As officers placed Dejuan Paul in handcuffs outside of Covenant House, a youth shelter on the edge of New Orleans’ French Quarter, the distraught 21-year-old pleaded with his counselor.
“Miss Foots!” he shouted. “I thought you weren’t going to send me away!”
Cynthia Foots, who has worked at the shelter for more than 10 years, tried to tell Paul everything was going to be OK. “You can come back home, baby,” she said, trying to reassure him. “They’re going to take you to get some help.”
A few minutes earlier, Paul had warned Foots there were voices in his head. They were telling him to kill her.
“I’m losing control. I can’t control them!” Paul had shouted. “I need my medicine!” He then made a “loud squealing noise,” according to a Covenant House critical incident report.
Foots didn’t want to call police. She promised Paul she wouldn’t, that she would stay by his side and help him, no matter what. But he was a danger to himself and others and needed help.
As she watched the patrol car drive off, taking Paul to the behavioral health emergency room at University Medical Center, she assumed he would be committed for several days, possibly weeks, to receive the treatment and medication he so desperately needed. But only 27 hours later, Paul appeared back at Covenant House. The hospital had released him with instructions to follow-up with a mental health care provider.
A week later, on June 24, 2017, Paul and three other young men attacked and robbed two tourists in town for a Unitarian conference, leaving one hospitalized in critical condition.
Today, Paul is an inmate at Elayn Hunt Correctional Center in St. Gabriel, serving an 8-year sentence after pleading guilty to two counts of second-degree armed robbery.
Elayn Hunt Correctional Center in St. Gabriel. (Photo by Brett Duke, NOLA.com | The Times-Picayune)
Foots is a product of the Desire and Melpomene public housing developments. There are few things capable of unsettling her. And yet, what she experienced that day, and the events that unfolded over the ensuing months, shocked her conscience, she said.
It wasn’t just the crime itself, captured on dramatic surveillance video that stunned even New Orleans and made headlines across the country. It was also what the crime exposed – widespread failures in a broken Louisiana mental health system that, Foots asserts, is partly responsible for a preventable violent act.
A review of Paul’s UMC medical records by NOLA.com | The Times-Picayune raised significant questions. Four hours after he was admitted, a doctor wrote that Paul was “having auditory hallucinations” and that he was “a potential threat to himself and other people as well as gravely disabled.”
This assessment gave the hospital a legal right to involuntarily commit Paul for up to three days for observation and treatment, with the possibility of holding him an additional 12 days following a re-examination by the coroner. And yet doctors still chose to discharge him, just one day later.
Behavioral health experts said this is not uncommon, that people in need of psychiatric treatment are released on a regular basis, a result of the state’s gutting of its mental health care funding and infrastructure.
In the past 13 years, the number of psychiatric beds for the indigent in New Orleans shrunk from 100 at the old Charity Hospital to 60 at its replacement, University Medical Center, a 40 percent drop.
As the number of psychiatric beds decreased, demand exploded. Behavioral health admissions to UMC have increased by 45 percent over the past three years, from 1,585 in 2015 to 2,291 in 2017. This year, the hospital is on pace to have more than 2,400, creating an untenable situation where doctors are forced to triage the mentally ill.
“The lack of beds and investment in mental health care has made the criteria for admission stricter, leaving out more and more people who might need help,” said Anne Romig Tucker who served as UMC’s director of behavioral health from 2015 to January 2018. “People who are gravely disabled and can barely function in society are often discharged.”
This approach has both human and financial costs. Instead of investing in Paul’s mental health care on the front end, the state could now be paying more than triple that amount to incarcerate him for nearly a decade. It costs $31,000 annually to house an inmate with a mental illness compared to treating the person with community health services, which cost about $10,000, according to national statistics from the National Alliance on Mental Illness.
Paul is one of hundreds of homeless kids who cycle through Covenant House and other outreach programs every year, Foots said, many suffering from the same mental health disorders as him, some more severe. If the level of care doesn’t improve, and if hospitals continue to turn away people in need because they lack the necessary beds and funding, she fears what happened to Paul and the men he injured could become more commonplace.
“I work with these kids every day and I know they are all very troubled,” Foots said. “I see their mental illness, but they rarely get the help they need. Just like Dejuan. Those damn voices in his head got ahold of him and he just lost it.”
