Anatomy of an End - Episode 3: Noor - External Reactions, Internal Realities

"We build courts and jails to process external actions, but they are fundamentally ill-equipped to understand internal realities."

At first glance, Noor's story seems straightforward.

A 19-year-old woman struggling with the criminal justice system. Court records. Stalking charges. Threats against a judge. A jail suicide.

But psychological autopsies rarely begin where they end.

In this episode of Anatomy of an End, forensic psychological consultant D. Edward Tatum and Davis reconstruct Noor's final months through the lens of a real-world psychological autopsy, revealing a profoundly different story than the public record alone can tell.

Together, they examine the devastating intersection of severe mental illness, cultural stigma, social isolation, psychosis, PTSD, the psychology of attachment, and a justice system that often struggles to distinguish psychiatric crisis from criminal behavior. They explore how schizophrenia and schizoaffective disorder can distort reality, why depression is so deeply misunderstood, how untreated mental illness reshapes relationships and decision-making, and why correctional institutions have become one of America's largest providers of mental health care.

Most importantly, they ask a difficult question:

What happens when every system around a vulnerable person interprets symptoms as defiance?

This is not a story about assigning blame. It is a conversation about understanding the psychology behind behavior, recognizing missed opportunities, and examining how seemingly ordinary decisions, made by families, clinicians, courts, and correctional staff, can converge into irreversible tragedy.

If we hope to prevent suicide, we must first understand the lives that precede it.

If you are in crisis, you do not have to struggle alone. Dial 988 for 24/7 support.

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Transcript

SPEAKER_00 0:00

The following episode discusses suicide and mental illness, including sensitive details regarding a death in custody. Listener discretion is advised. Support is available at 988. If you read the court transcripts, Noor looks like a threat. A 19-year-old facing stalking charges handed a three-year sentence for threatening a judge. If you look at the jail logs from two days later, she looks like a behavioral problem. Stripped of her cellmate and moved into a dark isolation cell for making a rude remark to a deputy. But a psychological autopsy forces us to look at a much larger, more uncomfortable truth. It exposes just how undercooked our public institutions really are when it comes to handling severe mental illness. We build courts and jails to process external actions, but some of them are fundamentally ill-equipped to understand internal realities. They run on rigid black and white rules, leaving them completely blind to the messy, high-stakes complexity of a psychiatric crisis. Before Nora ever stepped into a courtroom, her mind was already a crowded, terrifying place. The system completely misread her reality. And when the heavy steel doors of that isolation cell clicked shut, they locked a drowning 19-year-old in the dark. Welcome back to Anatomy of an End, a podcast where we retrace the final days of those lost to suicide through the lens of forensic psychological autopsy. Our goal is not to cast aspersions or assign blame, but rather we want to understand. Understand the warning signs, the missed opportunities, the myths and stigmas surrounding the topic of suicide in our society, so that together we can all become a greater force for prevention. Hey everybody, and welcome back. Today, a forensic psychological consultant D. Edward Tatum and I are pulling back the layers on another case. We're examining the precise intersection where severe mental illness, intense cultural pressure, and the rigid mechanics of a system running entirely out of its depth collided. This is the case of Noor. Now, before we uh talk about Noor, Dana, you've been bridging this kind of gaping chasm between our systems and meaningful mental health treatment for the last 25 years. Easily, yes. So let's like we always do, let's start with the person. Let's start with Noor. Can you tell us a little bit about her and and where does this story really begin?

SPEAKER_02 2:49

Noor was uh not unlike many young people, she was, as you said, nineteen years old and uh has found herself in a a great deal of trouble, most of which, uh clinically speaking, was a manifestation of her illness. An illness that her parents, like many parents, um were unable to really comprehend. And due to cultural issues within their family, when I say cultural issues, I mean what one would consider cultural norms for persons uh of their background. Originally the both parents were born in a in in East Asia in a community, a small community in an East Asian country. I'm not we don't need to identify exactly which country because it's not a nationality issue we're talking about. We're talking about a cultural norm. But in their cultural background, their cultural schema, mental illness was something that's in many ways doesn't exist. It's considered something like um I think even many Americans believe. It's uh it's so stigmatized there as here that many people believe it's it's a choice. It's something you just should shake off, snap out of it, quit acting that way. And in their culture, uh, you can multiply that attitude times a hundred. So here you have a young person suffering from severe mental illness at an early age and not given help, not given the the medical care she needed, because culturally speaking, and familial culture, you know, just in their home, this was something that was not going to happen.

SPEAKER_00 4:32

Aaron Powell How would her family have reacted to her if she had come come forth to them and said, I think I think something's wrong, I think I need some help, that kind of help.

SPEAKER_02 4:42

Well, it w it would have been a reaction of, well, let's go see a doctor, and they would look for a physical issue. And when the doctor would come back and say, Well, this is a mental issue, then it would be dismissed, discounted as something that she could control, something that she needs to change. This is rebellion, you need to stop acting this way. You're being ridiculous. And then as that progresses and the illness gone untreated becomes more severe, she would be treated as possibly an embarrassment. Somebody that, you know, we need to just keep her separate from the what we would call the in-group of the family and and others, and hopefully she'll grow out of it.

SPEAKER_00 5:23

So in in her culture, the a diagnosis or or an assessment that resulted in a doctor saying, like, oh, she this is this is a mental issue, that would be perceived as just a defect of self-determination.

SPEAKER_02 5:36

Aaron Powell That's correct. It would be seen as something that she decided, and possibly even something that's due to Western influence in this particular family having completed the psychological autopsy, obviously, on this on this tragic case.

SPEAKER_00 6:14

What was said about her personality that maybe the public record completely missed? Well, think about teenagers.

SPEAKER_02 6:20

Nora wanted to be Nora wanted to be accepted. She wanted to have friends. She wanted to be a part of what she considered her peer groups, high school girls and and and boys. She wanted to be a part of that world. She was unable to own a couple of a couple of ways, uh, that a couple of barriers rather that kept her from being a part of things. One, her dynamics of her family not allowing her to, you know, assimilate completely uh being the f you know the first generation born here. Um there were some reservations about how American teenagers act and what they do and how they move about and uh the social norms that we consider, you know, uh, and norms a tough word when it comes to to our society. There's a lot of norms, but in general, very generally speaking, she wanted to be like any other high school teenager in America, and that was a barrier in and of itself. With now, add to that the onset of severe mental illness at an early age.

SPEAKER_00 7:25

Sure. And what did what did that look like for her? Do you have any indication that she as to when maybe she noticed there was something that was that where she was deviating from those around her? Maybe there was something that needed to be addressed or that she didn't quite feel like she fit in. Was there anything like that that happened?

SPEAKER_02 7:40

Yes. Examining records as part of the process of the psychological autopsy, I found that she had severe diagnoses, first beginning with troubles in school. The the school psychologist found that there was a mood disorder and a possible dissociation at times from reality, which was were barriers to her learning ability. Um, this was seen, her bad grades were seen as a disgrace by the family and and a lack of effort. And so that that starts the ball rolling. Now, later, as much as I could sift from very scant medical records, that she received a diagnosis at what would be considered a very early age of schizoaffective disorder. Now, that is a a a very serious diagnosis in a long way.

SPEAKER_00 8:30

Can you can you just explain real quick what the difference between schizoaffective disorder and schizophrenia would be? Certainly.

SPEAKER_02 8:37

For a person uh in the old DSCM as uh especially to be diagnosed as schizoaffective would require that one, that patient meets all the criteria diagnostically to be diagnosed as a schizophrenic. Okay? Okay. But also they would have to independently, outside of the schizophrenic diagnosis, meet all the criteria to be diagnosed with a mood disorder. So it's a double whammy. You have a mood disorder that in and of itself is severe, then you have schizophrenia. Now that what would that mean? What would that look like? Imagine a schizophrenic, a person who may have psychotic episodes, episodes where they're not oriented to time, person, place, situation. They may have paranoia, they may have auditory or visual hallucinations, tactile hallucinations, olfactory hallucinations, gustatory or taste hallucinations. They have all these different things that could possibly be going on, as well as a combination of them. But maybe they cycle out of it sometimes, like many schizophrenics can, and they may have periods of lucidity. Well, with schizoaffective disorders, so a big chance that even during those periods of lucidity being oriented, what's waiting for them is a severe mood disorder, like depression. Now, she also later after her initial arrest received a diagnosis of post-traumatic stress disorder, PTSD.

SPEAKER_00 10:08

But she was was she diagnosed with some things before she was uh institutionalized? Yes.

