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.

Severe mental illness: a mother's perspective

On today’s San Francisco Chronicle blog two mothers each tell heart-breaking stories of their grown sons’ struggles with severe mental illnesses. As the Chronicle writes in the introduction to the video clips:

California is a state that has a strong belief in patient rights. It sounds like a good and reasonable theory until you talk to the mothers of severely mentally ill children.

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.

Victims of untreated mental illness

Two recent stories at opposite ends of the criminal justice system mirrored those of Andrea Yates, LaShaun Harris, Sherry Sims, Christine Wilhelm, and so many others.

In Massachusetts yesterday Helen Kirk was found not guilty by reason of insanity for fatally strangling her 3- year-old son. Kirk had a long history of mental illness and believed her son was the devil when she strangled him. She will finally be getting treatment in the state hospital where she is committed.

A young mother in Texas faces a capital murder charge. On Saturday, Alysha Green doused her three girls and herself with gasoline and lit them on fire. One of the girls died; two remain in the hospital.

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 last three weeks.

Will Alysha Green someday be committed to treatment as Helen Kirk was? Maybe.
For now four children are victims of untreated mental illness. The mothers are victims too; once they're brought back to reality they must live with something unfathomable.

To the jury

The LaShaun Harris case will go to jurors today.

During the trial, a cadre of psychologists and psychiatrists called by both the prosecution and defense testified that Harris is schizophrenic and prone to hallucinations. “She had been suffering from it before, during and after” the incident, said court-appointed psychologist Paul Good, whose statement that the schizophrenia caused Harris to kill her children was stricken from the record as conjecture.

Texas two-step

After 2 years of treatment, Dena Schlosser, who killed her infant daughter by cutting off her arms, has been ordered to remain in a forensic psychiatric facility for at least another year. But Lisa Ann Diaz, who drowned her two daughters, has been released on the condition she undergo outpatient treatment.

This is focusing many in Texas on the issue of what constitutes appropriate punishment for someone like these two mothers.

"There needs to be a change in the law, something that would allow a person to receive treatment for illness but not escape punishment," said Greg Davis, a Collin County prosecutor. Davis and others are pushing for a new sentencing option in the state, guilty but mentally ill.

Apparently it isn’t punishment enough to have a debilitating brain disease, deteriorate into psychoses, and brutally murder your own child. Once you are restored to sanity, you then must spend the rest of your life behind bars plagued by what you did when you were lost to the symptoms of an untreated mental illness. Others in similar situations tell horrible stories of their torment once medication brings their symptoms under control.

As the editorial board of the Dallas Morning News noted: “The public can temper its revulsion by considering the very condition of mental illness. The afflicted do not cause or invite their torment. They suffer from it. Mental illness doesn't boil up from some malevolent core. Rather, it commonly stems from chemical or structural abnormalities in the brain.”

Goldstein gets 23 years

“When I took a train today and I waited for the train and I looked down the platform for the train to come, I was just sick, thinking, you know, of my daughter waiting for that train,” said Webdale’s mother Patricia Webdale. “And the only other emotion I could share with you is I felt great sadness when I looked at Andrew Goldstein. Just really sad. Not hatred, like, ‘I really hate you,’ but ‘I really am sorry that you didn’t get treatment before you killed my daughter.’”

“I don’t think we really hate Andrew Goldstein,” said Ralph T. Webdale. “We really hate what he did; maybe the system that didn’t take care of him well enough to have this not happen.”

"I wonder how my kids are doing ..."

Lashaun Harris (or in some news reports, LaShuan Harris) has pleaded not guilty by reason of insanity in the murder of her three young children. The sad recounting of her current delusions is even sadder because if and when she is restored to competency, she will know the full weight of what she did.

In her videotaped confession to police, Harris described how she struggled with two of her boys as she stripped them and plunged them from Pier 7 in an area where tourists stroll along the waterfront. Her youngest boy laughed, thinking it was a game ....

In January, she said, ''I wonder how my kids are doing, if someone good is looking over them.'' She told one family member, ''T.J. is in school and Josh is walking and talking.'' She said her dead grandmother bathes them and ensures they eat properly.

