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IMPORTANT & BREAKING: FAMILIES IN MENTAL HEALTH CRISIS ACT INTRODUCED

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Saving my son

By Pete Earley

The Washingtonian April 13, 2006

Reprinted with permission of the author. All rights reserved.

In his twenties Mike started having breakdowns. When I tried to get him help, I found out that our mental-health system now is mostly jails and prisons.

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

My son Mike sounded tired. We were speeding south on Interstate 95, near Baltimore, racing toward a Fairfax County hospital.

I had rushed to Manhattan that morning to get Mike after his older brother telephoned me in a panic. They both lived in New York City. Mike hadn't slept in five days, had been walking aimlessly throughout the city, and was about to lose his job as a waiter. He was convinced God was sending him encrypted messages.

In the car, Mike burst into laughter: "Dog God! God dog! Get it?"

Just as quickly, he began to sob. I hadn't seen him in such pain since he was five years old and got smacked in the head by a playmate. I had driven him to the hospital that day and held his hand while a doctor stitched him up. Now he was 23.

"Why are you crying?" I said.

"I can't tell you because you'll hate me forever."

I had been a journalist for more than 30 years, a Washington Post reporter, and the author of books about crime, punishment, and society. I'd interviewed murderers and spies, judges and prosecutors, attorneys and defendants. But I was always on the outside looking in.

I had no idea what it was like to be on the inside—until Mike was declared mentally ill.

Our trip from New York to Fairfax in August 2002 was the start of a harrowing journey. Because of what happened to Mike, I've spent four years examining America's mental-health system both as a father struggling to help his son and as a journalist.

Nearly all Americans have a mentally ill relative. Three million Americans are so debilitated by mental illness that they're considered disabled.

Few of us worry we'll wake up mentally ill. But what if the phone rings and it's someone telling you about your sister, your daughter, your mother—your son?

my wife, patti, had alerted the emergency room at Inova Fairfax Hospital. It's where we had taken Mike when he'd suffered his first breakdown a year earlier.

There had been no warning signs then, no known family history of mental illness. Mike had seemed ready for success. He had graduated from a Brooklyn art school and had started job-hunting when one of his friends showed up with him at my door.

Mike was babbling about a girl named Jen, telling me she was in danger, that people were going to hurt her and he needed to save her.

None of it made sense. I put him to bed, but he became paranoid. When I finally persuaded him to go to the hospital, security guards had to wrestle him down. That was when I first heard the term "bipolar disorder" applied to him.

With antipsychotic medication, time, and psychotherapy, Mike had become his old self again and returned to New York. I called every Sunday, but our recent conversations had been shorter than usual. Still, I hadn't suspected anything was wrong. The truth was that he and I both wanted to believe that the doctors had made a mistake—that he had been misdiagnosed and his first episode had been a fluke brought on by stress and too little sleep.

Then his brother called. Mike hadn't been taking his pills and was acting crazy.

"Please take your medicine," I said in the car. I'd been trying to get Mike to take Zyprexa, an antipsychotic drug, since I'd picked him up.

"Pills are poison."

Moments later, he said, "Okay, I'll take your damn pill."

He reached for a water bottle but paused before slipping the tablet into his mouth and then dropped his hand next to the car seat. Was that the pill?

I pressed harder on the gas pedal. I had to get him to the hospital. The doctors would know what to do.

Mike and I reached Fairfax Inova at 8 pm. The intake nurse rolled her eyes as Mike rambled on about God. She put us in an examination room to wait. For the next two hours, no one came. Another hour passed and then another. It was now midnight.

"I'm leaving," Mike said.

I flagged down a nurse. Moments later, an emergency-room doctor came in. As he stepped toward Mike, the doctor raised his arms as if surrendering to enemy troops. "There's not going to be much I can do for you," he said.

I thought: You haven't even examined him.

The doctor asked Mike: "Do you know who I am?"

"You're the witch doctor. Ow-ee-ow-ah-ah."

The doctor smiled.

This isn't funny, I thought. I said, "He's been hospitalized before for bipolar disorder. He hasn't been taking his medication."

