Mental Illness is now back in the news, as a result of the video of a California Highway Patrol officer punching a mentally ill woman. The family of the woman plans to sue the police department for the officer’s actions.
Here is a piece I wrote regarding the painful issues that loved ones of mentally ill people deal with. These are actual stories, with the names omitted.
A 76 year old man was diagnosed late in life with schizophrenia. One of the side effects of this disease is that you do not believe you are ill or need medication; this elderly man was no different. After the death of his wife, he began to lose touch with reality. He began to neglect himself, not eat, and sit in an apartment during a heat wave, refusing to turn on the air conditioner. He was involuntarily hospitalized under the laws of the state, since it was found that he was a danger to himself. He received medication, was stabilized, and after two months, released back to his home with a care plan.
Approximately 1 in 4 adults across America suffer from some form of mental illness. Every state in the country has some version of what we call in Florida “the Baker Act”. If a friend, family member or neighbor sees someone who has mental health issues that are becoming out of control, they can call a local hospital, who visits the person in question. The police have the power to make this call as well. A psychiatric team visits the person, making observations about the person’s behavior, hygiene and surroundings. The team will ask questions, and determine whether or not the person is a danger to themselves or others. If the person is considered a danger, the law gives the team authority to have the person hospitalized (even against their will) for a minimum of 48 hours. The police are allowed to take the person by force if they refuse to go.
Several months later, the elderly man decided he was well, and stopped taking his medication. He became more and more angry, yelling at his daughter, and refusing to let the members of the care team into his home. He even physically pushed the aide who bought him groceries on a regular basis out the door of his house, because he was paranoid about why she was there. The difficult decision was made to call the medical team again to assess him. They determined he was a danger…but this time, he refused to go. The police came, and he fought. He fought with every fiber in his 76 year old being…until he was placed in a chokehold, handcuffed, and dragged out of his home of 40 years. At the hospital, he refused medication and refused to bathe. After going to court, the judge gave permission for the doctors to inject him with medication. So by force, he was held down and injected.
Medical intervention with the mentally ill is not always pretty. The question becomes, will this person harm themselves or others? It is even more difficult for the family, who has to stand by the sidelines, helpless and watching. The law allows for force to be used, as ugly as the result may be.
An attorney struggles with bipolar manic depression. When he is on his medications, he is the nicest guy you would ever want to meet. Generous, friendly, and great in the courtroom. However, when he stops taking his meds, he becomes violent and angry…almost a “Jekyll and Hyde” scenario. He hits his wife, ignores his children, and ends up stealing from a client. He is arrested, prosecuted, and loses his ability to practice law ever again.
Some mentally ill people end up in the criminal justice system. They may use illegal drugs to self medicate, in order to “make the voices stop”. They may commit crimes of violence against family members, law enforcement, and regular citizens. Some are less violent, but live in their own version of reality.
The other issue is the family. While the family suffers the ill effects of the person’s actions, they are struggling with the fact that deep down, the person is not bad, but ill. The age old question of “if your family member had cancer, would you stop speaking to them? How is mental illness different?” makes the struggle more difficult.
The criminal justice system, which is designed to punish, is slowly becoming more sensitive to these issues…but there are no easy answers. You can have a million programs in place to help the person struggling with mental illness. But the problem that remains is keeping the person on medication, when the disease tells them that they are fine.