Short bits

• TAC executive director Mary Zdanowicz is interviewed for Officer.com on law enforcement and the mentally ill. [Also see our briefing paper on this subject.]
• Pete Earley will be a guest on "Community Matters Weekend Edition" at 6 a.m. Sunday (Sept. 17, 2006) on KPTK-AM (1090) in Seattle. Pete is the author of "Crazy: A Father's Search Through America's Mental Health Madness." (Already read his book? Let him know what you thought.)
• "I am unable to talk with him about anything except his delusions now," a social worker says about Rosario "Russell" Miraglia.
• Christine Wilhelm accepts plea deal.

Plagued by the memories

In Tennessee on Monday, Sherry Sims drowned her 4-year-old daughter. Sims' mother said to reporters: "My daughter is a good mother. She takes real good care of her children. She loves her children. I know if she was still taking her medicine [for schizophrenia], nothing like this would've ever happened."

A news story from New York this week reports that Christine Wilhelm, like Andrea Yates, is "plagued by the memories." Wilhelm also drowned her 4-year-old child, and attempted to drown his brother. She is sentenced to spend the rest of her life in prison.

Will Sims and Wilhelm have more of a chance to get treatment instead of punishment considering the recent Andrea Yates verdict? Possibly. But their children suffered the same fate. And their mothers, once brought back to reality, must live with something unfathomable.

The status quo is unacceptable

It took five terrible years for a jury to decide that Andrea Yates was insane when she murdered her children, despite overwhelming evidence regarding the severity of her illness. She will likely spend the rest of her days in a maximum-security forensic hospital. Eric Clark will spend at least the next 25 years in an Arizona prison, where his family still struggles to ensure he receives adequate treatment. And a story from Pensacola, Florida is the latest in a mind-numbingly long list detailing the terrible conditions the mentally ill face when incarcerated.

The theme running through each of these tragedies is simple: the criminal justice system is a meager substitute for mental health care. Mental health departments across the country are failing in their missions, and are far too willing to abandon the most difficult individuals to jail cells and prisons.

So the next time you read an article about the horrendous conditions in a local jail, or an incident where a family couldn’t get treatment for their son because he wasn’t “dangerous enough yet,” ask yourself, is my mental health department doing all it can to help the most severely ill? Have they implemented AOT? Are they still relying on outdated dangerousness standards for determining who needs care? Are they advocating for change, or simply enforcing the status quo?

We’ve seen the results of the status quo, and they are unacceptable.

Was it worth it?

Andrea Yates has been found not guilty by reason of insanity in the drowning deaths of her five young children. No doubt many pundits, like Andy Cohen of the Washington Post, will find this verdict a victory for both compassion and common sense.

We agree but also ask an additional question – why was this trial necessary at all? The possibility of a capitol sentence was eliminated in the first trial. Hundreds of thousands – if not millions – of public dollars were expended determining whether Andrea Yates would spend her next guilt-ridden years in a jail or a locked psychiatric facility.

Sad anniversary

A mother on her son:

Jevon was diagnosed with bipolar manic depressive disorder on June 18, 2005. I was told it was an incurable mental illness. The diagnosis was unbelievable and overwhelming to discover. He had been healthy his entire life and did not believe he was ill. I sought help from the doctors at the hospital but was told he did not meet the commitment standard of dangerousness to self or others, so there was nothing they could do. I begged for help, insisting that something was terribly wrong. He did not believe what the doctors were saying. Every mother knows when something is wrong with their child. I could see it in his eyes; the emptiness, confusion and fear. He promised me he would be alright; it was a promise he couldn't keep. Thirty-one days later, [he] was dead.

Jevon Lampkins was 23 when he died. His case is not unusual, though we wish it were. His mother couldn’t get him help because of a weak treatment law. And like too many others, he died in an encounter with a law enforcement officer.

Our thoughts are with Jevon's family today. And with all the other families who are still trying to get help. Keep making noise.

How to get into an inpatient psychiatric facility ...

Is the only way to access inpatient treatment for someone who is extremely ill an act of unfathomable violence?

William Bruce will be moved from prison to a psychiatric facilty at least long enough for evaluation - the local sheriff is relieved, noting the prison isn't a good place for inmates with serious mental health conditions. Bruce killed his mother, his family had been trying desperately to help him.

Too often such horrible events spur a call for punishment instead of compassion. Andrea Yates' fate is being decided in the deaths of her 5 children for a second time, but recall that the first time, she ended up in jail. That is where Brenda Drayton is headed as well - for the next 20-30 years, for killing her daughter.