The doctor cut me off: "What's happened before this moment really doesn't matter."

He asked Mike to name the President. He had him count backward from a hundred. He asked, "What does the phrase 'Don't cry over spilled milk' mean?"

Mike answered each question and then added that God had made him indestructible.

"Virginia law is very specific," the doctor told me. "Unless a patient is an 'imminent danger to himself or to others,' I cannot treat him unless he voluntarily agrees to be treated." Before I could reply, he asked Mike, "Will you take medication?"

"I don't believe in your poisons. Can I leave now?"

The doctor said yes.

Mike got off the exam table and hurried toward the exit.

"But he's not thinking clearly," I said.

The doctor told me if Mike tried to kill himself or hurt someone, I could bring him back.

Nothing can prepare a parent for watching his child being tormented by his thoughts. During the next 12 hours, Mike slipped deeper into a mental abyss.

In the morning, I spiked his cereal with an antipsychotic medication. But Mike spied flecks of the pill's pink shell in the milk and erupted: "Take me to Mom's house!"

His mother, my ex-wife, lives nearby. During the drive, he became so furious at my badgering about his pills that he jumped out before I could bring the car to a full stop. He ran the rest of the way there.

Forty-eight hours later, the Fairfax County police called. Mike had been arrested. He'd gotten up before sunrise and gone outside. Suddenly he felt so dirty that he had to take a bath—immediately. He shattered a patio door at a stranger's house and went inside. The homeowners were away. After rummaging through the kitchen, Mike went upstairs to take a bath. Alerted by the burglar alarm, the police sent a dog inside. It bit into Mike's arm and dragged him downstairs. It took six officers to subdue him.

The police drove Mike to the Woodburn Center for Community Mental Health, less than a mile from the Inova emergency room where I'd first taken him for help.

A police officer, Vern Albert, was standing at the Woodburn Center's entrance.

"Even though your son has broken into a house, unless you tell the medical personnel inside that he's threatened to kill you, they aren't going to treat him," Officer Albert said. "We'll end up taking him to jail, and you don't want that. Not in his mental condition."

"But he hasn't threatened to kill me."

Albert gave me an exasperated look.

So I went inside and lied. The police drove Mike to the psychiatric ward at Inova Mount Vernon Hospital in Alexandria.

When I got there, I asked a nurse, "How long does it take antipsychotic med-¬icines to work?"

She seemed surprised: "Just because your son is being admitted doesn't mean he's going to be treated." It was against the law for doctors to force Mike to take antipsychotic medication, she told me, even though he was clearly psychotic.

A few hours later, an attorney called and explained she had been appointed to represent Mike. I was hopeful because I thought she was going to help him get treatment. But she said her was job to get him released as quickly as possible if that was what he wanted.

"But he's not thinking clearly," I said. "He's sick."

"I'm just doing my job."

At a commitment hearing the next morning in the hospital, Mike agreed to sign himself into treatment.

"Why are you doing this?" the hearing officer asked.

"Because I'm having a relapse and my parents want me somewhere safe."

I felt relieved. Now he could get help.

That night, I brought Mike a box of fast-food chicken; I knew he wouldn't like hospital food. It happened to be my 51st birthday, and despite his confused state, Mike remembered and handed me a hand-drawn card.

From nowhere, he mentioned a fishing trip to South Dakota we'd once taken. He was five and wandered off from the lake. The ground gave way at the edge of a ravine, causing him to fall halfway down before he grabbed a shrub and stopped the fall. I climbed down and rescued him. Over time, the story grew. The gully became a hundred-foot cliff. That was when he was little and I was still his hero.

We laughed about the story in the hospital. Then I said, "Get well, son—that will be the best birthday gift ever."

The next morning, the hospital psychiatrist called. A pill had been found on the floor of Mike's room. He had pretended to take it and then spit it out. That night, I confronted him.

"I keep thinking this is all a dream," he said. "I'll just wake up and it didn't happen."

I touched his hand. "This is real. You've got to take your medication."

