Bringing County Mental Health issues into focus

Mental health treatment, liability and risk, inmate deaths at the County Jail...these topics are hot right now since the County recently settled a huge lawsuit with a family over the death of their son at the jail.

I was in attendance at my last all staff meeting of the human resources department yesterday. Our director was giving a briefing on current County issues, and the one at the forefront was a lawsuit resulting from the death of an inmate at the county jail.

The agenda was structured in such a way that there would be a few reports made, and then a round table discussion would take place where each staff member would report on their current activity and relay any information to the group that they felt was necessary. My turn to speak would be near the end and I was thinking of what I was going to say to the group as my turn approached.

My direct supervisor had mentioned in her report that I was leaving HR and going transferring back to work for the Sheriff's Department. So I led into my speil by thanking all of the staff members, as I looked around the room at each of them, for all of the experiences and assistance I had received in my year at HR. I told them that the two most impactful terms I had learned this year were: "organically", and "stretch assignment." They all laughed, because that pretty much sums up HR.

Then I briefly explained when I left the Sheriff's Department a year ago, I had to get out of the jail and off the night shift because it was killing me. I had planned  to make a new career, hopefully, in HR Risk Management, but then this opportunity came up for a Legal Clerk position that was too good to pass up. I would be going back to the Sheriff's Department, not at the inside the jail, but into the Records and Warrants Division, where I would be utilizing the skills I learned at HR to take on additional responsibilities and assignments and hopefully progress in that department as far up the chain as I would be able. The schedule, the days off, everything had aligned just as I had wished for, perfectly and organically.

Then I segued into the topic of the recent case and settlement. I told the group that I had an interest in the case because I had a son who had developed schizophrenia and committed suicide eight or nine years ago. I told them how we had tried to get help for Andrew and how difficult it was to navigate a system that doesn't clearly tell a person how to get help for mental health issues. I told them how it was my greatest fear that my son would end up on the streets and get arrested and taken to jail. I told them of how, while working in Booking, I would often take calls from parents or family members who expressed relief that their person had been arrested, because they felt that now they would be able to get the help they needed. I said to this group, of course, that is not how it works.

Mental health cases come in and out of the jail all the time when people are arrested for petty crimes. However, they don't get treatment until they have committed a heinous crime where they will spend a considerable amount of time in jail and psychological reports are mandated to prove their ability or inability to stand trial.

I mentioned that the jail is not equipped to deal with all these mental health cases, as has been stated in recent news articles. I emplored the HR staff to pay attention, and do what they could to ensure improvements in the system occur and that the Community is educated on ways to best intervene for their loved ones and get them the mental health treatment that they so desperately need.

From the moment I began talking about Andrew my tears started following and even though I couldn't look at anyone any longer I knew a lot of them were shedding tears also. I got a lot of hugs from my HR co-workers as the meeting ended and we headed out the door. Even the director came over and gave me a hug and expressed her sympathies for the loss of my son. I have to note here that I had been saying for the past month one of the reasons I was going back to the Sheriff's Department was because it felt more like a family and that I got hugs from the sheriff whenever I encountered him at the county building and I had missed all that. So now in my last meeting, I had made a rather deep and personal connection with the HR staff, and hopefully left them with something that they could relate to in a more human way as they managed their assignments dealing with County issues.

I feel a little guilty leaving my supervisor with the task of filling my job and my role, because I knew I had filled a big void in our Administrative Services Team. It had been a rocky journey for me and my supervisor, but I handled the problems I encountered intuitively, proactively, and  emerged with a base of good relationships with everyone I had worked with there.  My teammates have told me how much they're going to miss me and I know it's true. But fortunately, the stars have aligned, and the perfect person to replace me has appeared. The girl I am training is catching on so quickly and has enough experience in her background that she will be able to take what I have accomplished and run with it. My greatest contribution was in creating an accounts payable manual for our HR department that sifted through all the information and whittled it down to everything a person needs to know about our specific accounts payable responsibilities.