Most often weak state laws make us wait until a crime is committed to help someone ... and then the focus is on punishment, not treatment. People with severe mental illnesses deserve to get real help from the civil treatment system before situations occur that lead them to be punished by the criminal one.

William Bruce, Andrea Yates, Brenda Drayton - if they could have been on an outpatient commitment order long before they committed murder, they might not have gotten so sick to need a hospital bed ... or land in a jail cell.

MD and VA offer little defense ...

"What do I have to do, have him kill someone to get him treatment?"

That is the prophetic question a Reston (Virginia) mother asked mental health professionals shortly before her son beat her to death with a baseball bat in her home nearly eight years ago. History repeated itself this month when Pamela Jones was killed in her Fairfax City home by her mentally ill 24-year-old son …

In the years between these two tragedies, Virginia has kept the same outdated law that requires the mentally ill to be "imminently dangerous" before their objections to treatment can be overridden, even though they may be too sick to realize that they are ill. Incredibly, Virginia families are often told that nothing can be done to get their loved ones into treatment unless they become homicidal or suicidal.

Maryland law is similarly restrictive …Read more from the Washington Post …

Another needless death

The Washington Post’s editorial board today is up in arms about the recent tragedies in Virginia attributed to people who are psychotic – the murder of two police officers and the beating death of a woman by her own son. They say in part …

The concern for their rights, in practice, represents a cruel kind of joke: a right to exist in a delusional state and then get prosecuted severely for the damage. The cost savings are mythical, too. Society pays in so many ways for failing to take the problem of mental illness seriously. One of those ways is tragic killings, like those of Detective Armel and Officer Garbarino.

Yates leaves prison

Andrea Yates will get treatment in a psychiatric facility instead of prison ...

READ MORE: A mother speaks from jail about killing her child (not Andrea Yates) Words from Yates’ mother Better off in a hospital?

Insanity Defense: A True Story

[Lori] Farmer says she knows ... the voices weren't real. God would never urge her to hurt someone -- least of all her 4-year-old son, who loved Batman and used to run around in a cape that his grandma made from an old skirt. Zane was buried in his pretend cape 10 years ago. Farmer killed him.

When you read news reports of Andrea Yates’ new trial, keep Lori Farmer in mind. Farmer was found not guilty by reason of insanity and is now living in a group home, after years of treatment in a secure psychiatric facility. Her story is a rare look at the insanity defense from the perspective of the person charged with a crime.

And if the emotions of her story don’t get you, think about this.

People who are treated at places such as Western State Hospital are much less likely to commit another crime than those who land in prison, according to Bruce Gage, supervising psychiatrist for the hospital's Center for Forensic Services. He said most people released from prison will break the law within three years, while the recidivism rate for people found insane and treated at a specialized psychiatric program is less than 5 percent.

Yates better off in hospital than prison?

Andrea Yates will be moving from prison to a psychiatric facility until her new trial. It is a small win in a story of terrible loss.

Yates’ family had a history of bipolar disorder and depression and she had a history of suicide attempts and hospitalizations. By all accounts, Yates was in a state of continued deterioration in the months before the murders – she would sit and stare into space, she had lost a tremendous amount of weight, she was not showering.

Notes from her April 2001 release from one voluntary assessment say to “contact [the doctor] if danger to self or others.”

On June 18, 2001, her husband said she was still deteriorating and asked that her medication be adjusted. The doctor “told Andrea to think positive rather than negative thoughts.”

On June 20, she drowned her five children.

In interviews after the murders she talked about how her children would “perish in the fires of hell if they were not killed.” She asked for a razor to see if the “mark of the beast (666) was still on her head.” She also mentioned that she had been unable to destroy Satan, so then-Governor Bush would have to do it.

Yes, a psychiatric hospital is a better place for her than prison. How sad that we let the debate reach this point.

MORE: A mother speaks from prison about killing her kids ... Yates’ mother hopes Andrea can get treatment ... Children deserve protection ... Wait until he escalates ... Andrea Yates ... Parents who kill their kids

A mother speaks

There are too many stories about mothers with untreated severe mental illnesses who kill their children – and too few answers to the questions of “why?”.

You rarely hear directly from the mothers themselves, people like Andrea Yates or Lashaun Harris.

An unusual jailhouse interview with Naomi Gaines sheds some light … Gaines threw her 14-month-old twin sons into the river in St. Paul and then jumped in after them. She and one of the babies were rescued.

"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."