A MOTHER SPEAKS

Earlier this week I posted a call for caretakers of the mentally ill–usually parents, siblings and offspring–to throw off their habitual cloak of invisibility and silence, and launch a crusade against public cluelessness and apathy; in particular, public policymakers. The link below, focusing on my home state of Vermont, shows just one example of legislative inertia: the ongoing crisis of too few beds for too many patients in psychotic states:

https://vtdigger.org/2016/12/19/involuntary-psychiatric-hospitalizations-record-high/

And here is one searing response to my call for speaking out:

“I wonder what I would do if Tom should decide he can no longer bear this burden.  If I should find him gone one morning.  Would I lay down beside him, hug his lifeless body in my arms, and go to meet him?  Or would I give my life to him?  Tom’s voices threaten to kill him and his family. From his letters for help, which are heartbreaking, he says “they are certainly adding other types of frequencies that are causing extreme agitation, sometimes depression, anxiety, stress; voices described as scary or haunting or terrorizing; more death threats against me and my family and they won’t quit.  I have driven as far as the coast and cannot get this off of me.  The police just come and put me in the hospital.  I don’t know how to be more clear to them and they aren’t listening at all”. What if, in the dark of night, in his madness, he did not see the mother he loves but a horrifying delusional apparition there to harm him and his family; perhaps the act of killing me would finally get him the help he needs, a chance to quiet the voices and terrifying paranoia, and find some peace.

“I have only been afraid of Tom once, his delusions of people coming to harm him, and me not understanding.  I never know the right thing to do or say.  His brain is screaming at him, voices only he can hear, shouting down any shred of reason that may be left.  His despair and fear so great I am afraid he will lash out at anything, anybody nearby, not knowing what he is doing in his insanity. Any suggestions of getting help are met with incredulous sighs and anger.  Why don’t I listen, why don’t I understand, I am the one that needs a doctor, I am the one that is in denial.  I hide the knives that night.

“We leave Tom alone now. He doesn’t talk anyways, he doesn’t hear us, or if he does he responds with something unrelated and unintelligible. I buy health food and leave it around, hoping he will get some nutrition in him   He isolates in his room, sometimes for weeks at a time, not bathing, sitting so long his feet and legs swell up so bad he can barely walk, drinking coffee.  He is going mad in the room I had remodeled for him, to keep him safe for as long as I could.  I pray he will go into a coma and I can now call and say come get him and help him, he is a danger to himself.

“I go to do the dishes, but they are already done.  I don’t remember doing them.  I lose track of time, I wait.  The wolf at the door will surely come bursting thru any day now; it is almost six months of no meds.  One afternoon Tom comes to me, puts his arms around me and says ‘I love you mom.’  I’m still a light in his mind, I’m still there.

“The months go by.  I ask myself how much worse can it get, but I already know, much worse. My nightmares turn into terrifying faces coming out of the dark.”

Mary Welch

SPEAK OUT!

Scott Walker By Michael Vadon (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
Scott Walker By Michael Vadon (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
My upcoming book’s title, NO ONE CARES ABOUT CRAZY PEOPLE, is intended as ironic: it is taken from a notorious, subpoenaed email written in 2010 by an administrative aide to Scott Walker. The aide was trying to shield the then-Milwaukee County Executive from accountability for a mental-hospital scandal that was unfolding at the time.

In the few weeks that I have been publishing this blog, I’ve found myself thinking about an alternative title, one that lacks irony and only somewhat overstates the truth.

the screamThat title would be: NO ONE KNOWS ABOUT CRAZY PEOPLE.

For centuries, society has hired, or elected, custodians to see to it that the mentally tormented are kept out of sight and out of—well, out of mind. Those who take for granted their place in the “normal” world prefer to sidestep the colossal moral challenge—the primal fear—triggered by walking, talking evidence that people very much like them can go insane. (“There, but for the grace of jails. . .”) Thus, the mentally ill continue to struggle for their humanity under a cloak of social invisibility, and silence.

None of this is to suggest that people in the throes of psychosis should be left to roam the streets. Hospital treatment and supervision are imperative during such episodes. The problem is this: despite the growing consensus among research psychiatrists that a patient’s integration into a sympathetic community can dramatically reduce the symptoms of brain disorder, progress toward this goal remains slow: impeded by the cloak of invisibility and silence.

Dorothea Dix
Dorothea Dix

Few people have better understood the human spoilage guaranteed by this cloaking than the great pioneering reformer Dorothea Dix, whom I quote in the epigraph to NO ONE CARES ABOUT CRAZY PEOPLE. In remarks to the Massachusetts legislature prepared in December 1842, following her tour of mental asylums in the state, the small and sickly crusader declared:

“I have come to present to you the strong claims of suffering humanity. I come as the advocate of the helpless, forgotten, insane men and women held in cages, closets, cellars, stalls, pens; chained, naked, beaten with rods, and lashed into obedience. . .”

