family members said they were similarly distressed.
“You’re seeing in the news, another death at the Pima County Adult Detention Center, and then you see another death, and then one death at the mental health unit,” says James, Pat’s brother-in-law. “So you’re telling me that’s the best place where he can be right now? But what’s the alternative?”
Dueling crises of mental health and substance abuse have left officials in local jurisdictions throughout the country uncertain how to respond. Officials in local governments and law enforcement have been resorting to arrests and jail time when no other treatment options are available.
“It’s absurd,” Pat says, thinking back on his time in jail.
“We have a system designed to help people but it does nothing but messes us up, makes us worse than we thought possible.”
VIEW LARGER Pat Grenier speaks with a reporter outside his transitional housing on Tuesday, May 14, 2024. Pat’s history with mental illness
Pat was an accomplished carpenter. He used to build and install wood trim and cabinets, and helped design and construct local restaurants. In his spare time, he crafted rocking horses for his grandkids and detailed frames for mirrors.
Pat also painted watercolors and played the piano. By all accounts he is gracious, charming, and often hilariously funny. A graduate of the University of Arizona, Pat says he worked for decades at Pima Community College in building and maintenance.
His brother-in-law, James, calls him, “Tucson loud and proud.”
About 15 years ago, doctors diagnosed Pat with schizophrenia, and bipolar and anxiety disorders, according to medical records and his sister, brother-in-law, and daughter. For decades, amid manic episodes, his family members say his personality has swung from charming to impetuous.
Pat is a thoughtful and funny raconteur, though he often gets sidetracked and falls into expletive-laced rants. Those who wait for him to steady his emotions will often win a self-settling smile and a return to his colorful personality. Even over the phone you can hear Pat’s puckish grins.
When Pat’s thinking he tends to lift his chin slightly, giving him a dignified air that sometimes contrasts with the cumbersome and ill-fitted back brace he often wears. He has thinning white hair and a white mustache that he lets grow below his lip-line.
His eyes are clear blue-gray. Recently, his family says, a doctor added another diagnosis to the list: dementia.
“I refute the diagnosis,” Pat puts it bluntly. He argues he doesn’t have any mental health disorders, except for post-traumatic stress disorder.
He says his PTSD stems from an accident that occurred in 1970, when he was 16. Pat had saved up enough money from delivering newspapers in Tucson, by bicycle, for over five years to buy a car: a 1969 Chevy Nova.
In an Arizona Daily Star article from 1969, Pat said he wanted to use the car to expand his paper route. He was taking journalism classes at Sunnyside at the time to become a high school correspondent. He hoped to join the Air Force.
But then tragedy struck.
In 1970, Pat was driving his new car on the south side of Tucson when, according to both Pat and his family, an intoxicated pedestrian stepped off the curb and into the street. Pat hit the man with his car, killing him. Police said the pedestrian was not in the crosswalk and had been drinking, according to a 1970 Tucson Citizen article. Pat was not cited in the accident.
While he would continue to excel in school — in his senior year he was both class president and prom king — Pat says the memory of fatally hitting the pedestrian still keeps him up at night. Still makes it hard to think straight. It’s also why, he says, he recently tattooed a tear at the outside corner of his right eye.
Restoring to competency
The dispute over Pat’s health diagnosis and treatment is just one of a tangle of difficulties the family contended with when trying to secure him stable housing, medical treatment, including mental health support, and simply, keep him safe.
Pima County’s Restoration to Competency program is run by the behavioral health department inside the jail. The program focuses on evaluating detained people deemed incompetent to stand trial.
“‘Incompetent to stand trial’ means that as a result of a mental illness, defect or disability a defendant is unable to understand the nature and object of the proceeding or to assist in the defendant’s defense,” according to Arizona law.
The law specifies that the county board of supervisors must designate a restoration to competency program. County judges then must “select the least restrictive treatment alternative,” which includes determining whether or not “confinement is necessary for treatment” and whether or not the defendant is a threat to public safety.
The average time someone spends in the program is between three and four months.
People in the program receive the same services as anyone else who is incarcerated, said Prather, who manages Pima County’s restoration to competency program. The only difference would be that NaphCare — the for-profit Alabama-based medical provider in the jail — provides a psychiatrist who specializes in providing clinical services.
“The RTC program does not select who is in the program or decide whether a person is incarcerated, the court does,” Prather said. The court may or may not choose to order people to an out-of-custody program.
Pat, his family, criminal justice experts and Pima County’s own sheriff all decry the fact that counties are attempting to stabilize people with mental health issues inside the jail.
Nanos said in 2023 that about half the jail population has mental health disorders, which presents serious challenges for his overwhelmed staff.
“The restore to competency program, I think, adds to that problem,” Nanos told Arizona Luminaria and AZPM in April 2024.
A third of the jail’s population was on long-term psychiatric medication, and jail workers were performing an average of 400 mental health evaluations a month, according to a January 2024 report by Pima County’s Blue Ribbon Commission tasked by the board of supervisors to explore the need and feasibility of building a new jail.
