‘HELP ME!’: A Texas man begged for aid as his mental health spiraled, but the system failed him

The giant tin “S” that hangs front and center on the wall of Elizabeth Waller’s resale shop is only $10, but she refuses to sell it.

Situated between shabby chic picture frames and worn, wrought-iron wall art, the “S” is in great condition and stands at least a foot tall.

But in the year that Elizabeth has owned her shop in the East Texas town of Flint, the “S” has never left the wall — no matter how many people ask to buy it.

“My son’s name was Stetson,” Elizabeth tells shoppers when they look at her, confused. “I can’t bear to part with it.”

The past tense hangs in the air. An awkward silence punctuates the room.

Elizabeth sits down at whatever recently painted table and chairs are showcased at the front of her shop, grabbing a framed photograph of her middle son that always sits on some piece of furniture.

And she begins to tell a story.

A story of a charming young man who excelled at school and sports, who loved God and put family above all else.

A story of a descent into mental illness that started with the death of a beloved grandmother and spiraled into paranoia and voices no one else could hear.

A story of how a 24-year-old man gave doctors and police officers a life or death warning, but the Texas mental health system still failed him.

Elizabeth’s desperation clings to her throat — a desperation to help her son that started years ago and continually slammed into the reality of mental health care in the state, which is strained beyond capacity. A Houston Chronicle investigation found that there aren’t nearly enough beds — private or state-funded — to help everyone in need, forcing mentally ill Texans to seek out crisis care through emergency rooms and, often, the criminal justice system. Though the state has tried in recent years to fund the addition of hundreds of psychiatric beds to lighten the load, there still were about 1,500 people waiting to get into a state-run hospital as of May.

Shoppers often stand in front of her, thrifty finds in hand and mouth agape as Elizabeth shares the highlights of the worst three days of her life. And that’s when she realizes she has to start at the beginning.

“It all started in 2018,” she says as her shoppers sit down beside her.

Aug. 7, 2018

Waco, Texas

Elizabeth was resting in her bedroom at the apartment she shared with her son, Stetson, when he walked in clutching his head and squinting his eyes.

“Mom. My head. It hurts,” Stetson said, his 6-foot-tall body hunched over in pain. “It feels like my brain is being zapped.”

Stetson Hoskins had always been Elizabeth’s strongest kid. The second of three sons, he won a President’s Education Award in fifth grade. On the baseball field, he was a brick wall between second and third base: Absolutely nothing got past him. At age 10, he wrote a letter to his adult self:

“If I read this later on I want myself to know. In every sport I play, give 110% and never give up. If I give up I will be giving 0% and that sucks. I will never give up my dream to be a pro-baseball player. For example if I get hurt keep playing. You get 1 life and don’t screw it up.”

Stetson Hoskins loved playing baseball as a kid and dreamed of playing professionally. This is Elizabeth Waller’s favorite picture of her middle son, Stetson. 

Mark Mulligan, Houston Chronicle / Staff photographer

This was now the second time in less than a month Elizabeth had taken Stetson to an ER because of severe head pain.

But it still shocked Elizabeth to hear Stetson say he was hurting. She grabbed her keys and made for the front door.

“I want to kill myself,” he told her. “I want to stab myself in the stomach.”

IN CRISIS: How Texas fails the mentally ill

She rushed him to the Crisis Treatment Center in Waco, run by the Heart of Texas Region Mental Health Mental Retardation Center in collaboration with the Providence Healthcare Network. Doctors there recommended inpatient care, but they determined he was too agitated and aggressive to be admitted to a psychiatric setting.

So they placed him under an emergency detention order. Security escorted him to Providence Healthcare Network’s emergency room two-tenths of a mile down the street.

The air was thick with humidity as Elizabeth waited for Stetson to be seen by doctors. They placed him on the waitlist for a bed at Austin State Hospital, one of the state’s 10 publicly funded psychiatric facilities.

The placement, though, was futile. At that time, there were 657 people waiting for a bed at one of these hospitals.

But then, a stroke of luck. Cedar Crest Hospital, a 68-bed psychiatric hospital in Belton, said it could take him. Before noon the following morning, he was transferred.

Elizabeth didn’t know what was wrong or why he had been transferred. Because Stetson was an adult, Elizabeth didn’t go back to see the doctor with her son. She didn’t have a right to see his medical records.

So Elizabeth believed him when he said he was fine — that he didn’t need to take the medication doctors prescribed.

But weeks later, she found his emergency room discharge papers strewn across the dining room table.

“Patient reports having ‘something in his head,’ but denies hearing voices,” the medical records read. “Patient has already been diagnosed with bipolar disorder.”

The papers shook in her hands as she flipped the page. The word schizophrenia stood out.

Bipolar disorder is like waking up to a sunny day and going to bed in a thunderstorm — sometimes, Stetson would wake up happy and upbeat only to go to bed horribly depressed. He’d hear a man talking but look around and see no one there. The voices were mean, and the only way to respond was by shouting at them, or punching them.

“I’m the master of puppets. I do not give a f—. I will f— your whole life up and catch your whole house and everybody in it on fire.”

Elizabeth had always assumed Stetson was bound for college, but his grades had started to slip his senior year in high school. He got into drugs. Two months before graduation, he’d been expelled for showing up to school high.

