Trigger warning: Probably NSFW, especially for those of us whose family members have “unresponsive to treatment” mental illness, because here are all of your worst fears and shameful secrets spelled out. But it’s a powerful, and important, story.
Stephanie McCrummen, in the Washington Post:
HE WAKES UP, and even before he opens his eyes, he can see his beautiful, delusional son.
Gus, Creigh Deeds thinks.
He lies in bed a few minutes more, trying to conjure specific images. Gus dancing. Gus playing the banjo. Gus with the puppies. Any images of Gus other than the final ones he has of his 24-year-old, mentally ill son attacking him and then walking away to kill himself, images that intrude on his days and nights along with the questions that he will begin asking himself soon, but not yet. A few minutes more. Gus fishing. Gus looking at him. Gus smiling at him. Time to start the day.
He gets out of bed, where a piece of the shotgun he had taken apart in those last days of his son’s life is still hidden under the mattress. He goes outside to feed the animals, first the chickens in the yard and then the horses in the red-sided barn. He leads the blind thoroughbred outside with a bucket of feed, the same bucket he was holding when he saw Gus walking toward him — “Morning, Bud,” he said; “Morning,” Gus said, and began stabbing him — and then he goes back inside…
*******
… Gus’s mother had him evaluated. Gus was given a diagnosis of bipolar disorder, and at some point that Deeds cannot remember, he was told about it. His son had a mental illness.“I never wanted to believe that about my son,” Deeds says. “I just wanted to get him back.”
He kept trying to get him back. He helped Gus get a job washing dishes at the Homestead, a sprawling mountain resort in Hot Springs, because surely the structure of a job would help, but then Gus got fired after some sort of fight Gus never explained, and in June of 2011 he moved in with his father, the two of them together in the old white wooden house in Millboro…
“He was having delusions, and I was under the illusion that things would work out. I’m optimistic. Sometimes I’d say to Gus, ‘Come on, pull yourself up.’ For a period of months, he had this book, ‘Confederacy of Dunces,’ and I said, ‘You’re like the hero in the book,’ ” he says, referring to the brilliant, eccentric, philosophical but also slothful main character. “I said, ‘Come on, Bud, you’ve got to do better than this.’ I said, ‘Gus, what’s the plan?’ ”
He shakes his head at how he reacted.
“I just didn’t know what to do,” he says.
He had no information. Gus was an adult, and so his medical records were private…
***********
HE DRIVES TO RICHMOND. He walks into Senate Room B, Siobhan holding his hand. He sits at a long dais and bangs a gavel, facing a room full of mental-health workers, state officials and families assembled for the first meeting of the Joint Subcommittee to Study Mental Health Services in the 21st Century.“I’m Creigh Deeds,” he says after the other legislators introduce themselves. “I represent the 25th District. You know who I am.”
Before everything happened, his legislative work revolved around economic development, cleaning up a Superfund site, transportation, electoral law and public safety. He supported changes to the mental-health-care system after the 2007 Virginia Tech massacre, but it wasn’t until the day before Gus attacked him that Deeds fully grasped how dysfunctional the mental-health system could be.
That was the day he obtained an emergency custody order for Gus once again. But at the hospital, the legal time limit to find a psychiatric bed for someone deemed to be in need of commitment — at the time, six hours in Virginia —was reached before a bed could be found, at which point Gus was sent home with his worried father.
Then came January, two months after the attack, when Deeds returned to the state legislature, his scars still raw, his eyes red from crying, knowing, he says, that “it would be damn difficult” for legislators to say no to his requests, which they didn’t. Now, because of Deeds, the legal time limit to find a bed is up to 12 hours, and if no bed can be found, the state psychiatric hospital must provide one.
There were other changes, too, but not enough, Deeds says, and so now he is chairing the subcommittee to study Virginia’s mental-health system….
Omnes Omnibus
I see it is downer night here at Balloon Juice.
ETA: I do note that Deeds used his family’s situation to improve the system a bit, so there’s that.
PsiFighter37
Incredibly sad.
Jacks mom
Mental illness and it’s often time companion drug abuse/addiction is such a stigmatized thing. You lose someone so dear to you from an overdose or suicide and not only do you have that gaping hole in your life, you have all that guilt & judgement to go with it.