Nanos elaborated at a Democratic primary debate for the sheriff’s race on June 8. “There’s a lot of people in my jail who are sick,” he said. “If you’re a sick person, suffer from substance abuse or mental illness, you belong in a hospital. We have a lot of people there who are just sick, and they shouldn’t be there.”
Cramer, of the NAACP, pointed to what she sees as misuse of the jail. “We’re using the jail as a mental health facility and a detox and drug treatment facility,” Cramer said. “And it’s not working.”
“We need to stop sending people there who are sick and send them to a place that is geared to treat them,” she said.
VIEW LARGER Pat Grenier poses for a portrait outside his transitional housing on Tuesday, May 14, 2024. Leaving Pat in jail was ‘heartbreaking’
Eventually, months into his stint in the jail, doctors wrote in notes shared with the family that Pat had frontal-lobe dementia, although James says they never issued a formal legal diagnosis. While he was in jail, doctors also confirmed that Pat had schizoaffective disorder, bipolar type, he says.
Pat remains steadfast. The idea that he has dementia or schizophrenia is “laughable,” he says.
The diagnoses weren’t all that disturbed Pat about the jail. He says he was abused by guards and denied medication. He was frequently isolated, and said at one point he spent six straight weeks in a cell by himself. Arizona Luminaria could not independently verify the claim.
Adam Schoonover, a spokesperson for the sheriff’s department, responded to Pat’s allegations of mistreatment in the jail, saying in August 2024 that he spoke with jail staff and Pat is “providing you with false information.”
Brianna, Pat’s daughter, has been supporting her dad for years. She says the reality that they were leaving her father in jail was “heartbreaking” and “devastating.”
“It does not feel good,” she says, speaking while her dad was still in jail. “He talks about not eating enough, that he’s hungry, and so we deposit money in his commissary.”
Fighting back tears, she says that her father told her that guards were not letting him access his commissary to buy supplemental food.
“He said he was just beaten by guards the other week,” she says.
Schoonover, with the sheriff’s department, disputed these allegations, saying that Pat was providing false information.
Pat says he felt chest pains and struggled with asthma and a hernia. On July 24, he was transferred from the jail to the hospital in an ambulance, according to a sheriff’s department incident report. In September, he was assaulted by his cellmate who punched Pat, according to a jail incident report.
“I was not attended to,” Pat says about his treatment in the jail. “They let me feel worse and worse.”
Pat’s family was scared he would die inside.
Pat says he lost more than 40 pounds during his stay in jail. He also developed bronchitis, according to Pat and his family members.
“Second by second. And then those seconds minutes and then hours, and then over the weeks and the months, I felt that I had no hope of ever getting out again,” Pat wrote in an undated entry from a diary he kept while in the jail and shared with Arizona Luminaria and AZPM.
Court says Pat can’t be restored to competency
After more than six months behind bars, the family says Pat was released from the jail after the court ruled he could not be restored to competency. His charges were dismissed.
When a person charged with a crime is ruled by the court to be “incompetent” and “there is no substantial probability that the defendant will regain competency within twenty-one months,” there are a number of steps that can take place, according to Arizona state law. Those steps include further evaluation, involuntary commitment to an institution, or releasing the person and dismissing the charges.
That’s what happened with Pat.
VIEW LARGER MHST officers transport a woman who missed her court ordered mental health appointments to Kino Hospital on May 2, 2024. Better community options?
Jason Winsky runs Tucson Police Department’s Mental Health Support Team, designed to identify and assist people living with mental health challenges, and ensuring they show up for court-ordered treatment.
Winsky’s team of nine officers focuses mostly on making sure people follow treatment plans. Court-ordered treatment plans are implemented if a person is deemed to be a threat to themselves or others.
Members of Winsky’s team help people show up for court hearings. “We don’t typically respond to an active crisis situation,” he added. Those situations are typically left up to patrol officers, many of whom do not have extensive mental health training, he said, though the department is training more incoming officers.
In cases where someone has a warrant for a “failure to appear” to court, it’s the police officer’s discretion to make an arrest and book that person in jail or take them to treatment, Winsky said.
There also has been “a huge shift generationally,” he said, in how police officers engage with someone experiencing a mental health crisis.
“There’s a million ways diversion and deflection can work, and there’s a million ways that it can fall through the cracks,” he said. “We’re not resistant to the thought that there can and should be resources other than a badge and a gun responding to a lot of these situations.”
Both Tucson and Pima County also rely on private medical and mental health providers to fill in service gaps.
VIEW LARGER Pima County Sheriff Chris Nanos addresses the audience at a candidate forum on June 17, 2024. There are about a dozen other diversion programs operated by Pima County Attorney’s office. Still, the jail population has climbed in recent years, and is forecasted to grow by 50% in the next 20 years, according to findings from the county’s Blue Ribbon Commission. County officials chartered the commission to assess the need and feasibility of building a new jail after Sheriff Nanos told the board of supervisors, in December 2022, that the jail was in a “full-blown crisis.”