As the years progressed, Stetson was charged multiple times for drug possession and once for assault after throwing objects at his aunt and injuring her knee.

Then Nanny Bobby, Elizabeth’s mother, died in 2016. Stetson was so distraught, he couldn’t bear to attend the funeral. His cousin often heard him mumble under his breath: “I don’t have a Nanny anymore, so f— it.”

Since then, he’d struggled to hold down a job for more than a week or two, constantly getting into fights with other employees.

Unable to afford a place on his own, Stetson had moved back home. “He reports this (has) been an issue for 6 months now,” Elizabeth read.

It made sense. Six months ago, Stetson had started shouting curse words at random. Doctors initially diagnosed it as Tourette syndrome.

Elizabeth’s sister had spent six weeks at a state hospital after suffering a mental breakdown. Her cousin had frequent psychotic episodes that left him wandering Fort Worth searching for himself. Her aunt had died at a mental hospital.

Should I have seen this coming?

Elizabeth Waller listens to a song written by her youngest son, Colton White, at her home in Tyler. Colton, who wants to be a rapper one day, wrote the song about his brother, Stetson Hoskins. 

Elizabeth Waller listens to a song written by her youngest son, Colton White, at her home in Tyler. Colton, who wants to be a rapper one day, wrote the song about his brother, Stetson Hoskins. 

Jon Shapley, Houston Chronicle / Staff photographer

September 2018

Laneville, Texas

Ashley Waggoner stood with her back against the bedroom door, shakily forcing the lock into place.

Her three children sat on the bed, wide-eyed and scared, listening to the curse words now muffled by the closed door.

“Goddamn it!”

“Motherf—!”

Ashley didn’t know what to do. This wasn’t the Stetson she knew and loved.

Stetson, who was always outgoing and funny.

Stetson, who played make believe with her kids.

Stetson, who would never hurt a fly.

Ashley was the oldest female of nine cousins. She became a mother hen of sorts, chasing the little ones around Nanny Bobby’s house.

So when Stetson called from a McDonald’s in Palestine — an hour’s drive away — asking for a ride and a place to stay, she dropped everything, left work and picked him up.

But the man who got into her gray Ford Edge that day was terrifying. His sentences were fragmented. His eyes were dark. He wouldn’t stop shouting. It was like he had no soul.

TIMELINE: How Texas’ mental health system became overwhelmed

As she braced herself against the bedroom door, Ashley’s mind raced back to the third grade. Her mother, Elizabeth’s sister, had been acting strangely, paranoid about everything and everyone. She had a confused, dark look in her eyes — almost like she was possessed.

It was the same look Stetson had given her before she locked herself and her children in the bedroom.

Tears welled in her eyes. She picked up the phone and called a short-term housing facility for the homeless in Nacogdoches. They could take him the next day.

She sat down on the bed next to her children, gripping their little hands and offering a slight smile: They’d only have to make it through one night.

Feb. 23, 2019

Flint, Texas

Colton White absentmindedly scrolled through Facebook, checking in on his friends from high school — their new jobs, their new friends, their new lives.

But his thumb suddenly stopped when Stetson’s name caught his eye. A familiar sense of dread filled his chest.

What did Stetson post this time?

The 19-year-old had always idolized his brother, five years his senior.

Where Stetson was goofy and outgoing, Colton was quiet and reserved. Stetson begged for pictures; Colton shrank away from the camera.

When Stetson made a big play on the baseball field, he danced. He waved his arms up and down to encourage cheers from the crowd. When Colton did the same, his cheeks would flush at his mother’s shouts. He’d pull his cap farther down over his brows and stare at the ground.

The two brothers couldn’t have been more different. But they were inseparable. Stetson taught Colton how to talk to girls. How to catch a fly ball. How to be a man.

But the brother Colton loved so much was slowly disappearing.

His taste in music changed. His stories made no sense. He was quick to anger.

Some nights, Stetson would scream curse words for hours in his empty room. Colton would bury his head beneath his pillow, crank his music and try to sleep.

Colton forced himself to read the post.

“Stop or keep going. Im on such a roll. Lol imma do it for the people who aint got s— and just wanna be left alone without prosecution or judgement. Ya heard me. Where yall at. Im coming home dont worry. Just coolin right now. Haha cant wait to meet my long lost family that dissapeard in australia when i was born.”

Colton knew he would soon be fielding questions from friends and family about his brother’s nonsensical words. Everyone thought Stetson was on drugs. Colton wasn’t sure he disagreed.

He clicked on his brother’s profile, scrolling farther down the posts.

“I’m the master of puppets. I do not give a f—. I will f— your whole life up and catch your whole house and everybody in it on fire.”

Colton shook his head.

What is happening to my brother?

Elizabeth Waller and her youngest son, Colton White, look through family photographs at Elizabeth's resale shop in Flint. Before Stetson Hoskins, Elizabeth's middle son and Colton's brother, started getting sick, he was a star athlete. An excellent student. He taught Colton how to catch a fly ball and talk to girls.

Elizabeth Waller and her youngest son, Colton White, look through family photographs at Elizabeth’s resale shop in Flint. Before Stetson Hoskins, Elizabeth’s middle son and Colton’s brother, started getting sick, he was a star athlete. An excellent student. He taught Colton how to catch a fly ball and talk to girls.

