"Residentially challenged"

When you have a home but refuse to live in it, can you really be called "homeless"?

William Royce had a home, and a loving family. But he died in the elements after mental illness robbed him of his ability to make informed choices. A local police department spokesperson called Royce "residentially challenged,' which many, including one letter-writer, called "a new low in political correctness."

But might that actually be the most accurate way to describe someone like William Royce?

In a response via a letter to the editor in the Tallahassee Democrat, William Royce’s father Charles makes this unique argument.

I thought "residentially challenged" was a very correct way to describe the situation, and our family appreciated its use in the newspaper.

This was a young man who wasn't homeless, but he was residentially challenged, and he chose to live where he was found. He was also mentally challenged. He had been diagnosed with schizophrenia and he periodically was affected by that. Whoever coined that phrase, or opted to use that phrase, was very kind in his choice of words and the family appreciated that.

Community members call for better treatment in Virginia

The following quotes are from news coverage of the death of Susanne Thompson, who was stabbed while walking her dog Saturday morning. Johnny Hughes, the man charged with her murder, has a history of mental illness.

He's [Richmond Mayor L. Douglas Wilder] concerned that state law doesn't always allow mandatory treatment of mentally ill people with criminal histories.

“… this situation represents a much larger problem. The real question is how many others are similarly situated across the state and the region who need coordinated mental health resources in order to reduce any possibility of this situation recurring.”

Hughes' younger sister, Chesterfield County resident Jackie Lewis, said the killing could have been avoided.

"We are so deeply sorry for this innocent loss," Lewis said on behalf of her family. "I'm sure if my brother was in his right mind, he would feel the same way."

"Somebody dropped the ball in terms of his care," she said.

Richmond Sen. Henry Marsh: "The purpose . . . is to create an assisted outpatient treatment program so that those mentally ill persons who are capable of being maintained safely in the community with the help of such a program can receive those services."

"The things he [Hughes] was saying, he didn't belong here," said [Richmond Sheriff C.T.] Woody, who has complained that the jail does not have the facilities or resources to care for the hundreds of mentally ill men and women doing time there.

Keeping children safe

As a community tries to understand the shocking deaths of three children at the hands of their own mother, today’s Deseret Morning News reports on the link between severe mental illness and filicide:

In the medical community, the practice of parents killing their children is known as filicide. A study printed in a 2005 Journal of the American Academy of Psychiatry and the Law article found about 2 percent of homicides are filicides.

Another study found about 40 percent of filicidal parents previously had been treated for psychosis, but about 75 percent likely were suffering from symptoms of mental illness.

While people who are being treated for their severe mental illness are no more violent than the general population, those who are not properly treated for their symptoms do pose a greater risk to themselves, others and, sadly, even their own children.

Suicide at UCLA

In Los Angeles, 19-year-old Simon Latimer committed suicide last Friday by walking off a balcony at a UCLA campus. Latimer’s mother, Dianne Taylor said Simon had schizophrenia, and toward the end of his life heard voices from God and wandered around LA looking for God.

Like so many other parents whose grown children have a severe mental illness, Simon’s parents tried to get him help.

“He did well in school, got awards, and then about a year ago, he started hearing voices and became schizophrenic. His personality changed, and he refused treatment,” Taylor said.

Though his parents tried to get him into programs, Simon declined. Since he was over 18, his parents had no choice but to let him go his own way.

“Because he wasn’t considered ‘bad enough’ by the authorities, I couldn’t get him into a hospital,” Taylor said.

She added that this was especially hard since refusing treatment is a common symptom of schizophrenia.

A mother testifies in Pennsylvania

In Pennsylvania yesterday, the Senate Committee on Public Health and Welfare heard testimony on SB 226, including this all-too-typical story from a mother who supports the bill.

Thank you for inviting me to speak to you this morning. My name is Dorothy Tengler.