Time has brought improvement to the plight of insanity victims caught in psychosis—the untreated, the undiagnosed, the wrongfully incarcerated, those who refuse to confront their illness and aggressively repel efforts at help.

Time has not brought enough improvement. Not early enough improvement.

The cloaked suffering of the mad thrives, and it thrives. NO ONE CARES is laced with accounts of insane jail and prison inmates, many of them unindicted, who took their lives in their cells or in solitary confinement (I hope against hope that you might read this, Governor Chris Christie of New Jersey, and reverse your support for this gruesome form of soul-murder), and who thus died beyond the range of public attention, save for a few readers of transient news accounts.

Thus, “No One Cares” is fed by “No One Knows.” The two collide, and collude.

Thus far in this essay I have focused on the “invisibility” aspect of “No One Knows.” Of equal destructive importance, I believe, is the silence. The self-imposed silence that mutes the voices of those most entitled—and, I think, obliged—to break the silence.

I speak of the close friends and relatives, parents especially, of the afflicted. These people are qualified not by professional training or certification, but by a precarious vantage-point that no one else can share who are uniquely qualified by direct observation with psychosis.

And yet here is one of the most desolate truths about “No One Knows”: it is far too often a by-product of silence. Self-imposed silence. Silence maintained by those closest to the victims of mental illness who are in active psychotic states. This usually means their relatives. Typically, “relatives” means parents. And “parents” often includes the sub-category of single mothers, women who for one reason or another have been left to care for their volatile children—often male children, as a statistical fact. (Men typically develop schizophrenia between ages 15 and 24; women, between 25 and 34.)

Left to care, and left to scream in silence as police and community social-service agencies designed to help them often fail during episodes of crisis—or in pre-crisis. Police remain under-trained in this area, or not trained at all. In too many cases, the desk-man either shrugs off the frantic phone call or the squad arrives only to make matters worse. Paramedics and social workers feel hamstrung by coils of legal restrictions created to protect the civil rights of people in psychosis who “reason” that they don’t need help. (People in psychosis are, by definition, people deprived of reason.)

And so the family caretakers scream in silence—while their deracinated children scream aloud their suicide threats or violent threats against others, often including the caretakers, as the untreated psychosis deepens. and the cop on the phone explains (in essence) that the screamer cannot be detained unless he or she “constitutes a threat to others,” and that the uttered threat is not enough; the psychotic victim must actually carry out the threat, which, of course, in theory, law enforcement exists to prevent.

The caretakers scream in silence. And their urgent silent screams go unheard by the world around them. And the cloak remains in its suffocating place.

The reasons for self-imposed silence aren’t hard to track down. They’re rooted in human nature. The fear of embarrassment—stigma—is a fundamental one. To appeal publicly for help for a struggling insane relative is to acknowledge that one has an insane relative. Most people live their lives outside the community’s spotlight. To step into its glow for any reason can be terrifying. The imagined shame and ostracism such an admission might bring on is a powerfully, and sometimes fatally inhibiting burden.

Anxiety over the future of the victim is another. What if everybody knows she is schizophrenic? She will never get a job! She will never have friends! She will never marry!

And then there is the soul-crushing factor of futility. America, especially rural and suburban America, remains dotted—clotted—with service agencies, police departments, and courts that remain either stubbornly self-anesthetized to the gothic realities of psychosis, or else are paralyzed by the fear that any action they take might violate some law or statute or other restriction, real or imagined, that would make them civilly liable or criminally accountable for carrying out a good-faith intervention. Thus, far too many desperate mothers and fathers have called police, hospitals, lawyers—anybody—for help, against a background of menacing threats and the pounding upon a locked door, only to be told: “There is nothing we can do.”

This is surreal. This is grotesque. This is beyond the imagination of anyone in the “normal” world; only those who have endured it can appreciate the resulting dread that soaks the heart and blots out hope.

Schizophrenia has struck at both my children; once, fatally. I understand the heartbreak, the dread, the galactic frustration of my fellow survivors and sufferers who must watch their loved ones slip into a state that the world would prefer not to hear about, nor try to heal. I understand the powerful protective wish to remain silent.

And yet, in my core, I cannot accept the silence. I cannot accept it because silence is the lifeblood of “no one knows,” which in turn is the lifeblood of “no one cares.”

In my core, I want to confront all the silent sufferers—“confront” is the only word—and shout at them to shout their stories from the rooftops: to badger the newspapers and radio and television stations in their communities to pay attention to their stories, and amplify them, urgently and accurately, and damn the risks of stigma and anxiety and imagined futility. I want my fellow sufferers to raise a collective voice all across the nationwide archipelago of the mentally ill. I want an impassioned, fearless grass-roots movement to rise up and intersect with the hopeful, but top-down breakthrough of the recently enacted 21st Century Cures Act.

