Sarah Stillman, a Yale University journalism professor and staff writer at The New Yorker, wrote one of the best health care stories of 2025.
In a year filled with heart-wrenching articles, her piece, “Starved in Jail,” was one of the saddest — in part because she asked a chilling question that remains unanswered: Why are incarcerated people dying of neglect, primarily from a lack of food or water, while, at the same time, private companies are paid millions for their care?
For journalists, this story is worth pursuing in all of the nation’s more than 3,100 county jails. As a professor of investigative journalism and founder of Yale’s Investigative Reporting Lab, Stillman asked some of her students to assist in her reporting, she told me.
You will find details that Stillman collected and that she and her students compiled for a website that explains the facts behind each of 30 former prisoners she reported on who died in jail of dehydration, starvation or neglect. The site includes drawings of each victim, their story, name, age, county, cause of death and the private company that monitored their care.
As a journalist and a 2016 MacArthur Foundation fellow, Stillman focuses on social inequality. She won the 2024 Pulitzer Prize for explanatory reporting for an article The New Yorker published in 2023. In that article, “Sentenced to Life for an Accident Miles Away,” she addressed the inequities stemming from felony murder charges. That charge results in thousands of defendants — mostly young and Black — being sentenced to prison, the Pulitzer judges wrote.
‘Sites of domestic lawlessness: American county jails’
Social inequality is pervasive in county jails where a disproportionate number of inmates are unable to pay the cash bail that courts impose, the American Bar Association explained. Many of the more than two dozen inmates Stillman named in “Starved in Jail” would be alive if they or a family member had paid their cash bail, she wrote.
At about 11,000 words, “Starved in Jail” explains the criminalization of mental illness and how county jails pay outside companies to watch inmates by video for a flat fee: a capitated rate for remote monitoring.
In more than a year of reporting, Stillman found it challenging to explain what she was learning about how county jails observe prisoners’ conditions, she wrote.
“It’s probably one of the hardest things I’ve ever done and [it was the] most kind of heartbreaking,” she said. “But this article really took me to a new level of heartbreak because of the neglect people faced and how unnecessary it was.”
In the article, she explained why.
“I was reporting on places where starvation and dehydration deaths had unfolded across a span of weeks or months — but these were not overseas famine zones or traditional theatres of war,” she wrote. “Instead, they were sites of domestic lawlessness: American county jails.”
Mental illness leads to a mother’s death
“Starved in Jail” begins with an anecdote about Carlin Casey, the son of Mary Faith Casey, who died at home after prolonged starvation in Arizona’s Pima County Jail. “We know that Mary is one of many,” Mary’s sister, Michelle, told Stillman.
After she met Carlin Casey and his sister Karina, Stillman scrutinized more than 50 cases of people who died of starvation, dehydration or related medical crises, she wrote.
In some cases, hundreds of hours of abusive neglect were captured on video, relevant portions of which I reviewed. One lawyer, before sharing a confidential jail-death video, warned me, ‘It will stain your brain.’ It did.
‘Starved in Jail’ by Sarah Stillman
The cases Stillman investigated included a mix of seniors, teens, parents and military veterans, she wrote.
“In nearly all the cases I reviewed, the individuals were locked up pretrial, often on questionable charges,” she added. “Many were being held in jail because they could not afford bail, or because their mental state made it hard for them to call family to express their need for it. (These jail deaths would not have occurred, several lawyers pointed out to me, in the absence of the cash-bail system.)”
Those who died of starvation often were held in solitary confinement or other forms of isolation, both of which deepen psychosis, she wrote. “Some were given no toilet and no functioning faucet, or were expected to sleep on mats on concrete floors, in rooms where the lights never turned off,” she added.
Many prisoners who suffered these deaths had family members who would have helped if they knew of their loved one’s condition, she wrote.
“That was one of the big surprises for me,” she said. “Many of the prisoners actually had a very supportive care network around them, including family members who loved them and who would have mobilized on their behalf. In many cases, the family members tried to help their parent or child or loved one but sometimes that led to that person being incarcerated and facing this type of death. That was another layer that was troubling and haunting to me.”
Avenues for reporters
For journalists seeking to report on how county jails monitor prisoners’ conditions, Stillman’s team asked jail officials for the names and other details on all prisoners who died in the previous months or years. When prisons submitted these lists, journalists could then inquire about any deaths that might have resulted from neglect.
Other sources include the legal firms that represent families in cases that result in wrongful death suits, such as Budge and Heipt in Seattle and Dan Smolen of Smolen & Roytman in Tulsa, Okla., Stillman said.
“Local jails, as the holding pens for people whom our society would seem to want to disappear, tend to be governed by a simple philosophy: ‘Let’s spend as little as we can,’” Stillman wrote. “But the severe medical and mental-health needs of the jailed population make this a daunting task. Jail deaths, too, pose a steep cost; they often lead to litigation.”
Since the 1970s, the high cost of incarcerating hundreds of prisoners and the need to avoid costly lawsuits led counties to hire private companies, such as NaphCare, a firm in Alabama that provides medical and mental-health care at a capped cost, Stillman explained. Any additional funds spent on care come from the company’s earnings, she added.
“The companies often try to control their costs by understaffing,” Stillman wrote, citing Carlin Casey’s partner, Eric, a former paralegal, as her source.
Other companies that monitor inmates in county jails are listed on the Starved for Care site at Yale’s Investigative Reporting Lab. Another resource is the four-part series that Reuters published in 2020 examining jail-death data.
Resources
- “He died in a jail cell, pleading for help. No one told his father why,” Christopher Damien, USA TODAY
- “Why Are People With Mental Illness Starving to Death in Jail?,” Ryan Levi and Dan Gorenstein, Tradeoffs podcast“
- Mentally ill and starving to death in American jails,” Josh McGhee, Mindsite News
- “A woman died of hunger and thirst in Tarrant County Jail custody. Her daughter seeks answers,” Miranda Suarez, Fort Worth Report and KERA
- “Why people with mental health issues have ‘Starved in Jail.’ A journalist investigates,” Dave Davis, NPR
- “Starved for Care,” Investigative Reporting Lab, Yale University
- “Indiana Jail Let Man With Schizophrenia Starve to Death in Solitary, Lawsuit Alleges,” Tana Ganeva, The Appeal
- The Hidden Crisis in American’s Jails: Dying Inside, a Reuters investigation, Peter Eisler, Brad Heath, Ned Parker, Grant Smith, Linda So, Jason Szep