Ruckus
@Omnes Omnibus:
Tis the shame that it took a legislator with a mentally ill son to make those changes. No one seemed to be able to see that there is a huge problem until it got to be personal. Yes I’ll give the man a break in that he did do something to help make things better but he was a legislator before this happened. No ability to see that our system sucks donkey balls? Is that a lack of empathy or am I reaching?
Chickamin Slam
The mental health safety net in this country is woefully inadequate. “We’re number #1 !”
The beds are not there and thus tragedies that can be prevented often do not. How many lives lost, dollars spent after the fact for the sake of a few pennies? “Tax cuts for the rich!”
In other news I came across this, somewhat related >.>
http://www.nytimes.com/2014/11/02/us/bernard-mayes-85-dies-started-first-us-suicide-hotline.html?_r=0
Omnes Omnibus
@Ruckus: Or he might not have been in a position to push it in the same way. As Deeds noted, he knew when he came back that people couldn’t say no to him.
Omnes Omnibus
OT, but someone needs to send up a flare for Steeplejack. “Pandora’s Box” is on TCM late tonight.
Nicole
@efgoldman:
And I think a lot of overworked medical professionals give up on patients whom they can’t “fix” quickly. I’m glad the person in your life is doing better, and very glad she had people who cared enough to keep pushing for what she needed. I have a friend who, at 21, tried to kill herself and was diagnosed at the time as manic, even though she’s never actually had a manic episode. It seems like every psychiatrist she’s seen since then just accepts that diagnosis and bases her medication prescription accordingly. She’s on permanent disability (has been since her mid-30s) and I don’t know what she’ll do when her parents die, as I don’t think she can live on her own.
JCJ
As a person whose wife has been hospitalized three times for psychosis (bipolar) I have nothing but contempt for those who put such obstacles in the way of patients getting the medical care they need. My daughter has significant PTSD as a result of her having seen my wife (her mother) out of control, swinging away at me and then squeezing her head to try to chase away the demons my wife was imagining. It was obvious to anyone who went to medical school and did not sleep through the psychiatry rotations that my wife was psychotic, yet state law would not let anyone do anything until the shit hit the fan. I get edgy just typing this. I am lucky my wife never turned to a knife or other weapon.
Schlemazel
@Omnes Omnibus:
Funny, I see this as a positive story because of the outcome. Horrible things happen every day around here so that I’m glad it happened to someone who could make things better for everyone else. Its sad for him but a win for families dealing with the fallout of mental illness. It makes me wish horrible things would happen to a lot of state and federal officials who could make the changes we need. Particularly if they are the exact ones that can’t be moved today.
JCJ
@efgoldman:
My wife’s hospitalizations have cost us quite a few thousand dollars. There was a limit of $10k. Fortunately the last time she was hospitalized was 2003.
Omnes Omnibus
@Schlemazel: We are such very different people. I did recognize the positive result that came from it.
skerry
Not sure why Annie thinks this is NSFW. I think saying that contributes to the stigma that mental illness carries. I’ve seen more graphic posts on this blog without a NSFW warning.
PhoenixRising
3 years ago this month, we lost my wife’s friend to suicide. After 22 years of “treatment”, her parents were broke, she was unemployable in any small-group hiring process and her despair was a reflection of her actual situation: Mental illness coverage is shamefully ineffective and unconscionably expensive, even if your dad is a state senator, even if you’re a PhD with adjunct status, even if…
I can’t imagine how bad it is for patients whose families have no resources.
Ruckus
@efgoldman:
I know a lot has changed for the worse in the last 40 yrs. That long ago I worked while going to school at a mental health center, one day a week. We answered suicide calls and saw clients, referring those with more serious conditions to professional and/or law enforcement. Getting someone committed for a 72 hr observation was very difficult, it has gotten worse. The thing was for the most part us part time amateur counselors were the front line other than law enforcement. Insurance? It is to laugh. That is one of the real unsung great parts of the ACA.
Anne Laurie
@skerry:
Because if I read this at work, I’d break down in public, and I didn’t want to do that to any other readers.
gogol's wife
@Omnes Omnibus:
Also OT I’m loving Clara Bow in It
Schlemazel
@Omnes Omnibus:
A lifetime of practice at finding any trace of a pony at the bottom of many piles of horse shit.