I want the “invisible” mothers and fathers and caretakers of our most helpless citizens to take up the banner of Dorthea Dix, and affront the conscience of emergency responders, police, doctors, judges, and the largely oblivious and benumbed legislators across the country. I want to see a great and vital conversation burst into public awareness: a conversation that until now has been conducted under the cloak: in furtive telephone calls, emails, hushed conversations, and within the several “confidential” websites where members may speak candidly under strict rules of confidentiality.

All these conversation forms are cathartic. None is enough.

I grant that my career choices have annealed me to public exposure and its consequences. My training and experience, now spanning five decades, has been in journalism, which has in turn led me to nonfiction narratives. Over this time I have learned gradually to overcome my own severe native reticence, and to place truth-telling (as I understand it) above all other considerations. I have grown comfortable with violating my own privacy. NO ONE CARES ABOUT CRAZY PEOPLE, if it is nothing else, is a testament to this.

I respect—I ache for—my good, grieving, terrified sisters and brothers who cannot yet imagine shouting their stories from the rooftops, seizing the world by its lapels and screaming, “YOU’VE GOT TO PAY ATTENTION!” I wish I could deliver them from their agony. I cannot. The hard truth (as I understand it) is that they must do it themselves, until their individual voices meld into one continuing thunderous voice. We must throw off the cloak. No one will do it for us.

More on this subject later in the week.

The 21st Century Cures Act: We Must Move from Euphoria to Vigilance

By Timmurphy (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
By Timmurphy (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
Families and caretakers of severe mental-illness victims are still jubilant, and justly so, a day after President Obama signed the 21st Century Cures Act into law. The $6.3 billion health care bill marked a historic triumph for America’s most helpless and marginalized sub-population and for Congressman Tim Murphy (R-PA), a statesman of mental-healthcare reform. Murphy, a Naval officer and a practicing psychologist, fought valiantly for four years for acceptance of his Helping Families in Mental Crisis Act, which is enfolded into the new law.

Murphy’s several allies in his crusade have amounted to a “Dream Team” of warriors for mental-health reform. Foremost among them have been E. Fuller Torrey, the prolific author and brilliant pioneering critic of our country’s responses to its mentally ill citizens, and Dj Jaffe, the “ultimate insider” activist and author of the forthcoming book, “Insane Consequences” (Prometheus Books, April 11, 2017) for which Fuller Torrey has written the Foreword.

By Andrii IMath (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
By Andrii IMath (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
The new law (whose provisions have been widely reported) has spread joy and hope throughout the “nation” of stricken families, to a degree probably unimaginable to outsiders. I can attest that their messages have amounted to a collective folk-poem of gratitude.

Yet now that the law is safely on the books, we must temper our euphoria with active vigilance. As one of my correspondents put it this morning, “We must all be watchdogs.”

The Achilles Heel in the new law—widely debated during its route to passage—is its easing of restraints on the pharmaceutical industry’s strong impulses toward excessive production and marketing of lucrative psychotropic and antipsychotic drugs.

I will defer a detailed analysis of this weakness to the masterful essay below, written by Adam Gaffney for this morning’s New Republic:

https://newrepublic.com/article/139328/congress-just-quietly-handed-drug-companies-dangerous-victory.

But I will underscore Gaffney’s piece with an excerpt from NO ONE CARES ABOUT CRAZY PEOPLE–one that provides a context for the need to press forward from the Cures Act toward new legislative oversight of Big Pharma:

“That the rising flow of riches in the pharmaceutical industry might bring trouble in its wake—trouble in the form of litigation—apparently did not trouble the giddy pharma-entrepreneurs of the Reagan years and beyond. (And as the years went on and litigation spread and court settlements and fines seemed to add zero after zero to their totals, it grew clear that the entrepreneurs didn’t really care. Their sales figures were adding even more zeros.) The international catastrophe of thalidomide should have been recognized for the dreadful omen that it was, but for some reason this did not happen. The German-made drug, introduced in Europe in 1957 as a completely safe antidote to morning sickness and soon a global phenomenon, caused multiple thousands of birth defects in children of women who trustingly bought it—such as flipper-like arms and the absence of toes, legs, and ears. Roughly half the cases were fatal. Some of the litigation continues today. (Thalidomide was never approved for sale in the United States, yet the makers sent samples to American doctors, who passed them along to their unsuspecting patients, with the inevitable results.)

“The first serious American-made hint of bad consequences arrived with clozapine, whose makers flirted with legal reprisal before voluntarily withdrawing their new atypical drug. But it was the debut of another “atypical” drug, Risperdal (risperidone), that introduced Big Pharma to Big Lawsuit.

“Risperdal went on the market in 1994, a product of Janssen, itself a subsidiary of the pharma giant Johnson & Johnson, the largest marketer of medications in the world. The drug was sold as a treatment for bipolar disorder and schizophrenia. Its makers assured the public of its safety based on three internal trials before submitting it to the FDA for review. Somehow, the trials failed to demonstrate that the drug could result in fever, muscle stiffening, irregular heartbeat, trembling, fainting—and the dangerous disorder tardive dyskinesia.