Dr. James Dee called the next morning. Mike was taking his pills, but there was a new problem. Our insurance company wanted Dr. Dee to discharge Mike later that day. Dee didn't believe Mike was ready, but because Mike hadn't tried to kill himself and was now taking his pills, the insurance company wanted him out.

I called the insurance company. The woman there said, "Your son can recover at home."

"But he's not stable!" I said.

Then I did something I had never done before as a journalist. I warned her I was a former Post reporter and was friends with Mike Wallace of 60 Minutes. If her company forced my son out, I'd notify the Post. I'd call Wallace.

I had lied to get Mike hospitalized and now I was violating my professional ethics to keep him there.

That afternoon, Dr. Dee telephoned and said the insurance company had backed off. Mike could stay in the hospital.

He slowly got better, and we arranged for him to enter a community day-treatment program in Reston. I began to feel optimistic. Then the phone rang.

"I'm Detective V.O. Armel," the caller said. "Two felony warrants have been issued for your son's arrest."

Mike had been charged with "intentionally destroying, defacing, and damaging property in excess of $100" and "breaking and entering . . . with the intent to commit larceny." Both charges carried up to $10,000 in fines and five-year prison terms.

"But my son's mentally ill," I said. "He didn't know what he was doing. I tried to get him help in a hospital before this happened."

"Just because your son is mentally ill doesn't mean he can't be charged with breaking the law."

A mental-health revolution has occurred in the United States. In 1955, some 560,000 Americans were patients in state mental hospitals. If you took the patient-per-capita ratio in 1955 and extrapolated it out to today, you'd expect to find 930,000 patients in mental hospitals. But there are fewer than 55,000. Where are the others?

More than 300,000 are in jails and prisons. Another half million are on court-ordered probation. The largest public facilities for the mentally ill are jails and prisons. They have become our new asylums.

To find out why, I went to Miami. I chose that city for two reasons. I didn't want to risk irritating local officials in Fairfax by writing about the jail system here, as they would be in charge of deciding Mike's fate. Also, I had been told that Miami has a higher percentage of mentally ill residents than any other big US city. Three percent of the population in most American cities is mentally ill; in Miami, the figure is 9 percent.

In addition to the usual 3 percent, 3 percent come to Miami for the warm weather, and another 3 percent arrived thanks to Fidel Castro. In 1980, Castro released patients from Cuba's mental hospitals into the stream of refugees fleeing to Florida from the port of Mariel.

Miami has been struggling to deal with its mentally ill. Its jail system is the nation's fourth largest. Sixteen percent of its inmates have severe mental disorders. The craziest are housed on the downtown jail's ninth floor in the "suicide watch" cells with plexiglass front walls so officers can watch them.

Dr. Joseph Poitier, the psychiatrist at the Miami jail, took me on his morning rounds. As we entered C wing, I gagged. The air smelled of urine, perspiration, excrement, blood, and discarded food. Prisoners hacked, coughed, groaned. Correctional officers yelled commands. Leg chains clanked as prisoners arrived.

A lot of it was typical jail noises. When I listened more closely, I heard asylum sounds: a prisoner sobbing, another moaning, a third screaming.

Thud, thud, thud. Then louder: THUD. THUD. THUD. An inmate was banging his forehead against a plexiglass cell front.

The inmates peering out in the first cells were naked. There was nothing in their cells except a combination sink and toilet. No chair, no place to sleep. The temperature in each cell hovered in the 60s.

Inmates trembled in the chilly air. A few rocked back and forth on their heels. Some had urinated and defecated on the floor. Most stood at their cell fronts looking out. They had blank expressions, hollow eyes.

"What I do here is triage," Dr. Poitier said.

There is no meaningful treatment, he said. As we moved from cell to cell, Poitier tried to persuade prisoners to take their medication. They had arrived on C wing with no medical records. Many were homeless. Most of their families had given up on them. Psychotic inmates could spend months there. Others would be released only to be arrested within hours on charges related to their illnesses, such as trespassing or being a public nuisance.

