NOT RECOMMENDED FOR PUBLICATION File Name: 25a0030n.06
Case No. 24-1536
UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT FILED Jan 23, 2025 KELLY L. STEPHENS, Clerk ) KATHERINE CRADDOCK, et al. ) ON APPEAL FROM THE Plaintiffs - Appellants, ) UNITED STATES DISTRICT ) COURT FOR THE EASTERN v. ) DISTRICT OF MICHIGAN ) WELLPATH, LLC, et al., ) Defendants - Appellees. ) OPINION )
BEFORE: McKEAGUE, GRIFFIN, and LARSEN, Circuit Judges.
McKEAGUE, Circuit Judge. Stephen P. Long died by suicide in his jail cell. His estate
brought a 42 U.S.C § 1983 action against Macomb County and Wellpath, LLC alleging that
defendants violated Long’s Eighth and Fourteenth Amendment rights by failing to thwart his
suicide. The district court granted summary judgment in favor of the defendants. Because County
officials did not violate Long’s constitutional rights, we AFFIRM.
I.
In October 2019, Steven P. Long died by suicide after hanging himself in his jail cell. This
put an end to what was a very unfortunate stretch of his life that began in 2004, when he suffered
third and fourth degree burns in a workplace accident. The accident put Long into a coma for a
month, and although Long’s physical injuries healed, he was never truly whole again. Long had No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
always suffered from anxiety, depression, and substance abuse, but after the incident, he was
diagnosed with post-traumatic stress disorder as well.
The accident worsened Long’s substance abuse and caused him to have several run-ins
with the law. In 2016, he was convicted of larceny from a building and concealing stolen property.
Because of subsequent probation violations, Long was incarcerated at Macomb County Jail eleven
times between 2016 and 2019.
Long also had a history of suicide attempts. In 2015 and 2016, he attempted suicide several
times by overdosing on heroin and opiates. Long also attempted suicide by choking himself in
2017 and by overdosing in 2018. In fact, Macomb County Jail officials deemed him a high risk of
suicide and placed him on suicide watch during one of his incarcerations in 2017.
In October 2019, Long ended up in Macomb County Jail for another probation violation.
Long tragically committed suicide four days into his incarceration. When Long arrived at the jail,
the arresting officer declared that Long did not “verbalize[] thoughts of suicide.” Jail Detention
Card, R. 39-2 PageID 619. During booking, a Macomb County deputy screened Long and issued
a suicide risk questionnaire. As part of the questionnaire, Long denied contemplating suicide,
experiencing suicidal thoughts over the past three months, or having a psychiatric hospitalization
in the previous month.
Macomb County has a contract with Wellpath to provide healthcare for its jail inmates.
Pursuant to the contract, a Wellpath staff member separately screened Long and conducted another
suicide risk assessment. Again, Long did not express any thoughts about killing himself. Notably,
he also denied attempting suicide in the past. The staff member assessed that Long did not appear
“overly anxious, afraid or angry” and did not show any “signs of depression.” Wellpath Screening,
R. 39-4 PageID 625. The staff member also observed that Long did not show any “feelings of
2 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
helplessness and hopelessness” and overall presented an “[a]ppropriate” mood. Id. at PageID 626–
27. His mental health status was marked as “[r]outine [p]roblems.” Id. at PageID 627. Based on
this evaluation, the staff member did not place Long on suicide watch.
But Long did admit that he had a psychiatric history to the staff member. He stated that he
would “snort” nonprescribed Xanax and heroin and that he suffered from withdrawal when he
stopped using the drugs. Id. at PageID 624. He also admitted to past use of “psychotropic meds,”
psychiatric hospitalization, and outpatient mental health treatment. Id. at PageID 626.
Accordingly, the staff member recommended that a mental health professional evaluate Long. He
also referred Long to a withdrawal protocol and recommended that he be put in a “Medical Detox
unit.” Id. at PageID 627. Under the protocol, Long would take detox medication to help with his
anxiety and withdrawal, and Wellpath staff would assess Long every eight hours for the first five
days of his incarceration. Unfortunately, Long was never evaluated by a mental health
professional. Neither was he placed in a detoxification unit, which is constructed with glass panels
and can be observed from the control tower. Macomb County Jail only had two such units, which
are typically reserved for inmates inebriated to the point that they are unable to take care of
themselves. Hence, Long was assigned the bottom bunk of a first-floor general population cell
which officials could easily reach without having to use the stairs. Once in the cell, officials
observed Long on an hourly basis.
Long had a tumultuous time in jail before his suicide. He struggled with the fact that he
was in jail and appeared “anxious [and] nervous.” Paszek Dep., R. 42-19 PageID 1974. He
admitted as much during a phone conversation with plaintiff and fiancée Katherine Craddock when
he proclaimed that his “life is over” and “it’s the end for him” because he was likely to be sentenced
to 25 years. Craddock Dep., R. 40-5 PageID 1013. Sensing Long’s despondency, Craddock
3 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
inquired whether she should call jail staff and ask them to put him on suicide watch, to which Long
assured her that he was fine, and he was not going to hurt himself. He stated he would never do
something like that to his kids, his parents, or Craddock.
