TREATMENT ADVOCACY CENTER
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July 12, 2002
1. SAY YES TO HELP -- San Jose Mercury News,
July 9, 2002
2. HELPING PEOPLE OFF THE STREETS -- Los Angeles
Times, June 26, 2002
3. JAILING MENTALLY ILL FOR MINOR OFFENSES HELPS NO
ONE -- The Atlanta Journal-Constitution, April 4, 2002
4. MENTALLY ILL MAN GETS LIFE IN ATTACK ON COPS
-- San Diego Union Tribune, June 21, 2002
5. MENTAL ILLNESS HIJACKS FAMILIES -- Deseret
News, May 19, 2002
1. SAN JOSE MERCURY NEWS (CA), July 9, 2002 [top]
[Editor's Note: This week the struggle to secure California's
Assembly Bill 1421 received help from a new quarter: The San Jose Mercury News,
which is the fifth largest of the state's many daily newspapers. Such exposure
is a key to not only passing the bill, but in getting the Senate to restore the
measure to its original form.]
Editorial
SAY YES TO HELP
Mentally Ill Don't Have To Sink Deeper Into Delusion; State Senate Should
Restore AB 1421 And Pass It
EVERY day throughout California, people suffering from severe mental illness
fail to get therapy and medications that could relieve their suffering and help
them lead more normal lives. They live on the street, or in jail, or with
relatives who watch helplessly as their loved ones sink deeper and deeper into
delusion or depression.
The sad part is that usually treatment is available, but the mentally ill refuse
it, and state law prevents them from being forced into treatment until they hurt
someone or are so sick that they can't care for themselves.
It need not be this way.
The current state law, passed in 1968, was written to protect patients' rights
at a time when the mentally ill were routinely locked up, doped up and
forgotten. Today, better medications and less restrictive, out-patient therapy
are available. But treatment only works if the patients take their meds. And it
is the nature of certain mental illnesses, such as schizophrenia, that patients
refuse to get help.
Assemblywoman Helen Thomson, a psychiatric nurse, has fought for years to change
the law to allow involuntary treatment when a person's condition is clearly
deteriorating. Her efforts have been supported by many health care professionals
and the families of the mentally ill. But she has faced stiff opposition from
those she aims to help: mental health clients.
Two years ago, a sweeping reform bill she authored died in the Legislature. Last
year she introduced a more modest bill, AB 1421, which passed the Assembly
nearly unanimously. But last month a Senate committee, under pressure from civil
libertarians, amended AB 1421 so drastically that it would have no impact.
Thomson no longer supports it.
The purpose of Thomson's bill was to give judges the authority to force people
who are severely ill to take their medications. She included several safeguards
-- and more were written in -- to protect patients from unjust confinement. But
AB 1421 clearly took away some freedom of choice from the mentally ill, some of
whose advocates argue that involuntary treatment robs them of their dignity.
Where is the dignity for those who are in jail, homeless or lost? Most states
have stepped in to help. California must do so. The Senate should restore the
guts of Thomson's bill and pass it.
Readers
response to this article.
2. LOS ANGELES TIMES, June 26, 2002 [top]
[Editor's Note: And - by now we can almost say "of course" - it
was the Los Angeles TImes that first called for AB 1421 to be freed from the
most damaging effects of the California Senate's Health Committee's amendments
to the bill. When Senators vote on AB 1421 they will know that the California
print media is strongly in support, and that its members will be watching. ]
HELPING PEOPLE OFF THE STREETS;
A Tiny, and Huge, Change
In his dozen years as a deputy with the Sacramento County Sheriff's Department,
Sgt. Matthew Reale has encountered people dwelling on the street who are wildly
delusional, utterly wretched and clearly unable to make decisions that could
lead to a healthier life. And, like these people's frustrated families, Reale
has been powerless to help because of California's rigidly restrictive 5150
standard--named for a section of the Welfare and Institutions Code that says
people can be compelled to get treatment only when they are in imminent danger
of harming themselves or others.