Mark Mulligan, Houston Chronicle / Staff photographer

Oct. 5, 2019

Waco, Texas

The thought of Stetson sitting in jail, unmedicated and shouting, left Elizabeth on edge.

She drummed her fingers on the kitchen table at her house in Waco, staring at the blank piece of paper in front of her and trying to put her feelings into words.

Eight months earlier, he had shown up on the doorstep of the dad of a childhood friend, desperate for a place to stay. The dad said no. He ordered Stetson off his property.

Instead, Stetson stole the white Chevy Silverado sitting outside the man’s home. He’d been in jail ever since.

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His letters from jail were the ramblings of a sick man: He’d swing from telling Elizabeth how much he loved her to hurling curse words her way and calling her a villain. He’d scrawl his confabulations across disciplinary paperwork, the blank spaces filled with half-completed hangman games and scribbles so thick and dark the paper was nearly perforated by the pen.

“I’m glad you stepped in when I needed you to. You’re truly a queen and a hard working mom that nobody can f— with when it comes down to it. You’re a bad b—,” Stetson wrote in one letter. On the flip side of the page, his tone changed: “HAHA you’re a bad person. I just figured that out. I like villains. F— you’re like me I prefer being the bad guy. Its a lot more funner that way. I think we just became closer. That’s good mom. I’m just bored and need to breath so you’re hearing my sad talk.”

In the letters and phone calls, Stetson told his mom he wasn’t taking any medications.

She just wanted her son to get help. Since being diagnosed the year before, Stetson had been hospitalized a dozen times. But each time, he was released within a day or two, prescription in hand.

He never filled the prescriptions, ranging from Ativan for anxiety to Haldol for schizophrenia to Oxcarbazepine for bipolar disorder. The drugs made him feel groggy and empty inside. He didn’t think he needed them.

In September, Stetson had been removed from the courtroom for causing a ruckus.

Elizabeth knew jail wasn’t where Stetson needed to be. He needed to be committed to a mental hospital long-term, where he would be forced to take his medication and get better.

She sat down at her desk and penned a letter to the judge handling Stetson’s case, Henderson County 3rd District Court Judge Mark Calhoon.

“If his court-appointed lawyer would have taken the time to meet with my son before his court date, he would have been aware of his condition,” Elizabeth wrote. “I am begging you to please look into his medical records and his disruptive behavior while he has been incarcerated before sentencing him to state jail or granting him time served, and consider court ordering him to long term treatment at a (state hospital) and court order him medication.”

“I truly believe that would be his only chance at leading a normal life.”

Elizabeth’s letter went unanswered.

Elizabeth Waller re-reads letters written by her son, Stetson Hoskins, while he was in jail in 2019. Though the letters are rambling and, at times, incoherent, Elizabeth often revisits the letters to feel close to her middle son.

Elizabeth Waller re-reads letters written by her son, Stetson Hoskins, while he was in jail in 2019. Though the letters are rambling and, at times, incoherent, Elizabeth often revisits the letters to feel close to her middle son.

Jon Shapley, Houston Chronicle / Staff photographer

Nov. 22, 2019

Corsicana, Texas

9:24 p.m.

Stetson sat next to Elizabeth in her friend’s car, punching his fist into his hand over and over and shouting obscenities.

“You know I could put a cigarette out on your face right now?” he shouted at his mother. “I tell you what, you step on those damn brakes like that again, see what happens!”

Elizabeth was terrified. She pressed her body against the driver’s side door, trying to get as far away from her son as possible, and veered into a Shell gas station off Texas 31 in Corsicana, just an hour southeast of Dallas.

She clambered out of the car, trying to keep the panic at bay.

“I have to go to the bathroom.”

But she didn’t. She was just trying to figure out what to do.

Forty minutes earlier, she had picked Stetson up from the Henderson County Jail after Judge Calhoon had ignored her pleas to commit him to a mental hospital and instead released him on time served.

He’d been threatening her life ever since — his eyes wild and his movements erratic.

I’m not going to make it home alive if he stays in the car, she thought. How do I get him out of the car?

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But then, Stetson, a goofy grin plastered to his face, hopped out of the car like a little kid and all but skipped into the McDonald’s next door.

“I’m going to get ice cream. They don’t have ice cream in jail.”

Elizabeth waited a beat. Then she jumped back into the car, careening out of the parking lot and back onto Texas 31.

And then she dialed 911.

“911. What’s your emergency?”

“My son is bipolar and schizophrenic. He just got out of jail after 10 months. He’s unmedicated, and he’s on the rampage.”

When officers arrived, Stetson repeatedly told them he was out of control — that he wanted to kill himself and harm others. They transported him to Medical City Green Oaks Hospital, a 124-bed psychiatric facility in Dallas.

Dec. 11, 2019

Laneville, Texas

Ashley had just returned home from her sales job when her cellphone buzzed in her pocket.

“You’re my favorite cousin,” Stetson said on the other end of the line. “How are you doing?”

Ashley was glad to hear from him. If Stetson was calling, he wasn’t in jail. He wasn’t in a mental hospital. What’s more, he sounded coherent.

