USA Today: Living with mental illness

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Living with mental illness Posted 5/1/2006 9:28 PM ET By Pete Earley

"Dad, how would you feel if someone you loved killed himself?"

My college-age son, Mike, has stopped taking medication for the mental illness that was diagnosed a year ago, and he is having a relapse. He and I are speeding to an emergency room. Hang on son, I think. The doctors will help you.

But after waiting four hours, a doctor appears and tells me it's illegal to treat Mike. He is not sick enough. He is not in "imminent danger," and because Mike now thinks "pills are poison," the doctor cannot forcibly medicate him under Virginia law. I'm told to bring him back if he tries to kill himself or someone else.

No parent should watch what I see next. Mike sinks further into a mental abyss. Forty-eight hours later, he breaks into a stranger's house to take a bubble bath. The homeowners are away, but Mike is arrested and charged with two felonies. I've been a journalist 30 years and thought I knew a lot about jails, courtrooms and mental illness. But I was always on the outside looking in.

I was so outraged about what happened to my son that I spent the next three years investigating America's mental health system.

I went to Florida, to separate myself from Mike's case, and spent time in the Miami-Dade County jail. I followed psychotic prisoners through the courts, rode with cops, interviewed judges, attorneys, psychiatrists, mental health advocates, parents and persons like my son.

System in disarray

I discovered our system is in a shambles. Jails and prisons have become our new asylums.

Deinstitutionalization — the haphazard closing of state mental hospitals and dumping of patients into the streets during the '70s and '80s — began the migration from hospital wards to jail cells.

In 1955, about 559,000 Americans were patients in state hospitals. If you took the patient-per-capita ratio then and extrapolated it out to today, you'd expect to find 930,000 patients in those facilities. But there are fewer than 60,000.

Where are the others? About 300,000 are in jails and prisons. An additional 500,000 are on probation. According to the Department of Justice, 16% of inmates in state correctional facilities say they have a mental condition or have spent a night in treatment. The largest public mental facility in the USA is the Los Angeles County jail.

Lawsuits filed to protect patients from abuse in horrific state hospitals created legal barriers that are now preventing parents and other loved ones from intervening until it is too late, just as they did in Mike's case. A shameful lack of community services, including treatment programs and housing, also are to blame.

In Miami, I saw homeless men with chronic schizophrenia arrested for trespassing, jailed, released untreated and arrested again days later. They are stuck in a vicious revolving door.

No one is immune

Mental illnesses are chemical imbalances that affect how nerve cells in the brain send and receive messages. They can strike anyone. Nothing in our family's history hinted that a debilitating disorder loomed ahead. And Mike did nothing to bring this sickness on himself.

Sadly, we are making jails a core part of our mental health care network. Jail officials are building separate facilities for psychotic prisoners. In effect, we are reconstructing the dreaded "warehouse" asylums from our past inside our jails.

Jails are not safe places for a person with a mental illness, and the sick shouldn't have to become criminals to get help. Most can get better. Treatment works in 80% of cases — if it is available.

Incredibly, we are continuing to shut down psychiatric wards in favor of jails. My state, Virginia, has lost 84% of its psychiatric hospital beds since 1955. Why are we choosing cells over beds? The cost of a psychiatric bed exceeds $500 per day. The cost of a Virginia jail is $89 per day.

My son is back on his medication. But now he faces the stigma of having a mental illness and a criminal record. That's wrong. Few of us worry we'll wake up with a mental illness. But what if the phone rings and it's someone telling you about your sister, your daughter, your mother — your son?

I've been on the inside looking out now. It is frightening.

Pete Earley's book, Crazy: A Father's Search Through America's Mental Health Madness, was published this month.

Find this article at: http://www.usatoday.com/news/opinion/editorials/2006-05-01-mental-illness_x.htm?POE=click-refer

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