Last week, at a hearing for AB 1421, the 32-year-old deputy joined families of
people with severe mental illness who had hurt themselves or others. The bill,
by Assemblywoman Helen Thomson (D-Davis), would lower the standard of
involuntary treatment to what insiders dub "5149 and a half."
Thomson's legislation is called "Laura's law," after a 19-year-old high school
valedictorian killed in Northern California by a man whose mental illness went
untreated. Under it, a judge, after consulting with a severely mentally ill
person, his legal representative, family members and mental health
professionals, could order outpatient treatment if that person would otherwise
be at risk of "substantial deterioration." Law officers like Reale could send
the sick person to a hospital or clinic.
Reale says the ever-so-slight lowering of the standard would "help 20 severely
mentally ill people I know who are living on the streets right now."
AB 1421 passed the Senate Health Committee last Wednesday in a 7-0 vote, but
only after civil libertarians persuaded the committee's chairwoman, Sen. Deborah
Ortiz (D-Sacramento), to tack on a bevy of amendments. The Senate Judiciary
Committee will probably consider the bill next week.
Most of the amendments are sensible attempts to strengthen the legislation's
already strong protections of the rights of people with mental illness.
The amendments would, for example, require public defenders to be present at any
commitment hearing and require county mental health directors to review each
petition to ensure that severely mentally ill people aren't sent to court
frivolously.
We urge Assemblywoman Thomson to compromise and accept six of the seven proposed
add-ons.
She, Ortiz and the Judiciary Committee, however, should reject the remaining
amendment: rigid ideologues' brazen attempt to nullify the bill by restricting
eligibility for the new program to people who meet California's current 5150
standard.
Like others who are fed up with the deplorable status quo that allows mentally
ill people to live and die on America's streets, Reale says the peculiar
amendment befuddles him. "We already have a system for 5150--hospitalization and
jail," he says. "We need something for people before they get to that
[condition] so they can receive treatment in the community."
3. THE ATLANTA JOURNAL-CONSTITUTION, April 4, 2002 [top]
[Editor's Note: As the laws in most states stand, intervention
for many overcome by severe mental illness must wait for a sickness induced
crime to be committed - psychiatric treatment does not come until it does so
from the other side of a jail house door.]
JAILING MENTALLY ILL FOR MINOR OFFENSES HELPS NO ONE
By Dr. Richard L. Elliott
A recent report commissioned by the state parole board warns that Georgia could
soon face a prison crisis. The report said that while Georgia's population
increased 78 percent since 1970, its prison population grew 417 percent. Equally
troubling but not included in the report is this: Between 1991 and 2001, the
number of inmates in Georgia's prisons with serious mental illnesses more than
quadrupled, from 1,251 to nearly 6,000.
Georgia mental health advocates have been concerned for years about the
unnecessary incarceration of persons charged with nonviolent offenses. As more
people with severe mental illnesses have been released into communities, and as
funds for treatment have been reduced, patients go untreated and find themselves
in trouble with the law for some minor offense. Sometimes, a patient is
recognized as mentally ill and diverted to a mental hospital for treatment. Much
more often, however, the patient is sent to jail, where services are minimally
available.
A 1998 survey of mental health services in Georgia's jails showed the majority
of sheriffs believed that the number of people with mental illnesses in jail had
increased dramatically, largely as a result of unavailable community services.
The situation in Georgia mirrors the national picture, where, over the past 15
years, the number of available hospital beds has dropped 40 percent and the
number of people in jail with mental illnesses has soared 150 percent.
Eight times as many persons with severe mental illness are admitted to
correctional settings as are admitted to hospitals, and it is estimated that 10
percent to 15 percent of inmates have a serious mental illness, for which jails
rarely have the resources or funding to provide adequate treatment.
The financial and human consequences of incarcerating people with mental
illnesses charged with minor offenses are great. Jails become crowded. Court
dockets become taxed and pretrial delays become longer, resulting in further
jail crowding. The end result is higher costs for taxpayers. For patients and
their families, incarceration means increased suffering, greater risk of suicide
and the added stigma of being labeled both "mad" and "bad."
