Father, NAMI Advocate Frustrated By Flawed System That Sets Up Young Man For Incarceration Instead Of Treatment

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Dear Pete,

Just letting my emotions get the best of me.

 Last Saturday afternoon I received a phone call from a distressed mother.  I have known her for almost 20 years.  She has a son who has been diagnosed with schizophrenia.  He has been committed to a state hospital six times because of his illness.  He also has participated in a study at the National Institute of Mental Health (NIMH) in Bethesda, Maryland, on medication management. He also was sent to Stanford University for a trial with an experimental medication. 

There is no question he suffers from a major mental illness. The problem is that he stops taking his medication after he is discharged from the hospital.

 He lives in a different city than his parents. Every Saturday his parents drive to his apartment from their home to buy him food and give him some spending money.  He is on SSDI due to his mental disability.  When the parents arrived last Saturday, they found the food and money from the previous week were still on his kitchen table. 

After some investigation, the mother learned that her son had been incarcerated in a detention facility. The mother called the detention facility and was told that she would need to come in a fill out forms to allow her to visit and be made aware of the charges.

His mental illness is what caused him to be arrested. He had a habit of leaving restaurants without paying because he didn’t believe he needed to pay. He was jailed for theft but was released from jail after a few days because the detention facility needed his cell for someone who was violent.

He didn’t appear at his court hearing. He also had a series of restraining orders placed on him by neighbors and area grocery stores because of the psychotic behaviors precipitated by his mental illness. This led to additional charges, his re-arrest and this time, having his bond set at $50,000.

Needless to say, the mother was deeply concerned. 

What I am wondering as I write this is: Are there solutions? 

We have a young man suffering from schizophrenia and psychosis sitting in our overcrowded detention facility.  He has been in the state hospital 6 times yet he will not continuing taking medication when released.

As a friend of the family, a parent of a child with a mental illness and a long time NAMI advocate, what would I do in this situation? 

The answer: I would have him committed to the state hospital for as long as it took to stabilize him and I would not release him until he was stabilized.  A 30-day, 60-day or 90-day commitment often is not enough in some cases.  Once he was stabilized, I would find housing for him and he would continue receiving help from a Assertive Community Treatment (ACT) Team. 

I believe these steps would let him recover and live a full life.

 What do I think will happen?

This young man will be stuck in our Criminal Justice System.  He will be sentenced to a state prison where the treatment for his mental illness will be inadequate.  He will serve a lengthy term and when he is released, he will not receive appropriate follow-up care. The revolving door will continue. 

If he is lucky, he will be committed to a forensic treatment facility.  There, he might have a chance to recover.  

But the odds are against him. Like too many people with serious mental illnesses, there’s a good chance he will rotate between treatment and jail on a continual basis.  The traditional revolving door.  In the worst possible scenario, he could become a danger to himself or others.  This happened in my home state last month in Helena in a separate case and ended with a tragedy. 

Someone help me understand why I am wrong!

Dr. Gary Mihelish, President

National Alliance on Mental Illness (NAMI) Helena


NAMI Montanas’ Dr. Gary Mihelish received NAMI’s national “Distinguished Service Award” for 2013. This is NAMI’s highest award. Past recipients of the Distinguished Service Award include Congressman Patrick Kennedy and Dr. Joyce Burland. Dr. Mihelish is a longtime leader of both NAMI Helena and NAMI Montana. He helped lead the charge for mental health parity in the Montana legislature and has been a teacher of Family-to-Family with his wife Sandra for more than two decades. Dr. Mihelish has also been a means of support and information for desperate families across Montana that didn’t have anywhere else to turn.

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.