But she knew how quickly that could change. Her mother had been hospitalized numerous times over Ashley’s 31 years of life. She thought back to the vivid memory of her mother sprinting out the doors of a mental hospital, screaming “HELP ME! HELP ME!” before Ashley’s father whisked his daughter away.

“Stay safe and behave, Stetson,” Ashley said. “Don’t get into trouble.”

“I love you cuz,” Stetson said.

“I love you, too.”

That same day, Stetson got on Facebook.

“2 + 2 = eat s—.”

Dec. 16, 2019

Gholson, Texas

Elizabeth looked around her apartment near Waco feeling defeated. She was being evicted again because of Stetson’s constant screaming.

She’d had to move every three or four months since he was diagnosed. Neighbors were always complaining about the stream of profanities that seeped through their walls every hour of the day and night.

She’d managed to find a spare bed at her friend’s house in Mexia, about 50 miles away. But her friend wouldn’t let Stetson come.

He was too disruptive, she said: Too scary. She didn’t know what he would do.

So Elizabeth found him a motel room in Waco and paid for a full month.

As she packed up her things, Elizabeth begged Stetson to take medication — to go to a mental hospital and get real help.

Stetson started ranting. Elizabeth reached for her phone and pressed record.

“I know you know that medicine won’t help me,” Stetson said matter-of-factly.

“Yeah it will help you! How do you know it won’t?”

Stetson stumbled over his words, his voice erratic and jumbled. He’d start sentences and never finish them. At certain points, he’d address someone who wasn’t there or interrupt his thoughts by screaming “Goddamn it” so loud Elizabeth jumped in surprise.

“These people that are in the head, that control the f— world and everything we f— do, they’re the ones that are hurting me!” Stetson started to shout. “It’s not a goddamn medical problem! They’re in my f— head preying on my f— head talking to me all the f— time, making me hurt all the time!”

Elizabeth Waller had repeatedly begged her son Stetson to take medication for his bipolar disorder and schizophrenia. In December 2019, she recorded one of their many conversations about the matter. She provided it to the Chronicle for publication. Video: Houston Chronicle

When Stetson was diagnosed with bipolar disorder and schizophrenia, his mother hadn’t truly understood what it meant — or how sick he really was. He’d never told her he was hearing voices or that there were people living inside his head.

And then he closed his fist and started hitting his skull.

“Sometimes I get some relief. Just because why? Because they turn it off. Whatever the f— they’re doing up there, they turn it off and I get ahhh, some relief.”

Elizabeth started to cry, even as Stetson disparaged her for it.

Stetson believed medicine wouldn’t fix him — the only way the voices would stop is if the people in his head hit a button and turned it off. They were trying to fix him, he said, because he was special.

Dec. 20, 2019

Waco, Texas

The bed was on cinder blocks. The TV was busted. There were roaches everywhere. But Stetson was in high spirits when Elizabeth and Colton showed up to visit him at his motel.

“Colton, come look at my room, it’s pretty nice,” he said. “They promised to fix the TV and everything.”

There wasn’t a hint of the Stetson who had talked about people living in his head just days ago. Instead, he was being silly, cracking jokes and teasing his brother. It was almost as if Stetson wasn’t sick.

Except when he started talking about how he was a god; how he raised mountaintops. He’d stop mid-sentence and stare at the ceiling, only to return to the conversation 30 seconds later.

“Man, what are you doing?” Colton finally asked.

“It’s raining in my head.”

Still, Stetson was calm throughout the visit — a rarity as of late.

“I love you, bro,” Stetson said, closing the grimy door.

“I love you, too.”

The Crisis Treatment Center in Waco,  run by the Heart of Texas Region Mental Health Mental Retardation Center in collaboration with the Providence Healthcare Network, provides intensive mental health care ranging from community-based treatment to short-term residential care. Stetson Hoskins wound up here on Jan. 7, 2020 after finally deciding that he needed help for his mental illness.

The Crisis Treatment Center in Waco,  run by the Heart of Texas Region Mental Health Mental Retardation Center in collaboration with the Providence Healthcare Network, provides intensive mental health care ranging from community-based treatment to short-term residential care. Stetson Hoskins wound up here on Jan. 7, 2020 after finally deciding that he needed help for his mental illness.

Jon Shapley, Houston Chronicle / Staff photographer

Jan. 7, 2020

Crisis Treatment Center, Heart of Texas Region Mental Health Mental Retardation Center

Waco, Texas

10:52 p.m.

Stetson got right in the security officer’s face, shouting loudly and threatening to punch him.

An employee at the Crisis Treatment Center — which provides intensive mental health care ranging from community-based treatment to short-term residential care — had just informed Stetson that he was going to be discharged soon.

And Stetson wasn’t happy about it. He needed more intensive care, he shouted at the security officer.

The security officer tried to calm Stetson down. Stetson shoved him. As security officers restrained him, the crisis center called Waco Police.

Earlier in the day, Stetson had called Elizabeth: “Mom, I’m getting help. I’m going to go to a long-term mental hospital. I’m going to get better.”

Elizabeth was relieved when her son explained where he was. He might finally have a chance at a real life.

She told her son she loved him.

“I love you too, ma.”

But now, in the pitch black of night, sitting outside the Crisis Treatment Center in restraints, it looked as though long-term care was out of reach.