One big plus of what transpired in that meeting was that I did have the ear of the HR Director, who will have much influence on how the county procedes with mental-health issues. I know that I was able to create that emotional, human connection to the issue and that was exactly what I wanted to convey. Some of the comments I received afterward had to do with "being brave". I don't know about that, but I do know that I have put it out there into the universe, and I will be watching to see what the ripple effect could be.

Therapy didn't have a chance to work...

My son Andrew committed suicide on April 14, 2009, six years after his first major psychotic break. His father found him at home, lying on the floor. At first he thought Andrew was sleeping. Andrew had suffocated himself while his father was in taking a shower. He had just finished breakfast. It was two days after Easter, and Andrew had fasted and given up meat for Lent. When I wrote the following essay, I had just gone back to work after being off for two weeks to plan and hold his memorial services and take care of matters with the family. I knew I would be writing about this and sharing with others about my wonderful, inspirational son, Andrew. What level of sharing remains to be seen. Now four months has already passed and life has resumed in its familiar fashion. Most people think that I am doing okay. I am, but Andrew is constantly in my thoughts. We all miss him...

April 30, 2009 -- I always dreamed of writing the Great American Novel…but recently I read in “People Magazine” that my idea has been done by Jeffrey Zaslow with “The Girls from Ames”. Seems his non-fiction book is about some girlfriends who grew up in a small town and then all went their separate ways, but kept in touch from time to time as they go through life’s joys and agonies. They are all very different, yet very connected to each other.

Really, that was always my idea…to write a semi-fictional tale using my real-life friends from high school as character models, and explore our stories of marriages, births, divorces, illnesses, deaths, successes and failures. Relate how our lives had taken different paths, yet we shared common feelings and experiences. A few of us are still married, some are divorced, single parents, in a new relationship, have become grandparents, stepparents, or are childless. One went to Hollywood and is now a successful choreographer-director, never married. Another manages a lucrative title insurance company and has a beautiful home in Santa Barbara, but no children. I raised my children in the same town that I grew up in, then moved to the “big city” 20 miles away after getting divorced and started a new job and a new life. Many of my friends have made and lost small fortunes and started over. We’ve lost parents, brothers and sisters, and a few children. I started to outline the characters for my novel a long while ago after I attended a Writer’s Conference at the local community college. That was back in the early ‘90’s, and then I got sidetracked with life…my three children, my husband, extended family, work and the rest…so my novel went on the backburner.

Fast-forward 19 years and here I am, two weeks after the suicide-death of my beloved 26 year-old son and four days after his memorial service in which I was reunited with all my old girlfriends, trembling at the thought of resuming life-as-usual. They all called, emailed, sent flowers and cards and attended the service. There were so many people there that I only had a few moments to greet each person and didn’t even have a conversation with most of them…but they were there, and we were flooded with memories of the times when our paths had crossed over the years…memories of weddings, baby showers, our children playing sports, attending school together, sharing birthday parties and that great big graduation shindig that we parents had planned and prepared for three years leading up to the event.

I remember thinking as I greeted each person and group in the reception line following the memorial service that this was like my life, or Andrew’s, passing before me. His first grade teacher was there, his youth coaches, high school coaches, our neighbors, old friends, new friends from work, former employers, our huge extended family, ex-inlaws, people from church, school, and Andrew’s friends or their parents.

Even my friends that didn’t have any children still ached for my loss in the same way those with children felt it. They had nieces and nephews who had known Andrew. At this point in our lives, several close friends of mine had lost a loved one and we had grieved that person together. It was a familiar drill. We suffered through divorce one by one, and then celebrated new relationships. Some had battled cancer and as 49-year-olds, we were all experiencing pre-menopause, high cholesterol and weight gain. I had led the way by having a mild heart-attack at age 47.

