When Pete Earley’s son Mike was a senior in college, he told his dad that he had taken five homeless men to breakfast at McDonald’s. They were homeless, he said, and he wanted to talk to them. What Early didn’t realize was that his son was entering a full-blown psychotic episode. It was the beginning of a long journey for Early, a journalist at the Washington Post.
Later the same day, Earley got another call from Mike. “He wanted to clarify his story. He wasn’t certain if he had actually taken them to breakfast or if he had just dreamt that he had.” Mike got worse, began to cry and told Early he’d had trouble eating.
Like any good parent, Earley got into his car and drove up to see what was wrong. That led to an examination of Mike by a psychiatrist. He got some treatment, but his condition persisted and worsened. His behavior became obsessive and irrational. Mike was mentally ill, and eventually was diagnosed with bipolar disorder - a mood disorder.
Mike was put on two drugs, Zyprexa and Depakote, which seemed to help. But Mike didn’t like taking the drugs and they caused him to gain weight and be sleepy all the time. He decided he didn’t need them. His condition flared up again.
Mike had a scrape with the law - he was driving down the street and suddenly just closed his eyes and let go of the wheel, crashing into a parked car. Mike was sent to a hospital, but was released. Earley knew the accident was caused by Mike’s condition, something Mike confirmed, but he was not treated.
“The doctor said, ?Virginia law is very specific. Unless a patient is in imminent danger to himself or others, I cannot treat him unless he voluntarily agrees to be treated.’” Mike won’t take the “poison.”
Mike got worse and worse. Eventually, Mike wound up running off and getting arrested after throwing a lawn chair through the patio door of a house in a nice suburb of Fairfax, Va., where Earley lives. The owners weren’t home at the time, but the burglar alarm alerted police who arrived to find Mike taking a bubble bath in the homeowner’s teenage daughter’s bathroom.
Even then, he couldn’t be forcibly treated for his illness.
“The doctor told my ex-wife that it was not illegal for someone to be mentally ill in Virginia. But it was illegal for him to treat them unless they consented. There was nothing he could do.”
As Earley was drawn deeper and deeper in the plight of his son, he saw that he wasn’t alone. Mentally ill people are everywhere, because of changes in government policy and the legal system, they can’t be committed to state-run asylums involuntarily anymore. That’s good Earley found, because most of those places have shut down. Mentally ill individuals who are found to be a danger to themselves or other are just locked up in jails and prisons. No treatment is forthcoming.
That revelation lit a fire under Earley who decided to write a book about it. With help from a sympathetic judge, he spent a year in the Miami-Dade County Jail, following a group of mentally ill individuals through the system to see what they endured. It was harrowing. Because they can’t be forcibly medicated, most mentally ill people are turned out on the streets. There they invariably run afoul of the law - for inappropriate public behavior, public nudity, stealing, assault.
When they get arrested and are deemed a threat to themselves or others, mentally ill inmates are usually found incompetent for trial because of their illness. Then they are shipped to a facility to be made sane enough to face trial. Then they are shipped back to the jail to be held for trial. While they are there waiting on the backed-up court system to process them, they don’t get their medicine (budget cuts) and they regress into mental illness again. When they go before the judge, they are no longer competent for trial. So they are sent back to treatment centers and forced to take medicine to become competent. Then they are sent back to the jail. It’s a brutal cycle, and many inmates, Earley found, can spend years boomeranging back and forth.
As Earley continued research for his book, he met experts who gave him a sobering look at what has happened to the American system for treating the mentally ill. One of them was psychiatrist E. Fuller Torrey, who testified before a congressional subcommittee in 1997:
“Between twenty-five (and) forty-five percent of homeless individuals have a severe psychiatric disorder,” he told the panel. “The quality of life for them is a national disgrace. Twenty-eight percent get some food from garbage cans ? a third of homeless mentally ill women have been raped.”
Torrey believes he knows who is to blame. “This problem has be exacerbated by well-meaning but misinformed lawyers who changed state laws to make involuntary treatment virtually impossible in most states. These lawyers, under the American Civil Liberties Union and Bazelon Center for Mental Health Law, argue that mentally ill individuals should not take medication unless they wish to do so. But since half of these mentally ill individuals do not think there is anything wrong, they will not take the medication.”
And that rather neatly sums up the problem. These people are sick and need help. Laws prevent them from receiving help. What’s left to consider is the human face of the mentally ill, a view Earley provides with his portrait of his son and of the other mentally ill individuals he profiled during his study - people who do things because “voices” tell them to.
They are as much victim as victimizer in most cases, one woman Earley tracked in Miami was gang-raped twice. Yet these individuals don’t take their medicine because the nature of their disease makes them believe they are not sick. Many of them die in confrontations with police, who are not trained in the special skills needed to deal with violent mentally ill people.
Earley also tells of the heroes in the situation, the sympathetic judges, enlightened social workers, tireless doctors and caregivers, dedicated family members, understanding politicians and police. There are some programs to help with the problem. But there’s just not enough of them, and there’s not enough money or drug therapies. So the mentally ill stay on the streets, scrounging for their existence until they do something to get arrested or killed. They can’t be helped unless they do something violent. It’s a lethal Catch-22.
Earley’s book was published in 2006. It is the summer reading selection for the One Book One Community program in East Baton Rouge Parish this year.