Dejuan Paul spent 20 days in June 2017 at Covenant House, a youth shelter near the French Quarter. Paul is pictured here at Elayn Hunt Correctional Center in St. Gabriel on Sept. 7, 2018. (Photo by Brett Duke, NOLA.com | The Times-Picayune)
When Paul first arrived at Covenant House on June 5, 2017, he didn’t tell the staff much about his past or what led him to being homeless, only that he had nowhere else to go.
Foots introduced herself and, as she does with all new residents, laid down the rules: 6 p.m. curfew on weekdays and 8 p.m. on weekends; all bags will be searched; and absolutely no smoking indoors, drinking, inappropriate clothing or threats of violence.
Paul listened, gave Foots a big hug, told her she reminded him of his grandmother and said he loved her.
“Here’s this big, tall guy. Really, really nice kid. I would think he was raised by a very good family that gave him very good structure,” Foots said. “That first day, you don’t even notice he has a problem. You really don’t.”
Ten days later, a boy charged into Foots’ second-floor office shouting, “Miss Foots, you got to come outside! Paul down there circling one of your babies and his eyes rolling behind his head!”
Foots rushed downstairs and into the back courtyard where she found Paul. He was walking around another resident in an “aggressive manner,” mumbling incoherently as white foam formed at the corners of his mouth.
Foots separated the two boys, then told everyone to clear the area, leaving herself alone with the troubled young man. He said he was hearing voices and he couldn’t make them stop. Foots told Paul they needed to get out of the summer heat and walked him inside to the main lobby. Paul became even more agitated. He paced frantically while hitting himself and repeating, over and over again, that he needed his medicine.
Then, as if someone pulled a string, he slumped to the floor near the kitchen.
Foots knelt down, her face inches from Paul’s, and locked eyes with him. She said he needed to focus, that he was in control of his mind, no one else. Ignore the people in your head, she instructed him. Staff members told Foots to keep her distance. She refused.
She then asked Paul what the voices in his head were saying.
“I don’t wanna tell you. I don’t wanna see. I don’t want to hear what they’re telling me,” Paul said, according to a Covenant House report. He then pulled his hoodie over his head, covering his eyes, and screamed, “I don’t want to do it! They’re telling me to kill you!
Cynthia Foots, right, helps a current resident at Covenant House size a pair of pants on Sept. 14, 2018. (Photo by Brett Duke, NOLA.com | The Times-Picayune)
It’s been more than a year since that June morning and Foots is still trying to make sense of what happened.
There are three criteria hospitals use to determine if people admitted for mental health problems will be involuntarily committed: homicidal, suicidal or gravely disabled. If the patients fit into any of those three categories, they can be placed under a physician’s emergency commitment, or a PEC. This allows the hospital to hold them against their will for 72 hours.
At some point during those three days, the coroner’s office will re-evaluate them and can, if it deems necessary, issue a coroner’s emergency certificate, or a CEC. This permits the hospital to hold the person for a total of 15 days.
This is what Foots thought would happen with Paul when she called 911. In her estimation, he was clearly homicidal and a danger to himself.
“The police told me when they got him, ‘At least he’s going to emergency. They’re going to give him some medicine. He’s going to be better and everything is going to be good,’” Foots said. “And that’s what I told Dejuan, but that’s not what happened.”
So why did UMC release him the next morning?
The hospital declined to comment, citing patient privacy laws. But medical records released to Paul’s attorney shed some light on what happened during the 27 hours he was at UMC.
He first arrived at the hospital at 10:59 a.m. on June 15, 2017. Paul was interviewed by a registered nurse who wrote in his notes that he was acting “bizarre” and “displaying a facial tic around left eye.” He added that Paul’s speech was “pressured” and he was “grandiose at times telling this writer that he is a genius.”
Paul denied threatening Foots but told hospital staff the voice in his head — which he identified as male — had been getting worse over the past several months, telling him he is “just a worthless piece of walking flesh.” He admitted to having a “mental breakdown” and that he felt “real eerie” and was “losing myself at the time.”
Paul was given 10 mg of Zyprexa, an antipsychotic typically prescribed to people with bipolar disorder or schizophrenia. A toxicology screen came back positive for marijuana. Paul confessed that he smoked marijuana every day since he was 15 and that over the past several weeks he had rarely slept more than four hours a night.
Four and a half hours after Paul was admitted to the hospital, a doctor wrote in her notes, “Mr. Dejuan is distressed and is having auditory hallucinations. He is agitated, irritable, and a potential threat to himself and other people as well as gravely disabled.”