No charges were filed, but it was clear to officers that Stetson was experiencing a mental health crisis. He was a danger to himself and others.

They placed him under an emergency detention order, which allows a police officer to take a person into custody and transport them to the nearest inpatient mental health facility or emergency medical services provider.

Three officers transported Stetson two-tenths of a mile down the street to the emergency room at Ascension Providence Hospital, the new name of the hospital that treated him in 2018 when he threatened to stab himself. They checked him in, the fluorescent lights that lined the low ceilings casting a dingy glow over the small waiting room.

“I want to kill myself,” Stetson told the emergency room physicians.

They ordered a transfer to Ascension Providence’s DePaul Center, a 64-bed psychiatric facility just a few blocks away.

A statue of Mary greets visitors at Ascension Providence Hospital in Waco. In January 2020, Stetson Hoskins was admitted to Ascension Providence's Emergency Room on an emergency detention order after he told police officers he was going to kill himself. 

A statue of Mary greets visitors at Ascension Providence Hospital in Waco. In January 2020, Stetson Hoskins was admitted to Ascension Providence’s Emergency Room on an emergency detention order after he told police officers he was going to kill himself. 

Jon Shapley, Houston Chronicle / Staff photographer

Jan. 8, 2020

Ascension Providence DePaul Center

Waco, Texas

8:20 p.m.

Stetson stripped off his clothes and threw them in the shower, pacing naked back and forth across his room.

“HELP ME! HELP ME!” He begged the nurses to tie him down. The voices and the pressure in his head were getting worse. The only thing that helped was to scream.

Still naked and pacing the room, the doctor on call gave him a dose of Ativan, used to treat anxiety. Stetson eventually quieted and lay down.

The registered nurse on duty filled out her progress notes:

“Problem: Out of Contact w/ Reality. Pt denies auditory, visual and tactile hallucinations. But, patient has been observed yelling in room and swinging at air. Goal: Pt will verbalize a decrease in hallucinations daily for 3 consecutive days.”

She continued:

“Problem: Self harm risk. Patient endorsed suicidal ideation with a plan to stab himself in the gut. Pt. denies suicidal ideation/plan and thoughts of self harm during admission assessment. Goal: Pt will verbalize no suicidal ideation/thoughts of self harm daily for 3 consecutive days.”

Jan. 9, 2020

Ascension Providence DePaul Center

Waco, Texas

2:15 p.m.

Stetson was screaming and kicking in bed.

“I don’t wanna put my hands on you but can’t help it,” he told the nurse outside his room.

As the nurse rushed to get an emergency injection of medicine, Stetson demanded that a security officer come speak to him.

“I don’t wanna hurt you, but I got to,” Stetson repeated. He started pushing the security officer over and over.

The officer tried to redirect Stetson. He tried to distract him. Nothing was working.

So, he drew his Taser and pointed it at Stetson. In response, Stetson lay on the ground to be handcuffed, and Waco Police were called.

Stetson started to cry. He alternated between talking calmly to staff and attempting to jump off the floor and charge more employees. He asked for the shot doctors gave him last night.

He was due for doses of Ativan and Haldol. He didn’t get them.

DON’T TAKE ME BACK! Texas pays tax dollars for private hospital beds. For years, the state didn’t track which hospitals got the money

Dr. Joshua Warren, a psychiatrist, came to talk with Stetson.

Stetson told the doctor he thought he would get an Ativan injection if he attacked the security officer. The doctor informed Stetson he was going to be discharged from the hospital and given a ticket for assault.

Stetson told him he was going to run in front of an 18-wheeler if he was forced to leave DePaul.

Stetson was released from the hospital to Waco Police anyway.

Jan. 9, 2020

Ascension Providence Hospital’s Emergency Room

Waco, Texas

3:05 p.m.

Waco Police officer Tracy Simonette saw that Stetson was a danger to himself — but he couldn’t stay at DePaul.

So for the second time in two days, Stetson was placed under an emergency detention order and transported the two-tenths of a mile back to Ascension Providence’s emergency room.

Simonette told the front desk that Stetson was threatening suicide.

Once checked in, Stetson repeated his wish to kill himself — that he planned on jumping in front of a semi-truck.

He told the physician he felt out of control; that he was anxious, restless and violent. She cleared him for transfer to Cedar Crest Hospital about 50 miles away in Belton. DePaul had already refused to take him because of his past violence.

“His mood appears anxious,” the physician wrote in her notes. “His affect is labile and inappropriate. His speech is rapid and/or pressured. He is aggressive. He is not actively hallucinating. He expresses suicidal ideation. He expresses suicidal plans.”

Before the end of the day, Cedar Crest had refused to take him, too.

“I just want to get out of here,” Stetson told a nurse on duty in the ER, denying any thoughts of suicide.

Jan. 10, 2020

Ascension Providence Hospital’s Emergency Room

Waco, Texas

11:05 a.m.

By the time Dr. Warren began his consultation with Stetson, the emergency room doctors were running out of options.

Cedar Crest had already refused Stetson. The Mobile Crisis Outreach Team in Waco rejected him because of the violence he had previously exhibited. Doctors had placed Stetson on the waitlist for Austin State Hospital. But the likelihood of getting him in was slim to none: The waitlist for a state hospital bed had burgeoned to more than 900 people.