After release, patients find it much more difficult to obtain decent housing and
employment with a criminal record. Those who fail to reintegrate have a greater
risk of being rearrested or rehospitalized, because people with untreated mental
illnesses are likely to engage in erratic and unpredictable behavior, often
unintentionally causing harm to themselves or someone else.
What needs to be done? Jail diversion and treatment programs need to be funded.
Diversion programs teach officers how to recognize people with severe mental
illnesses. When an officer realizes a "suspect" has a mental illness, different
techniques can be used to resolve the situation and subdue the patient. If
charged with a minor offense, the person can be diverted to an inpatient
treatment setting, a less costly alternative by virtue of a usually much shorter
stay.
Persons charged with more serious offenses should be screened by a mental health
provider and provided appropriate treatment -- including access to the full
range of mental health medications -- while incarcerated.
Mental health courts should be created to handle, on an expedited basis, such
cases to reduce crowding in jails and in courtrooms. Finally, funds need to be
provided to community mental health agencies and to jails for providing services
to inmates with serious mental illnesses.
Neither the patient's nor the public's interests are best served by
incarcerating people with mental illnesses who are charged with minor offenses.
Programs such as those outlined above have short-term costs, but will lead to
long-term savings by reducing the need for jail, court and public hospital
capacities. We must educate those responsible for funding, to the personal and
economic benefits and necessities of these programs.
Dr. Richard L. Elliott is a professor of psychiatry and medicine
at Mercer University School of Medicine in Macon.
4. SAN DIEGO UNION TRIBUNE, June 21, 2002 [top]
[Editor's Note: And if it is possible, the tragic waste of human
potential because treatment lags is multiplied in those states with "three
strikes" laws. Under these laws, those who repeatedly commit certain types of
crimes face ever-longer sentences. The dragnets these laws create are designed
to catch career criminals but they also sweep up those who cannot control the
symptoms of their psychotic illnesses because of laws that forbid help.
The end equation? In the case described below convictions for assault, evading
an officer and resisting arrest caused by mental illness equaled life
imprisonment.]
MENTALLY ILL MAN GETS LIFE IN ATTACK ON COPS - JUDGE DENIES BID TO LIFT
EARLIER STRIKE
By Onell R. Soto, Union-Tribune Staff Writer
A mentally ill San Diego man who pleaded guilty to repeatedly attacking police
while in a drug-induced craze was sentenced to life in prison yesterday.
The sentence was set despite pleas from the man's lawyer that when he is on
lithium he's not dangerous.
Michael Montello, 42, pleaded guilty in March to assault, evading an officer and
resisting arrest in connection with a Dec. 22 uproar after his family called
police to report he'd hit his brother in the face with a rock.
Montello had earlier convictions on similar incidents in 1988 and 1993, which
made him eligible for a life prison sentence under the state's three-strikes
law.
A psychiatrist diagnosed Montello with bipolar disorder and drug addiction.
Defense lawyer Selena Epley urged San Diego Superior Court Judge John L.
Davidson to dismiss at least one of the earlier strikes and avoid a life
sentence for a man she said simply "fell through the cracks" of the mental
health system.
"He can be saved," she said. "This is a changed man. He's on the right
medication."
Davidson said he could not justify dismissing a strike.
"It would be an abuse of this court's discretion," he said, instead sentencing
Montello to 56 years to life in prison.
Prosecutor Douglas Rose, citing earlier attacks involving a flashlight, the pin
of an officer's badge and a shovel, said it's too late for Montello.
"He had the chance to address that before," he said. "It's maybe tragic that he
did not take advantage of the opportunity to get mental health treatment."
Police officers also urged the judge to lock Montello up for good.
"Right and wrong is the issue here. It's not whether or not he can be treated,"
said San Diego police Officer Michael Headley, whose patrol car Montello struck.
"We didn't start the fight with Mr. Montello that night. He did."
Late Dec. 22, one of Montello's six brothers called police to his mother's
College Area house, saying Montello was acting crazy, having smashed his
brother's face with a rock.