Paul was placed under a physician’s emergency certificate and moved to an inpatient bed. The next morning, doctors interviewed Paul again and noted that his demeanor had changed overnight. He was “calm, cooperative, and pleasant, exhibiting a linear, goal-oriented thought process.”
Given the rapid clearance of his symptoms, doctors concluded the incident was “likely drug-induced” and he was ready for discharge. They wrote that if Paul avoids marijuana or other drugs, “he has a strong chance of staying out of the hospital and leading a successful, independent life.”
Another doctor had a slightly different interpretation of Paul’s sudden change in behavior. “He was manipulative during my interview, and knew what to say to be discharged,” the doctor wrote. Still, he signed off on Paul’s release, the records show.
At 2:05 p.m. on June 16, 2017, roughly 27 hours after he was first admitted, Paul was discharged and given a cab voucher back to Covenant House.
Dejuan Paul was diagnosed at the age of 14 with ADHD and depression, according to his family. He is pictured at Elayn Hunt Correctional Center in St. Gabriel on Sept. 7, 2018. (Photo by Brett Duke, NOLA.com | The Times-Picayune)
When Paul returned to the shelter after his hospitalization, the first thing Foots asked is whether the doctors gave him his medication. Paul, who had been diagnosed with ADHD and depression at the age of 14, said, “No.”
“I was like, are you f—-ing serious? So, what are we going to do now?” Foots said.
According to his medical records, Paul told the doctors at UMC he had “racing thoughts about everything and feels stuck in his own head.” If he could get some Vyvanse, a drug prescribed to people with attention deficit hyperactivity disorder, he said he would feel “much better and everything would be OK.” That’s why he smoked marijuana, he said, to calm himself down.
Hospital staff contacted a mental health clinic that previously cared for Paul and received confirmation that he had been prescribed several ADHD medications. They also contacted his mother, who said Vyvanse had worked well for him in the past.
Paul, however, had been forced off his medication for more than a year. When he turned 18, he lost his Social Security disability payments, which paid for his prescriptions. This is not unusual. Approximately one-third of young people lose their benefits when they reach the age of 18 due to the stricter eligibility requirements applied to adults, according to the Disability Benefits Center, a private service that connects patients with attorneys to help obtain benefits.
Normally, when someone arrives at UMC with a mental health issue, doctors will determine if “there’s a medication you’ve been non-compliant with” and if so, “we will resume that medicine,” said Dr. Peter Deblieux, the hospital’s chief medical officer.
In this case, however, despite receiving confirmation of Paul’s diagnosis and prior care, UMC doctors refused to give him his medication, his medical records show. There was no explanation provided in the records.
There are differing views in the field of psychiatry on how to appropriately administer ADHD medications which are stimulants. They can, at times, cause psychotic episodes or be abused as street drugs. Withdrawal from ADHD drugs has been known to cause insomnia, depression, anxiety, increased heart rate and anger management problems.
With Paul back from the hospital unmedicated, the problem, once again, landed on Foots. She contacted a doctor who works with Covenant House. He prescribed Seroquel to help Paul sleep. They also gave him Tylenol for a persistent headache.
“We’re putting a band-aid on a big old wound,” Foots said.
Next, she tracked down the mental health clinic that previously cared for Paul. Foots arranged an appointment with their doctor but since the clinic hadn’t seen Paul in months, they needed to do a full check-up, including blood tests, before they could prescribe him anything. The process would take a week, maybe longer.
Meanwhile, back at the shelter, Paul’s condition was rapidly deteriorating. He was sweating profusely, had difficulty sleeping, and seemed constantly on edge. He was a time bomb, Foots said.
“You have this society that’s giving out medication freely to other folks and this young man is dying to get what he knows he needs, and he didn’t get it. They sent my baby back to me without any medications. Nothing!” she said, slamming her fist on a table.
Tim Byrne and James Curran – Boston residents in town for a Unitarian conference — were in the French Quarter just before 9 p.m. on June 24, 2017 when they were attacked and robbed by four young men.
Surveillance footage released by police shows Byrne and Curran walking in the 200 block of Iberville Street when they were rushed from behind. The first suspect can be seen in the black and white footage launching himself at Curran’s back. He puts the unsuspecting tourist in a chokehold and punches him as he wrestles Curran to the ground.
