Dead man's family: Prison opted for cheaper drugs

Cindy Jones buried her son this week, still uncertain about how he died after wandering into a wooded area a few streets away from home — and questioning whether the state gave him the help he needed.

Jessie Russell Arlo Parish's body was found at about 9:30 a.m. May 19 when a vegetable gardener discovered it among some brush in southern Des Moines.

For much of his life, Parish had battled with paranoid schizophrenia, anxiety and drug dependence that landed him in treatment and, more recently, prison.

Jones and family members contend that Parish, 32, had been getting better under a medication that was part of his court-ordered treatment. But then Parish was sent to prison, where officials apparently swapped out his medication for a cheaper — and, his family believes, less effective — equivalent.

On May 5, Parish was released from prison in a much worse state than he went in, his family said. And two weeks later, he was dead.

"The voices in his head … It's like the devil preying on him," Jones said of Parish. "What it really boils down to is, people with mental illness, they need help, not prison."

During episodes, walking toward water

A day after his death, his friends and family sat among boxes filled with his belongings, including poetry neatly written on notebook paper and stashed away among folders of medical and incarceration records that detailed his ongoing struggles.

Parish had an affinity for words, scribbling pages of rap lyrics and short stories in neat cursive.

"Until the date on my grave is scratched and engraved in, I'm droppin' flows and they're just unstoppable. It's astronomical. It'll make your ears pop," Parish wrote in his journal.

His trouble with drugs dated back to 1997, when at 14, he received probation in juvenile court for possession of a controlled substance and was released to his mother's custody.

Charges mounted over the years. He had an arrest for possession of methamphetamine and marijuana with intent to deliver in March of 2004, exacerbated by a parole violation, and arrests for consumption or intoxication and fifth-degree theft in 2008 and 2010.

Josh Vogel, Parish's childhood friend, said his best friend changed "seemingly overnight" about 10 years ago. Parish had called his house crying, asking to be picked up after he'd wandered.

"He'd walk off once the voices started. But when he does, he usually is drawn toward water," Vogel said.

When Vogel lived in Des Moines' Beaverdale neighborhood, Parish would often leave and wander toward Witmer Park's pond, he said.

Yeader Creek runs near the patch of land where Parish's body was found May 19, but it's still unclear what caused his death. His death certificate has not been issued, and toxicology reports are pending.

Jones said she's certain he took over-the-counter and prescription medication before he disappeared May 15.

She reported him missing to Des Moines police at 8:52 p.m. May 17, police records show.

Hearing voices before TV station incident

Jones said Parish would use drugs to self-medicate when his prescriptions failed to stave off the voices in his head.

On Oct. 13, 2010, his mental illness escalated.

He was watching a KCCI-TV broadcast that evening and believed the newscaster was talking directly to him, taunting him and telling his life story, his family said.

"He called it seeing ghosts," Vogel said. "He said people on the news were talking (bad) to him, directly."

Minutes after the 10 p.m. news segment, Parish showed up at the station at 888 Ninth St. in Des Moines and began throwing rocks at the windows and vehicles parked outside, according to the police report. He shattered two front windows and two vehicle windows, court records show.

Then he entered one car, took papers out of the glove box and threw them around the parking lot.

KCCI employees called police, thinking someone was shooting a gun at their building.

Parish was taken into custody and later pleaded guilty of second-degree criminal mischief and two counts of third-degree criminal mischief.

"I've been on drugs all of my adult life, and I'm tired of it and I am ready for a change," Parish wrote to District Judge Glen Pille in a May 17, 2011, letter, asking for a reduced sentence and in-jail substance abuse treatment, instead of prison time.

He got five years' probation and paid more than $3,000 in restitution to KCCI for the broken windows, plus $1,750 in fines.

Medication prompts controversy

As part of the sentence, the judge ordered Parish to comply with all requirements from Eyerly Ball Community Mental Health Center in Des Moines, court records show. That included taking all required medications and meeting with health care providers.

Jones said Eyerly Ball's Golden Circle Behavioral Health Clinic prescribed a drug that seemed to work where others failed, an injection called Invega, in March 2011. According to the medication's website, it's a once-monthly injection that treats schizophrenia.

But it's expensive — almost $2,000 per shot, according to estimates on GoodRX.com. Jones said Golden Circle helped find funding to pay for the shot.

Still, Parish slipped back into methamphetamine use, and court records show he violated parole three times. He was in and out of several institutions before finally being sent to the Newton Correctional Facility.

Once there, Parish's family believes prison doctors substituted a cheaper schizophrenia medication than Eyerly Ball prescribed.

"He was court-ordered to stay on the Invega shot. The state never once gave him that Invega shot," Jones said. "They just want to throw him in prison and put him on the cheapest drug that's out there."

According to an offender exit-status document from the Iowa Department of Corrections Health Services dated May 2, 2015, Parish was issued a prescription for fluphenazine, an anti-psychotic, and hydroxyzine, which treats anxiety disorders, when he left Newton's correctional facility.

Fluphenazine is about $10 for a bottle of 30 5-milligram pills, according to GoodRX.com. Hydroxyzine costs around $14 per bottle for the liquid form of the drug.

Invega "was the only thing that worked for him," Vogel said.

Professor weighs in on prescription debate

Joseph McEvoy, a professor at Georgia Regents University Department of Psychiatry and Health Behavior, co-authored a 2014 study that found that newer drugs such as Invega work no better than cheaper, older drugs such as fluephenazine or haloperidol.

"The therapeutic benefits were absolutely equal," save a few differences in side effects, McEvoy said.

Typically, schizophrenia symptoms get worse when patients are off their meds or skip dosages, McEvoy said. Those who struggle with that problem often are prescribed long-acting injections in the first place.

A clinical summary from Eyerly Ball obtained by The Des Moines Register shows Parish had a prescription for haloperidol pills just four days before he went missing.

Eyerly Ball officials told the Register they couldn't release medical information on a patient, alive or dead, including information on prescriptions.

Fred Scaletta, a spokesman for the corrections department, echoed Eyerly Ball, saying that HIPAA, a federal law dictating health privacy, prevents the prison from giving out personal medical information to the public, even if that person is deceased.

"We can confirm medications are given, a 30-day supply, once they leave," Scaletta said.

Scaletta said Iowa prisons allow inmates to continue taking their prescription until it runs out. Prison doctors then select the same or a similar drug from a list of medications called the Department of Corrections Mental Health Formulary.

"As a government agency we have to go through the process of making sure we get the best product at a decent cost to the taxpayer as possible," Scaletta said. "I can assure you we're not going to ignore somebody's medical needs. We'll address them the way they need to be addressed."

But Jones remains skeptical, in part because she said she was informed only after her son's death that he tried to commit suicide while in prison.

"I'm just glad he's finally done fighting this battle in his head," Jones said. "He can finally be at peace."