Omnes Omnibus
@gogol’s wife: She doesn’t do it for me. Louise Brooks, however…
Schlemazel
@gogol’s wife:
I have heard so much about her but never seen her work. I should keep an eye out for her stuff. What’s your opinion?
pseudonymous in nc
@Ruckus:
You’re reaching somewhat. Deeds is out in nearly-West Virginia. Virginia is a state where the bulk of the population is clustered around DC. Resources for everything get sparse as you hit the mountains. And when you hit the mountains, you hope that prayer will lift the demons, because there’s nobody else there for them.
The system’s failures are both complex and simple. The system as it was had the kind of confinement that hurt as many as it helped. The system as it is now works best when mentally ill people, especially those in rural areas, simply kill themselves, and rural areas provide many ways for that. The system is as it is because there is no social contract that accepts there are people whose healthcare we need to pay for. That we ought to pay for, because we live in society. The system is as it is because every night we’re sold ask-your-doctor-about pills that fix things, when some things aren’t easily fixed. The system is as it is because states simply aren’t prepared to pay mental health professionals a salary that reflects their expertise.
Mental health is a weak link in even the best healthcare systems. In the US, where there is (still) no healthcare system, only a scatter of things that approximate systems, it’s a complete fucking mess. The saddest part about it is that had Gus Deeds lived, and been locked up for trying to kill his father, he’d have had access to some kind of therapy.
Tissue Thin Pseudonym (JMN)
@efgoldman:
I have never had a psychiatrist that was not some combination of creepy and useless. Fortunately, I’ve had a very good therapist that communicates with my primary care physician and I just get my meds through him. I have no intention of using a psychiatrist again.
PhoenixRising
@efgoldman: Oh, I know.
The shrink, provided to the patient by Student Health for the 10.5 years from undergrad through dissertation, attended her funeral.
I didn’t spit on him. What a useless bag of skin–you’re on the faculty of an Ivy med school, nothing you delivered in a decade helped, but you didn’t refer ‘the most brilliant, insightful mind I ever treated’ to someone else.
She was more than a genius; she was also a deeply troubled child who became a deeply troubled, fatally ill woman on his watch–and he came to the funeral.
What a stellar example of the ‘helping professional’!
Tissue Thin Pseudonym (JMN)
Mental health patients get hit on the other side, too. Every disability insurance policy I’ve ever seen has an absolute cap of 18 months of payments for mental health issues. No exception. If you have a physical disability, you might receive disability payments for life. Not mental health issues.
Aside from that, the question of when one stops being disabled is relevant: is it when you could do the job again if someone would hire you despite a history of mental health disability or is it when someone actually will hire you despite a history of mental health disability?
bemused senior
@efgoldman: I thought this was stand-up comedy, but I guess it was a representation of real life.
Chickamin Slam
The link I put above, not that anyone cares, went to an obit for the gentleman who started the first suicide hotline in the US. http://en.wikipedia.org/wiki/Bernard_Mayes
I also recall there being a push to increase awareness of mental health in reaction to the suicide of Garrett, a son, of then (R) Oregon senator Gordon Smith around 2004. “Garrett Lee Smith Memorial Act, authorizing $82 million for suicide-prevention and awareness programs at colleges.”
Bad shrinks? A friend went to one whose advice was to “get laid” and if that wasn’t working “go to a strip club.” Pearls of wisdom for $250 a hour.
skerry
@Tissue Thin Pseudonym (JMN): I’m one of the few lucky ones. My policy provides disability income until age 65 for certain mental illnesses. I won the diagnosis pool.
It is a constant worry that someone in an office far away from me will decide that I am no longer disabled. I certainly can never work again in my chosen field/industry with my medical history. I’d be very surprised if I could find employment that approaches the amount of my disability income, especially since I have been out of the workforce for years now.
Omnes Omnibus
I am going to keep reading this thread, but I am done saying anything. I realize I know nothing about this, and I won’t presume that I do.
gogol's wife
@Schlemazel:
I’ll answer you in the open thread above.
Omnes Omnibus
@efgoldman: No. I do not.
Ruckus
@Omnes Omnibus:
Even if all you’ve ever done is read this thread you know more than most.
I’ve been out of the “business” if you will for a long time now. But I spent nearly 4 yrs one full day a week. I had regular clients, both phone and walk in, some for as long as 6 months. One phone in was a young girl who I was assigned to for almost 3 yrs. I still remember some of the people and days like it was yesterday, they made that big an impression. But we were knocking about the edges, nothing hard core. We also had to debrief in group sessions with a fully licensed psychiatrist to ensure that we were actually helping and not just wasting someone’s time. It is a humbling thing, working with people’s minds, trying to help them see and understand what it is that’s not working for them.