"He's a known psychopath," George Montello told a dispatcher on a tape played in
court yesterday. "We can't tolerate any of this."
When they arrived at the home, police said, Michael Montello was attempting to
flee in a Ford Ranger. He smashed into a patrol car and drove the pickup into a
yard, where it got stuck against a wall.
Montello, dressed only in underwear and an open flannel shirt, got out of the
truck with a clublike car lock and threw it at the officers, police said.
One of the officers said yesterday the only reason he didn't shoot Montello was
that other officers were in the line of fire.
Montello would be dangerous if released, officer David Iorillo said. "Somewhere
along the way, he's only going to kill a cop, or be killed by a cop," he said.
Montello said yesterday he didn't mean to harm anyone.
He said he got paid in methamphetamine for plumbing work and was high when his
brother and mother confronted him for smoking a cigarette inside her house,
where he lived.
Then he went into a paranoid rage.
"I changed just like that when confronted," he told the judge.
He got scared when officers pointed guns at him and threw the club in the air.
"It was stupid, I know, but I didn't intend on hurting anybody," he said.
"Taking the lithium has helped me considerably. I can think more logically. ...
I didn't want to come to jail to get it."
******************************
July 12, 2002
5. DESERET NEWS (UT), May 19, 2002 [top]
[Editor's Note: We found this article to be different from most
profiles of the effects of severe mental illness. For while it does focus on
people who suffer from psychiatric disorders, the writer does so through the
viewpoint of those who love them.]
MENTAL ILLNESS HIJACKS FAMILIES
By Amy Joi Bryson, Deseret News staff writer
Helen Royce is working when she gets a phone call from her daughter.
"I'm seeing leprechauns."
"Kathleen, you're OK. I'll be home in a little while."
On another day, Kathleen is riding the magic bus again.
Then she's in the kitchen, hysterical.
"She just kept crying and crying. This time, she's sure I've been way out of the
country on the same magic bus."
Royce is tired.
"I feel like I don't live my own life."
Her daughter, 44, is schizophrenic.
Not long ago, Terrell Sorensen slipped outside and shimmied under his truck
while the rest of his family slept.
He knew he would find help there. His mind churning and his body in pain from
construction accidents, he lay there drinking motor oil. It would lubricate his
back, loosen the tumor and make it slide away.
Later, he disappeared into the mountains and tried to copy the elk and deer. He
knew many of them were shot but managed to heal.
If he ate what they did, lived like they did, he would recover.
But he has schizophrenia, not a bullet wound.
Teri Stock's son had been hospitalized 12 times in five years that included
seven suicide attempts and multiple encounters with the police. During one of
the most recent hospitalizations, doctors assured Stock that her son was taking
his medication and getting better.
Rob, who is bipolar, called her from the hospital.
I'm doing fine, he said, and told her about the chicken legs he was growing.
Mental illness steals the minds of its victims and hijacks the rest of the
family in the process. Mothers like Royce must care for adult children as if
they were still youngsters.
"I just wish she could live a normal life like other people, because when I do
die and go, I don't know what is going to happen to her," Royce says. "A baby
can always grow up."
Sue Perry knows firsthand that jail is the net for the addicted and mentally
ill.
She and her husband, Von, pull out two batches of yellow letters they've saved.
The return address is the Salt Lake County Jail.
In the first set, son Jeff pleads for forgiveness. He promises to change.
In the next set, he is seething.
"You still appear to have no clue . . . If I am really that big of burden, then,
fine, goodbye."
There are tears in Sue Perry's eyes. She isn't sure if she should visit again.
"There are times when it's really hard to love him," she said. "Are you supposed
to have these feelings as a parent?"
Peggy Sorensen knows when her son, Terrell, is on the edge of disaster.
He stops worrying about combs and hairbrushes and clothes.
"When he starts worrying about his hair and agrees to get it cut, I know he's
getting better."
Terrell's illness began slowly.
Four years ago he had friends, a job, a fiancee. Then little things started to
happen.
He broke up with his girlfriend. He started sleeping a lot, retreating to his
bedroom for hours, days.
