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Anger. Fury. Frustration.

Just a few words to describe my viewpoint towards the nature of care that the mentally ill receive in this country. While in some ways America has made progress in the civil rights and treatment of our mentally ill (we are no longer locking them up in scary, sub-standard facilities with a minimum of three signatures to be subjected to heavy medication and electro-shock therapy), however I feel that we have now allowed the pendulum to swing too far the other way. In my opinion, the mentally ill are now quite literally suffering and dying from their own freedoms and with it, so suffer the people and families around them.

While the movie "A Beautiful Mind," starring Russel Crowe, which tells the true story of an academic suffering from schizophrenia, ended in a more or less happy ending with the character coming to terms with his affliction and living a productive life, not all individuals suffering from mental illness in America will be so lucky.

This blog is supposed to be about issues affecting families and in my opinion this is a major one. Not to mention it is highly personal at this exact moment considering the drama that is currently unfolding on the street that I live on. At the end of my street a very nice gentleman about my same age is living alone with only his pets for company. This same man, when we moved in, was very kind and always stopped when walking his dogs past our house and chatted whenever we were in the front yard. I knew him to be a bit quirky, but never anything but rational and considerate. Then about a year and a half to two years ago he lost his job. People stopped coming to the house not long after that. I still saw him walk his dogs and we talked about him looking for work. Then, within the last six months I started seeing him less and less until one day I realized I hadn't seen him out in quite a while. That is about the time the reports from neighbors started coming in. Strange sightings of him in his front yard arguing with no one. Knocks on peoples doors asking them who he was and why the government was trying to trick him about his identity with false and illegal birth certificates.

Then the police started coming.

The police have been to our street many, many, many times. Sometimes they come in unmarked cars with one or two officers. Sometimes they come with four or five marked SUVs. One particularly alarming day I arrived home to find our street blocked off, no one could come in or out. There were police, fire trucks, ambulances, and animal control vehicles. The result, they knocked on his door, checked that he seemed lucid and left. Another fun weekend night I looked out my living room window to see police in my front yard using bushes and cars on our street as cover and aiming rifles at the house in question. My friend called just then to ask if we were still having dinner since she was stuck at the end of our street unable to get through. Again, nothing happened. They were "just checking on him and there is nothing to worry about." Umm...if there is nothing to worry about, then why do you have multiple rifles trained on the house?

In all fairness, I think they are most likely correct. I had a visit one night shortly after dark. I heard a knock at my door and it was my neighbor. I greeted him and asked if he was ok. He was standing there with a bucket and he asked if he could borrow some water from our front faucet, his had been shut off. He was so polite and lucid I thought maybe he was back on his meds (he told another neighbor he was off of them because he could no longer afford them since he lost his insurance). No such luck though. I told him to please help himself whenever he needed it and that he didn't need to ask each time. He seemed fine right up until I said I was sorry his water was shut off and he started raving about government conspiracies, mind control devices, illegal birth certificates and how his family was behind it all. At no time did I ever get the sense that I was in any danger, but it made me profoundly sad. Then he came by a week or so later and he seemed much more agitated, and much more delusional. He was seemingly unaware of me after a moment and instead was heatedly arguing with the moon. I found it to be unsettling and made me feel a little more uneasy.

WHY, when he so clearly needs assistance are the police doing nothing? I thought, if they are here every other day checking on him, why can't they do something to help?

Being the person that I am, I immediately took to the Internet and began a full-scale search of mental health laws and services in this country, hoping I could find some way to help my neighbor who has never been anything but nice to us. What I found was highly alarming. There have been recent stories in the news, horrifying stories about similar issues with individuals suffering from mental illness. These stories have one thing in common, which is that the family was trying to get the individuals help, but were hand-cuffed by civil rights laws protecting the freedoms of the individual. I found an article here, that discusses neighbors unable to get help for a woman down the street who was holding the entire neighborhood hostage. I found examples just recently in my home state where we have had a 24 year old man who is suspected of killing his mother who tried to get help for him and feared for her life, or the largest mass shooting in American history this year when James Eagan Holmes opened fire in the premiere of the new Batman movie and who apparently had seen a psychiatrist on the CU campus where he attended school who specialized in schizophrenia. There are many more across the United States.

