Support for the Family of John and Joshua Fox

Joshua was a kind-hearted child who loved writing, art, rap music, and wolves. He developed signs of schizophrenia at age 15, but the symptoms were intermingled with substance use, so Joshua didn’t get appropriate psychiatric treatment. At age 18, John and Crystal Fox tried to petition their son for involuntary treatment after he stabbed his leg with a knife, jumped out of a moving vehicle, ran into traffic, and started asking to purchase a gun. He was taken to Connections Health Solutions - UPC, an overcrowded psychiatric screening center in Phoenix, but he was released without treatment. At age 19, Joshua’s symptoms became increasingly dangerous. One week after Joshua’s 20th birthday, his father John tried again to petition him to a hospital. Instead, Joshua was arrested and jailed on domestic assault charges.

While in jail, Joshua’s attorneys ordered a psychiatric evaluation and an evaluation for Serious Mental Illness (SMI) designation, an Arizona state benefit that would have granted Joshua significant psychiatric services. Dr. Gwen Levitt diagnosed Joshua with severe psychosis and determined him to be dangerous, meeting all requirements for Serious Mental Illness (SMI) designation, and meeting criteria for inpatient and court-ordered treatment (COT) with medication. Unfortunately, the SMI benefit evaluator never received Dr. Levitt’s report, and Joshua could not fully participate in the screening. The SMI benefits were denied. Tragically, Joshua was released from jail with increased illness and trauma, and without any psychiatric services.

Joshua was released to the “custody” of his mother Crystal, with the expectation that she would “get help” for her son, a legal adult. Like millions of mothers with mentally ill adult children, Crystal was given complete responsibility to care for her disabled adult son but was not provided any resources or authority to do so. At the very least, Crystal should have been given emergency temporary guardianship with mental health authority.

The day of Joshua’s release from jail, Crystal took him to Aurora Behavioral Hospital in Tempe. Joshua was turned away because of arbitrary admission criteria requiring that he say “yes” when asked if he was suicidal. The next day Crystal called the La Frontera mobile crisis team, who suggested taking Joshua to a medical ER because he was insisting that he had “syphilis.” Crystal took Joshua to Banner Thunderbird Medical Center, where he tested negative for syphilis. The medical doctors did, however, recognize Joshua’s significant mental illness symptoms. They transferred Joshua to Banner Behavioral Hospital.

At Banner Behavioral Hospital Joshua became combative, still convinced he had “syphilis.” Since they could only accept “voluntary” and cooperative patients, the hospital staff filed another petition for involuntary treatment. Unbeknownst to Crystal, Joshua was transferred to another overcrowded psychiatric screening center, Community Bridges Inc. (CBI). Crystal received a call from Joshua the next day – from a Burger King in Avondale; he had been released to the streets without treatment.

Joshua attended a few outpatient telemedicine appointments with Terros Health that were scheduled by CBI before his release. Joshua frequently refused to eat, claiming his food was poisoned or contaminated with “semen and feces.” He often seemed emaciated or catatonic. He remained convinced he had syphilis, and thought his parents were trying to kill him by withholding treatment. But the services at Terros Health were all “voluntary,” and they refused to speak with Crystal because Joshua was an adult. To ease his mind, Crystal finally took Joshua to an STD clinic that would give him a penicillin shot, even though he didn’t need it. It didn’t help.

In all, seven mental health agencies refused to treat Joshua. Sometimes they said it was “just drugs.” Sometimes there were no hospital beds available for court-ordered psychiatric evaluation. Other times Joshua didn’t “verbally state he was suicidal.” Many agencies simply failed to collect history from his family and previous medical records, citing a misinformed version of the HIPAA privacy policy. Calls to the crisis hotline only wasted time trying to encourage a “voluntary” admission to avoid an involuntary petition. But the truth is, Arizona has a woeful shortage of psychiatric services and poor systems for accountability that allow mental health agencies to refuse treatment for the sickest patients.

Out of options, Crystal tried to care for Joshua at home. Eventually Joshua’s behaviors became unsafe around his elderly grandmother and disabled sister. Crystal finally moved Joshua to an Extended Stay Hotel where she could check on him and bring him food. John sent Crystal money to help with the added expenses; he had to avoid Joshua for safety reasons.

On June 4th, 2021, 20-year-old Joshua Fox stabbed his father to death in his SUV in the parking lot of a Fry’s supermarket. Joshua later stated that “clicking sounds like morse code” were sending him signals from the SUV’s engine. He offered a bizarre explanation that his father had accused him of “molesting children” and had posted sexual content on the internet.

In jail, Joshua was chronically suicidal. He starved himself, attempted hanging, and jumped off the second-floor balcony injuring his ankle. The jail failed to address his suicidal behaviors and he jumped off the same balcony, again. The second time he broke his vertebrae and both heels. While hospitalized for his injuries, Joshua explained that he jumped because “God” told him it would “bring a dead girl back to life.”