SPEAKER_02 10:14

The schizoffective uh diagnosis came before she was put in put in the uh went into the criminal justice system and it was ignored largely by the family as something that just didn't make sense to them. Uh and then these are intelligent people, so let's not mistake cultural differences with with intellect. These are very intelligent people, but their cultural bias was so strong in this regard that really no real help came to nor.

SPEAKER_00 10:43

So outside of that culture, some people would probably uh recognize that sort of reaction as as foreign to them or abstract, because you know, we're we're lucky, especially, you know, in in America, we we take mental health pretty seriously on the city.

SPEAKER_02 10:57

Well, we're we're learning to. Sure. But it's kind of like we take it seriously when we're affected by it, but as as observers of it, not personally affected by it, we still present quite a bit of ignorance.

SPEAKER_00 11:12

What did her diagnosis look like on a Tuesday morning?

SPEAKER_02 11:15

If you're unmedicated and you have the diagnostic criteria met for schizophrenia, you uh a Tuesday morning or a Thursday night or any other time, you could be hallucinating. You could be reacting to internal stimulus, you may not be completely oriented times four, which just means time, person, place, or situation. You may have hallucinations that are somewhat benign, or you may have hallucinations that are quite frightening. This could create paranoia. Reacting to the paranoia could involve a invoking, you know, parts of the limbic system and even fight or flight if the paranoia and the sense of danger is great enough, like any other human being. As you say, a Tuesday morning, maybe there are no symptoms of psychosis, but maybe there's the mood disorder. Maybe Tuesday morning there is an intense depression going on that makes a person just unable, unwilling to get out of the bed, maybe presenting anhedonia, which is an inability to find pleasure or feel pleasure, even in things that one once enjoyed.

SPEAKER_00 12:23

It seems to me, I'm sure you'll agree, the depression is one of the most heavily misunderstood diagnoses in our in our society, in our culture.

SPEAKER_02 12:33

It is the worst named mental illness ever to me.

SPEAKER_00 12:37

Yeah. Oh, I'm depressed. I think you said that you know, that was a word that maybe a kid would use to describe his baseball game being reined out, you know?

SPEAKER_02 12:48

A writer, his last name is Solomon, and I I really apologize. I cannot remember his first name, but uh he was much more eloquent than I. He described it as the poverty of the English language, that a word that describes the feelings of a seven-year-old whose Little League baseball game got reined out also is a word that we use to describe a devastating, even at times deadly, debilitating mental illness that can shut down someone's life. And this is an illustration of the poverty of our language. Depression used to be called other things too. Melancholia. Melancholia. And we used to laugh about how serious that sounded. Melancholy was a uh a very passive word, but if you look at it nowadays and you say, well, I think they have melancholia, you know, you might think, Well, wow, I gotta get to the doctor. I need some type of uh treatment for that. Melancholia, do I need an ointment? Do I need a an injection? I mean, that sounds serious. Unfortunately, we say depression, and the first thing that people react with are questions like, well, what do you have to be depressed about? Or you got a great life, or look at your car, or you got a, you know, you have this brand new job, or you make this much money.

SPEAKER_00 14:03

Like it's all external. They asked, it's all external.

SPEAKER_02 14:05

They don't understand depression, it's not sadness. Sadness can be an element of depression, but so can anger, irritability, anxiety, procrastination. These are all elements of anxiety. Frustration, it's not just a sad person. You know, we we asked that question uh uh uh I think on a previous episode. We're like, what does a suicidal person look like? And and the in the imagery, due to the pitiful words we use to describe this terrible illness, or the imagery that comes forth is typically a person crying and sad and depleted. And that may be the case, but also it could be a very angry person. It could be a very scared person, it could be a paranoid person, it could be a person unable to fulfill any of their dreams or or aspirations.

SPEAKER_00 14:54

Sure, because there's so many factors that go into it. And first of all, depression doesn't exist as just like you're either not depressed or you're depressed. There's a spectrum, right? You can be different very uh certainly.

SPEAKER_02 15:06

There's a there's a continuum that can be episodic, you know. Think about and I use this a lot when I'm teaching this stuff. I always challenge people. I say, has anyone in here in a in the classroom had mental illness? Of course, most people just look down at the ground. They don't want to answer that question. If I say anybody in here ever had strep throat, you know, the hands go up. Anybody anybody in here have diabetes, hands go up. Eyes forward, right? Anyone in here had mental illness? People look down at the desk, they look down at the floor, and I challenge them. I say, Well, I'm gonna challenge all of you on this. And I'll say to them, has anybody anybody in here ever lost someone very close to them, someone they left? Hands go up. I'll say to them, on that very day or the days after that terrible news, can you say that you felt the same, your appetites were the same, your energy was the same, your sleep patterns were the same, even your vision was the same, your perception was the same on those that terrible day as it is today sitting here with me. And of course they say no. And I'll say, Well, you were mentally ill, albeit an episodic illness, albeit an an illness that hopefully was temporary, your brain was reacting neurochemically and emotionally to this terrible news. So you had a reason for this so-called illness at that time. So therefore you don't call it an illness, you call it mourning or you call it grief, you call it sadness. Now imagine those same elements, those inability to sleep or sleep too much, eating, everything affected about you physiologically and emotionally, and it doesn't go away, and you don't climb out of it in time. For some people that it takes a catalyst, but for others, there is no real etiology that shows, well, your depression started on this day because of this. It just comes upon people. So this is debilitating. This is this is hard to understand. And when you go to someone and say, I'm depressed, especially a young person, and a lot of times, especially men, because there's a stigma involved that depression equals what? Weakness. In Norris family, to say one's depressed was a ridiculous notion. Who are you to be depressed? We have things to do, we have work to do, you have a job to do, you have a roof over your head, parents that care about your well-being. Exactly. Exactly.

SPEAKER_00 17:35

You don't have anything to be depressed about.

SPEAKER_02 17:37

So stop being depressed. That's like telling someone with pneumonia, stop coughing. That's ridiculous. Just stop it.

SPEAKER_00 17:44

And of course, the person suffering with depression, especially a younger person like that, what the way they're going to internalize that is like they're right. I am a problem. I need to figure this out, which just makes it worse, right? Yes, it makes it worse. Think about this.

SPEAKER_02 17:58

And many adolescents go through this. You know, they go through periods where no one understands me is is their feeling. I'm as though they were the first person to ever be an adolescent in the world. That's part of being an adolescent, that you're self-centered, the world revolves around you and no one understands you, that you're extremely special in the sense that your issues, problems, and such could not be understood by a parent or a teacher. Only other people like you could understand them.

SPEAKER_00 18:26

Well, she had no peer group. So she was she didn't have a whole lot of friends that she was close to?

SPEAKER_02 18:31

Not at all, because she was isolated in her home for most of the time. Come straight home after school, do your homework. And in time they removed her from the school.

SPEAKER_00 18:41

So was she being homeschooled at that point?

SPEAKER_02 18:43

Or No, I I uh the best I can tell from the information I I received is that she tested out through, you know, one of these programs where you can uh go to school online, you know, uh these certified programs that the public schools offer now. That was can there her family felt that was safer, better, and would keep her away from the wrong kind of people and the wrong kind of influences, which obviously are the reasons that she feels this way because she's around the these wrong people.

SPEAKER_00 19:11

And and we're gonna we're gonna kind of take a closer look at how that didn't work out. Did not work out. And it's you know, I don't want to place too much blame on the parents because they're also they're also facing pressure from their own culture. You know, they had parents too. This is just what they know. Yes. And so ultimately she she's dealing with these these these mental health struggles on a daily basis. They're they're probably getting worse. She's guilty now. She has reg she has remorse and regret and guilt for feeling this way because she feels like something's wrong with her for not being able to overcome it. How does this um condition lend lend itself to her trajectory?

SPEAKER_02 19:49

Well, these type of feelings that she no doubt there's no doubt in my mind that she was manifesting and uh were exacerbated by one her illness, but also her isolation. Isolation only exacerbates mental illness. Isolation cannot make a mental illness better. You add to the fact that her age being adolescent, and that was quite a young age for that diagnosis. Most of the time that diagnosis is held back till you know people are just a little older, they rule out, try to rule out other things. She had this diagnosis, which for some people, a diagnosis is like, you know, the word stigma comes from what? Stigmat, which is a stain or a brand.

SPEAKER_00 20:29

They ascribe a diagnosis to as a facet of their own identity. Exactly.

