The (Continuing) Education of a White Writer Regarding Black Americans and Mental Illness

This post is for two of the best women I know, the New York actor and activist Madeline McCray and her close friend Terrie M. Williams, the author of BLACK PAIN: IT JUST LOOKS LIKE WE’RE NOT HURTING.  

Terrie Williams and Madeline McCray

Madeline and Terrie, you tried to put me wise to the special challenges of African-Americans who suffer from mental illness. You reached out to me as I began research on NO ONE CARES ABOUT CRAZY PEOPLE.

You provided me with sources. You tried to educate me. I promised you that I would look deeply into this topic in my book. But in the end, I did not look deeply enough.

Recognition of this truth arrived, appropriately enough, on Mental Health Day, October 10. It arrived in the form of a young woman in Cleveland, an African-American service-staff employee at the Intercontinental Hotel. It arrived just minutes after I’d finished addressing an exemplary civic group on—well, on the topic of education. Education about mental illness. How important this kind of education is.

(from left) David E. Weiss, board chairman; Honoree Fleming; Ron Powers; Elizabeth Newman, president and CEO at The Centers for Families and Children Benefit Luncheon 2017.

It took a three-minute conversation with this soft-spoken young woman to make me realize that my own education has been incomplete.

This is a rich irony—or a well-deserved comeuppance, depending on your point of view. I wrote NO ONE CARES essentially as an effort at education. After schizophrenia invaded my family and attacked both my sons, triggering the suicide of one of them, my wife and I realized that we’d become citizens of a “sub-nation”: the largely opaque nation of the afflicted and their families. Years later, when I recovered my willpower, I decided to write the book as an attempt to widen public understanding (and my own) about the nature and the reach of serious mental illness. That, and to illuminate the gross deficiencies in the American systems of mental health-care, criminal justice, and political willpower in addressing the problem.

As I’d hoped, writing the book educated me—but incompletely, as I now understand.

It is not as though the book ignores the particular ordeal of mentally ill black Americans. At least the public symptoms of that ordeal. It covers the epidemic of fatal shootings, by police, of unarmed and psychotic black men on the street. It portrays the overcrowding of the nation’s jails by juveniles, mostly black, who have been charged with crimes but not yet tried; and the violence visited on them by wardens and guards.

All of this is important. Yet in merely evoking these familiar abuses, I failed to cross an elusive border: the border that defines the daily realities of a sub-nation within a sub-nation. The lives of African-Americans struggling with mental illness amounts to unknown territory—unknown, at least, to most white Americans, of which I am one.

Ron Powers – keynote speaker at The Centers for Families and Children Annual Benefit Luncheon

I was ushered across that border in Cleveland on Mental Health Day.

My guide, the young service staff member, approached me just minutes after I had finished speaking at the annual luncheon of the Centers for Families and Children at the Intercontinental. (I am withholding her name. It’s a sad possibility that in these hair-trigger times, her employment could be jeopardized by the very fact that she spoke up to me about a racially charged public issue.)

Woodlawn Avenue, East Cleveland

The Centers deserves a moment of illumination here. It is a sterling civic institution. A nonprofit with an annual budget of $55 million, it reaches out to the poor, the hungry, the under-educated, the sick, and the troubled—some twenty-five thousand clients—in a city striving to overcome chronic post-industrial poverty entrenched racial tensions. The racial stress is burned into the city’s history along lines of segregation in its housing patterns: most of its black and poor population is concentrated in the near East Side, and most of its white population farther west. Cleveland’s incidents of fatal police gunplay in recent years, highlighted by the shooting of the 12-year-old Tamir Rice in 2014, have deepened black Cleveland’s distrust, bordering on paranoia, toward the mostly white police department.

David E. Weiss

Amidst these overwhelming challenges of poverty and racial unease, the Centers for Families and Children persists as a national model of enlightened civic service and hope. Its board chairman, the lawyer and businessman David E. Weiss, ranks among the most socially engaged civic leaders in the country. Its new director, Elizabeth Newman, has re-ignited its six hundred volunteers with her own passionate sense of mission: to help people find job opportunities and early-education conduits for their children, provide food for hungry families, dispatch pharmacists to households to help manage nutrition and medications, find treatment for substance abuse, and summon emergency services in crisis situations.