“These complaints caught the attention of consumer protection agencies in thirty-six states between 1993 and 2004. The state’s full catalog of complaints would have made a Gilded Age railroad baron recommend prayer and penitence. They included allegations that J&J payed kickbacks to the charmingly named Omnicare Inc., the largest nursing home pharmacy in America, to prescribe Risperdal to the generally clueless seniors—many of them suffering from dementia. (Risperdal’s packaging includes a “black box” warning with this language: “Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death.” Risperdal of course is an antipsychotic. Caveat emptor.) The kickbacks included money, offers of paid vacations for doctors’ trips, and “lucrative consulting agreements” to prescribe Risperdal to more patients. Johnson & Johnson decided to contest these charges and lost. Omnicare, for its part, agreed to pay $98 million to resolve claims that it accepted this booty and thus violated the False Claims Act.

“J&J later reached separate settlements with Texas in 2012 and Montana in 2014 for $158 million and $5.9 million, respectively. Settlements with other states added up to $181 million.

“The dollar amounts of these state trial costs and settlements might lead a reasonable observer to conclude that they taught Big Pharma a lesson it would not soon forget. The reasonable observer is invited to read on, preferably while seated or holding on to a firm object. Not long after the turn of this century, settlements and verdicts against drug companies began to roll out from federal court trials on a monetary scale that obliterated the state-level penalties and threatened to obliterate the very notion of “scale” itself.”

Governor Christie Strikes Again!

By Michael Vadon (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
Yesterday he vetoed a bill that would have limited the use of solitary confinement. (As one of the most demonstrably mind-destroying forms of punishment available, it should be banned altogether, everywhere.) Now he is restricting funds for the most abject members of society, the seriously mentally ill. This points not only to Christie’s particular brand of heartlessness, but also to the destructive myopia of too many public officials about the hellscape inhabited by “crazy people.”

Read more about the bill here: N.J.’s mental illness public funding shift will neglect most vulnerable

A Report from Dean’s Soul

Dean March 2016
Dean March 2016

A little while ago, I idly clicked on my son Dean’s Facebook page and found the stunning post below. As I told him a bit later, my heart was still pounding. And it still is.

On the surface, this is an account by Dean of his attempted suicide about four years ago. (Our family had lost Kevin, Dean’s younger brother, to suicide in 2005 after his three-year struggle with schizophrenia deepening in to schizoaffective disorder.)

This at least is the surface account—which Dean has never talked about until this morning. On a more profound level, it is an extremely rare glimpse into the soul of a schizophrenia sufferer, written with blazing clarity and candor. In NO ONE CARES ABOUT CRAZY PEOPLE, I narrate that terrible day from Honoree’s and my point of view, as we realize that we have lost phone contact with him, then learn from police that his truck had been found beside Lake George, some thirty miles to the west of us, and then sit helplessly for hours, trying to absorb the possibility that we had lost our remaining cherished son.

I am inexpressibly proud of Dean for giving us this. He was a promising young writer until misfortunes in his life began to multiply, culminating in a psychotic break a few years after Kevin’s death. This essay tells me that Dean is working hard and fearlessly to regain and re-master his gifts. To which I say, Godspeed, my good son.

But the significance of the essay goes well beyond my fatherly pride for Dean. It should be read by anyone who believes that mental-illness victims have lost their humanity; that they no longer are capable of insight or of reaching out to the “normal” world.

And it should be read by sufferers themselves. One of your brothers has held out a lamp to illuminate the richness that remains in you.

__________________________________

“Three years and several months ago: i texted my buddy and boss as my gps led me to the wrong spot. “I’m lost.”

I saw a truck that looked like mine parked beside a trail. I parked there and started walking down the trail. Snakes got startled, several of them, slithering away as i walked past them as though they were frightened by me. As i walked i felt the tedium of daily life weighing on my shoulders.

I came here knowing there was danger only to face it and meet my fate. As the steps drew on and i felt tired bugs started swarming around my head. I had a vision in that moment of me several thousand years ago drunk and staggering and lonely. Death sounded like comfort.

I turned around and walked back as a crossed a small wooden bridge i saw trash in the water and my Eyes started to tear up as it crossed my mind that we are trashing this gift God gave to us. Then a low flying plane flew directly over head as if God was telling me you made your appointment i see you and all is well.

Then i got back in my truck and drove to Lake George. My eyes scanned my surroundings at a red light and they settled on a “no right on red” sign. I gunned the throttle and turned right on red. I pulled into the parking lot, left my wallet and my phone in the truck.

I got out walked to the beach took off my shirt socks and shoes and got in the water. It was July. There were other people in the water. It felt good. I walked out a little ways till i was waist deep and took a plunge. Suddenly i felt this wonderful energy running through my arms and chest as i held my knees to my chest. I was going to turn into a school of fish and swim off into open freedom. It was like i could breathe under water.