This is my only son, Todd – a blue-eyed, blonde-haired, gentle little boy not unlike all the other little boys on the block. He was smart. He was funny. He was loving. That was 35 years ago. Today, Todd roams the streets of his town, believing he is a member of the United Nations. He has tried to force his way into the back rooms of a local supermarket to investigate a murder he believes to have happened. He has stood outside the elementary school, copying down the numbers of the school buses, telling police officers and wary onlookers that all the children inside the school belonged to him. As a member of the UN, Todd believes he does not need to pay his electric bill, so his electricity is turned off on a regular basis. I can’t reach him on his cell phone anymore because he has taken out the chip, looking for evidence of surveillance. Todd believes that most of us are somehow connected to Hitler. Even me. He doesn’t believe I am his mother. He believes that I ran an illegal sperm bank when he was a little boy, and somehow he is a result of that. Before all this happened, Todd earned a degree in computer graphics, was a talented musician, and loved spending time with the rest of his family.

But when Todd was in his early thirties, he was diagnosed with schizophrenia. Todd’s delusions have been chilling, including being hunted by the FBI in helicopters for, among other evil acts, the murder of his grandfather. He has been hospitalized more times than I care to count. He has been mandated to periods of outpatient therapy, and when forced to take a low dose of antipsychotics, Todd has been highly functioning and able to live a fairly normal life.

But Todd doesn’t believe he is sick. So, he refuses to take medication.

In fact, it has been at least 3 years since Todd last took medication. And his paranoia is escalating. Recently, he was arrested for simple harassment. He didn’t appear for the hearing because, of course, as a member of the UN, he has the power to veto court orders. So, a bench warrant was issued. Todd still doesn’t quite understand what he did to be arrested. He spent 3 weeks in prison before he had someone call me to post bail. He faces a trial at the end of October.

Todd is a ticking bomb. And I wait each day for his life to explode.

Now, I believe that each of us has the right to exert control over our lives – be able to decide if we want treatment for our diseases, be able to say yes or no. However, there comes a point when the very nature of many mental illnesses precludes the ability to reason and destroys any trace of insight. To that end, I believe that as moral human beings, those of us standing on the sidelines of these devastating illnesses need to extend a hand and help these individuals become stable and reclaim their lives. What I don’t believe is that those with mental illness be left alone in
their darkness until they reach a certain level of dangerousness before receiving treatment – like waiting for a certain number of fatalities to occur at a dangerous intersection before erecting a traffic light.

As a family member, a mother, I support PA’S SB 226. With assisted outpatient treatment, we can bring many of these loved ones back to their families, their friends, and importantly, their communities. Pass SB 226 for the millions of untreated persons with mental illness. Pass it for my son, Todd.

"I had to press charges against my son..."

“I am unable to do anything for my son now because as an 18-year-old, he is considered legally responsible for himself. I see him often wandering my neighborhood, wearing bedroom slippers, walking around wide-eyed and confused. Hopeless.

I had to press criminal charges against my son in hopes of getting treatment.”


- op-ed in the Atlanta Journal Constitution in which a mother describes her struggle to get treatment for her son who has a severe mental illness

Oprah on bipolar and violence

Andrea Petrosky killed her child. On The Oprah Show today, she talks about it, and about her bipolar disorder.

Petrosky is one in a long line of mothers whose untreated or wrongly treated severe mental illness had such a sickening result. In fact, of children killed by a parent, 15.8 percent of defendants had a history of untreated mental illness.

What she has to say about it sounds very familiar.

Andrea says the person who killed her son "wasn't me. It wasn't the real me. It was a very sick me, because I would never hurt him. Never," she says.

Her voice is an eerie echo of many who have been through similar circumstances. Like Naomi Gaines, who killed her 14-month old twins.

"I know how I was feeling that day. I know I was not the same Naomi who got up with my kids a million times before and fed them and bathed them and walked them and breast-fed them and cared for them," she says. "I wasn't that same person. So I know that I would never hurt them if I had had my sanity."

It isn’t the disease that leads to violence, it is the lack of timely and effective treatment for that disease.