And to co-ordinate intervention and help in the crises of the mentally ill. Elizabeth Newman explained this cornerstone service to me in detail:

Elizabeth Newman

“The Centers is equipped to support people with serious mental illness, this skill set actually sets us apart in the community. We routinely assist people living with schizophrenia. We have psychiatrists on staff, in addition to relationships with the local/regional hospital systems and emergency rooms. In terms of onset of psychosis, we are outpatient providers but work in partnership with inpatient providers, so it really depends on the level of severity.  Another agency in town runs the mobile crisis unit, but we receive referrals and connections to clients directly from that unit.”

Which brings me (in my round-about way) to the topic of this blog.

Ron Powers

As mentioned, I had completed my remarks and was standing amidst the departing luncheon attendees when she emerged from the mix of people. She wore the brown uniform of the hotel’s service corps, and her manner was hesitant; yet it was clear that she had something she wanted to say.

What she said was, “Thank you for speaking about schizophrenia.”

I sensed the urgency behind this polite comment and asked her: “Is there a history in your family?”

She hesitated for a moment, as if trying to decide whether she could trust me with an answer, and then:

“My mother. And my brother.”

There is no way to prepare for a response like this, no matter how much you expect it, no matter how often it comes. One rule of thumb is to avoid “condolences.”

I asked her the only questions that seem fitting, and necessary:

“Are they getting treatment? Are they on medications?”

She smiled just a little before answering; and the smile should have told me everything I needed to know. But she spelled it out anyway.

“Black folks don’t like to get treatment. Black folks see it as a white man’s disease.”

While I was digesting this, she added: “Black men don’t like to talk about mental illness. They see it as a sign of weakness.”

And then, as if recognizing the need to explain the obvious to a blockhead (accurate, I suppose, in this instance): “So, no. They aren’t getting any treatment.”

And there it was: a key to the inner realities of a sub-sub-nation. The culturally learned set of attitudes that makes it all the harder for doctors and psychiatrists to intervene in the mental-illness crises of African-Americans. African-American men in particular, who routinely suffer violations of their self-respect, their safety, their very humanity, at the hands (and guns) of those who view them as inherently alien, dangerous, unworthy of inclusion in society.

Which, when you think about it, is exactly the same way that many people view the mentally ill in general.

 

I left the Intercontinental Hotel in Cleveland as the educated educator. I thought of my friends Madeline McCray and Terrie Williams, and about the exasperation they must have felt at my failure to cross that border. Felt silently, without rebuke, in the way many African-Americans experience the myopia of their white friends.

Back home, I sought to verify the viewpoint of the young service-worker at the Intercontinental in Cleveland. Below are some samples of what I came up with. There are more, many more, as a Google search of “African Americans mental illness” will show.

–That African Americans are 20 percent more likely to experience serious mental health problems than the general population, owing in part to the exceptional stress they experience just living their lives. The problems include major depression, attention deficit hyperactivity disorder, recourse to suicide, and post-traumatic stress disorder (this last because African Americans are especially likely to be victims of violent crime).

–That many black Americans misunderstand what a mental health condition is and don’t talk about it. Many thus believe that a mental health condition is a personal weakness punishment from God.

–That stigma—which knows no color lines—triggers especial reluctance among African Americans to discuss mental health issues and seek treatment.

–That a pervasive deficit of information—education—causes many African Americans to have trouble recognizing the symptoms of mental illness and to underestimating its dangers. Some may think of depression as “the blues” “or something to snap out of.”

(The above examples are taken from https://www.nami.org/Find-Support/Diverse-Communities/African-Americans)

–That black Americans’ distrust of doctors has some factual justification: Blacks are “over-diagnosed with schizophrenia, frequently misunderstood by their psychiatrists, and largely disenfranchised,” in the opinion of William B. Lawson, the distinguished African-American professor and chair of psychiatry at the Howard University College of Medicine. (https://www.medscape.com/viewarticle/768391#vp_2)

 

A Closing Thought

This has been far from an easy blog entry for me to write. No one likes to own up to failures of understanding, especially in the fraught arena of of racial relations. As with NO ONE CARES ABOUT CRAZY PEOPLE itself, I at first resisted writing it at all. Then I decided I had to write it because it was the truth. I hope that it is read with an understanding that writers are often fallible—just like ordinary people.