Outside of jail, individuals like Joshua easily qualify for psychiatric intervention and COT. But seriously ill inmates are generally allowed to refuse treatment. Jails and prisons instead use solitary confinement to “treat” problematic behaviors rather than offer psychiatric treatment. Even after his serious injuries the jail allowed Joshua to deteriorate for another year – to the point of near death – before sending him to a psychiatric hospital where he finally received SMI designation and a COT order for medications.

Under COT, Joshua slowly regained his ability to eat, speak, and function. Importantly, he was able to figure out the prison telephone. He began calling Crystal every day. Joshua told her that he was taking medications and he wanted to hear updates on his siblings and pet dogs. He asked to be sent family photos. Sometimes in recovery, individuals with schizophrenia awaken to a reality that is difficult to accept. One day Joshua called Crystal to say that he wished he hadn’t killed his dad. She explained that it wasn’t his fault. He didn’t kill his father, his schizophrenia did. She let him know he was forgiven, by God, by his family, and by his dad in Heaven. Joshua understood.

In Arizona, defendants with severe enough mental illness can be found Guilty Except Insane (GEI) and be committed to treatment at the Arizona State Hospital (ASH) instead of prison. But Joshua’s prosecutors, Juli Warzynski and Maureen Feeney refused to consider GEI plea options. They insisted that Joshua’s history of domestic violence, assorted drug problems, and the fact that he fled the scene of his father’s “murder” and admitted to arguing with him was an indication of guilt with a clear motive.

The prosecutors’ opinions, based not on science or law, would ultimately prove to be Joshua’s death sentence. In the end, Joshua’s penalty was dictated by the Maricopa County prosecutors, not a judge or jury.

Joshua’s illness improved with antipsychotic treatment. He was previously found incompetent to participate in his trial, but prior to sentencing he was declared “competent but medication dependent.” Joshua was able to accept a plea agreement. Prior to issuing his sentence, Judge Scott Minder, who was a bright light throughout the entire justice process, said he wished there was another option besides prison. On December 15th, 2023, he sentenced Joshua to 8 years in prison for manslaughter, with credit for time served, followed by 5 years of mental health probation. Judge Minder also wisely ordered that all of Joshua’s mental health records be sent to the prison and made a formal recommendation for psychiatric prison services. Sadly, Superior Court judges do not have the authority to order that defendants get placement in the psychiatric prison wing. This life-or-death judgement is made by the Department of Corrections.

Perhaps the most tragic words spoken at the sentencing hearing were Prosecutor Feeney’s statements implying Joshua’s sentence was lenient because “he would still be a young man when he got out of prison.” Her statement was wrong – dead wrong. Clearly Maricopa County prosecutors do not understand the risks of sending chronically seriously mentally ill individuals to prison.

On December 18th, 2023, Joshua transferred to the Alhambra prison through the general population intake. Despite Judge Minder’s orders and recommendations, either the jail did not send his medical records, or the prison did not read them. Despite Joshua’s SMI designation, COT order for medications, documented suicide attempts, and active suicidal behavior, Joshua was placed in a standard cell without supervision or psychiatric accommodations. Within 30 hours Joshua hung himself.

One final egregiously negligent mistake in Arizona’s continuum of care for the seriously mentally ill resulted in Joshua’s death. He was declared dead on December 23rd, 2023.

Amidst the tragedy that followed more than four years of systemic institutional neglect, there was a final Miracle in Joshua’s life. Joshua was already baptized in the Christian faith. Before his sentencing he told Crystal he wanted to join the Catholic Church, like his father John Fox, when he got out of prison. Thanks to quick efforts by hospital chaplain Deacon Jeffrey Strom and Father David Sanfilippo, Joshua received two Holy Catholic Sacraments of Confirmation and Anointing of the Sick, hours before his death.

Joshua is finally at peace. The kind boy that loved his siblings, wolves and rap music has had his broken body and mind perfectly restored. On December 26th at 4:22pm Joshua was escorted by family, hospital staff and prison guards along the Walk of Honor in which he donated multiple organs across the country for those in need, including his heart, kidneys, liver, and pancreas.

A community of self-proclaimed “Mad Moms” has come together representing families whose loved ones have been harmed by failures in Arizona’s treatment systems for serious mental illness. They will be fighting for the billions of Arizona tax dollars that have been wasted on inadequate and fraudulent “community treatment” programs to be redirected to acute psychiatric inpatient and secure facilities where these funds and services are badly needed. They will be fighting to stop criminalizing serious mental illness and for inmates to receive appropriate psychiatric treatment and humane care.

Crystal Fox, supported by the Mad Moms, will be demanding a full investigation into every behavioral health agency that failed to properly treat Joshua Fox, including the final errors that cost him his life.

Your donation will support Crystal Fox with Joshua’s final expenses. Additional funds collected will support the Mad Mom’s advocacy efforts in bringing legislative change and accountability for Arizona’s jails, prisons, and behavioral health facilities.

Services for Joshua Fox will be held:

Tuesday January 2nd, 2023

Messinger Mortuary and Chapel

7601 E. Indian School Rd.

Scottsdale, Arizona 85251

11:00am – Viewing

1:00pm – Service

Reception will follow.