SPEAKER_02 20:33

And you have a person who thinks no one understands me, I'm isolated, and uh another world begins within her, uh, a world where that she creates, unfortunately, due to her illness, a world that she creates not based on at times reality, which caused her to fixate on someone. And we don't need to name the person, but she started to fixate on an individual, and she was because she had a computer, she was able to uh begin just trying to find out more and more about this person and and began to stalk this person. Now, why do I bring that up? That's what led her into the criminal justice system, but it's a bigger picture than just the criminal justice system. That's what she was led down that path of that desperate act because of her condition, because of her isolation. Had she had normal peer support, normal peer interaction, had she had uh an acceptance and treatment of her illnesses, then there's a very strong possibility that that wouldn't have never been an option for her, you know.

SPEAKER_00 21:42

Because people who deal with attachment in an unhealthy way, sometimes they they just like the person or they become fixated on that person, you know, via infatuation or limerence just for the superficial reason of that that person makes them feel a certain good way about themselves. Is that what was maybe happening? Exactly.

SPEAKER_02 22:03

I mean, one of the strongest uh elements of any relationship is a relationship in which both parties feel heard. How do they feel about themselves when they're not in the presence or in contact with the other one? Do they feel bad or feel good about themselves? She has no experience in any of that. She had no experience in, you know, where we learn all this stuff, you know, hit or miss, right or wrong, we learn it through mistakes in our relations. We learn it through successes in relations. We learn it through first heartbreaks, first dates, first social interactions. She had none of that. None of that. No, no experience.

SPEAKER_00 22:41

Good relationships are built on a firm foundation of multiple bad relationships a lot of the time. It can be. It can be yeah sometimes. I'm not saying that's always the case. You know some people some people luck out. Is that first person?

SPEAKER_02 22:54

They some people do. Okay. Uh some people we it's later in life based on experience and and what they hopefully what they learned. But she had no experience but she did have social media. And as we all know that is a it's very good for your mental health right oh yeah social media is awesome. Yeah it's it's the patron saint of maladaptive self-comparisons and really maladaptive methods of gaining one's self-concept.

SPEAKER_00 23:26

And in all seriousness, you know we we've we've spoken about this before comparison is what social media brought to the table. It brought this window this distorted window into other people's lives that make you feel like you're missing the boat on some facet of your own life look at how happy they are look at how fulfilled they are look at how complete their life is look at how rich, successful popular these people are and you and you point all that at yourself and you're like what is wrong with me? Why can't I achieve why can't I achieve this?

SPEAKER_02 23:57

Well I'll I'll translate all that you're correct I'll translate it as we did with when we talked about uh previously secrets comparison bad equation simple secrets and comparison both really bad for your bad for you they're not good for you comparing oneself to especially a false narrative is really um treacherous you know it's real tricky because these are things you cannot achieve so if I cannot achieve me not not I can't try I cannot achieve this thing I'm seeing that I am believing is how it's supposed to be right that's if that's not for me ever and can never be for me, well then where am I? And in her case that was where she was she was cornered rather secluded in a space both literally the home and emotionally because she had no experience with real peer interaction, real relationships What do many young people want? Acceptance acceptance love belonging sense of belonging right the sense of being wanted the sense of being desired and and I'm not before anyone gets upset I'm not talking sexually. I'm talking about the desire to be near that people want you with them. It's a more fundamental need than than intimacy. Yes. Think about those who have been fortunate enough not to have the barriers that Nor had think about the things you look back on now in your adolescent years that you didn't like and the things that you did like the things that you hated and the things that you loved. At least you had those things to compare to each other okay you're the things you loved and the things you hated. They were both experiences that built you one way and sent you down a path. Where do you think the path who finds the path when there is no input like that and there is no experience so you add to that Norr's general feedback within the home okay something's wrong with you stop acting that way. She have siblings uh my understanding she had one but I could be wrong on that because I I was not able to verify that.

SPEAKER_00 26:09

If she did that would be another source for comparison then correct?

SPEAKER_02 26:12

Well sure um in fact it'd be a I would say dangerous source for comparison because sibling rivalry is a real thing in some families depending on what type of sibling you have you have someone who loves you and cares about you and so understanding they could really build you up. And remember we're looking through the eyes of possible psychosis here. What if that sibling was a rival that you can never be compared to and the people who care for you, take care of you that your livelihood depends on favors that sibling that's more exacerbation.

SPEAKER_00 26:45

But she also had that diagnosis of PTSD. Right and let's talk about that PTSD is one of those things that is pretty misunderstood.

SPEAKER_02 26:53

It is post-traumatic stress disorder some will say that's overdiagnosed others will say that that's only because it was underdiagnosed in the past so it it appears to be overdiagnosed. A lot of people don't understand that PTSD the serious levels of PTSD especially they actually they they change the the way the brain functions all of us have you've heard of fight or flight right okay so fight or flight is a physical animalistic instinct that's built in it's built into all of us right right it it's a it's a system that's made within us to keep us safe right we've kind of touched on it earlier in other episodes so within that system there in the brain there's several parts of the brain there that are play a big role you know of course your frontal lobe which is your your governing power of reasoning and logic and and is the brake system for your impulses if you you know that's how your impulses are kept in check because that frontal lobe puts the brakes on them. But there's also the amygdala and the amygdala and this is a super simple explanation but it'll work. The amygdala is kind of standing guard right the amygdala is observing and ready uh it sensations are past and the amygdala uh may realize in most of us you know be working at a certain level that is you what you would consider a normal baseline in other words uh the amygdala would become highly reactive if we were facing some type of danger if we if there was a lion running at us head on right amygdala would be kicked in at a very high level the amygdala is what makes you get startled by loud noises and stuff like that.

SPEAKER_00 28:35

Yes.

SPEAKER_02 28:36

Now what does the amygdala do? An oversimplified explanation here but bear with me the amygdala calls over to the hippocampus and it's and it's like what is this? What's about to happen? And the hippocampus can say a couple of things the hippocampus can say hey hey we've done this before or that's not a lion that's that looks like a lion but it's not okay it's a kid in a lion costume. And the hippocampus can say don't don't worry about a thing you're it's all good. We have this experience and here's here they are here's all the experiences or the hippocampus can say I don't know I don't know so then what? Well there's a couple other pieces that jump in then the cingulate and the insulin and the the insula they kick in and therefore a hormonal response takes place cortisol you know the the distress hormone the distress hormone and adrenaline. Now I hate this term but I'll say it for um descriptive purposes you've heard people say well crazy people are strong right no they're not what is strong is a person in fight or flight who may be psychotic and paranoid and thinks they're about to be killed they can be very strong because of the adrenaline now in a in a so-called normal person uh the frontal lobe kicks in as well and says hey relax take a breath it's gonna be okay and a so-called normal person the hippocampus will help explain this away the amygdala will slow back down but with PTSD the amygdala remains overstimulated overreactive the hippocampus remains understimulated underreactive so you're always on high alert you're right on the threshold of it now for a normal person you meet all you meet this danger right and then uh the whole system reboots and you flush the adrenal and and the cortisol you know through your kidneys and it's flushed out and you come back to baseline. With PTSD they never quite can flush they never can quite come back to baseline. So those parts I named those areas of the brain I named they're there's they're at the threshold of what could be a fight or flight uh response but they don't quite go into fight or flight but they just have the feeling of of being uh about to always on that edge always trying to edge trying to like when you walk into a room you're immediately just looking for danger everywhere and the severe cases that's what it's like for them there are less severe cases obviously there's a continuum but in the most uh graphic of severe cases that's what that person's life would look like being on that edge. Now you add to that the triggers that create this something that the brain has associated with their trauma a smell a texture a feeling a temperature a sight whatever it may be a person an actual person or persons then that just exacerbates it right the trigger's there the sensations there the association has been built the frontal lobe does lets them down the hippocampus can't explain it away the amygdala does its job goes into full blown fight or flight sometimes and and I think probably something that at least some some of those listening right now are adjacently aware of somebody gets out of an abusive relationship they flinch a little bit easier than somebody else might and that's a result of that that could be a component of PTSD a bit more vigilant maybe hypervigilant it is a lot more to it than that obviously but I think that's a very good explanation a very good diagram of the system and how it works. It's also good for people to understand it is physiological they're not making this up it's not their imagination that makes them feel hypervigilant scared or even fearful right there's a there's a cause there's a cause there's something happening there in the brain that's creating these feelings. So is there a treatment for this? Yes yes absolutely there are several treatments for it some require maybe a combination of of therapy and medication there's other there's uh rapid eye movement desynthesization treatment which is a technique using um uh a light system and I won't go into the whole details of that but it's well known cognitive behavioral therapy to understand your triggers and understand ways to cope with them before they reach that point where all those parts of the brain are kicking in and be able to pull it back in and relieve that pressure and relieve that fear.

