Years of inquests and lives on hold: Why did Shaun Coolwell die in custody?

Tragically, this isn’t the first death in custody for the family of Murri man Shaun Coolwell. Three years after he died, his family don't know when the inquest findings will be delivered.

Image of Sonya and Karen Coghill with fists raised Image of Sonya and Karen Coghill with fists raised

Sonya Coghill was 15 years old when the first member of her family died in police custody.

The first was her aunt, Barbara Yarrie, in 1986.

Barbara lapsed into unconsciousness in her cell after being locked up for public drunkenness. Hours later, an ambulance was called, but the 29-year-old would never wake up.

In 1988, another aunt, Fay Yarrie, became the second.

Fay was placed in a cell with two other women and left unattended for 40 minutes, during which time she was fatally assaulted by one of her cellmates .

The third was Sonya’s cousin, Bobby Yarrie, in 1998.

Bobby was only 16 years old when he was found hanging in his cell at the John Oxley Youth Detention Centre.

Sonya’s older brother, Bradley Coolwell, was the fourth in 2011.

Bradley’s family describe him as a family man who loved music, especially playing 1960s surf rock hit Wipeout on guitar. Though he “had some special needs”, he was non-violent, the “peace-maker” of the family and a father figure to his many nieces and nephews.

In 1991, Bradley was diagnosed with schizo-affective disorder and spent much of the next 20 years in involuntary care at the Park Centre for Mental Health.

A year after his release, in September 2011, police admitted Bradley to Logan Hospital.

A coronial inquest heard he became distressed when nursing staff attempted to replace his pyjamas with tear-proof security linen, which can’t be used by a suicidal patient to form a ligature. Hospital guards restrained him face down, holding his arms behind his back while they removed his clothes.

The coroner found that the 39-year-old died from the “combined effects of respiratory and cardiac failure”.

Four years later, in October 2015, Sonya’s youngest brother, Shaun Coolwell, became the fifth member of her family to die in custody.

A week after Shaun was released from jail, where he’d been serving time for property offences, Sonya says his family called an ambulance because he’d cut his foot in the bathroom.

Paramedics arrived with police officers, who claim Shaun was uncontrollable” and incoherent when they arrived. They restrained and handcuffed him while paramedics injected a sedative, midazolam. He lost consciousness and died in hospital hours later, aged 33.

Barbara Yarrie.
Fay Yarrie.
Bobby Yarrie.
Bradley Coolwell.
Shaun Coolwell.

Sonya carries a folder, a tragic family album with their photos, funeral programs and death certificates.

“This is what causes the breakdowns of our families,” says Sonya.

“It’s years and years of deaths in custody with no closure, with no answers.”

Every death in custody triggers a coronial inquest to examine the cause of death. It’s a lengthy, complex legal process that many Aboriginal and Torres Strait Islander families struggle to understand.

“I remember them really trying to get answers,” recalls Sonya’s cousin, Karen Coghill.

“You had them filling forms out and being interviewed, but we didn’t really understand what they were doing.

“Our people aren’t really good at articulating what the systemic issues are.”

In Bradley's case, the inquest took five years to deliver its findings.

No charges were laid over his death, however the coroner did recommend a review of a section of the Mental Health Act.

The findings of Shaun’s inquest are yet to be delivered.

Sonya describes the inquest process as a “pathetic joke” and “worse than a day in war-torn countries”.

“You can’t even look at the healing when there’s no closure,” she says.

“And proper closure in terms of go through everything, [and say] ‘we’re sorry this happened, this is what we’re gonna do to avoid it, this person’s going to be charged’.

“If that happened on our watch, we’d never work again. We’d actually be chucked into jail. But because they’re under the Crown, or under this government, they’re untouchable. It’s just ‘oh shucks, we’re sorry that happened’.

“It may all look that’s it’s being addressed, but it’s just names on paper to us, nothing really changes.”

Karen Coghill says the process is dehumanising.

“It’s people’s lives, but by the same token we’re being de-sensitised,” she says.

“Where’s the duty of care?

“The case with Shaun and Bradley – there was no crime involved. They were seeking help. It was health issues.”

Sonya adds, “That minute that they’re taking them into care, they’re invisible to us and anything can happen from that time.”

These days, Sonya says she and her family are reluctant to call police, or go to the hospital for help. She worries about her children, and the mental scars they’ll carry into their future.

With little communication from the courts, she scans the newspapers regularly for any developments on Shaun’s coronial inquest.

The frequent news articles about deaths in custody are quick to trigger her own trauma and pain. Aside from her family and her local Aboriginal community, she feels unsupported.

Asked whether she’ll ever be able to heal, she replies: “Oh I think we never ever do really. I think it just takes a piece of our heart and when we get to see them again, that’s restored again.”