Fellow inmate Andrew Bush overheard this telephone conversation. Bush spoke with Long
afterwards, and Long asked whether Bush could “get [Long] enough drugs within the housing unit
to kill himself.” Death Investigation Report, R. 42-20 PageID 2029. Bush did not think Long was
serious about this statement and did not report his conversation to jail staff because he felt that he
“sufficiently talked [Long] down.” Id. Long had a similar conversation with his cellmate John
Paszek and fellow inmate Jordon where he mentioned that even though he did not want to kill
himself, he would be “okay with it” if he died from drug overdose. Paszek Dep., R. 42-19 PageID
1968. But Long never expressly mentioned that he wanted to harm himself or others. And the
record does not indicate that either inmate reported these conversations to jail officials or Wellpath
staff.
Long also suffered from withdrawal. Paszek claimed that Long would vomit on occasion,
and complained of chest pains, and heartburn. Paszek also stated that Long would hoard his detox
medication and snort coffee grounds in an attempt to get high. Consequently, staff had to seize his
detox medication. Furthermore, the night before his suicide, Long banged on his cell door asking
for medical help for heartburn and chest pains. During that episode he also yelled out to his “friend”
Jordon and said, “I got to get out of here” and “I don’t want to be here.” Paszek Dep., R. 42-19
PageID 1977. Long was eventually treated for heartburn that night.
On the night Long committed suicide, Ronald Lowery, who was serving weekends in jail
for violating probation, was assigned to Long’s cell. At one point, Long asked Lowery whether he
knew how to make a noose, to which Lowery replied he did not. Lowery was on the top bunk and
4 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
did not notice or hear Long tearing up the blanket that Long used to make a noose. Although
Lowery thought Long appeared sad, he did not think he was going to commit suicide and did not
alert jail staff. Shortly before lockdown, Lowery stepped out of the cell into the common area
because Long had to use the bathroom. Long covered the cell window with paper, which was
normal practice among inmates to ensure privacy. Lowery eventually walked back to his cell but
could not get in. When deputies noticed Lowery outside of his cell after lockdown, they opened
the cell door. Once they opened the door, Long fell to the ground and “a torn piece of a blue jail
issued blanket [was] tied tightly in a knot around his neck.” Death Investigation Report, R. 42-20
PageID 2025. Long was later pronounced dead.
Long’s estate brought an action under 42 U.S.C. § 1983 in Macomb County Circuit Court,
alleging that Macomb County and Wellpath violated Long’s Eighth and Fourteenth Amendment
rights through deliberate indifference. They argued that the County’s unlawful custom, policy, and
failure to train its employees caused the violation of Long’s rights. In addition, they claimed that
an unknown Sheriff’s deputy employed by Macomb County was liable for wrongful death under
Michigan law. Wellpath moved to remove the case to the United States District Court for the
Eastern District of Michigan.
The district court dismissed the Sheriff’s deputy from the lawsuit because Long’s estate
could not identify the deputy. The court also dismissed all Eighth Amendment claims because
Long was a pretrial detainee, so the complaint’s allegations only implicated the Fourteenth
Amendment. Finally, the court granted defendants summary judgment on the remaining claims.
The court held that Long’s estate was not able to satisfy the objective component of deliberate
indifference, and therefore, was unable to show that the defendants violated Long’s Fourteenth
Amendment rights. The court went on to explain that even if there was a violation of Long’s rights,
5 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
the County’s policy, or its failure to train its employees, did not cause the violation. This appeal
followed.
II.
We review the district court’s grant of summary judgment de novo and may affirm on any
basis supported by the record. Campbell v. Riahi, 109 F.4th 854, 860 (6th Cir. 2024). To hold a
municipality liable under § 1983, plaintiffs must establish that one of its customs or policies caused
the underlying constitutional violation. Monell v. Dep’t of Soc. Servs., 436 U.S. 658, 690 (1978);
Street v. Corr. Corp. of Am., 102 F.3d 810, 818 (6th Cir. 1996). A municipal liability claim fails
if there is no such violation. See Phillips v. Tangilag, 14 F.4th 524, 537 (6th Cir. 2021).
Accordingly, we first assess whether defendants violated Long’s Fourteenth Amendment rights.
III.
The Due Process Clause of the Fourteenth Amendment requires jail officials to “take
reasonable measures ‘to protect pretrial detainees from harm.’” Campbell, 109 F.4th at 860
(quoting Lawler v. Hardeman Cnty., 93 F.4th 919, 926 (6th Cir. 2024)). When officials fail to do
so, plaintiffs may bring a “deliberate indifference” claim, which traditionally consists of both
objective and subjective elements. See id. We need not analyze the objective prong here because
Long cannot satisfy the subjective element of deliberate indifference. See Downard ex rel.