People with severe psychiatric disorders are not more dangerous than the general population - if they are being treated. But without treatment, some commit acts of violence because of their delusions and hallucinations. Many of the cases in the news eventually uncover the fact that the person who killed their child was not taking medication. And research shows that the most common reason that people with severe mental illness refuse treatment is because they are too sick to realize they need treatment.

Don’t believe the hype you will hear today from some in the mental health community – that these cases are extremely rare. In Texas just last week, Alysha Green doused her three-, five-, and seven-year old daughters with gasoline and lit them on fire. The three-year-old has since died. Alysha’s husband says his wife had a history of mental illness with a past diagnosis of bipolar disorder. She was prescribed medication. She stopped taking her medication and, her husband reported, her behavior deteriorated in the three weeks prior to the tragedy. That same week, Helen Kirk was found insane in her murder trial in Massachusetts – she told police she believed her son Justin was “the devil” after she strangled him.

Oprah also talks to General Hospital star Maurice Benard and actress Jenifer Lewis from their perspectives as people with bipolar disorder. Benard returns to the issue of violence when he recounts what happened one evening when he was off medication.

“I started yelling. And I told [my wife] if she didn't stop [crying], that I was going to kill her—in my mind I didn't believe I would."

As much as we don’t want it to be true, violent behavior is one of the consequences of failing to treat. Even NIMH gets that now.

Oprah doesn’t delve into the concept of assisted outpatient treatment, which is too bad. The obvious question after a show like this is “how can we help people before they get so sick?” Maybe in a future show, they will include the perspectives of so many who can attest to the importance and value of earlier intervention.

Until then, we call this a good beginning.

Another tragedy that "could have been avoided"

A letter to the editor in today’s Allentown Morning Call:

Gary Miller did not deserve to die as he did (The Morning Call, Aug. 1). His son, Kenneth, did not deserve to be hospitalized as a criminal. The death of the father by the son could have been avoided if only the health authorities listened to a pleading mother. My cousin Marjorie pleaded and cried out for help on numerous occasions. As late as Saturday (and Monday), she pleaded for her son to be helped.

Several times, she called Crisis Intervention, but always the same questions were asked of the patient. The mother, who had common sense, was ignored. Naturally, the sick patient will answer questions as he sees the situation, not knowing himself how sick he is. A mother, with all her love for her son, knows what is best for him!

A caseworker told my cousin her Kenneth could not be hospitalized for not taking his medicine. He should have been hospitalized and made to take his medicine. Then perhaps, the death would not have happened. It seems nothing can be done until something happens. Well, something did happen -- a loving father was knifed by his loving, but delusional son.

Now, that son is lying in a bed in a hospital as a criminal, instead of being in the hospital as a sick patient, as plans are being made for the burial of his father.

Our family is furious! We call upon all state legislators to look into the matter and change the laws.

John F. McHugh
Allentown

The Pennsylvania Senate has the opportunity to take up the call of Mr. McHugh. SB226 has been introduced in the Senate Public Health & Welfare Committee for consideration this legislative session. Modeled after New York’s highly successful Kendra’s Law SB226 would update Pennsylvania’s outpatient commitment law to ensure that individuals in need were able to receive consistent care in the community. Its passage will be a monumental step forward for Pennsylvania consumers and their families. We urge all of our Pennsylvania readers to contact their Senator and tell them to support SB226 as a commonsense approach to helping the most severely mentally ill.

A "roller coaster ride" that you hope never makes the news

Families of the most severely mentally ill individuals share some unique experiences.

“Advocates refer to it as the family roller coaster - a terrifying, heart- wrenching ride that leaves people frustrated and exhausted.”

When you love someone who suffers periodic relapses of a severe mental illness, it can sometimes feel like you are on a roller coaster. When your loved one is doing well and things are on the upswing, you have to keep your emotions in check because you never know when things might head downhill again.

And then there is this experience that many TAC families will recognize:

"Families who have members with mental illness read the paper differently than other people. We're always scanning between the lines - here's a family suffering as we did, caught unawares, doing what they thought was right. And it wasn't enough."

