Keith Skunkcap’s grief began with a phone call. He was out bowling with some friends on a Thursday night in Cut Bank, Montana. He was having a good time, grabbing a beer at the bar, when his cell phone rang. It was his brother.
“He tells me that my sister is gone,” he said. “I just broke down.”
Brandy Skunkcap had just died in the federally-operated jail on the nearby Blackfeet Reservation. She was Keith's little sister – a shy, slight woman with brown hair. When she was a child she loved drawing pictures of eagles and horses.
But as she got older she fell into an addiction to painkillers, methamphetamine and alcohol. When she lost custody of her four kids, her family says she took a turn for the worse.
“We could tell it was taking a toll on her body,” Terra Brauhn, her sister-in-law, said. “[She was] very small, very frail. Her teeth were falling out. Not the Brandy that we were really used to seeing.”
It was this Brandy that was arrested on March 23, 2016. Her skin was jaundiced and, two weeks prior, she had been in a hospital vomiting blood. She told a guard she didn’t feel well. The Bureau of Indian Affairs, which oversees more than 70 such detention centers in Indian Country, has health and safety standards that require guards to perform a physical and mental health screening upon an inmate's arrival at a jail. These standards also require them to ask about past medical conditions, as well as alcohol and drug dependency, and to look for any behavioral or physical abnormalities.
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Skunkcap was intoxicated when a correctional officer booked her into the Blackfeet Adult Detention Center that Wednesday evening. The guard decided that Skunkcap wasn't ill enough to warrant a trip to the hospital, so he just locked her up, jail records show. He also failed to note on the intake form that she was jaundiced and complained of being in pain, a violation of federal policy.
At 6:12 p.m. the following day, Skunkcap had what appeared to be an alcohol withdrawal seizure as her cellmate watched helplessly. It was captured on surveillance video, but guards missed it. When they checked on Skunkcap nearly 90 minutes later, she was "unresponsive" in her bed, according to jail records. Correctional officers violated federal policy by failing to initiate immediate first aid, those records show. Instead, it took six minutes before a tribal police officer arrived and began lifesaving measures.
Every tribal correctional facility is required to have a working defibrillator on-site, but an Interior Department spokesman declined to say whether there was one. If a defibrillator was there, guards didn't retrieve it, law enforcement records show.
The correctional officer who booked Skunkcap later told the coroner that he noticed Skunkcap had "a yellowish tint" to her skin and had complained of not feeling well. But he never noted those ailments on her inmate medical screening form. David Mathis, a California physician who specializes in prison health care, said that this failure highlights a systemic problem within BIA detention centers.
"You cannot ask a correctional officer to make a medical decision," he said.
For years, details about Skunkcap's death were hidden from her family. Her brother, Keith Skunkcap, said he tried to find out what happened to her but was rebuffed by authorities.
"It's just going to be one of these [cases]," he thought at the time. "Just another Native dead."
She is one of at least five inmates at tribal jails who have died after guards failed to provide proper medical care and attention since 2016.
In 2017, the National Congress of American Indians, an advocacy group that represents tribal communities, passed a resolution urging the BIA to ask Congress for money to place medical personnel in its jails, arguing that the current situation puts a strain on tribal jails and "exacerbates the already challenging problem of health disparities for American Indians."
Indigenous people have some of the highest substance abuse rates in the country because they're a high-risk population, according to federal government statistics. About one-third of all people booked into tribal jails are arrested on drug- or alcohol-related charges.
Native Americans have suffered historical, generational trauma since the federal government took Indigenous land, systemically broke their culture and shattered families. That created poverty, health disparities, premature death and domestic violence on some reservations and fed into high rates of addiction, according to Brandy Tomhave, a lawyer and member of the Choctaw Nation who runs a tribal advocacy firm in Washington, D.C.
"The challenges that American Indian families face on reservations exceed the wildest imagination of most Americans," she said. "Some folks cope with that by abusing substances."
Tomhave has long advocated for the federal government to fund on-site medical personnel in jails to care for Native Americans, saying they have a responsibility to provide adequate health care for inmates. This duty stems from treaty obligations in which tribes gave up their land in exchange for promises of health, safety and security from the U.S. government.
"The federal government has chosen to ignore their legal obligation to provide appropriate staffing and programming in the form of medical care inside tribal jails," she said. "That decision has gotten people killed."