If they were charged with a felony, they would eventually be sent to one of Florida's three forensic hospitals. But there was a long waiting list, and even then they wouldn't be treated. Instead, they would be given medicine until they were judged "competent" for trial and returned to Miami. Sometimes it could take five or six trips between jail and hospital before they were stable enough to appear in court.

Dr. Poitier and I paused outside a cell designed for two men but holding six. A prisoner was lying on the floor next to a toilet that another was urinating in. Because the splash was hitting the inmate's face, Poitier asked a prisoner to rouse the man to make certain he was not dead. The inmate raised his head and rolled over.

As we were about to move on, I noticed movement under a steel bunk. Dropping to my knee, I peered through the plexiglass wall. A man was curled up—he had schizophrenia, which can cause hallucinations and confused thinking—and was chewing on orange peels. He smiled and waved.

I checked my watch after we finished the rounds. Dr. Poitier had spoken with or observed 92 inmates. His rounds had taken 19½ minutes.

"A lot of people think someone who is mentally ill is going to get help if they are put in jail," Dr. Poitier said. "But the truth is we don't help many people here. We can't."

A man with bipolar disorder, which causes rapid mood swings, had been put in jail. For 25 years, he'd taken his medication and lived an ordinary life. But then he'd lost his job and couldn't afford his pills. He had attacked his father and been arrested. In jail, he jumped from a top bunk headfirst into the floor, snapping his neck. Now he was a paraplegic.

"Jails are not hospitals," Dr. Poitier said. "Mentally ill people belong in hospitals."

That night I woke up sweating. I had dreamed I was making rounds with Dr. Poitier and spied an inmate under a bunk. When I bent down to see, the inmate eating the orange peel was Mike.

In a well-schooled Virginia drawl, Fairfax defense attorney Andrew Kersey assured me he'd be able to cut a plea bargain for Mike. Because my son had no previous criminal record, was clearly psychotic when he broke into the house, and was now in a treatment program, Kersey felt confident the Fairfax County prosecutor assigned to the case would reduce the two felony charges to misdemeanors. Mike would be given a year's probation.

On the morning of his court appearance, I asked Mike if he understood what was happening. He didn't. He was still groggy from medication but was eager to go to court. When I asked why, he replied, "I get to wear my new suit!"

Before becoming manic, he had bought a suit for a job interview. His court appearance would be the first time he'd worn it.

"There's a problem," Kersey said moments before the hearing. "Our plea deal is off."

The assistant prosecutor had never cleared the deal with the homeowners. Whenthey heard about it that morning, the wife got angry.

"She wants your son put in jail or an institution," Kersey said. "The victims are demanding he plead guilty to at least one felony charge."

"But a felony will ruin Mike's future," I said. His college degree was in a profession that required a Virginia state license. Felons were ineligible.

Kersey said, "What's odd is the judge will still give Mike the exact same sentence."

If Mike pleaded guilty to two misdemeanors, he'd get a year of probation. If he was forced to plead guilty to a felony, he would still get a year's probation.

Kersey wasn't certain whether the wife understood this, so he went back into the courtroom to talk to her, leaving us to wait in the hallway. I checked my watch. Six minutes to go before court started.

Kersey reappeared. The husband didn't care, but the wife wanted Mike pun¬ished. Before Mike had taken his bath in their house, he broke a family heirloom dish, turned photos of her children face down on the mantel, drank some liquor, and left the bath water running, causing extensive damage.

Most of all, Kersey said, the wife felt violated. Mike had taken a bath in her teenager daughter's bathroom. Why had he chosen their house? What if he came back? She was so unnerved that she was pressuring her husband to sell their house.

"What she really wants," Kersey said, "is for your son to be put in prison."

"But he's mentally ill," I said. "Bipolar disorder is a chemical brain disorder. It's like cancer. You don't do anything to get it. It just happens to you."

Kersey nodded at his watch. Four minutes to go. He explained our options. If Mike pleaded guilty to a felony, the case would be over. If he pleaded not guilty, the judge would set a trial date. But a jury would probably find Mike guilty because he'd been arrested inside the house. It might send him to prison.