Increased risk for family members

Family members are the primary caregivers for people with severe mental illnesses who live in the community. If their loved one has an untreated severe mental illness, they face a very real risk of violence. A 1997 study focusing on the prevalence of abuse faced by families of individuals with a mental illness found that 32 percent of relatives had been struck on at least one or two occasions. Verbal abuse, threats, and temper outbursts were reported by more than 50 percent of the relatives. The American Psychiatric Association notes that

"Family members are most at risk of a violent act committed by a mentally ill person … [Another study] found that among those who had attacked people prior to their admission [to a psychiatric hospital], 65 percent ... had attacked a family member."

Two stories that made the news this week emphasize the danger families can face if a loved one with untreated mental illness becomes violent:

In Palo Alto, California this week a middle-aged man with paranoid schizophrenia stabbed his brother to death in their mother’s home where both men were living. The middle aged man had a long history of mental illness and criminal activity.

In Indiana, a younger sibling is alleged to have shot his older brother in self-defense after the older brother, who had bipolar disorder attacked his younger sibling.

Of course, individuals with severe psychiatric disorders are no more dangerous than the general population - IF they are being treated. Click here for tips on what to do if someone with severe mental illness does become assaultive.

How families feel about AOT

The Otago community treatment order study has provided us with valuable information on how AOT has been working in New Zealand. There, researchers examining the views of participants concluded that, “the usefulness of community treatment orders is accepted by most patients under them in New Zealand, as well as by most physicians.” Their most recent study, “Family perspective on community treatment orders: a New Zealand study” carries this research over to consumers’ families, a group whose experiences and views of their family members have been little studied.

Seeking treatment for a loved one in Virginia

The Roanoke Times delves into the horribly difficult process of seeking treatment for a loved one with anosognosia in Virginia. Unfortunately, part of that difficulty can also be attributed to Virginia’s community services boards (CSB’s) – the group tasked to provide community mental health services in Virginia. Despite the fact that outpatient commitment has been on the books for years, it’s clear that they are woefully unaware of their own state’s laws. In fact, the director of one CSB recently admitted, “We’re not clear how it will work… We’re trying to get the process in place.”

In the face of challenges like these, it is vitally important that families have all the information they can before a crisis occurs. More on seeking treatment for a loved one is available here.

Undying love and the search for treatment

Without appropriate treatment options, parents of a grown child with severe mental illness are often the ones left to provide care. As care providers, families face a very real risk of violence. In fact, the most common victims of violence and homicides are family members, especially mothers. Despite this risk, families continue providing care and fighting for treatment.

“The first thing I thought of is … I can’t help him if I’m dead.”
- One mother’s reaction to her son’s attempt to harm her.

My brother's battle: And mine

"Away from home in those early years of my brother's disease, before cellphones, I thought about getting a pager so my mother could reach me if my brother beat her up. I have lived in dread ever since that I'd get a phone call saying that my brother, who lived at home, had killed our parents. When he threatened me last fall, my family and I made a heart-wrenching decision for the sake of everyone's safety: We had him committed to a psychiatric hospital."

- Journalist Asra Nomani's personal account of her family's struggle to get treatment for her brother in West Virginia - "My Brother's Battle: And Mine" - The Washington Post

"She belongs in jail where she can't hurt somebody else"

Tiffany Sutton is under arrest for stabbing a man and attempting to drink his blood.

Her mother - like many others - is actually feeling a measure of relief that her daughter is now in an Arizona jail - because perhaps now, she will get help, or treatment, or at least be kept safe.

"I knew it was coming," [Lorrie] Hanneman said. "I told the police officer I talked to on the last time that she's become a danger to herself and others. She's not afraid to die right now. I honestly believe she wants to die, so I just keep waiting for that phone call that she's dead."

"If I can't help her, then she belongs in jail where she can't hurt somebody else. What else can I do?"