RoonieRoo
Many people on BJ know that my first husband died as a result of his mental illness and I, by fortune and due to his love that existed deep in his soul, survived. My late husband had schizo-effective disorder and used a legally purchased gun to end his life shortly after changing his mind about ending my life.
I am always grateful when the front pagers post about mental illness and how it affects us as a society.
I will never forget the days I spent calling his doctor from pay phones in between my university classes begging them to help me with him. I knew he had stopped his meds, I knew things were heading in a dire direction but the way things are structured there was nothing I could do to stop the train that I saw barreling towards us. By the grace of FSM, I survived it but it is in spite of our psychiatric system and laws that I did.
Debbie(aussie)
My SO, Ross and I are going through tuff times regarding mental health, we both have severe depression. R is seeing a psychiatrist and has had his meds changed and upped to very high doses. I too am seeing a psychiatrist for med changes, but also a psychologist for counselling, which I find very helpful.
R has had a claim for disability knocked back and I really can’t see him able to look for work. Especially after 27 years in one job and being over 55.
Here in Aust we have big problems too. But some recognition of the needs of those with mental health, tho rarely much follow through. I can’t find the stats but a very large percentage of those in prison suffer from some form of mental illness (25% I think).
Our gov’t financed TV ABC just had a mental-as week. Highlighting the issues and support needed through comedy shows, more serious sit down interviews and a fundraiser as well. Some very interesting stuff.
Steeplejack
@Omnes Omnibus:
Got it covered. Recording Lubitsch’s The Wildcat, which I’ve never seen, and probably the 1921 Camille with Alla Nazimova. Can’t remember ever seeing her in anything.
a hip hop artist from Idaho (fka Bella Q)
The treatment of the brain disorders we call mental illness is complicated on many layers and by many levels. An enormous one is stigma. Sometimes even people with the kind of insurance that could get them very good treatment don’t get it because they don’t want the judgment. Even more people can’t get good treatment due to lack of access. There are not enough physicians and even when there are too many people cannot afford them. I was saddened to read that Bernard Mayes died – he began a great thing.
I spent last Saturday at a Psychopharmacolgy Update Symposium (volunteer staff – I know how envious most of you must be). While there I met a young woman who lives with schizophrenia which is currently well controlled. She’s written a book, as has her mother and the doc who wrote the forewords to the books is a friend and introduced us. Their story would be very different but for access. However, I’ll not that the psychiatrist who treated her and wrote the forwards is known to evaluate and diagnose patients off the books and get them referred in to the Psych Residents Clinic for affordable treatment.
There are so many things wrong with “mental health” treatment in this country that it’s often overwhelming. But I’ll remind the 4th Year Residents next month to be fastidious about insisting that these are medical disorders and part of physical health.
JGabriel
Ruckus:
I think it was less lack of empathy than it was lack of awareness. The article notes that Deeds had previously supported changes to improve Virginia’s mental health system, so I think the empathy was there – he just didn’t know how hard it can be to navigate the system until he experienced it personally.
I’m not seeing the completely callous and insensitive attitude that you usually see among Republicans who never show human compassion on an issue until it personally affects them.
Lee
Now hopefully they will actually fund the state hospital so that it can provide those beds.
Elie
@efgoldman:
I think good mental health care is hard to find all over the world. And treating it — even when you have resources, is a major challenge. Psychiatrists are pill pushers anymore. You need them, however, to have one who knows which pills to try and how to supervise — also someone with a heart — which many many do not. Since your psychiatrist does not do “talk therapy”, you have to find a separate talk therapist — again, a hunt for a good one. The expense of both is not trivial. All the drugs have side effects. Some are better managed than others. Side effects can be alterations in sensorium, to rashes to life threatening conditions such as acute liver and kidney failure.
Getting an accurate diagnosis seems easy and obvious. It is not. Of course, that drives the treatment decisions for what meds to use. Mistakes here can lead to many bad outcomes as drugs intended for x condition may not do as well for Y or may not work at all.
There are great support groups like NAMI that help you through as a family member. It doesn’t fix everything but they are there with regular meetings and up to date information and many contacts to help with everything from finding a doc to getting disability for a loved one. Thank God for them!