A startled Byrne turns to his right to see what’s happening when a second person blindsides him, throwing a wild punch flush into the side of his head. Byrne falls forward, hitting the ground face-first. He lies motionless on the sidewalk as blood pools around him.
Two additional young men run onto the scene and help the first two attackers rifle through the victims’ pockets. All four attackers then run away, down Bienville Street towards Armstrong Park. The robbery lasts 20 seconds.
Police quickly identified the suspects as Rashaad Piper, 20, Joshua Simmons, 18, and Nicholas Pogozelski, 18. The fourth man, described by police as the “main attacker,” the one who threw the punch that sent Byrne to the hospital in critical condition, was Paul.
Candi Paul was in Pensacola on the weekend of the attack, celebrating her one-year wedding anniversary when her phone rang. It was her son, Dejuan. He was crying.
“Mom, I need you. I need you,” he said. “When you coming home?”
He wouldn’t tell her what happened, only that he “messed up big” and was sorry. Then he hung up. A sense of dread overcame Candi. She tried calling him back, but no one answered, so she called Covenant House.
“I asked for him and the lady who answered said, ‘Who’s calling?’ I said, ‘This is his mom.’”
There was a brief moment of silence, before the voice on the other end responded by asking, “You didn’t watch the news?” The woman told Candi about the attack, how four boys had robbed two men in the French Quarter and that it looked like Dejuan was involved.
“I said, ‘Is somebody dead?’ She said nobody died, but it’s bad.”
Candi’s mind raced as she drove the 200 miles back to New Orleans. Their life had been hard, and her son struggled at times, but she never expected something like this.
Candi was 14 years old when she gave birth to Dejuan. She raised him as a single mother with the help of her family in the Lower 9th Ward until Hurricane Katrina devastated the community. Candi and her family safely relocated to San Antonio, but the young mother soon sunk into a deep depression. After three years in Texas, 26-year-old Candi returned home with her 12-year-old son.
Dejuan never had problems in school prior to the storm, but once back in New Orleans, he started acting out and failing his classes. That’s when doctors diagnosed him with ADHD and depression.
The medication he was prescribed worked for a time, but Dejuan continued to struggle. He was three grades behind and a constant target of bullies, so Candi enrolled him in the National Guard Youth Challenge Program, which helps troubled kids earn their GED. That didn’t pan out either. Eventually, at the age of 19, Dejuan decided to return to Texas to live with his grandmother.
A year passed. One day, Dejuan called his mom. He was depressed and discouraged. He couldn’t find a way to get his life on track. Everything seemed hopeless. He said he was coming back to New Orleans, but he wanted to try to make it on his own, so he was going to go to Covenant House.
“As a single black mother, I told him I just wanted him to be the man I know he can be, to stand on his own and get his life together,” Candi said.
A few weeks later, Candi received a call from her son. Police had just brought him to UMC.
“He’s telling me he was yelling some stuff. There were voices in his head. But he wants to leave the hospital and they don’t want to let him leave. I said, well you need to stay there and figure out how these people can help you. They kept him overnight and the next day he was released.”
Candi thought about all of this as she drove home from Pensacola. When she was an hour outside of New Orleans, Dejuan called again, frantic, weeping. He said he was near Claiborne and Tulane avenues and he needed her. His mother picked him up and drove him to see the family pastor at Mount Kingdom Missionary Baptist Church in the Desire neighborhood.
They prayed, after which Candi told him, though she knew he was sorry, they had to do the right thing. She had the pastor call a police officer who was a member of the congregation. The man arrived a short time later in his patrol car. He allowed Dejuan to kiss his mother goodbye, then took him to jail.
“I don’t know how mental situations work. I don’t know if you’re born with it or do they come out later on in life. I just know he didn’t mean to hurt this man the way he did,” Candi said, sobbing.
Tim Byrne, 56, has no memory of what happened the night of the attack. When he regained consciousness two days later in a bed at University Medical Center, where Paul had been treated just a week earlier, he was told just how dire the situation was during the first 24 hours. No one knew if he would recover.
Despite initial reports, Byrne did not suffer any brain damage. He lost eight teeth, which he is still in the process of repairing.
Byrne returned home to Boston 10 days after the assault and was cleared to go back to work that September. In addition to the dental surgeries, Byrne said he has undergone physical, speech and occupational therapy, as well as psychotherapy to deal with anxiety stemming from the attack.