Downard v. Martin, 968 F.3d 594, 600 (6th Cir. 2020).
In the past, plaintiffs satisfied the subjective element if they showed that a defendant
“subjectively perceived facts from which to infer substantial risk to the prisoner, that he did in fact
draw the inference, and that he then disregarded that risk,” Comstock v. McCrary, 273 F.3d 693,
703 (6th Cir. 2001). In the context of jail suicides, plaintiffs could show an official’s subjective
knowledge through facts that made it “obvious” that there was a “strong likelihood” that a detainee
6 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
would commit suicide. Downard, 968 F.3d at 600; Gray v. City of Detroit, 399 F.3d 612, 616 (6th
Cir. 2005).
But we have since modified the subjective inquiry for Fourteenth Amendment deliberate
indifference. See Helphenstine v. Lewis Cnty., 60 F.4th 305, 316–17 (6th Cir. 2023) (explaining
the divergence in the Fourteenth and Eighth Amendment deliberate indifference analysis
articulated in Brawner v. Scott Cnty., 14 F.4th 585 (6th Cir. 2021) in response to Kingsley v.
Hendrickson, 576 U.S. 389 (2015)). These modifications have lowered “the subjective component
from actual knowledge to recklessness.” Id. at 316. As a result, officials “can face liability even if
they did not actually know of a risk of harm to a pretrial detainee.” Lawler, 93 F.4th at 927. Instead,
a detainee “need only prove that the officers recklessly disregarded a risk so obvious that they
either knew or should have known of it.” Id. Notwithstanding this change, a plaintiff must still
advance facts that make it “obvious” that there was a “strong likelihood” that a detainee would
commit suicide. See Batton v. Sandusky Cnty., No. 23-3168, 2024 WL 1480522, at *3 n.1 (6th Cir.
April 5, 2024).
As tragic as Long’s death is, we find no such facts here. Long’s express denials of suicidal
ideation undermine the contention that his risk of suicide was obvious. See Downard, 968 F.3d at
601; Nallani v. Wayne Cnty., 665 F. App’x 498, 507–08 (6th Cir. 2016)). In Downard, we held
that a detainee’s consistent denial of having thoughts of suicide, feelings of hopelessness, or a
history of psychiatric issues across several screenings cut against a finding that there was a strong
likelihood that he would commit suicide. 968 F.3d at 601. In fact, express denials can be such
strong evidence that in Nallani, we held that there was not a strong likelihood that the inmate
would commit suicide even after the inmate informed the officer that he was suicidal during his
arrest, had harmed himself as a child, and failed to take prescribed anti-depressant for “months”
7 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
because, among other evidence, the inmate denied feeling suicidal during intake. 665 F. App’x at
507–08.
From the time he was booked in Macomb County Jail until an hour before he committed
suicide, Long consistently denied having suicidal intentions. Long did not mention any thoughts
of suicide to his arresting officer. Long denied contemplating suicide during both the Wellpath and
Macomb County intake screenings and he was not placed on suicide watch. Once he was in jail,
Long denied having any thoughts of self-harm every time Wellpath staff screened him for
withdrawals—a total of twenty times (twice during each screening). The last denial came less than
an hour before he committed suicide.
Long’s denials were not limited to officials and staff. He even denied having such thoughts
during conversations with others. When Craddock asked if Long should be placed on suicide
watch, Long assured her that he would not harm himself. Although Long told his fellow detainees
that he would be “okay with it” if he died from drug overdose, he qualified this statement by stating
that he did not want to kill himself. Critically, after these conversations, no one alerted jail officials
or Wellpath staff that they believed Long would harm himself. Even Long’s inquiry of Lowery on
tying a noose was never communicated to jail officials or Wellpath staff, undermining any
contention that this statement made it obvious to the defendants that he would commit suicide.
Long’s overall demeanor did not contradict these denials. Wellpath’s intake form indicated
that Long had an “[a]ppropriate” mood and that he did not display any signs of helplessness,
hopelessness, depression, anxiety, fear, or anger. And even though Long was not placed in a
detoxification unit, jail officials still observed him on an hourly basis, the last time being within
an hour of his suicide. R. 39-15 PageID 712–29. During these rounds, Long appeared normal and
did not exhibit any “odd behavior [or] aggression,” even during the very last observation. See
8 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
Galloway v. Anuszkiewicz, 518 F. App’x 330, 335–36 (6th Cir. 2013). The fact that Long was not
placed in a detoxification unit does not alter these observations. Regardless of where Long was
located, the fact remains that Long exhibited a normal demeanor and did not convey any suicidal
intentions to defendants, thereby undermining any claim that there was a strong likelihood that he
would commit suicide. See id.; Downard, 968 F.3d at 601.