________

The full recording of the interview with Elizabeth Newman and Ron Powers is available here: http://www.ideastream.org/programs/sound-of-ideas/finding-the-cure-for-aids-book-no-one-cares-about-crazy-people.

Additional coverage of the Luncheon in The Plain Dealer, the daily newspaper for Cleveland: http://www.cleveland.com/healthfit/index.ssf/2017/10/putting_a_renewed_focus_on_men.html

Solitary Confinement: Cries for Help and Voices of Despair from Victims’ Mothers

This blog has lately been focusing on solitary confinement of jail and prison inmates as an intolerable practice in our criminal-justice system. Solitary confinement is inhumane, unproductive as a “corrections” technique, and psychologically destructive. It must be abolished.

My mission is to encourage others who feel this way to petition their congressmen and women to initiate repeal—and to identify and support the several organizations who are already working toward this.

 

I recognize the odds against my voice making a difference. It is all too easy for anyone who’s not personally connected to a victim of “the hole” to utter tsk-tsk noises at a safe removal from Ground Zero. Neither of my schizophrenic sons was ever arrested and threatened with this living entombment. My wife and I have never had to watch helplessly as either of our boys disappeared into one of the jails around the country where this barbaric practice continues unchecked; where the mostly-young and often mentally ill inmates undergo tortures of the damned, and their mothers1 The reader will note that I write, “mothers.” The almost complete absence of fathers from this discussion or from any conversation on their offsprings’ mental illness is a phenomenon that needs further examination. And Pete Early, I am NOT looking at you! agonize while pleading in vain for justice, or at least mercy.

 

Therefore:

 

In this blog, we are going to eliminate the tsk-tsking middleman—me—and hear from a sampling of mothers at Ground Zero whom I know through correspondence. The rawness of their outrage and grief has given them a truth-telling eloquence that far surpasses anything I’ve written or will write. They speak for thousands upon thousands of similarly violated families who cannot or will not seek to make their stories public.  

 

I have edited their emails to me only lightly, for compression and clarity. I have included the identities of two mothers, who have given me their permission. One is Jennifer Tirkot of Coral Gables, Florida. The other is Kimberlee Cooper West, of Fruitport, Michigan.

 

We will begin with some brief entries from a blog kept over several years on a private site by Jennifer Tirkot. Ms. Tirkot’s epic struggle with the state’s corrections system on behalf of her brain-disordered son John far exceed the damage he has endured during several stretches of solitary. I am planning to devote a future blog to her nearly unthinkable plight. Pete Early has also written about Ms. Tirkot: http://www.peteearley.com/2017/02/06/mother-repeatedly-tries-to-get-her-psychotic-son-help-instead-he-beats-her-and-is-arrested-twice/

 

Entry No. 1: I wrote my son’s story to have him taken out of solitary confinement and transferred to the state psychiatric hospital. This is his 2nd incarceration in 2 years for having a brain disorder. The last time he was incarcerated for hitting a police officer and EMT worker. They were Baker Acting him for his psychosis when he hit them. They transferred him to jail and locked him away in solitary confinement for 10 months. I had no choice but to share my story with the world. Pete Earley is publishing it. My son spent last Christmas and this Christmas in solitary confinement for having a brain disorder.  That’s what we do now.  We lock them in solitary confinement in jails/prisons and refuse to medicate them. 

Entry No. 2: I would like to sue the State of Florida for over wait times for competency restoration. My son suffers from schizophrenia, schizoaffective disorder, personality disorder, bipolar, depression, and anxiety. He’s been in jail for over 7 months without medication.