There was a third choice. Mike could plead not guilty by reason of insanity, but if we won, he wouldn't be turned loose. He would be taken directly from the courtroom to jail to wait for a bed in a Virginia hospital. Mike could spend weeks waiting, and there would be no way to know when he might be released after he was sent to the hospital. He'd also be identified in court records as being innocent but insane.

"We'd win in court," Kersey said, "but your son would lose."

Three minutes and ticking. Three minutes to decide which was the lesser of three punishments that all seemed unfair.

"Offer them money," I said.

Kersey said no. The wife was legitimately afraid. She felt twice victimized. Mike had broken into her house. The prosecutor had not consulted her about the plea deal. She was the victim, not Mike.

Two minutes.

"What do you want to do?" Kersey asked.

I didn't know. How could this be happening?

Kersey had another idea. He'd ask Detective Armel for help. The police often bond with victims. He went back into the courtroom while Mike and I waited. Mike didn't have any idea what was happening.

When Kersey rejoined us, he shook his head. Nothing had changed. Detective Armel had explained that Mike's punishment would be the same, but it hadn't mattered to the wife.

We were out of time. Mike and I followed Kersey into the courtroom. I noticed Detective Armel was still speaking to the victims. I didn't know what to tell Kersey. Which was better? Pleading guilty to a felony and having Mike marked for life? Risking a trial and having him found guilty? Or pleading that Mike was insane? I'd been given less than ten minutes to make a decision that was going to determine my son's future.

The judge entered. The clerk began reading the calendar of cases. Mike's name was third on the list. I was frozen with indecision. I looked at Mike. I looked at Kersey.

At that moment, I saw Detective Armel walk down the aisle to talk to the prosecutor. I glanced at the husband and wife. She was sobbing.

Kersey hurried up to Armel. The clerk called Mike's name. The prosecutor said, "Judge, we'd like to continue this case."

The judge agreed to put it aside for three months.

Kersey hustled us out into the hall. Detective Armel had won us more time by telling the wife that Kersey might be able to come up with an offer that would be better for them than one year of probation.

The homeowners and Armel exited the courtroom. None of them looked at us.

"Mike," I said, "do you see those people walking there?"

He had no idea who they were.

In 1843, activist Dorothea Dix visited a Boston jail to teach a Bible class and discovered that mentally ill prisoners had no heat despite freezing temperatures. The jailer said: "The insane don't need heat."

Dix spent the next two decades exposing how "lunatics" were abused in jails and prisons. She would be credited with persuading 30 states to build asylums for treating the mentally ill rather than punish them because they were sick.

By 1900, every state had a mental institution. Patients were often committed by relatives. The system was abused, and the hospitals became a catchall for society's dis¬posables—the elderly, the deaf, the blind, the poor.

On May 6, 1946, Life magazine published the story "Bedlam: Most U.S. Mental Hospitals Are a Shame and a Disgrace." It began by describing a mental patient being tortured to death by the staff. Other articles compared conditions in state mental hospitals to Nazi concentration camps.

In 1963, President John F. Kennedy asked Congress to spend $3 billion to replace the nation's state hospital system with a network of community mental-health centers. The discovery of promising new antipsychotic drugs made it possible for mentally ill patients to return to their hometowns and live outside locked wards.

It was a good plan, but then Kennedy was assassinated, the Vietnam War escalated, Congress got ensnared in Watergate, and the mentally ill were forgotten.

In the 1980s, civil-rights attorneys began filing class-action lawsuits to close state hospitals. They won a slew of precedent-setting cases.

The police could no longer arrest someone just because he was mentally ill; a psychotic person couldn't be locked up indefinitely in a hospital or be forced to take medication or undergo forced treatments such as electric shock or lobotomies. The US Supreme Court ruled that the mentally ill were entitled to the same due-process protections as suspects in criminal trials. Congress agreed to make the mentally ill eligible for Medicaid and Medicare, but only if they were not living in a state hospital.

Congress gave state legislators a way out. Afraid of class-action lawsuits and mounting public pressure to do something about the asylums, state legislators began closing mental hospitals and discharging patients. This exodus was called deinstitutionalization.