My friends’ brought their families to the memorial: not just husbands and children, but their brothers, sisters, parents…whole families were there to grieve with my family. We pulled together, my ex-husband, my two daughters, my nephews that lived like Andrew’s brothers with him, my fiancée and his son, my former mother-in-law, our brothers and sisters, the cousins—everyone came together to honor my son and celebrate his accomplishments in life. A couple of my nieces had taken over the planning for the memorial service. My sister-in-law read Andrew’s obituary during the service. Our lifelong friends and the parents of Andrew’s best childhood buddy organized the potluck luncheon in the park. Everyone came together to support us. They all loved my son.

Writing was a passion Andrew and I shared. I had always wanted to be a writer and landed a job with the local small-town newspaper where I got to write features and do publicity articles. One aspect of my job was writing obituaries. I have written several for various members of our families who have passed on: grandparents, my parents, two uncles. Most recently, last June, actually, I had written one for my sister-in-law, the one that had become my ex-husband’s companion after her husband died. Preparing the obituary notice was one thing I could do for them during a difficult time, and after all, I knew her as well as anyone did. So I sat down with her mother and we reminisced about her daughter. It was like old times, talking and laughing about the silly things that happened with the children and family. We all share so many of the same memories. It wasn't so difficult a thing for me to do, and it was really rather therapeutic.

I wrote Andrew’s obituary. As I typed his life story, I remember thinking that it should be a hard thing for a mother to do, but it wasn’t. It was easy to think of things to say about him, and I wouldn’t have passed on that assignment for anything. As I typed his story into the computer, I remember thinking how I was on my own with this assignment…usually Andrew had proofread my other obituaries prior to publication. Oh, the irony! So I asked Rebecca and Jayne to do the proofing...

Andrew was a gifted writer in grade school, and in high school he joined the school newspaper and began writing sports articles. He had played sports all his life. He was a star growing up in youth sports. In high school, he might not have been the most valuable player or the most talented, but he was always the team motivator. He was often selected as Most Inspirational. He wrote sports stories from a players’ point of view.

He applied for a scholarship from the county-wide newspaper and won, inspiring him to study journalism at the community college. He wrote features and sports articles there, ending up as the Sports Editor in his second year. While still attending college, he landed a job with the bigger county paper and began to really delve into the craft of writing to meet a deadline, being accurate and hooking the reader all at the same time. “A beacon of concentration in a swirl of confusion. That was Andrew,” wrote his sports editor in a note to me and the family after learning of Andrew’s death. It was a profound statement, and we used it on the funeral cards. The statement seemed perfect when paired with a painting Andrew had recently completed of a ship in the midst of a storm.

Ironically, it was his inability to focus any longer that led to Andrew’s suicide. I scooped up his notepads from his bedroom a few days after he died and skimmed over the writings. He had written about all the different thoughts that were bombarding him all the time. He tried to block them out, stay busy doing projects, push all the thoughts away, but it was too much. He tried to keep up with his dad, who typically worked seven days a week. He finally was able to outwork the old man, and after the workday, he did projects at home. He repainted his truck—twice. He built planters and did all the yardwork, constructed arbors, planted a garden. He was exhausted and wrote that he just wanted to be able to focus on one thing at a time. He wanted some peace.

My husband and I had separated following the death of his brother, Andrew’s uncle, who had died in a tragic car accident in 2000. My ex and his sister-in-law turned to each other for support and ended up together. Their relationship provided her three boys a semblance of familiarity and normalcy, in a weird way. Bill became their father-figure and Andrew became their brother. They looked up to him and adored him.

It was all sort of Jerry Springer-ish, and may have detracted from us being able to really understand what was going on with Andrew. The illness hit Andrew in his early 20's -- classic timing, I'm told. While attending college, he had begun to exhibit signs of paranoia. He was going to school fulltime and had landed this great part-time job with the newspaper. It was like a dream -- perfect steps in his plan for the future. Then, eight months or so into it, he just quit…walked away, dropped out of college mid-semester, and said he just wanted to work with his dad in the family plastering construction business. I was devastated because Andrew had seemed to be on the path to success and I didn’t want to see him go into a downward spiral. I knew he was having some emotional conflicts, but who wouldn’t given the circumstances? He was worried about me, his dad, his sisters, and his cousins. He tried to be the perfect son, and mostly he succeeded.