But before i took my first breath an off duty new York state trooper pulled me out of the water. My arms opened up wide like i was on the cross myself staring up at the sun as he dragged me out of the water and put me on my back on the beach. I wondered if God could see me. Then i looked down at the water and saw a boat, the Minne Ha Ha. It was as though some competing force was telling me the world is mine haha. Then a helicopter swooped over head. It was like a movie.

The first thing i said to him was, “it’s in the eyes.” His eyes were hazel. Then all these competing arguments about the origins of the world and God flashed before my eyes. My heart beat rapidly in panic. I saw Ireland with its eyes never closing even as europe fell asleep during a card game. This gave me hope that it wasn’t all as bad as it seemed. Then before even a second elapsed I was put on a stretcher and put in an ambulance with two emts with blue eyes and i panicked again.

“All i want to do is rest in peace,” i said to them. “Oh we hear you,” the man said to me. He flicked the lights above me on and off several times. Then they took me to the hospital and i heard birds chirping and saw lights flashing when i blinked my eyes.

Eventually they put me in the psych Ward and i got pissed that i was getting locked up again. 5 guys and i were standing around in a circle. I said “nobody here has any authority.” Then they bowed their heads. They bowed their heads as if the authority was spiritual. Then they all laid hands on me and put me on my bed and shot two needles in my butt. And i said “those shots better kill me.” The medics head jerked as i said this as he plunged the medication home.

Later as i reflected on it i thought to myself, “they pulled me out of the water.” Baptism, evolution, pirates. “They pulled me out of water.” I was baptised into my true spirituality by an off duty new York state trooper. It also symbolizes our journey out of the ocean and onto land. And if i had walked the plank it’s like they threw me a rope to pull me back on board.

And if he hadn’t pulled me out i might have breathed and i might be dead. I don’t even know his name, but i want to thank him.”

Kevin and the Perfect Playboy Woman

Kevin Powers
Ron’s favorite photo of Kevin

In the late 1990s I contributed commentaries to Vermont Public Radio. I often drew upon Dean and Kevin for subject-matter. This piece, broadcast in 1997, is one of my favorites, and captures my younger son in all his instinctual goodness and decency.

Ron Powers/VPR Commentary

Kevin and the Perfect Playboy Woman

Promo:  This is Ron Powers.  What’s the best defense against sleazy junk mail?  Having a smart kid helps.  Stay tuned for a few minutes and I’ll tell you what I mean.

Announcer’s intro:  Researchers in Texas have discovered a new use for junk mail: it makes an excellent garden fertilizer.  Commentator Ron Powers is not surprised.

Commentary: I was scooping out the daily tonnage of junk mail with a backhoe the other day—when I spotted an envelope that was different from all the rest.  It was festooned with an oddly familiar logo; a pair of bunny-ears.  It was addressed to my son Kevin.  And then I spotted the legend stamped in the upper right-hand corner:

BULK RATE U.S. POSTAGE PAID BY PLAYBOY

Well, I opened it.  Call me a nuidge.  Inside were—guess what?–glossy photographs of young women with complicated hair, plunging décolletage and lip-gloss.  But here was the zinger: a personal message for my kid: because of his, quote, “proven good taste,” he was being invited to represent, quote, “The Sophisticated Male of the Nineties” and help Playboy Magazine construct—I quote again—“The Perfect Woman.”

“You read it right!” the copy burbled.  “From the many intelligent men in and around your state, we have selected YOU for our annual Perfect Woman Poll.”  The potential rewards included a vacation for two in the Bahamas; round-trip airline tickets to anywhere in North America and lots of cash.

The next page listed the questions that Kevin would have to answer.  The categories included “Vital Statistics” (the Perfect Woman’s measurements at bust, waist and hips); “Body Parts” (length and shape of legs, firmness of stomach, whether she should have an “innie” or an “outie”) and “Fashion Statements” (whether she should mostly wear bikinis, high heels, negligees, tattoos, handcuffs, or “nothing.”

Now, here’s what you have to understand about Kevin.  He still carries the cat to bed with him.  His passions include Monopoly, bagels with cream cheese, playing guitar and trying to make contact with Scottie Pippen of the Chicago Bulls.  Are we talking Sophisticated Male, or what?

How Playboy found Kevin was not hard to figure out.  A few months ago his older brother took part in a magazine subscription drive for the high school.  The family all chipped in.  Kevin’s choices were Snowboarding and Sports Illustrated.  This got his name into the computerized data system of subscription lists, which magazines buy and sell to one another.  Playboy was only a matter of time.

When Kevin got home from after-school ice skating, I asked him if he had ever thought what the Perfect Woman might be like.

He was still wearing an orange knit cap pulled down to his eyes, and his cheeks were scarlet from the cold.  He gave me his sidelong, you’re-tricking-me look.

“Like a grown-up?” he asked after a minute.  I nodded.  His blue eyes trailed upward in thought.

“Smart. . .” he said.  He thought again.