SPEAKER_00 33:09

Yeah there's treatment so she it's fair to say she she had a lot going on a lot going on and a lot that was not being actively addressed other than the only way it was being addressed is it was making her feel a certain way about herself feeling like she was letting her family down, letting herself down not being able to operate optimally she got infatuated or she got obsessed with this individual and we were talking about how this might have started her down her um down her dark path.

SPEAKER_02 33:38

I I that's that's my finding I I believe that sincerely because remember now during episodes of psychosis it's typical that a a person may believe everyone else is wrong. You know everyone else is not telling me the truth because my reality based on what my brain, my senses, all the things that tell the rest of us what's real and not real are telling them something different.

SPEAKER_00 34:03

It's very hard for someone to understand that too somebody who isn't doesn't have that condition. It's hard to see somebody who's struggling like that and not say to yourself what it how do they not get what's actually real and what's not real that's it's something that's very hard to to be able to um to understand.

SPEAKER_02 34:21

It is very hard to understand and I always you and I were speaking earlier pre-production that the way I put it to people is you know I'll ask them maybe to look at a wall that's white and I'll say to them what color is that wall and they'll say oh it's white and I'll say well you sure and they'll say well yeah I'll say are you really sure? And they go well yeah and I'll say well how do you know and they'll say well because it's white all right so basically they're saying that's what they learned at a certain age therefore they trust that therefore in that part of the brain that keeps track of what we've learned visually I ask them a question about a visual thing they came up with white instantly and I'll say to them what if that same neurological sequence of firing off and and neurotransmitters moving about your brain gave you a different answer. The same mechanism now not a different one but the same mechanism gave you a different answer than everyone else in the room everyone said white when I asked that question except you and you said something completely different. Would they all be wrong? Of course you know that's a tough question. Right. Would they be wrong or would I be wrong? But wait a minute what's telling them that it's white is telling me something different. So maybe I am right.

SPEAKER_00 35:40

Because it's also a scary place to be if you if you even have the ability to question whether you're the one who's wrong in that situation it's not just that instance of you being wrong it makes you question your whole reality and that's a scary thing and it makes a lot of people not want to go to that that's kind of a facet of schizophrenia. It's like if you found out that something magical happened in the real world right you it wouldn't just be that one thing that you found surprising disturbing it would make you be like what else can happen that's like that because that that's counter to what I know to be reality.

SPEAKER_02 36:14

Imagine this everyone you wake up one day and everyone around you sees everything different than you do. But these are people that the day before pretty much saw everything like you did. Now suddenly they're not suddenly they sound different suddenly they see things differently suddenly we can't agree on some basic things and suddenly also possibly they seem to be looking at me differently what if I woke up like that one day and I can't explain it then I may have some paranoia. I may feel like people are conspiring against me. They're not just different than me they're seem to be conspiring because how could everybody even strangers not agree with me?

SPEAKER_00 37:00

And then somebody comes up to you and is like no no look that this guy this guy's red uh oh he's in on it right he's part of the conspiracy so what is it that makes somebody who might be experiencing an episode like that and to be clear this usually happens a little bit at a time with someone who has the do they kind of build up these things over time.

SPEAKER_02 37:18

Well generally with with schizophrenia a first onset episode is generally not a full blown psychotic episode but it usually begins with some subtleties in their in their in their daily life such as becoming more recluse not wanting to take part in social activities possibly uh it can look like depression andhedonia not feeling pleasure in anything uh then it can be more isolation as it goes up that isolation could turn to distrust of others because obviously they don't see or talk or understand what you're talking about and they seem to be looking at you differently because they don't it could go a little further it become a kind of a loss of hygiene sometimes then the distrust grows and then maybe hallucinations begin which can be a part of one or more of your five senses as I said earlier delusional thought then enters you know delusions being beliefs versus hallucinations being a manifestation of one or more of your five senses then at that point you're in a full blown onset.

SPEAKER_00 38:21

And and let's not forget this young lady not one not two not three she had at least four major clinical diagnoses. When it's all said and done I understand that some of them didn't come about until after she was institutionalized but that sounds like hell.

SPEAKER_02 38:38

Especially when no one in her mind appears to be believing you or listening to you and along with the stigma that if you are presenting these behaviors, we'll call them behaviors right now instead of symptoms because that's how that how they were seen by many in her family these are behaviors. These are symptoms if that's what she's experiencing then what could her self-esteem be like what could her self-concept be like I would have at a crucial age non existent.

SPEAKER_00 39:06

I mean it's getting it's getting beaten down every day it's getting grinded into dust every single time something happens that makes her question her reality or feel like nobody cares. She doesn't have any friends because she's isolated and as you've pointed out isolation is obviously not good for this isolation helps mental illness the same way that you hear your car making a funny noise and you're just like that'll go away eventually it never does and it always gets worse.

SPEAKER_02 39:28

Everyone hopes it goes away. Yeah because that would be nice right I wouldn't have to admit to it I wouldn't have to say I'm mentally ill I wouldn't have to go to a quote unquote mental health person because that alone is got to be you know just a a stigmatizing event in your life. Your family doesn't have to make excuses for your behavior everything would be better if it just stopped wouldn't it?

SPEAKER_00 39:50

And it's stopping in that circumstance and in that environment that would be more of the medical oddity than the actual condition in and of itself. Absolutely that would be something for the books yeah you'd have to figure out what you got to get some of their blood and figure out what how do they pull that off and ironically though that's what families are hoping for it just will stop.

SPEAKER_02 40:11

It'll go away she'll grow out of it she needs to straighten up she needs to get herself together. Now what if what are her choices then go with the flow of everybody's right and I'm wrong and what can I do about it? How can I change? How can I stop what's going on with me? Or like a lot of adolescents who are not mentally ill take a stand and say I'm gonna do things my way I'm gonna you know fight against this thing that's out here on me right now. And what does she do? She reached out through social media tried to develop relationships maladaptive influenced by some people that are quite malicious out there and I know it's hard to hard to believe that there's malicious people out anonymously acting out here on the internet people on the internet acting in bad faith absurd.

SPEAKER_00 40:58

It does happen I have proof but uh but it's it's kind of it's a it's really a pressure cooker for somebody like this.

SPEAKER_02 41:06

Yes. You know again isolation bad again engagement good. Real engagement open eared engagement people listening not judging how did so how did this this obviously there was a catalyst and this obviously came to a head at some point where she crossed a line.

SPEAKER_00 41:25

What what what happened there?

SPEAKER_02 41:27

In her mind she had developed a relationship with an individual that individual did not have a relationship with her.

SPEAKER_00 41:34

And this is perceived is she like perceiving a relationship that isn't there?

SPEAKER_02 41:39

Yes pretty you know I mean the social media and the way people speak if you don't have experience in the way people speak if someone says hey great to see you I'm so happy that you reached out to me. Yeah. Well you have a person with zero experience there's no context for that sort of action for it and it grows and that that sounded like I love you to her. It sounded like hey you're the you're the best hey everybody's wrong you're awesome and you know there is a just a basic human element here to be accepted and so that basic element can be looked at as a threshold a threshold that can be high and only accepting of other people's compliments and admiration through a filter of common sense and safety or it can be very low threshold of please give me this this confirmation.

SPEAKER_00 42:29

Right. If you've never seen a flower before it's the most beautiful thing you've ever seen that's right that's right. So she acted in a way that was that was incongruent with what she was being given by this person.

SPEAKER_02 42:40

Aaron Ross Powell Yes and she became obsessed and she would she was able to stalk this person by the legal terms and this person felt that they were being stalked and and were being harassed what happens when you are rejected especially what if it's the first time you rejected uh romantically in your mind romantically to this other person's mind they don't even know you what do you think that rejection felt like uh catastrophe catastrophe my life is over and therefore two directions once again gosh they just don't want me or hey you tricked me you lied to me you know that wasn't nice of you to lead me on that wasn't nice of you to be ugly to me when from the lens of a delusional concept that person may have never said anything that should have led her to think any of those things. Right. But again we're talking about her mind and her state of mind untreated and everything that she knows to be everything she knows to be true. Right? Remember what do we know to be true? What color is that wall? Where does she go? She she lashed out and she crossed paths with the criminal justice system. She did not lash out physically remember this young lady was at the time of that offense was around eighteen, maybe just turned eighteen She had no car, she had no license, she couldn't drive, she lived in shut in the cross his house every night or anything like that. Knocking on anybody's doors or anything like that.