In researching what I might be able to do, I stumbled on to a wonderful article on the history of mental illness treatment in America, "Law Creates Barriers to Getting Care For Mentally Ill", which referenced a database, started in Virginia, called the "Preventable Tragedies Database." (you can search it's contents here) It is compiled by Dr. E. Fuller Torrey. The purpose of this collection is to record and track all tragic events that might have been avoided if only the laws existed to allow for state intervention for mentally ill individuals who are refusing treatment. The importance of this lies in the fact that until an individual shows the potential for imminent harm, or has committed a crime, they cannot be the subject of any state intervention with out their expressed consent and compliance. The downside of this law is that with many mentally ill individuals, there appears to be no identifiable escalation but merely a moment when they finally snap in some fashion.

So, in a horrifying Catch-22, my neighbor who lost his job in a crappy economy and was quirky enough not to immediately get re-hired, is now off of his meds and most likely unable to secure employment at this point. He can not get the assistance he needs because he is refusing to comply and is over 18. As a result of his job loss he has no money to get help, even if he wanted to, and is so far gone that it is doubtful he even understands he needs help. The authorities can do nothing because as long as he seems lucid enough, and has not done harm or is in imminent danger of doing harm, they cannot intervene if he is refusing treatment. Now he is living in a house where he has no water, and possibly no heat or electricity (although I thought I saw his lights on yesterday) with winter coming. It doesn't take a brain scientist to see how this story is going to end. It is going to end one of a few ways. He is finally going to commit harm to others resulting in his getting help through the criminal system, or help will be rendered unnecessary because he commits harm to himself. The other possibility is that he is going end up homeless with nowhere to go and will only be taken in by the state if he commits grievous harm (see previous statement). Either way I think it is deplorable that this story doesn't seem like it has any chance of a happy ending. He is a kind-hearted soul who is devoted to his furry (and scaly) friends and deserves a chance to get back on his feet.

In my opinion, which is hardly an island, America desperately needs to revise the laws to provide law enforcement a greater latitude to intervene when it becomes clear that the individual needs to be forced to continue treatment. In my opinion we need some sort of stepping stone system. It needs to be something that allows someone to maintain their freedoms as much as possible while still allowing the state more latitude in intervention in order to protect its citizens. It should be allowed, if enough community members or family members file complaints or concerns, that the court could issue a mandate of evaluation. It could be sort of a, "Hey your neighbors think you might be mentally unstable, please report to a shrink immediately and let's find out." The psychiatrist could evaluate the patient and decide if treatment is warranted. If it is found to be unjustified, or the neighbors are found to be making baseless accusations, there could be consequences for malicious reporting. But, if the individual is found needing medication, such as in the case of clear-cut hallucinations and they refuse to comply with treatment after three warnings, or if they never report to the initial visit, it could be mandated that they be taken in for a 72 hour treatment and evaluation. If the individual refuses at that point to follow a treatment program, they could then be taken into state custody unless a family member steps up to take responsibility for maintaining their required treatment. We mandate treatment for drug addicts and alcoholics who drive under the influence whether or not they commit harm to someone else. Couldn't we extend the same courtesy to mentally ill patients who desperately need help if they are disturbing the peace or threatening neighbors?

I am praying that I will have a blog post coming sometime in the future where we can celebrate the recovery and assistance that peacefully resolves the situation, but I am far from optimistic. His neighbors are helping as best we can when he will let us (one even offered to pay his water bill if he paid to have it turned back on), but we are a poor offering compared to what he needs; medication, psychiatric care and a social worker/family member who can check up on him.


Update:
You can read the outcome in my post "Failed to Death"