“Pretty. . .” he added.

“Who doesn’t smoke.

“A very nice attitude.

“Who skis or snowboards and likes to play sports.”  His gaze turned quizzical again.  “Why do you want to know?”

I told him he had received a brochure from Playboy Magazine asking for his ideas about the Perfect Woman.

“I did?” he asked.  “Where?”  and then: “Why did they write to me?”

I told him the letter mentioned his “proven good taste.”  Kevin tilted his head.  “How do I have good taste?” he asked. “What are you talking about?”

I decided to show him.  He was excited at first—the name “Playboy” was not unknown in the corridors of his school—but when I put the brochure in his hands, he looked at it for several minutes, and his mood changed.

“Those people probably smoke,” he said quietly.  He sifted through the enameled images of cleavage and fishnetting and pouty lips.

“It’s gross.”

And then, walking out the door of my study: “I don’t want to think about it.”

You know what?  The direct mail geniuses at Playboy Magazine got it right.  The kid does have proven good taste.  This is Ron Powers in Middlebury.

KEVIN AT HIS MOST SUBLIME, IN WORDS AND MUSIC

Kevin could summon beautiful words as well as beautiful music. Below is his luminously phrased application to the Berklee School of Music in Boston, which he wrote at age 16. It is followed by the soundtrack to his extraordinary, probing solo in “Summertime,” a performance he gave at Castleton College less than three months before his suicide.
Kevin Powers Berklee Application Essay

Kevin Powers

Musical Experience

Kevin performing at the Berklee School of Music
Kevin performing at the Berklee School of Music

As a musician, one of the most profound events I experienced was getting my first Pat Metheny CD.  I was in eighth grade and the CD was “Like Minds,” a Christmas present from my dad.  It featured Gary Burton, Chick Corea, Roy Haynes and Dave Holland.  This was my first exposure to the jazz art form.  Hearing that CD made me want to play jazz guitar.

From the first chord of the first song, something unexplainable made me listen more intently than I ever dreamed I would to a jazz recording.  Gary Burton’s solo was intense.  His playing was classy and smooth but not cheesy, his melodic runs and progressive energy were all there.  When Pat started his solo, this was the first time I decided to give a new player a chance.  I was, up until then, a die-hard for the rock scene.  I had never heard someone play jazz in a way that inspired me to.  That all changed with Pat’s playing.

His solo was begun in a manner that made him sound like he was in my room talking to me, telling me all the great things the guitar could offer.  He started a little behind the beat with a short concise phrase and much as the title of the song would suggest, “Question and Answer,” the second phrase followed the first one perfectly.  It was so lyrical and melodic.  I had always enjoyed Joe Pass; however, I appreciate the two for different reasons now.  I had never heard improvisation that was in a sense a melody itself.  Pat was doing this.  I had heard over and over again from camps that I attended that “space” was important, that one’s solo needs to “breathe.”  Now it became clear to me why.  It was happening here.

As soon as I was at the next record store, I bought a Pat Metheny Group CD.  I realized that what I had heard on “Like Minds” was probably a small pixel in the larger scope of this guy.  For a period of about a full year, each successive CD of his that I bought was more interesting than the last.  Pat’s compositional ability is hard to comprehend.  His songs are so expressive and the forms are so intricate.  The most memorable experience I will have is attending the National Guitar Summer Workshop in New Milford, CT, where Pat came and spoke to us.  It was three hours with the words from the man himself about what he has been doing, does and will be doing in the future.  He is one of my biggest inspirations and I am very lucky to have been able to hear his music and see him.

Click below to listen to the track Summertime with Kevin Powers on guitar and Jonathan Lorentz on saxophone.

SOMETHING IS—MISBEGOTTEN—IN THE STATE OF OREGON

In case you’ve been kidding yourself that public care for the mentally ill is snugly enfolded in the bosom of America’s state government systems, and monitored by informed, crackerjack news organizations, take a look at the peculiar string of factoids stumbling forth from Oregon.

mental health
Oregon Governor Kate Brown. Credit: By Oregon Department of Transportation (M15-132_1cm7866) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
The factoids originate in a verifiable event. On Dec. 1, Governor Kate Brown announced her plan to close down the Junction City Mental Health Hospital, which opened with great fanfare just 18 months ago; boasts a 174-patient capacity, and offers employment to 422 people in a community that needs every job it can get.

That, as Dan Rather used to say, is what we think we know at the moment. Beyond this base, information remains sketchy, motivations murky, the announced rationale questionable, and the future of the facility’s patients up in the air, where the futures of such unfortunate human beings generally reside.

But why?

The governor herself—a Democrat, by the way, and thought of as generally progressive—has attributed the necessity to, brace yourselves, a tight state budget. Tight budgets are virtually always given as the reason for tapping into funds and facilities for mental health care, which in turn are virtually always the first areas to be tapped in a budget pinch.

But is Oregon really suffering a budget pinch?