There are “few other placement options due to funding,” an emergency room physician wrote in her notes.

Dr. Warren asked Stetson why he attacked the security officer at DePaul the day before.

“I feel like that shot you will give me … helps me and I knew that if I went out this morning, you guys here will give me a shot,” Stetson told the doctor.

After his consultation, Dr. Warren decided that Stetson didn’t meet the criteria for inpatient care — that he was seeking drugs and wasn’t suicidal, homicidal or commitable at this time.

“The patient was seeking medications” the day before, Dr. Warren dictated following the evaluation, repeatedly noting Stetson’s history of amphetamine use.

“He then stated he was suicidal when we reported (sic) we are going to discharge him as the patient has multiple external stressors and external motivating factors and the patient was attempting to avoid being discharged to the streets.”

Stetson admitted as much during the consultation, Dr. Warren dictated, and denied suicidal thoughts, both then and now.

At the DePaul Center on Jan. 8, Stetson told doctors he had used meth three days previously. But a toxicology screen the following day came back negative for drugs from amphetamines to cocaine to opiates.

Dr. Warren continued: “I would not recommend readmission to (the Crisis Treatment Center) or DePaul Center for this patient due to his antisocial traits, goal directed behaviors and history of assault.”

An ER nurse gave Stetson an information packet on homeless shelters, food banks and mental health resources in the community. He handed Stetson a bus pass.

Stetson called his mom from a hospital phone.

“Mom. They’re making me leave. What do I do now?”

Elizabeth could hear the desperation in Stetson’s voice as he explained what happened.

“I don’t know what I’m going to do. I don’t have a phone or anyone’s phone numbers. I don’t have money.”

Elizabeth was 50 miles away in Mexia and without a car. She had no way of getting to him.

She did her best to console her son.

“I don’t have a car yet but as soon as someone gets here I can go get some money and send you a Walmart to Walmart transfer.”

Stetson hung up and returned to his room.

Doctors gave him prescriptions for risperdal, used to treat schizophrenia and bipolar disorder, and vistaril, used to treat anxiety.

By 2:22 p.m., Stetson was walking out of the hospital.

The medications and information packet sat discarded in his hospital room.

People walk into the emergency room at Ascension Providence Hospital in Waco on a summer night in 2021. Over the course of three days in January 2020, Stetson Hoskins found himself in this emergency room multiple times, attempting to get help for his bipolar disorder and schizophrenia. 

People walk into the emergency room at Ascension Providence Hospital in Waco on a summer night in 2021. Over the course of three days in January 2020, Stetson Hoskins found himself in this emergency room multiple times, attempting to get help for his bipolar disorder and schizophrenia. 

Jon Shapley, Houston Chronicle / Staff photographer

Jan. 10, 2020

Near Ascension Providence Hospital

Waco, Texas

2:25 p.m.

Stetson had to shout over the sound of cars whizzing by so Elizabeth could hear him.

“Man, it’s starting to rain,” Stetson said into the phone he had borrowed from a stranger. “I don’t have no phone. I can’t call nobody. I don’t have no money.”

Elizabeth could tell Stetson’s anguish and frustration was ramping up.

“Stetson, I told you as soon as I can, I’ll send some money.”

“Just hold on.”

Stetson didn’t respond. Elizabeth held her breath — she never knew how he was going to react.

“You know what Mom? Don’t worry about it. I’ve got it all figured out.”

“I love you,” he said.

Then the line went dead.

Jan. 10, 2020

The 100 block of West Texas 6, near 7-Eleven

Waco, Texas

3:05 p.m.

Michael Brown, 49, was driving down Texas 6 in his silver Ford Focus, headed to his umpteenth cancer treatment appointment, when he noticed a bald man wearing blue jeans and a green camouflage sweatshirt sitting on the guardrail to his right.

The man got up as if he was about to cross the highway. He sat back down.

Seeming to steel himself, the man hung his dark gray backpack on the guardrail. He set his plastic Whataburger cup on the top of the guardrail post, still wet from the recent rain.

And then he started to sprint, crossing mere yards in front of the car driving right in front of Michael.

What are you doing?! Michael screamed in his head. He slammed on his brakes as the man jumped in front of the 18-wheeler in the far left lane.

The 18-wheeler came to a stop as Stetson’s body rolled 10 feet in front of Michael’s car. His head was completely crushed. The road was dark with blood.

Michael got out of his car, joining half a dozen other people in the road who had stopped to see if everyone was OK after watching the man Superman dive under a semi.

It was immediately clear to Michael that the man, later identified as Stetson, was not OK. As someone rushed to check Stetson’s pulse, Michael pulled out his cellphone and dialed 911.

“911, what’s your emergency?”

“There’s been an accident on the highway,” Michael said, breathless. “Someone was hit by an 18-wheeler.”

Michael called his doctor to say he would be late to his appointment.

He waited for the cops to arrive.

Jan. 10, 2020

The 100 block of West Texas 6, near 7-Eleven

Waco, Texas

3:12 p.m.

Officer Tracy Simonette was investigating a crash on West Loop 340 when a call came over the radio: There was an auto versus pedestrian crash on Texas 6 about 3 miles away.