His mother thought it was depression and he'd shake free.
He didn't.
She sought help, but Terrell was 26. A mother can only do so much for an adult
child, especially when she bumps into the system.
"I went from Layton city to the Davis County Courthouse and into Ogden trying to
find anyone who would listen, trying to tell them this kid had a mental problem
and needs help. You just keep running into walls because nobody knows what to
do."
Denial is often part of the disease. Injured
years ago in a pair of construction accidents, Terrell knew his body was broken.
He didn't accept that his mind was in trouble, too.
There was a trespassing charge. The tangents started. Terrell's reality changed
in a flash.
Bombs in the ground.
Flash.
Terrell has a cure for cancer -- sperm injections. So convinced it would help,
Terrell called a New Mexico doctor and later wound up on the steps of the
Huntsman Cancer Institute in Salt Lake City.
Flash.
He's convinced he has six children.
Flash.
"It kills you to hear the things they say. He'll get on tangents about people
out to get us. I could see him being one of those people the cops shoot."
The medication can halt the flashes of Terrell's changing reality, but Terrell
has to take it -- and in the right mix.
When his workers compensation ran out, so did his medication.
Terrell could feel the descent. Knowing that jail had doctors and jail had
medicine, he exposed himself to two junior high school girls.
His mother, facing one of the hardest decisions she ever had to make, opted to
leave him in jail to help him.
Like Terrell Sorensen, Rob Stock started his descent gradually.
In Kentucky, he was senior class president and a soccer star. He landed a
scholarship to a university in Colorado.
Rob gave up his scholarship, blew all his money and returned home.
His mother, Teri, wondered if her son was experimenting with drugs. She took him
to see a doctor, who told her, "You better pray it is drugs, because if it's
mental illness, you're in for a ride."
When the diagnosis was made, Teri had no choice but to climb on.
Bipolar disorder, formerly known as manic-depressive illness, usually strikes
between the ages of 19 and 24.
"We've been in the system for five years. There's been seven suicide attempts,
one right after he got out of the hospital. The good news is he took his
medication. The bad news? He took 50."
The pictures of her family on her baby grand piano don't tell that story.
There's one of Rob and the pretty blond girl he took to the prom. He looks
confident and handsome.
"One day, he had the world at his feet, and then it was taken all away. The day
I found out he was bipolar I refer to as the day my son died. The son I loved --
at times I see glimpses of him."
Rob checked himself in to the hospital in March when he felt a downward spiral
begin. His mother is grateful he recognized it. But the flip side of that
dawning consciousness comes with its own kind of misery.
"When he can articulate his pain, he asks me to give him something to live for.
What do I tell him?"
Rob's little sister made him a scrapbook, compiling newspaper articles about his
soccer career, photos from grade schools, notices of academic achievement and
his certificate of Aaronic Priesthood ordination.
He cried. It took him two years to look at it.
His mother understands.
"Since he was 19, the only thing I have to put in there is hospital reports."
Bipolar disorder affects about 1 percent of Americans. It is characterized by
alternating bouts of extreme depression and mania, where victims experience
dangerously impaired judgment and grandiosity.
Although it can strike at any time, the median age is 21-- an age when impetuous
behavior isn't that uncommon.
People with bipolar disorder don't listen to family, friends or co-workers and
have no insight into how extreme their behavior is when they are in the manic
phase. When they're depressed, they lose interest in nearly all activities, have
no energy and are preoccupied with death.
Bipolar sufferers often go for years without a diagnosis, with family and even
physicians unaware the swings are the result of mental illness. After diagnosis,
it often takes more than one type of drug to hold the disorder in check, leading
to frustrating periods of trial and error that only increase the likelihood of a
tragic outcome.
Sufferers in the manic phase often see no reason why they should behave, flaunt
their invincibility with police, and wind up in jail.
Sharlene Kuehnl's bipolar daughter was arrested for assaulting her boyfriend.
"She can be very violent and mean, but as long as she is on her medication she
is wonderful," her mother said.