SPEAKER_00 44:10

But she was making statements. What did she do where she crossed the line in the eyes of the law?

SPEAKER_02 44:16

Obviously, I'm not a I'm not an attorney and uh or nor a judge, but I would say that in my experience, you cross the line when you the other person can produce evidence of just harassment, of nonstop harassment at a level that goes beyond the pill of um common sense, uh maybe phone calls or uh or making statements that are that are um detrimental to that person's well-being or their happiness or their safety or their family's safety or happiness, uh consistently publicly, you know, interfering with their livelihood somehow, possibly by the constant need for attention, and you know, it could be knocking on doors, could be a consistent threat level where everywhere this person turns, there is some interference with their life because of this constant attention from the uh perpetrator.

SPEAKER_00 45:12

So all this was this was all digital?

SPEAKER_02 45:14

Most of it was digital, but she did get out of the house a few times, and though she never touched anybody or anything, she did show up at a a couple of stores and she had an ability to locate this person. You know, listen, you know, mental illness does not equate to there's not a correlation of severe mental illness and a lack of age. Yeah. She was this very smart person. She put those tools to uses that got her in trouble. I'm not going to go into the details of her stalking, sure. But I'll I'll just say that she was brought to an arrest. Her family's view of the arrest was we're not bonding you out. She could have bought it out quite easily.

SPEAKER_00 46:01

Wow. Um They didn't see Well and it's wild that they didn't understand how she could be like they know she's not really a social butterfly. They have to realize that. They're the reason for that in part. But maybe this will teach her a lesson, right?

SPEAKER_02 46:16

She can stop these silly behaviors.

SPEAKER_00 46:17

Oh, these silly like little side escapades and get back to doing what she's supposed to do.

SPEAKER_02 46:21

In all fairness, in time they did bond her out, and this is where the the secondary trouble began.

SPEAKER_00 46:26

Let's let's examine that a little bit, you know, because the system is kind of irrefutably a part of this whole story. We can't talk about we can't talk about Norr's tragic end without bringing into question some of the systemic ills that occurred here.

SPEAKER_02 46:42

We cannot because this is happening right now all over the our country and it has been for several decades.

SPEAKER_00 46:49

And what you do, we haven't really talked about this a lot. What you do is is very, very specialized. It's not really something that there's a ton of people out there doing psychological autopsies or bridging the gap between institutions and mental health. I mean, th those inst those resources exist, but there's not as many of them as there should be, right?

SPEAKER_02 47:08

Aaron Powell No, there's not as many as there should be. There's a lot of dedicated people out there who are working within these institutions to address the needs of the mentally ill. Things have gotten better in some municipalities and others that they have not gotten any better. I'm old enough to have witnessed the migration of the mentally ill from institutions into the jail with the hopes that the institutions would be cleaned up and the abuses that went went on there would be corrected, and then maybe the jail would not be the hospital. But that didn't happen. Once the jails became the hospital, they stayed the hospital. Any given jail across the country will be the largest accumulation of severely mentally ill people in that county across the United States.

SPEAKER_00 47:54

With officers in some cases, especially if they're brand new, zero experience dealing with severe mental illness.

SPEAKER_02 48:01

Probably not. I mean, you think about a person who goes into this line of work, law enforcement, civil to serve the public, and suddenly they're a frontline mental health professional with a minimal training. So some forward-thinking municipalities have taken that and worked really hard to correct that. Others have not, but working towards correcting that from an institution setting, it's working completely depends upon the individual officer, right? One officer in that link that refuses to adhere to the training, adhere to the proper policies and appropriate procedures. Something can go horribly wrong.

SPEAKER_00 48:42

And we we didn't really see that with Susan because it kind of feels like everybody did everything they should have. That kind of except for the the other inmate in that case. It's not like the system in that case really did anything wrong.

SPEAKER_02 48:54

No, it's a very different case because uh she was not psychotic. She did not have psychotic features, she was not suffering from delusions. The bulk of her elements were were moot and as well as personality disorders, developmental personality disorders.

SPEAKER_00 49:10

We've talked about a lot about these these disorders that Noor was struggling with, and it's easy to see how this could could come to a precipice of her entanglement with uh law enforcement and based on these stalking allegations, and I believe there was a terroristic threat um allegation as well.

SPEAKER_02 49:25

Yes. Let me back up a bit. Sure. When she first came uh in and arrested, she was assessed and it was clear that she was mentally ill. Therefore, she met criteria to be placed in the court system through a caseworker into what was called a mental health court, which is a court that's gonna take into consideration in its deliberations and its treatment of the so-called perpetrator their mental illness as a factor in what was going on with that person.

SPEAKER_00 49:53

But we don't want listeners to think like, oh, what are you guys talking about? Look, there's a mental health court. We obviously have the systems in place because we're gonna see why that's not really the case here.

SPEAKER_02 50:03

Well, you have the institutional mental health court, then you have individual players within it. In this case, she was put into a program whereby you complete the program, meaning what? You go to treatment, you know, there's a caseworker that's following you, you're out here, you're bonded out, you're going to treatment, you're taking your medications, you're doing everything that you're staying out of trouble, and in time, you graduate from the program, and then you're generally speaking, uh, not for everyone, but your charges are dropped or expunged. You know, your your sentencing becomes a suspended, and uh, you know, it's kind of like a what's known as a first offender status, you know, it's as though it never happened because you completed all this pre-sentencing criteria. In this case, it would be therapeutic criteria and so forth. Okay. Well, she was in that program and she was bonded out, but she didn't receive a lot of support in adhering to the criteria of the program. Trevor Burrus, Jr. Because her parents probably didn't see the value in it, right? Probably not. But also she didn't drive, she couldn't go to the court appointed treatment, uh, court order treatments and and things like this. It's kind of like being on probation but pre-sentenced. Well, and of course, responding to internal stimulus, responding to her uh the elements of her delusional content, she crossed that path again and and and reviolated.

SPEAKER_00 51:26

Aaron Powell But the first time, just to go back just a little bit, at this point, the system was were they seeing a criminal or were they seeing a they they were clearly seeing a medical crisis masquerading as as a crime before at least the first time, right?

SPEAKER_02 51:38

Aaron Powell Yes. Well, what what you see there is a person who is whose behavior, though uh technically criminal, technically breaking laws, we'll say, was a manifestation of their illness.

SPEAKER_00 51:49

And and it was instead of overt criminality. Trevor Burrus, Jr. And and this obviously doesn't matter as much because saying, oh, she didn't know any better, that doesn't really work in that environment. But she also didn't identify that her behavior was clo crossing a line, but then she did also have underlying mental health issues. Trevor Burrus, Jr. Well, that that's the point.

SPEAKER_02 52:06

She couldn't make that distinction. So she's now being told, hey, you can't do that. And what was her rationale? Well, well, wait a minute. This person said they love me. This person said they were going to do this, that, and the other for me, and they didn't. That's not fair. But that was her reality. That was witnessed and that was understood, therefore she was placed in mental health court. But the program within the mental health court was not working for her and her for several reasons. She was being let down by not just the system, but by uh, you know, other cultural and familial concerns. But then this is when it got bad. The judge called her in and they warned her, you're gonna go, you're gonna end up getting yourself in a lot of trouble, young lady, and we're gonna uh make sure you do. Now you're gonna do what we say, or do you just want to go to jail and do you just want to, you know, go to prison at some point because you know they became very strict with her.

SPEAKER_00 52:58

And that's terrifying for a young lady.

SPEAKER_02 52:59

It's probably terrifying very terrifying, but also the truth, because many of the people that are in mental health court, they're not psychotic. Uh meaning they they do have a grasp of uh time, person, place, situation.

SPEAKER_00 53:10

They may just have behavioral issues.

SPEAKER_02 53:12

And so they call them in, they and they, you know, hey, you know, they they give them a little coaching. Listen, you're you're you're messing up. Let's go. Get back in the program here. We're trying to help you, that kind of thing. Well, she misconstrued some of the the verbiage and what was said, and wasn't long after that. She made a threat on social media to a judge, at a judge.

SPEAKER_00 53:35

Okay, so she did this on she did this online. Yes. She named the judge, or she was just like, oh, this judge. She named a judge. And she made a threat.

SPEAKER_02 53:44

Yeah, that's not good. Not good. Bad. But again, a manifestation of her illness as already witnessed and understood, or she wouldn't have even been in mental health court.