Governor Brown pointed to a “projected” $1.7 billion revenue shortfall set against expenses for 2017-19. She intends to narrow this gap partly by raising taxes on cigarettes, liquor, and hospitals (a grouping that one does not often encounter). Yet a “Revenue Outlook” released by Oregon.Gov begins by reporting that “Oregon’s general fund outlook remains stable” https://www.oregon.gov/das/OEA/Documents/revenue.pdf and that revenues “are expected to total $19,526 million in the 2017-19 biennium, an increase of 8.4% percent from the prior period,” although $40 million below the September forecast.

So, again, to paraphrase Donald Trump—“Pinch?—or no pinch?”

Even if the Governor is drawing upon more reliable comparisons than are readily available to an outsider, it seems peculiar, bordering on bizarre, that she would choose the Junction City Mental Health Hospital as a first-round sacrifice.

Junction City opened to great applause and greater hope in March 2015, its features harkening back to the exalted “Moral Treatment” designs of the 19th century. (The cost was either $180 million or $84 million, depending on which Oregon press account you read, a testament to the quality of press scrutiny. As of this writing, no major outlet has done an in-depth examination of the proposed closing or the political dynamics behind it. My own calls and emails to Oregon reporters are as yet unanswered.)

Its rehabilitative amenities include a library, spiritual center, hair salon, fitness rooms, classrooms, a gym, and outdoor quads. Patients can go on outings (after a review process, learn social skills and money management, acquire cooking skills and learn how to call for help.

And in case those humane offerings might strike some taxpayers as a little—oh—cushy for people who are, well, you know; consider this: the alternative to clinical rehabilitation is, typically, jail or prison. These systems, dumping-grounds for an obscene number of afflicted people, add up to a far greater drain on public revenues than does rehabilitation. Oh, and by the way, they tend to be unspeakably barbaric. To the sane and insane alike.

In early May 2015, less than two months after Junction City opened, a public-interest group called Disability Rights Organization (https://droregon.org/bhu/) released a report that found “Oregon prisoners with severe mental illness are routinely tasered, pepper-sprayed, isolated, and denied access to adequate mental health care.” (“Isolated,” by the way, means “placed in solitary confinement,” the single most devastating assault prison guards can levy on a mental-illness sufferer.”)

As I write in NO ONE CARES ABOUT CRAZY PEOPLE, this list of sanctioned atrocities has changed hardly at all from the horrors of Bedlam Asylum more than 700 years ago, save for the technology.

I will continue to monitor the developments surrounding Junction City in the coming days, and the bedrock reasons behind the governor’s decision. Meanwhile, the links below offer a fuller discussion of some of the points I have raised.

https://www.change.org/p/kate-brown-stop-kate-brown-from-turning-her-back-on-oregon-s-mental-health-crisis?recruiter=6278772&utm_source=share_petition&utm_medium=facebook&utm_campaign=autopublish&utm_term=des-lg-share_petition-reason_msg

A VICTORY FOR MENTAL HEALTH REFORM IN CONGRESS—YET MUCH REMAINS TO BE DONE!

mental health
Congressman Tim Murphy. By Timmurphy (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
Parents, siblings and friends are rejoicing over Wednesday’s passage in the House, by a 392-26 vote, of the seminal 21st Century Cures Act, a $6.3 billion bill to overhaul mental health care in America. The bill is expected to quickly pass the Senate and secure President Obama’s signature, transforming it into law.

The Cures Act’s unexpected success thus far signals a radical departure from decades of Congressional indifference toward the mentally ill, interrupted occasionally by maladroit and socially damaging efforts at reform such as “deinstitutionalization.” Its strengths, weakness and potentially controversial sections are superbly analyzed by the pre-eminent mental-health blogger Pete Earley: http://www.peteearley.com/2016/11/30/murphys-family-mental-health-bill-finally-approved-next-step-senate-then-white-house/

The Act incorporates the language of the Helping Families in Mental Health Crisis Act, a measure created and promoted for years by Congressman Tim Murphy (R-PA), the pre-eminent champion of reform on this issue in all of Congress. https://murphy.house.gov/latest-news/breaking-helping-families-in-mental-health-crisis-act-language-finalized-full-vote-to-take-place-next-week/.

Despite the euphoria and likely full passage, even its advocates acknowledge that the 21st Century Cures Act faces strong opposition from several influential sectors. The reliably progressive Senator Elizabeth Warren (D-MA) has criticized it for failing to constrain the “Big Pharma,” the notoriously profiteering multinational pharmaceutical industry, from profligate pricing and lax testing standards for protecting the safety of customers. On the other side of the spectrum, the conservative group Heritage Action for America,which has denounced the “gimmicky nature of the pay fors” in the Act—“the newly creating funding mechanism designed to bypass spending caps, or the overall level of spending.” 