Byrne works for the Unitarian Church but he’s not a member. However, after the incident, he looked deeper into one of the church’s core concepts, restorative justice, which focuses on rehabilitation through reconciliation and social services, as opposed to imprisonment.
During this period of reflection, he said he met a woman whose son was murdered and yet she advocated a restorative approach for his killers.
“I thought if she could find it within her to seek out a different outcome for the people who had murdered her son then I could probably do this,” Byrne said.
Before Paul was scheduled to go to trial, Byrne wrote a letter to the District Attorney’s office, asking for leniency towards the four young men. The other victim, James Curran, who declined an interview request through Byrne, also wrote a letter requesting leniency.
Byrne said he made the request, not because he is more compassionate than others or that he personally likes the people who attacked him. He simply believes that if the end goal is creating a safer society, the means to achieving that can’t be locking everyone up.
It makes more sense, he said, to invest in mental health care on the front end as opposed to ignoring it and paying for it on the back end.
“Anything left untreated is a thing that’s going to come back and cause some damage to somebody,” Byrne said. “And, in this instance, it caused a lot of damage to me.”
Paul was arrested June 26, 2017, two days after the attack, and held at the Orleans Justice Center jail until, 11 months later, he pleaded guilty, along with his three co- defendants. During his nearly year-long stay at the Orleans Justice Center, Paul’s jaw was broken and had to be wired shut. He told deputies he fell and hit his face on his bunk. His mother knew different.
“He’s getting robbed by knife point in jail for slippers, for his sweater, for commissary,” she said. “It got to a point where he didn’t want us to send him no money because he would have to fight for (it).”
After sentencing, Paul was sent to River Correctional Center, a private prison in Ferriday, 60 miles northeast of Alexandria. He spent nearly three months there before the Department of Corrections transferred him to Hunt. Prison officials wanted to provide Paul greater access to mental health services, including a full team of social workers and behavioral health specialists, all of which are available at the St. Gabriel prison facility
DOC estimates that 23 percent of its prison population has been diagnosed with a mental illness.
During a recent interview at Hunt with NOLA.com | The Times-Picayune, Paul discussed a broad range of subjects, including his regret for hurting Byrne and Curran, his struggles with ADHD and anxiety, the need to become a better person, as well as the dark times in his life.
Sitting in a folding chair in a behavioral health office, wearing a white prison jumpsuit, Paul said he doesn’t remember much about his childhood in the Lower 9th Ward but has clear memories of Katrina. He was 9 when the storm hit.
“I was really scared. We had to leave everything behind. We had nowhere to stay. Shelters. Being around people we didn’t know. I remember being in a dark place, being lost,” he said. “I think about Katrina all the time. I wouldn’t say it mentally scarred me, but I most definitely have the memories from Katrina.”
The idea of being in a “dark place” is something Paul came back to repeatedly. He said he felt like he was in a dark place during the 20 days he spent at Covenant House and on the night he attacked Byrne.
“I was struggling, trying to maintain a good mental, stable place. I had lost everything. I had nothing at the time.”
Warden Perry Stagg, who was seated nearby, interjected to ask Paul if he had been given his medication at the prison. When Paul said no, that the nurse said they can’t prescribe it, Stagg said they would try to figure out potential substitutes “to get him back where he needs to be.”
Since former Gov. Bobby Jindal gutted the mental health care system, taking care of people like Paul has become part of the prison’s job, Stagg said.
“Unfortunately, the Department of Corrections has become the de facto mental health hospital for the state,” he said. “We need to get these mental health services back available on the street and try to catch some of these guys before they commit a crime.”
In the 20 years he has worked in the prison system, Stagg said his view of the people under his charge has changed drastically as he has become better educated on mental health disorders and the effects of childhood trauma.
“I’m an old, conservative Republican, a lock‘em up and throw away the key kind of guy. Until I came to the Department of Corrections and realized that, hey, that’s not always the answer. There are reasons for some of this stuff and some of this stuff can be corrected.”
As the interview came to an end, Paul said the crime he committed continues to haunt him and that he regrets what he did “every day I wake up.”
“I wish I could tell (Byrne) I’m sorry and I appreciate everything that he’s done for me this far, speaking on my behalf and forgiving me, hopefully. I pray for him every day.”
Paul is scheduled to be released with good time considerations April 13, 2024. He will be 28 years old.