SPEAKER_00 53:57

Because to her, this is like you're trying to keep me from the love of my life sort of thing. It's that was it that, or was it the fact that she just didn't like any part of this this whole legal process and she had had a lot of resentment because of that? Was it about them trying to separate the two of them or just the whole thing?

SPEAKER_02 54:13

The whole thing. I mean, think of it this way emotionally, she was about a 13-year-old. I mean, she had no real emotional content distinguishable from a 13 or 12-year-old, really, because she led such a closed life.

SPEAKER_00 54:26

Right.

SPEAKER_02 54:27

So, what happens when a so-called out-of-control 12-year-old, 13-year-old gets in trouble and they go slam their door of their bedroom, maybe? Uh they may yell, I hate you. I wish I was dead, or I wish y'all were dead. You know, you you hear these teenagers and young people or even adults sometimes.

SPEAKER_00 54:45

And they don't mean it because they don't know what they mean because they don't have emotional regulation. Yeah, and they don't understand the concept of permanence and all of that stuff.

SPEAKER_02 54:54

Well, take that into her hands, social media, and some of the things she may have said at this judge, right? Just like other teenagers may scream at their parents in this manner. The judge revoked her bond, revoked her participation in mental health courts, and sentenced her, which was her right. This was explained to Norr, but again, this is unmedicated, Noor. This is Nor not in treatment. The judge made a decision, and that judge uh gave her a sentence of three years in prison.

SPEAKER_00 55:27

And bond is done now, right? There is no bond. You're now sentenced to going to jail.

SPEAKER_02 55:32

So she goes from the court to the jail and is in jail. And where she's been before, now she was placed in a special unit for persons that are mentally ill. Three years was quite a stiff sentence for this, considering there was no way physically for her to follow up on these threats. She could have received some type of really stringent and highly supervised ankle monitored supervision instead of prison. A lot of things could have taken place. She was sentenced to prison for threatening a judge.

SPEAKER_00 56:04

And I mean, is this a common sense thing? Do you think another judge might have been like this d this young woman doesn't have the the agency to do any of this stuff? I mean, this doesn't really make sense here. This is a disproportionate punishment for what she's doing.

SPEAKER_02 56:19

That's my point of view. There are others that will agree with me. I'm sure there are others that say, hey, you know, you should cross the line. I get that too. But where are we? We're in a mental health court. We're not in just a municipality where this couldn't happen because there is no mental health court, therefore anybody who says these things is going to get the same type of treatment, right? She was already differentiated from other persons in the same population by being placed in this special, special type of court system.

SPEAKER_00 56:50

But then you have you have other individuals who have like five, six, seven times recidivism for violent crimes. And when you look at that, I think anybody would be like, this doesn't, this is nonsense.

SPEAKER_02 57:02

It is nonsense. I, you know, and and people will in the system will agree with this. I mean, I I've known people that have that I've dealt with that are are sentenced to uh for statutory rape and they're out of prison in five years. Okay. This is a little girl who made some threats on social media and sentenced to three years.

SPEAKER_00 57:20

This specific crime seems like the judge, this was more of like her. Like, you're not gonna you're not gonna say that stuff to me. Yes.

SPEAKER_02 57:30

I'm gonna teach a lesson. And also a judge that thought they understood mental illness through their own um I guess narcissism, but they did not understand mental illness. Right. I I promise that her clinical staff, which is part of a mental health court, would have disagreed with this sentence. Now, as part of a psycho autopsy, I'm listening to phone calls home, and these phone calls had to be translated from me, obviously. Uh, they were in their native language. The father was very strict. You're going to prison, you did a bad thing, you must be punished. And this is part of your punishment. You'll be fine. Just stay out of trouble, keep your mouth shut, don't bother people. You know, control yourself. The mother was a bit softer, but she didn't contradict the father. From a hardcore corrections and jail standpoint, people who see people sentenced all the time to ten years, twenty years, forty years life, life without parole to hear someone getting three years doesn't ruffle a lot of feathers amongst untrained people, especially new people, because it's like, oh, it's just three years, shouldn't be out in maybe a couple years.

SPEAKER_00 58:41

But hearing what the the offense was puts it in perspective, I would think. Right.

SPEAKER_02 58:45

But not to everyone. And so that's where things went really wrong because protocol was broken because this particular institution has some very good protocols in situations like this. A a specialized unit, specially trained uh officers who supervise said units, and so on. One thing that's never happens with a severely mentally ill person who's sentenced to prison is they're not isolated. They're given time to be around peers and process what's just happened. The mental health team would be there processing what happened and helping uh in any way they could, and as they await their transport to prison, which could take months, by the way, in some cases in some municipalities, you know, treatment is ongoing and there's a captive audience and so forth. Even group treatment, individual treatment, and so on. There's a peer group there that's real and live and shares some of the same type of problems, along with highly skilled professionals and trained officers. But a couple of days after coming back, uh an individual officer made some statements, uh, some directions, and Norr reacted poorly, Nor made some statements and uh thought they were funny. And and looking at the video, uh it appeared to me that Nor was trying to kind of make some of the other uh detainees in the in the vicinity laugh. Uh they were sitting at a table together and that's you know, she was sharing and and with these other folks and the direction was given and she smarted off as one would might think um any detainee or any adolescent detainee might. And for whatever reason, against protocol, against procedure in s in some respects, this officer took offense and was gonna show everyone their boundary was gonna be set.

SPEAKER_00 1:00:45

Well, that's what I was gonna say. It kind of almost seems like if the other people hadn't have been there, maybe it wouldn't have gone down this way. Like possibly not. Because, you know, corrections officer, I I think it's pretty normal. You don't want everybody around there seeing you get manhandled by an inmate. It it it undermines your ability to to control the environment and but it's it also is like you gotta you pick your battles, right?

SPEAKER_02 1:01:10

Like you pick your battles, but also you you gotta understand where are you? I'm in a mental health unit. I'm in a unit with people who may not have very good impulse control. I'm in a unit with people who may be responding to internal stimulus. I'm in a unit with people who may be psychotic. I'm also in a unit with someone who just came from sentencing, okay? So there's some things that are going on here. Uh as an officer, that officer had the option to set that boundary, or she all this officer also had the option to call the mental health team and say, hey, Nor is acting out verbally. You know, I know she just got sentenced. We may you guys may need to come on, come back in and check on her, see what's going on. That was an option. That option was not used. The option that was used was everybody back to their cells, and Nor, not you, you go in this cell. I'm gonna prove a point. Right. So she was isolated, and the Mental Health team was never notified that this person was isolated.

SPEAKER_00 1:02:12

And that's really the big mistake here. That's that was a breach of protocol, like uh on paper, that's an obvious and clear breach of protocol.

SPEAKER_02 1:02:20

Yes, yes, it is. That's also a common sense breach as well. You have a an a tip uh Nora was a teenager, a very immature teenager, who was severely mentally ill, who just got some very tough news, whose parents told her, There's nothing we can do about it, you just need to buck up, who was in her typically maladaptive way, uh incongruently reacting, you know. She would like a lot of people in with that level of mental illness, her her affect was incongruent. She would when she was scared, she laughed. When she was upset, she kind of had a grin, look like it looked like a grin on her face, but it wasn't. So therefore, for a person who has authority over you and you're telling them something very serious and they're laughing or smiling, then that's seen as what? Some type of rebellious behavior, some type of disrespect. All of which goes into the decision making of that officer in the moment. And so she decided, no, you're going to go to this room. She couldn't go back to her room with her cellmate whom she liked a lot. And that was you know, one could say, all right, well, you you can isolate someone, but then you needed to call the mental health team, and she did not.

SPEAKER_00 1:03:31

And having that cellmate, I mean, getting that taken away after leading a life of social isolation, that was probably almost as good for her as the therapy.

SPEAKER_02 1:03:40

Well, it was because she was developing a peer, a real life, not one online, a real life person who typically had some of the same issues. And also, you know, that cellmate was chosen for her because they knew it was somebody that would not take advantage of her, that uh might be a good influence on her. But a few hours later, as the sun went down, Nor took her own life. She hanged herself from the top bunk in between a permanent desk that's situated coming out of the wall and the bunk.

SPEAKER_00 1:04:15

And you were then called.

SPEAKER_02 1:04:18

Yes, I was called. Um the well, first obviously the code went out for persons to come and uh try to save her life. You know, I mean that's that's the protocol. Obviously, she was cut down, laid on the floor. Life-saving measures were began immediately by and a I just can't say enough about the courageous efforts of these individuals. You can the I watch everything and then I re-watch things on video. I watched the videos closely. We're talking about people who are working so hard that they exhaust themselves and then lack of a better phrase, they tag out the next person takes their place and continuing these measures.