Simonette raced in that direction, where emergency first responders were already on the scene.

Simonette saw what appeared to be a body lying on the pavement, the yellow blanket covering it sopping wet from rain and held down by the victim’s brown leather boots to guard against the wind. Simonette spotted a brown leather wallet a few feet from the body. He stooped to pick it up and pulled out the driver’s license: Hoskins, Stetson.

Twenty-four hours earlier, he had placed Stetson under an emergency detention order at Ascension Providence Hospital after Stetson had repeatedly threatened to kill himself by jumping into traffic.

Ascension Providence’s emergency room was less than a mile away, a 20-minute walk along overpass shoulders and grassy highway medians to get to this heavily trafficked area where two highways converge.

Simonette pulled back the blanket: It was undeniably Stetson, but his body was loose and contorted like a marionette doll. His head was split wide open.

Despite all the damage to his body, his medical bracelet still clung to his wrist. A phone was buried in the front pocket of his jeans unscathed — he’d been too sick to realize he’d had one with him all along.

Simonette’s colleague, officer Kristina Guerra, approached the 18-wheeler, whose driver was visibly shaken.

The driver was still in training, he told Guerra, and his trainer had been with him in the cab when the accident happened.

The driver had traveled this same route countless times, he said, making the trek from Dublin to Oak Farms Dairy with a truck stocked full of milk.

He saw Stetson sitting on the guardrail seconds before the crash but had no way of stopping when Stetson sprinted across two lanes of traffic.

He’d stopped as quickly as possible, he said, and gotten out to check on Stetson.

It was immediately obvious that Stetson was dead.

A broken and faded cross marks the spot on Texas 6 in Waco where Stetson Hoskins killed himself in January 2020. Stetson's mom, Elizabeth Waller, made the cross by hand and on the year anniversary of Stetson's death, she and her youngest son, Colton White, traveled to Waco in memorial. They haven't returned to the spot since. 

A broken and faded cross marks the spot on Texas 6 in Waco where Stetson Hoskins killed himself in January 2020. Stetson’s mom, Elizabeth Waller, made the cross by hand and on the year anniversary of Stetson’s death, she and her youngest son, Colton White, traveled to Waco in memorial. They haven’t returned to the spot since. 

Jon Shapley, Houston Chronicle / Staff photographer

Jan. 10, 2020

Mexia, Texas

3:30 p.m.

Elizabeth’s voice was a whisper when she answered Guerra’s call.

Guerra assumed she knew. She didn’t.

“Your son was released from (the hospital) earlier today,” Guerra said. “He went out into traffic and jumped in front of a vehicle.”

“I’m so sorry. He was killed.”

Elizabeth collapsed on the floor of her friend’s living room. She had just talked to Stetson. She had promised to send help as soon as she could.

Memories of her middle son — the son she had bonded with the most — flashed through her mind.

Walking across the football field with Stetson after he was named homecoming king nominee his freshman year of high school.

Swelling with pride as the crowd of parents erupted in cheers when Stetson fielded ball after ball as shortstop on the baseball field.

Laughing until tears rolled down her cheeks as Stetson tried to gut the catfish they had just caught with a dull knife.

“He went to them for help,” she told Guerra, choking back sobs. “He has voices in his head. He finally admitted he needed help.”

Elizabeth hung up the phone and immediately called Colton.

“Colton, it’s Mom,” Elizabeth said, her voice heavy with despair.

Colton was on his way to the gym. But Elizabeth’s voice brought him pause.

And all of a sudden, he knew.

“He’s dead, isn’t he?” Colton said.

A photograph of Stetson Hoskins sits by a guardrail on Texas 6 in Waco, part of a larger memorial for the 24-year-old marking the spot where he killed himself in January 2020. Stetson's mom, Elizabeth Waller, and his brother, Colton White, set up the memorial on the year anniversary of his death.

A photograph of Stetson Hoskins sits by a guardrail on Texas 6 in Waco, part of a larger memorial for the 24-year-old marking the spot where he killed himself in January 2020. Stetson’s mom, Elizabeth Waller, and his brother, Colton White, set up the memorial on the year anniversary of his death.

Jon Shapley, Houston Chronicle / Staff photographer

Epilogue

Each time the 2:06 minute video of Dr. Warren on Ascension’s website ends, Elizabeth drags the time bar across the bottom of the screen and plays it again.

“I’m very passionate about treating things like depression, bipolar disorder, anxiety. I like seeing people get better,” Dr. Warren says to the camera. “I want everyone that I see to feel like I care and that I’m listening.”

Elizabeth’s knuckles turn white as she clenches her fingers tightly around the phone.

If that was the case, why didn’t you listen to my son?

In the year and a half since Stetson died, Elizabeth has struggled to find justice for her son.

She has sought out and been rejected by three lawyers who say it would be too costly to hold anyone responsible for her son’s death.

She’s frustrated — because she knows that over that three-day period in January, Stetson repeatedly told doctors he was going to kill himself if he was discharged, specifically that he was going to jump in front of an 18-wheeler.

Dr. Warren signed off on his discharge anyway, saying that Stetson was seeking drugs and wasn’t suicidal.

The hospital and its parent company, Ascension, did not respond to repeated requests for comment. Neither did Dr. Warren.