Congressman Murphy pinpointed his satisfaction with the House vote while agreeing that it is far from a cure-all for serious mental illness in America: “We didn’t get everything we needed, but we needed everything we got.” The Congressman, who is a Navy veteran and a practicing psychologist, went to work on his Crisis Act in 2012, following the massacre of schoolchildren in Newton, Connecticut, by the 20-year-old Adam Lanza, who had murdered his mother before the shooting spree and who killed himself afterward.

I have devoted a couple of chapters to Congress’s history of ineptitude and indifference to mental illness in NO ONE CARES ABOUT CRAZY PEOPLE. In Chapter 13, “Debacle,” I examine the lingering social damage wrought by deinstitutionalization, the early-60s experiment in mass removal of patients from the nation’s flawed and overcrowded mental asylums without following through on guarantees that they would be cared for in a vast network of community-based centers operating without government oversight.

And finally, lest anyone imagine that the surviving mental and psychiatric hospitals have solved their problems, I offer the following short list of recent atrocities suffered by mental-hospital patients (all women, interestingly). I will add that my book takes its title from a string of horrific abuses, including at least one patient death by starvation (another woman, for whatever that may mean), that occurred at Milwaukee County Hospital in the years around 2010.

So: let us justly celebrate the House action on Wednesday in advancing the 21st Century Cures Act. But at the same time, let us not forget that much remains to be done—on the Act itself, and in our still-chaotic world of mental health care.

http://www.nbcnews.com/health/mental-health/after-mom-starves-death-questions-about-care-mentally-ill-n569461

http://www.sfgate.com/bayarea/article/Lawsuit-says-woman-died-because-SF-psychiatric-8346738.php

http://www.fox25boston.com/news/family-begs-for-answers-after-woman-dies-unexpectedly-at-psychiatric-hospital/290007987

http://www.wfaa.com/news/local/tarrant-county/woman-suffering-mental-problems-dies-after-shes-tased/185712630

http://www.post-gazette.com/news/health/2016/09/04/Young-woman-s-journey-ends-tragically-in-mental-hospital/stories/201609040069

On the Road With Kevin

I just answered a post by dear friend from college and early-career days. He grew up in Sudbury, Ontario. He’s feeling a little down, like a lot of us, over the election, and expressed a wish to return to his hometown.

I don’t know that I managed to cheer him up, but his message reminded me of a passage from NO ONE CARES ABOUT CRAZY PEOPLE. It involves a night spent in Sudbury as I drove Kevin, then 14, from Vermont across Canada and then south through Michigan to commence his studies at the Interlochen Music Academy. I’m reposting it below. If not exactly a cheerer-upper, it at least is a reminder of moments of beauty that appear from nowhere, conjured by the fingers of a gifted child and his guitar. This was before Kevin’s fatal onset of schizo-affective disorder:

Kevin at Interlochen
Kevin at Interlochen

“That September, I drove Kevin the nine hundred miles to Interlochen. It was a memorable ride.

“We chose a route that took us north to Montreal, then westward on Highway 17 for six hundred miles, skirting Ottawa and then the vast and pristine Algonquin Provincial Park, its primitive interior saturated with lakes and moose. We ate hamburgers at a log-built restaurant and gift shop somewhere along the route, and it became our traditional stopping-place on future trips. Traditions were important to both boys, but especially Kevin. We stopped for the night in a motel in Sudbury, Ontario. At Sault Ste. Marie, we turned south into Michigan along Interstate 75. We crossed the Straits of Mackinac, linking Lakes Michigan and Huron, on the majestic suspended arc of the Mackinac Bridge that stretched five miles.

“Kevin was upbeat during the long drive, but he admitted to me that he was worried about meeting new people at the arts academy. For one thing, he said, he didn’t know any good jokes. I told him that jokes could be over-rated, and the best way to make new friends was to ask them a lot of questions about themselves. This went for girls too, I added. Girls especially.

“In our motel room in Sudbury, Ontario, I was unpacking toiletries from my suitcase. Kevin was sitting behind me on one of the twin beds. I heard acoustic guitar notes, and turned around.

“The lamplight brought out the gold in Kevin’s hair, and he was in his usual playing position, bent forward a little, head down, the sole of one messy sneaker planted on the arch of the other.

“The piece was short, but lyric, and haunting, like a medieval ballad, and as it went on I stopped unpacking and sat down on the bed beside Kevin and listened. When he had finished, and when quotidian sounds—traffic horns, voices in the hall, TV sounds in other rooms—had resumed their noise, I asked Kevin where he’d learned it and how long it had taken him to memorize it. He shrugged and said that he’d made it up as he went along. He was just doing some finger exercises.

“Some weeks later, walking with him around the Interlochen campus during a visit, I brought it up again. I asked my son if he could reconstruct that piece from memory. He gave an absent shake of his head; his attention, at that moment, was on a pretty girl riding a bicycle in and out of the sunlight. A temporary, beautiful, golden thing had passed through that motel room in Ontario that evening, and then vanished, a presence to be experienced only once, and briefly, and then never again.”