SPEAKER_00 1:05:01

People don't realize how athletically intensive some of these life-saving um efforts can be. You know, if you've never seen it in person, you've just and I haven't either, you've just described it to me. I was shocked to hear how many just the absolute just relentlessness of these efforts until the absolute point where they're where everybody's just like.

SPEAKER_02 1:05:19

Oh, they exhaust themselves and it's an awkward position. They're on their knees, they're on the floor. I mean, uh Norr was about four foot eleven, maybe five feet tall, but she was morbidly obese, and they went right to work, and then the by then the medical team is in, they're coming in, they go right to work, and then later the EMTs show up and they go right to work until all avenues of life saving are exhausted and the the decision is made that um she's gone.

SPEAKER_00 1:05:48

And this this window of time where an individual is put into isolation before being transported to prison, especially in these mental health units, this is a big

SPEAKER_02 1:06:01

It's a very big deal.

SPEAKER_00 1:06:03

And this isn't the first time this has happened in this window, right?

SPEAKER_02 1:06:06

No. I'm I'm not even talking about mentally ill people, who who observe the the reaction will call back over as they to let the jail know, hey, Joseph Smith would really broke down in court today. Joseph Smith has received a 20-year sentence and he is taking it bad. And then a mental health person will be at admissions when they come back in from court and start processing with Joseph Smith, you know, keeping them safe, assessing for suicidal ideation, suicidal potential, and so on professionally, you know. It's a very difficult task. Uh it's obviously what happens when people get a life sentence or death sentence or something like that.

SPEAKER_00 1:06:57

It's absolutely vital that people be taken care of in the in those situations.

SPEAKER_02 1:07:01

Yeah, absolutely vital. It's a it's a statistically a high a very high time for suicidal uh attempts, a very high time for high levels of suicidal ideation, even without an attempt. It's something that has to be paid attention to. It typically is in forward-thinking uh municipalities. This particular one did have great protocols for this. In this case, um she was received by mental health on the way back from sentencing. She was processed, is what happened later that the uh the clinicians knew nothing about that she ended up taking her life. And this has affected a lot of people. Um, now even though, Davis, this was years ago that this happened. This is years ago. But I've been doing this a long time, and and a lot of people have been working in these environments a long time. And when I first started out, I think you and I have talked about this. When I first started out decades ago, things bothered me a lot. You know, I'd bring them home, I just really would chew on it and get very upset. Uh things really affected me tremendously.

SPEAKER_00 1:08:04

Yeah, I can't even imagine that. It's so it's it's impossible for me to put myself in that place. Like these you and people in your profession see horrendous things that most human beings will never see in their entire lives on a daily basis. I hope they don't.

SPEAKER_02 1:08:19

And it is difficult. And and then not just the in regard to what we're talking about, psychological autopsies, but also some of the things just in the therapeutic side, trying to provide therapeutic care for people, but also the forensic criminal work I've done. But in time, uh something probably equally bad happened to me, and that is nothing bothered me. I was like a machine. I mean, I've come in, I don't care what I'm looking at. It's like I'm walking through a grocery store just objectifying everything and doing my job. But now when this one happened and a couple others happened, and then a c there's a another crime scene that happened that really from a hostage situation that affected me, I start to notice things are starting to bother me again. So I've gone full circle.

SPEAKER_00 1:09:06

Which is maybe you could call it a good problem.

SPEAKER_02 1:09:10

Well, I think it it it is a at least I know I'm human. Mm-hmm. And secondly, it was a knowing that if things are bothering me again after all these years, I've gone full circle is what brought me to the realization that I needed to partner with you and present these podcasts because the content of these podcasts have been in my head for decades. But this realization that I've gone full circle was a signal to me that these stories need to be told, and that thankfully I met I met you and we've come together, and it was a feeling of resurfaced uh memories instead of letting it tear me down, we did this. So had I been that state of just being a machine, we would not be doing this right now, I promise you.

SPEAKER_00 1:09:56

It's a fulfilling endeavor, definitely. And I and I will say that like just for the sake of transparency, and I don't think I brought this up before, I haven't really ever been touched directly by suicide. But I was shocked at what I learned about it and how and and how nefarious it is in society. The fact that it's always it's like this this it's like water slowly rising under the floorboards. We're totally oblivious, and there's still this massive stigma around it, around suicide. You we we buy into this myth that it's always going to be obvious or that people will just ask for help if they're drowning, but they hide it. They they put on a face and we look right past them because we're just busy with our own routines. We're not bad people, we're not heartless people, we're just we're busy. We don't always know how to engage, and we always assume that this is the kind of extreme pain that's it's rare, that it only happens to strangers far away. But it's right here. It's in our jobs, it's in our neighborhoods, it's in our friend groups, but it's it's here, it's now, you know, the the beast walks among us. And uh yeah.

SPEAKER_02 1:11:09

I think you've said it once that none of us are more than two separations from suicide.

SPEAKER_00 1:11:15

Right, yeah. And and this is a this is a horrible thing to have to say. It's almost unbelievable that I don't really know anybody. And again, I probably do have uh two degrees of separation with.

SPEAKER_02 1:11:26

You know a family that probably has an experience with it that has not mentioned it or talked about it. Right. You know And why is that? Because of stigma. Stigma. It's one of the only uh ways of dying that creates shame, creates guilt, creates uh a lot of misunderstanding, a lot of feelings of abandonment. Most people don't know the statistics. I'm briefly, I mean, you know, there's generally more than twice as many suicides as homicides. Right. More people die by suicide than die by automobile accidents. Why doesn't everyone know this?

SPEAKER_00 1:11:59

Yeah, most people don't know the statistics, and most people don't consider that suicide is one of, if not the most, preventable causes of death. It is preventable. And to think that it's not is a myth. And and this is something that I also want to address. You know, it's difficult for some people to reconcile the fact that there may have been missed missed opportunities or warning signs with the fact that they lost someone. And, you know, I've mentioned this online before on our social medias, and I think it's important to address now, and I'd like to do it with you here. If you've lost someone to suicide, what we're what we're not saying is that you didn't do everything you could have to prevent that from happening. Absolutely not saying that. And it's it is a hard concept to to wrestle with that there are there are missed opportunities and there are warning signs out there. But if you've lost someone to suicide, you know, you you did everything you could. You acted with love, you acted with respect, and uh you acted with dignity, and that's not diminished at all by the fact that there are certain things that we as a society could do better to i in service of prevention.

SPEAKER_02 1:13:13

You're absolutely correct. You know, uh awareness, number one, the awareness that it is a possibility in our culture, in in all of us, that somewhat could react to the stimulus, the negative stimulus in their life in such a way that they could think that suicide would be a viable answer to that. And for most people, and you've done as many psych autopsies as I as I have, are generally receive the news of a suicide of someone they love or care about as disbelief, and that could not have happened. What we're saying here is not about someone being at fault. What we're saying here is it does happen, it can happen, and we have to be aware of that. We cannot say that, well, they're a safe driver and they don't smoke and they don't do drugs, so they're safe in the world. They smile all the time. They smile all the time. They they have a good job, or um, they're good looking, or they, you know, they you know, you would be surprised of the the the rationale that people have when they believe that suicide can never be a part of someone they care about's life.

SPEAKER_00 1:14:26

Yeah. We try really hard to to find some kind of logic to protect ourselves from the reality of it. And I think we we do the exact same thing on a much broader scale. Like looking through the comments on our on our posts online, I keep seeing this one idea pop up over and over again. People saying that suicide is just the natural endpoint of depression. Like it's this inevitable organic terminus uh of the illness. And I don't and I don't know. It just it feels like there's a massive blind spot in trying to normalize it like that.

SPEAKER_02 1:14:58

I you know, killing oneself is a callus for a litany of issues that will continue in all those that are left behind. To think that it's the organic terminus of depression is I'm gonna really confront that. Because here's why.

SPEAKER_00 1:15:15

Please it's definitely not true.

SPEAKER_02 1:15:18

It's well, listen to the word organic, meaning it's it's natural path, right? Our natural path is not suicide. Our physiological makeup dictates that we that we don't even have to consciously try to keep ourselves safe in certain situations. We have a natural system of survival that keeps us, that attempts to keep us safe. We have to defeat that to die by suicide. We have to defeat our own physiological, neurological makeup, wiring, if you will, to simplify it. We have to defeat that to die by suicide because organically we're going to try to be safe organically, right? We have a protective system within us. You know, I may have mentioned this before. You know, I was a lifeguard when I was younger. One thing they teach you you do not swim out to people who are drowning. That's your last resort. Why? Because they will drown you trying to stay alive.