Kuehnl called the jail where her daughter was incarcerated. She said her
daughter was mentally ill and that she hoped she received the right kind of
medication.
She didn't.
"When I heard her on the phone panicking and crying, it makes you feel so
hopeless," Kuehnl said. "You feel helpless anyway. It is hard enough when they
are young and they have a cold. Then mental illness comes along and a cold would
be wonderful compared to this."
Jeff Perry is among those on the fringe -- people who don't have a diagnosis but
whose family suspects he has a chemical imbalance.
"We can't him to go get treatment," Sue Perry says. "He thinks we are the ones
with the scrambled-egg brains."
The oldest boy of eight children, Jeff was a master of math in high school and a
strapping fair-haired teenager when he started to change. For the Perrys,
experiencing a male teenager in their household for the first time, it was a
confusing period. Jeff rebelled against any authority, but his parents were
unsure if it was simple teenage angst or something else.
A family doctor put him on medication that helped with depression and anger. But
when Jeff turned 18, he stopped taking the drugs, and his parents couldn't do
anything about it.
"When they're an adult and out of the household, they are outside the realm of
parents putting them in bed and giving them Triaminic and hoping they'll get
better," Sue Perry said.
The more his parents read about bipolar disorder, the more they are convinced
Jeff might suffer from the illness.
Jeff's first brush with police was driving on a suspended license. More serious
charges followed after Jeff started experimenting with drugs.
Experts say it is not uncommon for people with mental illness to also have
addiction problems.
That complicates making a diagnosis and often leaves treatment for the mental
disorder secondary to addiction.
It also frustrates parents trying to get help for their children.
"When he is in his good zone, he is the most kind, most unselfish, most
hard-working kid you'll ever see," his father said. "He's worth saving.
But when he gets outside that realm, he's a different guy. We're still at a loss
at what to do."
When Sue looks at her son's letters, the ones that beg her forgiveness, she
wants to believe.
"I want out," he writes. "I want out for good. No more crime and no more drugs.
Forget everyone before. I want to be Jeff again. Please help."
She wants to.
Another letter.
"You set the rules. Whatever they are, I will follow them. I am not joking. I am
crying. I am at the end of my rope with nowhere to go."
Jeff's problems have infected the household.
Some of his siblings are disgusted, some are embarrassed and frustrated, while
all hold out hope he will get better.
In late April, the family found a way to express that hope.
One of the Perrys' children, a daughter, came up with an idea for an activity
after family home evening.
The six children could write and offer encouragement to a brother in the middle
of finals or to Jeff.
They picked Jeff.
"It was so sweet reading their letters," Sue Perry said. "They wrote about their
lives and what was going on with them. He wrote an endearing letter back, and
put in a personal message to each of them."
The Perrys believe that the letter had an impact on their oldest son.
"Parents are supposed to love," she said. "But when it comes to brothers and
sisters, you can tell it meant a lot."
Society isn't always so understanding.
"People from the ward don't bring you over dinner when you have a mentally ill
person in the family," Von said. "When someone was diagnosed with leukemia, the
whole ward fasted and prayed and brought over food, which is fantastic. But when
it is mental illness, they think they're going to catch it if they look at you.
People would rather just stay away."
On a recent spring afternoon, warm under blue skies and sunshine in the
foothills of Bountiful, Teri Stock is watching her son play with his Husky dog.
In the gentleness of his touch with Chinook, she sees how the destinies of so
many people -- and animals -- have been cheated by mental illness.
Rob always wanted to be a
veterinarian.
"He has an incredible affinity for animals. He's brought stray creatures home to
care for them because he has such a great love for them."
The years have brought a bathtub full of snapping turtles, snakes under the bed,
a lizard on a leash and spiders in a jar.
Once, he gave mouth-to-mouth resuscitation to an ailing reptile.
Now, his big outing of the day is a walk to a convenience store to buy a soda
pop. He's 25.
"The reality of the pain of what might have been is pretty intense," his mother
says. "You look through the scrapbook and you see all the hopes and dreams.
Instead, it's been five years of pain and struggle and failures. But there is
always hope."
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