And what happened to the mentally ill?

In most states, patients were released without much effort to link them to community services—if there were any. President Kennedy's call for $3 billion went unanswered. There was no real network of community treatment centers, and those that had been built were never intended to help deeply disturbed patients. Chronically mentally ill people began appearing on street corners. By the 1990s, so many were being locked up on minor charges that a word emerged: transinstitutionalization—bureaucratese for the "transfer" of the mentally ill from hospitals into jails.

Like most states, Florida made no preparations before it began dumping patients. Eventually, it found homes for many in "assisted-living facilities"—cheap hotels and boarding houses. Today 4,500 mentally ill patients live in 650 ALFs in Miami. Almost 400 of these ALFs fail the state's minimum standards for boarding homes. They're unsanitary, unsafe, and in most cases wretched.

"I wouldn't put my dog in this house," a Miami police officer told me when we toured an ALF. But Florida allows these homes to operate because there is nowhere else to house the mentally ill.

Florida's state mental hospitals had been closed by deinstitutionalization, but the lives of the mentally ill hadn't gotten better. The state had scattered them and hidden them.

I checked the Washington area. Since 1955, the District has lost 92 percent of its public mental-hospital beds; Maryland has lost 86 percent, Virginia 84 percent. Although private hospitals have opened some wards, there are only 98 beds for every 100,000 mentally ill people in the metropolitan area.

As in Florida, the number of mentally ill in Washington-area jails has mushroomed. Today 2,551 inmates in Virginia state jails and prisons are considered severely mentally ill. Another 3,330 prisoners in Maryland—14 percent of the state's inmate population—are mentally ill. Thirty-three percent of the District's inmate population require mental-health services.

In a letter to the couple whose house Mike had broken into, our attorney said Mike would meet a much tougher set of restrictions if the homeowners would allow him to plead guilty to misdemeanors.

Instead of serving a year of probation, he'd serve two. He'd stay in the day-treatment program, continue seeing a psychiatrist after he was discharged, and submit to blood tests to prove he was taking his bipolar medicine. Kersey would obtain a restraining order that would forbid Mike from coming near their home. He reminded them that Mike had a clean record, was truly remorseful, and had chosen their house at random.

"This should do it," he told me.

A few weeks later, he received the couple's response. They wanted Mike in jail. They insisted he plead guilty to a felony. If anyone deserved sympathy, they said, they did.

"You need to prepare Mike," Kersey warned me. "He's going to become a felon."

Mike was wearing his new suit again when we returned to court. Just before it was about to start, Kersey came rushing up. The victims had telephoned the prosecutor's office the night before and asked for a continuance. The husband was out of town on business, and the wife didn't want to come to court alone. But the prosecutor had turned them down.

"If the wife isn't here, there's a chance the prosecutor will let your son plead to the two misdemeanors," Kersey said. He'd shown the prosecutor the list of additional restrictions that Mike was willing to accept.

We stepped inside. Every time I heard the courtroom doors open, I turned to see if it was the wife. The judge entered. The clerk began to call the docket. When he reached Mike's case, I heard the door swing open. When I glanced around, it was a stranger who had come in.

Still, none of us knew whether the prosecutor would accept our offer.

"Your honor," Kersey said, "we have reached an agreement in this matter."

In less than three minutes, it was over.?

As we left the courtroom, I thought about the wife. I had come to des¬pise her. But now I wondered how I would have felt if I had come home and discovered that a madman had broken through my patio door. How would I have reacted if he'd taken a bath in my teenage daughter's tub? What if I had become so distraught that I had put my house on the market? Would I have acted as she had? Or would I have showed compassion?

Because it was Mike, the answer had seemed obvious. But when I stripped away his face and replaced it with a deranged stranger's, I realized I might have reacted much as she had.

She and her husband hadn't had the knowledge that I now had about mental illness. But I wouldn't have had it either had it not been for Mike's plight.