SPEAKER_00 1:16:20

But you do need to throw them a lifeline.

SPEAKER_02 1:16:22

You throw them a lifeline. There's an old saying, reach, throw, row, go the equipment, and go. Go being your last resort. You reach for them, you throw them a rope, you know, you row out or some type of vessel if it's far enough out, you know, you go with equipment like a floaty or something, or you just go on your own. But going on your own is the last resort. Because we're so hardwired to stay alive that we could naturally, mistakenly take someone else's life while trying to stay alive. So I can't say that depression, the illness, not the feeling, has a organic ending, which is suicide as a possibility. Uh I have to disagree with that. Depression is an illness. The type of illness it is, it's misunderstood, but it's treatable. Right. There is a treatable way to address depression. And guess what? The treatment for it is organic because it helps people what resolve cognitive distortions, resolve negative cognitions, reframe negative cognitions, all right, resolve physiological issues, vitamin deficiencies, and and maybe hormonal deficiencies, and many other things that play into depression. Those are all organic endings or treatments for depression. Taking one's life, I have to disagree with that statement. And people may get upset with me. And listen, I respect all of your opinions on this. I'm just giving my opinion as someone who has dealt with this for decades and has witnessed the results of suicides, witnessed the results of attempted suicides on people, their families, and everyone else. Also, I can't agree for this reason. It is a myth, a well-known myth, that everyone that attempts suicide actually wants to die.

SPEAKER_00 1:18:20

Okay. And again, we've talked about this in our episode about William, our last episode. That's been proven time and again. Yes, it has.

SPEAKER_02 1:18:28

I can tell everyone, watch the documentary, The Bridge. In that documentary, there's a man, a young, young man at that they interview who jumped from the uh Golden Gate Bridge and survived. I won't tell his story. You can watch it. He's still alive, and he still tells his story. And like many people who have attempted and almost died, they realize moments into their attempt, I want to be alive. So if they had died, could we consider that an organic, natural terminus for depression? Probably not, or their brain wouldn't have clicked on and said, wait, wait, wait, save me.

SPEAKER_00 1:19:07

Yeah, and you know, the ironic thing is that if if we're so hardwired to live, then it makes no sense why we're so afraid to talk about something so preventable that is destroying human life. We'll talk about trauma and our anxiety. We'll talk about it publicly, we'll talk about it all day long, but we freeze on suicide because of that avoidance. We don't learn what a real crisis actually looks like. You know, maybe we mistake severe mental illness for a behavioral problem and we punish it instead of treating it, which is exactly what happened with Norr. So, Dana, looking back at her case, what can we actually learn from what happened to her?

SPEAKER_02 1:19:48

That's a good question. Uh you know, at the the end of a psycho autopsy, you know, you sum it up and you offer your findings, okay? In Nora's case, this was a determined act, but it was influenced by her mental illness. Her mental illness was exacerbated by the actions of a court system, a familial system, a cultural uh system, and the the mistake of of an individual in an authoritative position over her. Everyone underestimated her fear, everyone misjudged her ability to cope, everyone assumed that this is something that will pass, that she will learn a lesson from this sentence. Uh that that that's from the standpoint of the criminal justice system, from the standpoint of the family, that was understood that this was something that was in Norr's control and that she could just learn to stop acting the way she acts and straighten up in her life and and move forward. So she was let down, she was misunderstood, her presentation was one that didn't lend itself for people to listen. But what's really tragic in this case was the people who were trained to listen didn't listen. I don't blame the family. They acted upon their own instincts, their own knowledge level, their own baseline of understanding of these very odd and different presentations. But there was a whole litany of people who were trained and supposedly understood them that underestimated the impact that each of them were having on this individual, the impact of a judge, the impact of the sentencing, the impact of an officer's decision. Okay, and the result was the death of a young lady who could have been helped.

SPEAKER_00 1:21:46

And, you know, if we cultivate and nurture a better understanding of mental health topics and issues and suicide as a topic in and of itself as something that is very prevalent in our society, this societal understanding will snowball and become, it'll translate into societal pressure for these systems to put more things in place, like post-vention efforts and uh lost teams, crisis diversion units, co-responders, um, peer-run respite centers, you know, uh a broader availability of these mental health resources. And basically the spirit of what I'm saying is that societal efforts will ultimately translate into systemic, um, systemic efforts to to get better at at handling these sorts of things.

SPEAKER_02 1:22:34

Well, they will because what happens in a jail or prison is a direct reflection of the public uh sector in that vicinity. All right. So if there's a rise in in, let's say, uh jail suicides, one can needs to look at where is that jail located and look at the the number of suicides happening in the public sector where that jail is located. You see, what happens with people is suicides aren't reported like homicides. The public doesn't know about the suicides that are happening unless it's something broadcast, somebody's on a on an overpass or it's a or it's a celebrity or it's a well-known person or an athlete or something, right? So we don't know, the general public doesn't know all the suicides that are going on. So then they hear there were three suicides in in our jail the last year. That's that's incredible. What they don't know is there were probably six suicides every day in their town.

SPEAKER_00 1:23:32

In their community.

SPEAKER_02 1:23:33

And I've seen this firsthand. Uh I've been I was called in once in Volusia County, Florida, to take a look at a rash of suicides that were taking place in their jail. And I looked up the the number of suicides that were happening in their county, and they were among the highest in the entire state of Florida. And the public officials there didn't know that. I said, Well, call your coroner.

SPEAKER_00 1:23:56

So they just weren't tracking this metric at all?

SPEAKER_02 1:23:58

No, not at all. I said, Well, call the coroner and see.

SPEAKER_00 1:24:01

And this is just one municipality in thousands in the entire country.

SPEAKER_02 1:24:05

And the coroner told them, told the jail commander, sir, every every Monday when I come to work, I have 10 to 20 individuals waiting that I have to consider and examine and do to suicide.

SPEAKER_00 1:24:20

That's unbelievable. Now, when you lay out those numbers, 10 to 20 people a day, it kind of forces you to confront the actual scale of what we're talking about. And that's just one coroner. There are roughly 2,400 of these jurisdictions across the country. Now, obviously, I'm not saying every single one of those one of those coroners is dealing with 10 to 20 cases a day, but even if only a fraction of them are, the national scale of this crisis is staggering. So before we go any further, if you're listening to this and you're struggling, or if you're carrying a weight that feels too heavy to handle on your own, please don't keep it to yourself. You can call or text nine eighty eight at any time to reach the Suicide and Crisis Lifeline. It's free, completely confidential, and open twenty four seven, so please make that call. So we began this episode telling Nora's story. She was nineteen, dealing with PTSD and schizoaffective disorder, and carrying a heavy weight of depression. She never actually made it to state prison because she took her own life in a solitary cell. Putting someone in acute psychiatric distress in complete isolation is a direct violation of protocol, and yet the system did it to her anyway. Now, our goal with this podcast is simply to talk about these heavy, highly stigmatized topics openly and honestly, without the sensationalism. And doing this alongside you, Dana, bringing your 25 years on the front lines of forensic psychology to the table, is how we try to translate these tragedies into actual systemic prevention. I also want to thank everyone who's been listening and supporting the show, especially over on TikTok. I've been very surprised by the engagement we've we've been getting there. And we've been reading the comments and seeing the way you're all interacting with each other, offering support, sharing your own experiences, and talking to one another with real empathy means the world to us. You are building the exact kind of community we hope to create here. So thanks for being here, for caring, and for pulling back these layers with us. Dana, is there anything else I'm forgetting or that we need to talk about before we wrap up for today?

SPEAKER_02 1:26:23

I just want to thank you, Davis, for for sharing that with us. And I am honored that anyone would take the time to share their experience and comment on this effort we're making. It is important, but everyone please remember you're a part of this too. And as Davis said, we all have the power to intercede, intervene, and just be there for somebody.

SPEAKER_00 1:26:47

Absolutely. Now, if you want to help us keep the conversation going between episodes, you can find us on TikTok and Instagram at Anatomy of an End, or listen directly on YouTube at Anatomy of an End Pod. If you believe in the work Dana and I are doing here, the best way to support us is to hit follow or subscribe on whatever app you're listening on right now, and leave us a quick rating or review. Takes five seconds, but it genuinely helps other people find the show. That's it for today. Stay present, stay engaged, stay alive, take care of yourselves and each other, and we'll see you next time.

SPEAKER_02 1:27:18

Thank you.