But then he had a real psychotic break. He locked into a total paranoid mentality where he thought people were coming after him and trying to kill him. He mentioned some real-life characters from junior high and high school that he had had some confrontations with, so it didn’t seem that far-fetched. But we could tell he really needed some intervention. Someone directed me to French Hospital and, once Andrew agreed to go, a mental health crisis person met with him for an evaluation. She recommended that we take him to a mental hospital in Ventura and made the arrangements. I would have to drive him there as soon as possible.

I remember going to the house and packing a backpack for Andrew. My older daughter Jayne helped me as we humored Andrew’s paranoid comments and tried to mask our sense of urgency. He was looking out his bedroom window, scanning the cars that drove by on the roadway out front. Someone was coming for him—Mexican gangsters. They were going to shoot him. He named the boy he had been in a fight with in 8^th grade. He was scared to death. We were too, but we tried to hide that from him. We were steering him down the sidewalk to the car when suddenly he turned and wanted to go back into the house to get his running shoes.

“Its okay, Andrew, your flip-flops are fine. Just please get in the car,” I pleaded.

“No, Mom, I need my shoes. If they come after me, I can’t run fast in these,” He replied. Jayne and I exchanged looks, and we dashed back into the house with Andrew to change his shoes. I didn’t breathe until I finally had him in the car and we hit the freeway for our two-plus-hour drive to Ventura.

When we arrived at the hospital, it was dark and the front doors were already locked. There was a bell with a sign saying to ring it, and I did. The person who opened the door for us was a Hispanic janitor, much to my dismay. I was afraid Andrew would make some sort of Mexican-gangster connection and refuse to enter, but miraculously he didn’t. I let out a huge sigh of relief. They would help him here, I just knew it. Some doctors would fix him and he would go back to being my wonderful son on his way to a promising career. I stayed with Andrew through the intake process, then finally it was time for me to go. They had taken his shoe laces and issued him some hospital clothing. They gave him a toothbrush. I hugged him tight and promised him everything would be okay. Trust them, I begged. They will help you. Bill had arranged for a motel room for me in Ventura, but I cancelled it and drove home that night. I cried the whole way home.

The staff told us we would need to leave Andrew there for four days. On the last day we could come for a family counseling session. We got to talk to Andrew on the phone a couple of times before we went to pick him up, and he cried. He was so scared there. People were messing with him. A hospital worker stole his toothbrush. Other patients were so weird and they drooled. No one looked normal like Andrew. "Please come pick me up," he begged us.

We drove down in separate cars on Sunday. Bill smoked and didn’t want to inconvenience me. I also suspected my sister-in-law might not appreciate us riding together. Oh, brother! When we arrived we had to hunt for a parking spot because the parking lot was full. I ended up parking on a maintenance road above the facility behind a car that displayed a license plate frame with the statement, “You’re just jealous because I can hear voices!” Fat chance! I laughed that nervous kind of laugh you do when you are just about to crack.

We went to the family session. We saw the other patients. In our meeting with the doctor, he simply said Andrew had had a psychotic episode and would need further counseling by a psychiatrist. He said he could take it on, but due to the distance, he recommended we find a doctor in our area and gave us several references.

Andrew said he never wanted to go back to that hospital. We didn’t ever want to have to take him back. It took us three months to get in to see a local doctor. In the first session, Andrew made his case for all the reasons he didn’t want to continue with therapy, and so he didn’t. Actually, I think he might have gone to one more session. The psychiatrist was, of course, intrigued with Andrew, who he said was intelligent, good looking, athletic and yet, had this one tiny thing that no one could see by looking at him that was off…fascinating! I got Andrew to go see one other psychiatrist, a woman, but after two sessions he was done. He wasn’t going where ever the counseling tried to take him. He didn’t feel safe. Back at the Portola house where he had grown up, or working with his father, that was the only time he could feel secure…not entirely, but reasonably.