Even if Stetson hadn’t been released on Jan. 10, 2020, the chances of getting him a bed in a psychiatric hospital were low.

The Chronicle investigation published earlier this year found that the state’s mental health system is underfunded and lacks sufficient oversight.

The state doesn’t have enough hospital beds to serve its growing population, with waitlists that stretch on for up to a year.

And while the state has tried to expand its bed space and its funding for community mental health programs, it hasn’t done so fast enough. Some 3.6 million adult Texans — about 1 in 8 adults — suffered from mental illness between 2018 and 2019, the latest data available, according to the Kaiser Family Foundation. More than 1 million of them reported having unmet needs during that time.

That means more and more mentally ill Texans are being forced to fend for themselves and often end up interacting with law enforcement and the criminal justice system.

MORE BEDS: Texas lawmakers allocate nearly $400 million to state psychiatric hospitals

The Waco Police Department did what it could to save Stetson. Both times doctors released him for violent behavior toward security officers — not uncommon with mentally ill individuals who often have had negative experiences with law enforcement and are therefore afraid of them — police placed him under an emergency detention order because he was a danger to himself and others.

Henderson County Judge Mark Calhoon did not remember the specifics of Stetson’s case but said the onus of raising competency concerns lies with defense attorneys. Stetson’s defense attorney, Bill Stephens, did not respond to repeated requests for comment.

The image of Stetson diving under a semi truck plagued Michael Brown for days after the accident, coming to his mind at work as a postmaster in China Spring, a suburb of Waco, and at home with his wife. As his cancer has spread, Michael has learned how fragile life is. His time is coming soon.

Ashley misses her cousin every day. She finds herself expecting phone calls that never come — expecting to hear “I love you cuz” on the other end of the line every time the phone rings.

She’s gone back to college to become a counselor, hoping that one day she’ll be able to help lost boys and girls like Stetson find their way. She graduates in October.

Colton has struggled to keep his life on track. He broke up with his girlfriend of four years soon after the accident. He’s struggled to hold down a job. Once fit and muscular, Colton stopped going to the gym.

Unsure what to do with his pain, he turned to his only outlet: songwriting.

Remember who you are,

You really coulda went so far

Colton worries so often that his mind will turn against him like Stetson’s did that he’s made all his friends promise to have him committed at any sign of something amiss.

The thought of losing another son to mental illness keeps Elizabeth up at night, too — her hyper-vigilance any time Colton has an off day causes tension between the two.

Elizabeth has found solace in the resale shop she opened in Flint soon after Stetson died, losing hours at a time to fixing and refinishing used furniture. Paint constantly clings to her arms; dirt and furniture stain are embedded under her fingernails.

But she still barely sleeps. Late at night, lying in her bed, she stares at Stetson’s ashes, contained in a simple black box. She writes notes to him on Facebook messenger that will go forever unread.

After Stetson died, she refused to scatter his ashes, preferring to keep him close. No one ever seemed to want him — he got kicked out of everywhere, be it a homeless shelter, apartment or mental hospital.

She couldn’t bear to kick him out of her home in death.

Elizabeth Waller sits on the floor of her home in Tyler, holding a box containing the ashes of her son, Stetson Hoskins. A year and a half after his death, Elizabeth barely sleeps. The realization that she will never see her middle son ever again catapults her into frequent panic attacks. She just wants justice. 

Elizabeth Waller sits on the floor of her home in Tyler, holding a box containing the ashes of her son, Stetson Hoskins. A year and a half after his death, Elizabeth barely sleeps. The realization that she will never see her middle son ever again catapults her into frequent panic attacks. She just wants justice. 

Jon Shapley, Houston Chronicle / Staff photographer

About the story


Reporting by Alex Stuckey
Photography by Mark Mulligan and Jon Shapley
Editing by Mizanur Rahman
Copy editing by Charlie Crixell
Visual editing by Jasmine Goldband
Production by Jordan Ray-Hart

The Houston Chronicle spent more than a year investigating how Texas treats people who are mentally ill for its series “In Crisis.” The newspaper reviewed tens of thousands of pages of court documents, police reports and state and federal investigations. The examination revealed an underfunded system with an inadequate number of psychiatric hospital beds that failed to rehabilitate the mentally ill and instead cycled them through the criminal justice system again and again. To read the series, go to HoustonChronicle.com/InCrisis

To reconstruct Stetson Hoskin’s descent into mental illness and his final moments, the Houston Chronicle’s Alex Stuckey spent several months scouring hundreds of pages of medical records, court documents and police reports obtained through public records requests and family members. She pieced together Stetson’s final days by visiting hospitals, the scene of the crash and walking the last 20-minute walk Stetson would take.

She interviewed Stetson’s family members, witnesses to the accident and a judge. Whenever possible, she verified accounts with witnesses and documents. Direct quotations used in the story came from contemporaneous recordings, police documents, physician’s reports, court transcripts or the recollections of participants who consented to interviews; in each case, those quotes have been verified by the people to whom they are attributed or a family member. Italics were used when people recalled their own thoughts.



Need to talk to someone?


If you or someone you know is struggling with suicidal thoughts or depression you can call the Crisis of Intervention Houston Hotline at 832-416-1177.


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