I began to see the wife as the reader I most wanted to reach, the audience I needed to persuade. I was also forced to realize that she was a victim. Mike had victimized her.

I hoped that someday she would come to see that he had been a victim, too.

Mike kept the plea deal. He completed the day-treatment program, stayed on his medication, and began looking for a job.

He'd been told that being mentally ill was nothing to be ashamed about because it was a chemical imbalance. But when he mentioned that he had bipolar disorder, his job applications were rejected. Mike had a college degree, but our neighborhood supermarket turned him down for a job bagging groceries.

A sympathetic human-resources director told him not to be so forthcoming: "If I knowingly hire someone who is mentally ill and you end up hurting someone on the job, that person can sue me and the company. No one is going to hire you if you tell them the truth."

Mental illness, we discovered, carried its own life sentence.

A temporary service found Mike menial work, and he eventually became a full-time employee. Proud of his new independence, he invited me to lunch. We met at a steakhouse and sat outside.

He had come a long way. He recalled how I'd brought him fried chicken in the hospital. We talked again about the fishing story—about his falling down a South Dakota cliff and my rescuing him.

I watched him eat his steak. He was a handsome man. Tests showed his IQ was higher than mine. I realized how lucky we both were. He had recovered. He hadn't spent time in jail or been marked as a felon. He was doing well on his medication. His bipolar disorder was in check.

I thought about people I'd met in Miami. Judy Robinson's mentally ill son had been in and out of jail 40 times. Another mother's son had lived on the streets for nine years, despite her attempts to get him help. She had seen him rooting through garbage cans every morning on her way to work and had been helpless under the law to intervene. Civil-rights laws that had been passed to prevent the mentally ill from being abused in state hospitals were being cited to keep them from getting help until they hurt themselves or someone else.

I'd met a woman in Miami the same age as Mike. Her mother had gone to court several times to force her into a hospital, but doctors had repeatedly discharged her because her life wasn't in imminent danger. She had been twice gang-raped while psychotic on Miami's streets.

Another woman, Alice Ann Collyer, had shoved an elderly bystander at a bus stop during a delusional moment. Because she was considered dangerous, prosecutors had transferred her between the Miami jail and a state hospital for three years to keep her off the streets—three years in jail without being convicted of a crime.

Miami's treatment centers were overwhelmed and inadequate, its mental-health system broken. We now treat the mentally ill in America just as we did in the 1830s, when they sat in freezing jail cells because there was nowhere else for them to go.

I had begun my research because I wanted to save my son. I now realized that I had been searching for a way to save both of us. I had been trying to learn how a parent comes to accept his child's mental illness. So what had I learned—not as a reporter but as a father? Several quiet truths.

Life is often unfair, and nothing in life is guaranteed. There was a slim chance Mike would never have a relapse. But there was a better chance he would stop taking his medicine because he would become convinced he no longer needed it. His illness wasn't over.

"You know what your problem is, Dad?" Mike said as if reading my thoughts. "You worry too much. Just eat your steak and enjoy this lovely day. Everything is going to work out fine for me—you'll see."

It was the optimism of youth talking. At that moment, everything was fine. My son was thinking clearly. He had a job, was making plans for his future, and seemed happy.

No one knows whom mental illness might strike or why. There's no known cure. It can last forever. Because Mike is sick, he'll always be dancing on the edge of a cliff. I can't keep him from falling. All I can do is stand next to him, ready to extend my hand. All I can do is to promise that I'll never abandon him.

The sun was warm on my face. I was a proud father. Mike was laughing. He was safe. At least for now.


The information on Mental Illness Policy Org. is not legal advice or medical advice. Do not rely on it. Discuss with your lawyer or medical doctor. Mental Illness Policy Org was founded in February 2011 and in order to maintain independence does not accept any donations from companies in the health care industry or government. That makes us dependent on the generosity of people who care about these issues. If you can support our work, please send a donation to Mental Illness Policy Org., 50 East 129 St., Suite PH7, New York, NY 10035. Thank you. Contact office@mentalillnesspolicy.org Contact DJ Jaffe, founder http://mentalillnesspolicy.org.