Mental illness, criminal past made man an outcast

November 19, 2016

PITTSBURGH (AP) — James Michael Marasco was treated to a shopping spree last month, a week before he died.

Deodorant. A hair brush. New socks. Jessica Wolfe paid the cashier at the Munhall RiteAid, five blocks from Marasco’s residence. He seemed thankful. She finally felt a real connection, after 19 months of service as his court-appointed guardian.

Ever since his 1995 guilty plea to indecent assault and corruption of a minor, Marasco had lived as a pariah, according to his few acquaintances and many court records. Diagnosed with bipolar disorder and schizoaffective disorder, he bumbled for two decades from mental hospitals to homeless shelters, from jail cells to the streets.

Finally, at age 48, he had warmed up to the idea of sleeping under the same roof most nights. Unfortunately, the occasion for the RiteAid splurge was his impending return to the Allegheny County Jail. He faced a 10-day sentence for loitering at a bus stop.

“James kept saying, ‘I don’t understand why I have to go,’ ” said Wolfe.

He had to go to a lockup in which, officials have said, around 57 percent of the inmates have mental health problems — a figure in line with jails nationally. Some of those inmates, like Marasco, ricochet endlessly between communities and institutions, costing the public tens of thousands of dollars a year.

“It’s not like (sending someone) to jail is free,” said Edward P. Mulvey, a University of Pittsburgh psychiatry professor who studies mental illness and violence. “Mental hospitals are expensive,” he added, and a few psychiatric flare-ups, petty crimes and probation violations can “run up a very high bill” for the public. There are alternatives, like intensive “service teams,” he said, but such programs don’t always reach those who need them.

Sick and shunned, Marasco lived poorly, but cost society a fortune. Not long after one judge finally broke his spiral of isolation and instability, another sent him to serve his final sentence.

Road to the cleft

Marasco came of age in McKees Rocks, and upon reaching adulthood promptly entered the probation system. He and a few other guys had burgled some jewelry, a VCR and cassettes, a camera, 15 bottles of whiskey and $20 in pennies.

Four years later he married, but he quickly blew that. His wife accused him of punching her and knocking her down. She divorced him after he was accused of touching the genitals of a 3-year-old.

Marasco’s guilty plea to that sex crime in 1995 warranted probation and counseling, according to a judge. The passage later that year of Megan’s Law required him to register his whereabouts with police. He was ordered into a program to address sexual aggression, and later got treatment at mental health clinics and at Mayview State Hospital. When he was out, police in McKees Rocks and neighboring areas periodically arrested him for misdemeanors, most often disorderly conduct, usually resulting in fines.

He tried to stay presentable, said Rev. Regis Ryan, director of the Sto-Rox Neighborhood Family Health Center. “He always impressed me as just being in better shape than most folks with mental health problems as far as managing his own life.”

In 2006, the county’s Justice Related Services unit referred Marasco to Cleft of the Rock Ministries, a boarding house and church in Munhall that specializes in convicted men, including sex offenders with mental health diagnoses. The place is named for a passage in Exodus in which God pledges to place Moses in “a cleft of the rock” and shield the prophet from a deadly glimpse of the face of his deity.

“To me, he just needed someone to care and love him,” said Rev. Terry Moseley, who with her husband runs the ministry, “and that’s what I did.”

Little income, high cost

For the next decade, Marasco clambered in and out of the Cleft of the Rock, where room and board ate up most of his Social Security Income check. Sometimes, according to Wolfe, he would opt instead to spend his benefits — $763 a month — on cigarettes, alcohol, drugs and trips to the movie theater.

When the money ran out, he’d sleep on the streets or in homeless shelters, check into Western Psychiatric Institute and Clinic or other hospitals, or wind up in jail, where he spent 1,517 days over 28 years. At one point in 2009 and 2010, after he shouted profanities and threats at a motorist and his 8-year-old daughter, Marasco spent nine months confined, partly in the jail, partly at Torrance State Hospital for the mentally ill.

There’s little doubt that the cost to the public of housing and treating Marasco reached six figures some years. The jail’s budget amounts to $77 per inmate per day. An average inpatient day in a psychiatric hospital costs $590, according to the Pennsylvania Health Care Cost Containment Council. The state spends $839 per day per patient on Torrance’s forensic wards. Spend two months in each, and the costs reach $90,000.

There may be a cheaper way. The county funds community treatment teams, which give weekly attention and intensive help to people with severe mental illness, at a cost of around $21,000 per client per year. Marasco, though, didn’t have a team.

Community treatment teams can save public money, when they are directed toward people who would otherwise spend much of their time in jails and hospitals, said Mulvey, who outlined his research at an October symposium at Duquesne University’s Cyril H. Wecht Institute of Forensic Science and Law.

Sometimes, though, the rosters of such programs are filled too quickly, he said. “The hardest cases end up being ignored, a lot of time.” Why? “They’re a pain in the neck. You don’t see a lot of success with them,” so agencies focus on easier clients.

Marasco’s life only got tougher. In 2014, congestive heart failure and psychiatric problems put him in hospitals 30 times, according to court filings. At UPMC Presbyterian, he punched a hospital employee. Transferred to Western Psych, he repeatedly told doctors, “I need to go back to the bank and pay the magistrate.” (He had been making payments on his fines, from $5 to $55 at a time.)