Not guilty by reason of insanity

For years Bill and Tena Neely struggled to get appropriate and consistent treatment for their daughter Tracy, diagnosed with schizoaffective disorder. Even after Tracy shot her mother at the family’s home, the Neelys still had to fight to get treatment for Tracy. As one advocate noted, in South Carolina,

“… mentally ill people usually go to prison, where they may get little or no treatment.”

Tracy Neely’s family fought hard for her to get a rare “not guilty by reason of insanity” verdict – one of only 7 such decisions statewide last year. Now she is receiving treatment in a mental health center instead of serving time in prison. Her dad offers advice to other family members in similar situations:

"There's no rulebook. You've just gotta hit it as hard as you can and as fast as you can to save your daughter."

Good advice for families. But what about all of those with severe mental illness who don’t have someone to fight the system to get them treatment?

The importance of treatment

Two stories today illustrated the importance of consistent treatment for severe mental illness.

In Virginia, a young man tied up and assaulted family friends shortly after he was released from a state mental hospital. The victims, who have publicly forgiven their attacker, explained,

“When [he] takes his medication, he’s a nice caring person. But when he doesn’t, he’s dangerous.”

In Texas, the brother and sister of a man who fatally shot his parents before killing himself told sheriff's deputies their brother had a mental illness and had stopped taking his medication. Aransas County Sheriff Mark Gilliam explained:

"The family said the mother and father were dealing with trying to get him to take his medication and he wouldn't," Gilliam said. "When he didn't, he would go off the deep end."

The Shock, Grief, Panic and Guilt from the Other Side of a Tragedy

Severe mental illnesses can agonize in so many ways. The most direct manner is the impact on those who have them, but the scope can range far wider – to the families, others, and numerous critical components of our society.

Among the most heart-wrenching of anguish is that of families whose loved ones fall victim to the acute psychiatric disorder of another. We have painfully watched as families, such as those of Kendra Webdale, Laura Wilcox, and Gregory Katsnelson, bravely withstand the devastation of needless and unexpected loss. We have also been awed as members of these families have nobly turned their grief, not into revenge, but to bringing treatment to people incapacitated by illnesses like the one that ripped away their child, sibling or parent.

There is a flip side of these tragedies that rarely gets attention – the grievous turmoil of the families of the person who caused the harm, and did so only because of the symptoms of an illness that were neither asked for nor susceptible to self-control.

Imagine the turbulent mixture of shock, grief, panic and guilt experienced by the parents of Anthony Capozzi when their son, who has schizophrenia, was charged with two rapes in 1985 and later convicted of them. Was it the illness? Could his parents have prevented his actions? Something else? According to Albert Copozzi, Anthony’s father, "It is with you every moment …We don't go to bed at night without thinking about our son."

To put a twist on the Capozzis' distress that is hopeful yet also utterly confounding, imagine that – after 23 years of weekly eight-hour roundtrips to visit him in prison – Anthony Capozzi might not have done anything after all.

Twisted justice in Kentucky

No question Jacob K. Robling needed help. He was keeping the severed head of the family cat under his bed.

And no question his family was not setting out to have him arrested on animal cruelty charges.

Yet that is what happened.

Robling's stepfather said in an interview on Thursday that he and his wife never intended for Robling to end up in jail when they called police to report they'd found Clarabelle's remains. Gene Willis said he just wanted police to take their son to a hospital.

"I'm the face of a thousand people behind me just crying for help"

One mother in Utah has tried to help three of her adult children get the treatment they need. But what does it take to get them that treatment?

For these three siblings, the answer was murder, a suicide attempt, and an arrest. Two of the three are now receiving treatment in prison.

In 2005, nearly 1,300 people deemed "seriously and persistently mentally ill" were booked into Salt Lake County Metro jail. To incarcerate, assess and treat this population would cost the county more than $7.3 million.

That's just one jail system, and doesn't account for the human costs, said [Sherri] Wittwer [of NAMI Utah].

"What a difference it would make, for the individual, the family and the community, if we intervened earlier."