AP Photo/Reed Saxon

His father named him Itzcoatl Ocampo, after the fourth emperor of the Aztecs, a particularly combative emperor known for laying the foundation of what would become the Aztec empire.

Born in Mexico and raised in California, Ocampo would go on to have battles of his own. He joined the Marines at the age of 17 in 2006 and was honorably discharged four years later in 2010. He would return to the U.S. hearing voices that may have led him to kill six people, before he ultimately took his own life.

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Last month, on November 28, prison officials discovered Ocampo shaking and vomiting in his single-man cell at the Central Men's Jail in Orange County, according to a statement released by the Orange County Sheriff's office. The 25-year-old Iraq veteran was rushed to the hospital after he allegedly ingested the cleaning agent Ajax. He died a day later.

Ocampo was awaiting trial after being accused of six murders, including the deaths of four homeless men who were stabbed to death between Dec. 20, 2011, and Jan. 13, 2012. The series of murders spread through several cities, made headline news and terrorized an already vulnerable homeless population sleeping on the streets.

Ocampo said he had no history of psychological problems before going to Iraq, according to court documents. He said he only felt the need to kill after he was assigned to driving a water truck and a dirt truck on a military base in Iraq, instead of a combat position. The U.S. Department of Veterans Affairs diagnosed Ocampo with posttraumatic stress disorder (PTSD) upon his return, according to his lawyer.

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Ocampo’s family and lawyer are raising questions about how prisons systems treat inmates who suffer from PTSD.

“I’m not aware of guidelines specific to veterans with PTSD,” Lt. Jeff Hallock, an Orange County Sheriff’s department spokesperson told Fusion.

“Everyone that comes into our custody goes through a medical triage where we look at their medical and mental health condition at the time of booking and that is where a determination is made as to whether they need special medical housing.”

The day that Ocampo became ill and was found in his cell by the deputies, he was not housed in a medical unit.

“If you spent three minutes speaking to him you were acutely aware of the fact that he had serious mental issues,” Ocampo’s lawyer Michael Molfetta told Fusion in an email.

“Ocampo was a sick man who was facing the death penalty while he sat alone in a 8x11 or smaller cinder block cell upwards of 24 hours a day. Is it really too much to ask not to give him any substance that could be used to hurt himself or others? Is it really that hard?” Molfetta said.

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Final toxicology results are still pending but Orange County jail officials said inmates can request cleaning supplies.

“Typically inmates in Orange County jails are provided small amounts of cleaning products upon request because we have an obligation to provide them a means to clean their housing units,” Lt. Hallock said.

Hallock wouldn’t comment on the substance Ocampo ingested pending the results of the toxicology report, but described one of the cleaning products dispersed to prisoners as a “powdery substance that you mix with water” to clean.

In Jail With PTSD

(Anaheim Police Dept., File photo)

Itzcoatl Ocampo’s brother, Mixcoatl Ocampo, told the LA Times his soldier brother sank into a depression after returing from Iraq and often suffered from hallucinations.

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“He was always paranoid,” Mixcoatl Ocampo said. “He would search the closet and bathrooms of the home for bombs. I would tell him to stop being crazy.”

Suicide rates among military veterans has reached unprecedented numbers. A study US Army Public Health Command found suicide rates among Army personnel increased 80 percent between 2004 and 2008, and 17 percent of the soldiers had previously been diagnosed with a mental health problem.

But while multiple studies have looked at veterans and PTSD, little is known about treating veterans with PTSD who are incarcerated.

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A Veterans Affairs (VA) spokesperson told Fusion that the federal agency does not offer any medical or psychological services to veterans who are incarcerated in California institutions.

The most recent survey on the issue — compiled by the Department of Justice’s Bureau of Justice Statistics in 2004 — found that nearly one in ten inmates in U.S. jails had prior military service. [PDF]Like Ocampo, the study also found incarcerated veterans had shorter criminal histories than non-veterans in state prisons.

Ocampos’ father told the Orange County weekly the military paid little attention to his son once he returned from Iraq.

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"There are more like him out there, but the government will not acknowledge it," Refugio Ocampo told the OC Weekly. "There's a lot of others but they refuse to help him. To train someone to kill, [the military] needs to disengage them — but the government just throws them back in. They're not taking full responsibility.”

Before service members leave the military and enter civilian life, they’re supposed to go through a three-day workshop called Transition Assistance Program (TAP), where they learn about the services available to them, including medical and psychiatric care. Once discharged, it is up to the veteran to follow up and seek the services, a VA spokesperson told Fusion.

But when veterans with PTSD get into trouble and end up in jail they’re stuck in limbo: they can’t visit VA offices for benefits and the VA can’t enter the jails to perform services.

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“Everything that the VA offers is offered to a veteran after incarceration, we can’t do anything until they’re out of the system and have the ability to receive our services,” VA spokesperson Ndidi Mojay told Fusion. “We can’t go into prisons because that’s beyond our jurisdiction.”

The VA does have 44 social workers that work in 1,000 jails nationwide, but they only meet with veterans who are scheduled to be released and do not provide any services other than informing the soon to be released inmates of the services available to them.

Marie Middaugh, mother of Lloyd "Jimmy" Middaugh, who was one of the homeless victims, told the AP Ocampo’s death gives her some relief now that they won’t have to go to trial.

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"We don't have to relive things again,” Middaugh said. “I don't have to dread getting a phone call, we're going to have a hearing and all the horror coming back.”

Itzcoatl Campos’ father, Refugio Campos, said that per his son’s wishes, he plans to spread his son’s ashes at Camp Pendleton, where he started his military career.