If you had known me as a child, you would not have suspected that I would become an author. I was horrible at spelling and poor at grammar. As a teenager, I wasn’t much of a reader, either. But I always have been fascinated by people and their experiences and some of my favorite memories are of the times when my father, a minister, would take me with him at night to go “call” on members of his church. I don’t think many preachers actually visit people at their homes anymore, but in the 1960s in rural Colorado, they did and I discovered early on that nearly everyone has a story to tell.
Since the publication of CRAZY, I’ve visited 46 states giving speeches, touring successful treatment programs and meeting persons with mental disorders and their loved ones. Some of these individuals’ stories have been inspiring, others’ courageous, but most of what I have heard is heartbreaking because they are stories about persons who have not gotten the meaningful treatment that they needed. They have fallen through the cracks – big cracks in our system.
I’m going to tell you a story and I will warn you that it is a sad tale. It is also an important one because it is yet another example of how broken our mental health system is and how people are dying because of our ongoing failure as a society to help them.
This story begins in New Hampshire where I met Joan Bishop, a wonderful and kind woman, whose sister, Linda, developed a severe mental illness when she was in her 40s, which is later than most.
Joan described her sister as being smart. Linda breezed through high school easily earning “A’s.” She traveled through Europe with friends and earned an art history degree. She married and had a daughter. Life for the 5-foot-7 inch tall Linda with wavy light brown hair and bright blue eyes seemed blessed until she developed what doctors diagnosed as bipolar disorder and paranoia.
What happened next is an all too familiar story for many of us.
Linda’s life began falling apart. She began acting strangely. She would disappear without warning and she began self-medicating with alcohol. She divorced. Her daughter went to live with relatives. When Linda flipped over her car early one morning while drunk, she was arrested and taken to the Strafford County Jail where she got into even more trouble by throwing a cup of urine on a corrections officer. She was charged with felony assault.
Her sister, Joan, persuaded prosecutors to have Linda evaluated. Joan also petitioned to become Linda’s legal guardian. A judge, however, ruled against Joan, saying that Linda’s condition didn’t warrant it. Meanwhile, three different psychiatrists found Linda not competent to stand trial three times during a two year period. All this time, Linda refused treatment and steadfastly refused to take medication although medication had helped her in the past.
Linda finally was involuntarily committed to the New Hampshire State Hospital. The commitment was for up to three years, but the hospital released her after one year. There was no point in her staying because she refused all treatment and took no medication, which was her legal right.
By this point, Linda had turned against her sister and had refused to sign a HIPPA waiver, effectively cutting Joan out of the information loop.
Linda was discharged from the hospital without Joan’s knowledge. The first Joan learned about it was when a Christmas Card that she had mailed to Linda five months earlier was returned. And by then, it was too late.
So what happened to Linda?
The New Hampshire State Hospital should have set up a discharge plan for Linda that linked her with community services. A case manager should have been assigned to make certain Linda was getting help.
But Linda didn’t want help. She put down a fake address when she was asked by hospital officials where she was going. She continued to refuse treatment even though doctors knew she was ill. In short, there was no outpatient treatment. No follow up to insure that Linda was getting help. Linda literally walked out of the state hospital mentally confused and no one paid any attention to where she was going.
As Joan later put it: “Upon her release, she had no money, no housing and no after care.”
Linda literally disappeared.
Eventually Joan would learn what happened after her sister was discharged and she would learn it from an unusual source – Linda’s diary.
I’ll finish telling Linda’s story in my Wednesday blog.
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