To be sure, Long at times appeared “anxious [and] nervous” because he was in jail and
could not post bond. And these feelings were exacerbated because he feared that he would receive
a long sentence. But such general despondency is not enough to suggest a strong likelihood of
suicide. Barber v. City of Salem, 953 F.2d 232, 240 (6th Cir. 1992). The same is true when Long
asked Bush whether he could acquire “enough drugs within the housing unit [for Long] to kill
himself.” Bush did not think Long was being serious when he made those comments and he
specifically testified that he “did not” inform correctional or medical staff about Long’s comments
because “he felt he ‘sufficiently talked [Long] down.” So jail officials and Wellpath staff had no
knowledge of these statements.
Long’s past suicide attempts and mental health history are also not enough. Long attempted
suicide several times between 2015 and 2019. But Long denied making any such attempts at intake,
and jail officials claim they did not have access to the records detailing his attempts. Long has
offered no evidence to the contrary. But even if they were aware of these attempts, past suicide
attempts alone are not enough to show a strong likelihood that an inmate would commit suicide,
especially when, as here, the inmate denies harboring such intentions and “presented no other
obvious signs of risk.” Lawler, 93 F.4th at 931; Downard, 968 F.3d at 601; Mantell v. Health Pros.
Ltd., 612 F. App’x 302, 306–07 (6th Cir. 2015) (explaining that officers could not have drawn an
inference of a substantial risk of suicide when detainee denied being suicidal at intake and
9 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
presented in a calm compliant manner even though he previously attempted suicide and his
girlfriend warned officials that he might try to attempt suicide again); Starcher v. Corr. Med. Sys.,
Inc., 7 F. App’x 459, 465 (6th Cir. 2001) (holding that defendant was, at most, negligent when he
knew of previous suicide attempts and was told that the inmate should be “watched” but did not
investigate further); compare Schultz v. Sillman, 148 F. App’x. 396, 401–03 (6th Cir. 2005)
(holding that an inmate’s suicidal risk was obvious when jail officials knew of the decedent’s past
suicidal tendencies, knew that these suicidal ideations stemmed from the inmate’s kidney
problems, and observed him crying from kidney pain and ignored repeated requests to go to the
hospital).
And the recency of the attempts matters too. Here, Long’s past attempts occurred at least a
year before he was admitted to the Macomb County Jail. On the few occasions in which this court
considered past suicide attempts sufficient to establish deliberate indifference, the attempts
occurred during the same period of confinement as the actual suicide. See Perez v. Oakland Cnty.,
466 F.3d 416, 420, 421, 424–25 (6th Cir. 2006) (holding that there was a genuine issue of fact
concerning the objective component of deliberate indifference based on attempted suicides in the
past and the attempt in the same facility a month before suicide); Troutman v. Louisville Metro
Dept. of Corr., 979 F.3d 472, 477, 480, 484 (6th Cir. 2020) (holding that past suicide attempt
satisfied objective prong of deliberate indifference when it occurred in the same facility eleven
days before suicide).
Similarly, Long’s withdrawals on the night before his suicide do not change our conclusion.
Long was off his detox medication because Wellpath staff confiscated his pills. That night, Long
banged on the door of his cell asking for medical help for heartburn and chest pains, which he
eventually received. We have held that such disruptive behavior does not indicate a strong
10 No. 24-1536, Craddock, et al. v. Wellpath, LLC, et al.
likelihood of suicide when the inmate complaints about his physical condition but does not say
anything about suicide. Lawler, 93 F.4th at 933; Gray, 399 F.3d at 614–16. The record does not
indicate Long mentioned anything about harming himself that night. During that episode he also
yelled out to his “friend” Jordon and made statements like “I got to get out of here” and “I don’t
want to be here.” But an “inmate’s despondency coupled [] with other stressors, like drug
withdrawal” also do not indicate a strong likelihood of suicide. Downard, 968 F.3d at 601 (citing
Baker-Schneider v. Napoleon, 769 F. App’x 189, 193–94 (6th Cir. 2019)); see also Nallani, 665
F. App’x at 508.
Therefore, based on this record, a reasonable jury could not conclude it was “obvious” to
any jail official or Wellpath personnel that there was a “strong likelihood” that Long would commit
suicide. Lawler, 93 F.4th at 316; Downard, 968 F.3d at 601. Without that, Long’s estate cannot
satisfy the subjective element of deliberate indifference. Hence, Long’s Fourteenth Amendment
rights were not violated. Without an underlying constitutional violation, Long’s municipal liability
claims against Macomb County and Wellpath fail. See Phillips, 14 F.4th at 537; Barber, 953 F.2d
at 240.
We AFFIRM the district court’s judgment.