Marasco belonged in a personal care home or skilled nursing home, doctors wrote — but staff couldn’t find one that would take him. Meanwhile police charged him with a felony for failing to report address changes as required by Megan’s Law.

UPMC asked Allegheny County Orphans’ Court to name a guardian to take control of his affairs. Judge John A. Zottola agreed, and appointed Wolfe.

Settling in

“James was not a cuddly person,” said Wolfe. “He is that person that people shy away from and don’t talk to, because his behavior was kind of bizarre, his speech was kind of nonsensical.”

Wolfe, by contrast, had a master’s of social work and a background in politics, which blossomed this year into an unsuccessful run for the state House. In February 2015, Judge Zottola gave her the job of managing Marasco’s finances, for which she would be paid $100 a month, deducted from his SSI benefit.

Marasco hadn’t really tried to improve his lot, said Wolfe. She forgave him for that.

“When you’re an outcast,” she said, “what incentive do you have to not be that person? If you can never climb out of the shadow of your past, no matter what you do, why would you even try.”

She secured his room and board at the Cleft of the Rock, for $550 a month. That left him just $113 per month to spend on hygiene, his fines and the occasional movie. Marasco hated that, but it curtailed his roaming. He seemed to settle in.

“He’d always walk around town and say hello,” said Homestead police Chief Jeffrey DeSimone. Though Marasco was sometimes in the company of troublemakers, said the chief, “I personally don’t recall having issues with him.”

Wolfe said that he began to show a wry side. “He started referring to me as the sister he never wanted.”

Jail, then Vegas?

On a Sunday in July, a Homestead police officer observed Marasco “loitering at (a) bus stop for two hours” until around 6:20 a.m., according to the citation for summary disorderly conduct, which characterized that as an “ongoing problem.”

“On any given morning, you will find on 8th (Avenue) and Ann (Street), at least three, maybe four people that are suffering from mental illness,” said Chief DeSimone. Some of them, he said, hang out there after the Cleft of the Rock’s managers shoo them away for the day, or lock the doors for the night.

Rev. Moseley said that her boarders draw police attention no matter where and when they hang out. “The guys in our program, (police) always peg them, because they have some criminal background.”

The loitering citation resulted in an August hearing before District Judge Thomas R. Torkowsky. Marasco pleaded guilty to disorderly conduct, and the judge sentenced him to fines and court costs of $454.50, plus 10 days in jail, to start Oct. 5.

“It is a rare occasion that I give any jail time on a summary offense, and if I do, it’s usually appealed,” said Judge Torkowsky. But police told him that Marasco “had about five or six warnings.” He noted that kids often use that bus stop.

The fine exceeded Marasco’s entire disposable income for four months. “He had pretty much gotten level with the previous fines, and he felt like he had some breathing room at that point,” said Ms. Wolfe. “And he was really dismayed about getting this additional fine.”

The jail term, too, weighed on him.

“A week before (his sentence started), he and I were leaving out the church, and he said, ‘Pastor Terry, I need to make sure I’m ready to go up,’ ” said Rev. Moseley. “He accepted God and asked God to forgive him for anything he’d done.”

It’s not that he expected to die, she said. “I know he had plans on coming back. I know because he said he and I would go to Vegas. He was joking, of course.”

A few days before his jail date, on the day of the RiteAid spree, Marasco was “huffing and puffing” about not wanting to go to jail, Wolfe said. She and a case manager from Western Psych urged him not to go on the lam. “It will only escalate and become more of a problem, if you don’t take care of it,” she said.

Cradle to grave

Judge Torkowsky was surprised when Marasco came to his office Oct. 5, ready for jail. He wondered: Why didn’t he file an appeal?

“His appeal time was over. But he could still go down and file a late appeal,” said the judge, adding that he told the defendant about that option. “He said, ‘No, I’d just like to do my jail time.’ ”

The judge said he didn’t realize that Marasco was mentally ill.

At jail intake, Marasco told medical staff about his bipolar disorder, heart problems and diabetes, and listed his medications. Later in his stay, Marasco underwent urgent “stat” lab tests. Hours later, on Oct. 10, staff reviewed the results and went to Marasco’s cell. He was dead.

The cause and manner of death have not yet been determined, pending toxicology results.

Rev. Moseley “called me screaming, crying,” said Wolfe. “She said, ‘James is dead! James is dead!’ ”

“It surprised all of us,” said Rev. Moseley. “It was kind of hard to believe that he died.”

Marasco’s death spurred one change. On Oct. 24, the jail’s health administrator posted a new policy: “Effective immediately: Inmates who have been ordered a stat lab need to be monitored in the infirmary till (sic) the results arrive.”

Wolfe had envisioned a 10-year process, at the end of which Marasco would be stable for the long haul. Suddenly, it was over.

“That he died in that manner, in jail, just made me really, really sad,” she said. “I just felt like the whole situation, cradle to grave, just seemed so sad.”





Information from: Pittsburgh Post-Gazette, http://www.post-gazette.com