The city of Tucson also manages a diversion program focused on keeping qualifying people who have mental health issues out of jail.
Despite the diversion programs, there are “many, many roadblocks” and “services are almost impossible to get,” James says. The family has spent at least $5,000 seeking help for Pat, he says.
Pima County still largely relies on the jail when people go through mental health crises. And “the jail is not working,” Winsky said.
Recognizing the importance of getting more mental health providers and healthcare workers in the jail, Nanos told Arizona Luminaria and AZPM in an April 2024 interview that he questions the motive.
“Are we doing this because we want to put services in there for people who are there or are we doing it because we have nowhere in the community to put these people except in our jail?” Nanos asked.
Nanos also posed the question to county supervisors at the Pima County Blue Ribbon Commission’s first meeting in March 2023, less than a week after Pat was last booked into the jail.
“We’re making a mistake,” Nanos said, referring to the county’s detention of people with mental health issues. “That (care) should be handled by healthcare professionals.”
Trying to break the cycle
Pat is living on the outside. His family says he’s spent the past year living in and out of transitional housing and the hospital.
In May 2024, Pat sits on a walker under a carport outside a house on Tucson’s east side. The house is owned by a man who rents rooms to seniors and those transitioning in and out of institutions. For the past week, Pat has been living with three other older adults, all strangers to him and all dealing with medical or mental health issues.
VIEW LARGER Pat Grenier speaks with a reporter outside his transitional housing on Tuesday, May 14, 2024. His knee is double-wrapped in a black brace and an old elastic bandage, his loose-fitting chest brace is misaligned over his torso, and a carabiner hooks a bottle of antibacterial gel to a buttonhole on his long-sleeve denim shirt. He wears a black beret, tilted rakishly up and to the side.
Pat’s cramped room is filled with boxes. His bed and nightstand are covered by a spilled-open suitcase, a 24-case of Pepsi, a half-eaten cantaloupe, a bottle of CBD gummies, and notebooks and books. He keeps a travel guide to Vienna, Shakespeare’s “Romeo and Juliet” and Kafka’s unfinished novel, “The Castle.”
“It’s not my ideal,” he says about his living situation, “but it works.”
On the kitchen counter is a box of Bisquick pancake mix, mustard and a jar of olives. The house, smelling stiffly of industrial cleaning agent, has an empty and yet worn air. There is nothing on the walls.
A ‘total runaround’
By late July, Pat’s family says he’s been in nine different homes over the past five months.
“Everything we do with the state is an extremely long and drawn out process,” James says. “In Arizona you’re screwed because the legislature does almost nothing to support.”
“Dementia is the golden ticket,” he says, as it would open up funds from the Arizona Health Care Cost Containment System, or AHCCCS.
Though psychiatrists said Pat had dementia while he was in the restoration to competency program, it was not a formal, legal diagnosis, James says. AHCCCS, Arizona’s Medicaid program, funded by both the state and the federal government, has a long-term care program for qualifying seniors, such as those diagnosed with dementia, who require nursing-home level of care, according to the agency’s website.
“There’s an extreme learning curve to all of this,” James says. “And I’ve been finding out by making literally hundreds and hundreds of phone calls and conversations with various people.”
Pat’s daughter calls the family’s work to find help for Pat a “total runaround.”
The “behavioral health system has been abysmal,” Brianna says. “He’s been failed so many times. Such a dizzying and heartbreaking reality.”
“These institutions have just let him go to the wayside,” James says. “And again, he has folks in his corner advocating for him, trying to keep tabs on him, trying to help him and communicating with these entities.”
The years spent struggling to support Pat have been “immensely traumatic, immensely difficult,” he says.
In one undated journal entry during his recent stint in the jail, Pat writes, “Rule 11, which has kept me in this fucked-up asshole place in this arduous detention for well over 6 months with apparently no hope in sight, no paperwork, no counsel and apparently, no advocacy.”
Pat’s family hopes that with the assistance of a medicaid-appointed long-term caregiver, he’ll be safe. That depends on a definitive diagnosis of dementia, plus lots of paperwork and coordination between the insurance company, social security, and the state medicaid program.
“The system is flawed,” Pat writes in another journal entry from the jail. “How can I succeed without some sort of aid from the outside.”
“I was free so long ago.”
VIEW LARGER Pat Grenier speaks with a reporter outside his transitional housing on Tuesday, May 14, 2024. Summer 2024
Pat is standing on the hot sidewalk in a Trader Joe’s parking lot in Tucson’s east side. His eyes widen as he offers a barrage of life advice, including to “marry well, marry for love” and “watch out for the cartels.”
He smiles broadly, double-taps his chest with the side of his fist, and offers a sideways peace sign.
Pat winks, before limping away.
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