Entry No. 3: He’s severely depressed and they are not treating his depression. Plus, his hands are all scared and his knuckles are red. I asked him what happened to his hands and he said he’s been hitting his cell wall to punish himself for hitting the patient. After 72 days in solitary confinement, he developed Bell’s Palsy, where the left side of his face became paralyzed. He refused medication for it because he said God was punishing him for hitting the patient. The left side of his face is now paralyzed. He’s been without medication to treat his schizophrenia, schizoaffective disorder, personality disorder, bipolar, depression, and anxiety for over 7 months. I’ve been told by Elaine, head of DCF Forensic Hospitals, they can hold him incompetent without medication up to five years.

Entry No. 4 (dated July 21 of this year): Today is my son’s birthday…he’s in solitary confinement for having a brain disorder and the State of Florida didn’t take my “Do Not Release” letter seriously sent to Brevard County Circles of Care psychiatric care unit. I can never imagine crying anymore..but…I cry in my sleep, I cry when I wake up, and when I think I can’t cry anymore…I can’t stop crying…Happy Birthday to my loving son…

 

 

This mother, whose tragedy I mention in NO ONE CARES ABOUT CRAZY PEOPLE, posted briefly, and searingly, on a private site:

October 22, 2014 Josh died alone in a jail cell. My 39-year-old son killed himself today. Josh hung himself in a solitary confinement cell in a prison south of St. Louis, Missouri. He died alone, afraid, and powerless. Josh needed help. Instead, he got punishment. Like all mothers, I had dreams for my children — dreams that didn’t include mental illness or prison.

 

I have written before of the nearly inhuman outrages, including solitary confinement, visited on Kimberlee Cooper West’s mentally ill adopted son Tyler, who still awaits trial on a minor charge after being incarcerated last February (!) Kimberlee has bravely encouraged me to tell Tyler’s story, with identification, and she has plunged into research regarding the lingering psychic damage of solitary confinement, which I will draw upon in a future blog.

 

Here is Kimberlee’s latest message to me:

 

Hello Ron. We as a society have to look at Solitary Confinement honestly. The studies have shown high recidivism rates. The psychological effects last a life time. Is that a healthy thing for society?  During solitary confinement, Ty called home dozens of times a day. He was screaming, crying, begging, for our help. He asked what is going on?  Please come pick him up. By this point he was further into his psychosis. He did not understand why he was there. He was suicidal, banging his head against the wall. No one intervened. He did not understand what was happening. There were times they forgot about him. Times he was not fed.

 

Four separate times our son was sent to solitary confinement. It was not because he was a bad kid. He has a serious mental disorder and is also autistic. The jail staff did not know what to do with him. He needed a hospital. They stopped all his antipsychotics cold turkey. This can lead to convulsions, And death. The medication insert warns “Do not stop medication abruptly.” Ty said “My insides and body are uncontrollably shaking.” He said “It feels like I have the flu. It feels like I’m dying. Mommy, I can’t breathe in here.” He has moderate COPD, from his reflux and dysphagia.

 

Why do they put people in solitary with breathing problems? Health problems are not considered. If they live or die, no one cares about inmates. The Jails are short on staff, so they forget about these people. They use their own formulary of a cheaper antipsychotic.  They waited many days before prescribing antipsychotics. CMH [Community Mental Health] decides when they are released. Social workers and case managers, are not doctors. CMH is not there weekends or holidays. This prolongs an inmate’s time in solitary. 

 

Muskegon County Jail has a doctor only on Fridays. They save money by not using doctors. Nurses take the place of doctors. So many inmates will confess to anything to end solitary confinement. Guilty or innocent, it does not matter. Research has shown that autistic people do not benefit from solitary confinement. Yet I know several who are in solitary. It can cause lifelong problems for the autistic. Our son has the maturity of a 12 year old. He has never hurt anyone. Now he has trauma to add to his list of disabilities. Jail staff do not consider these mitigating circumstances. There still are no laws on the books to protect our autistic and mentally ill kids. Ty has experienced delusions and has been in a fog.

 

Solitary accelerated our son’s mental illness. From there on we were on a downward spiral. . . Our independent forensic psychologist has described Ty as in acute turmoil, in a hypomanic state with major depression and diminished coping mechanisms. . . 

 

[The idea of solitary is] to “teach a lesson.” That I challenge. How does that work if someone has an adolescent brain, is mentally unstable or withdrawing from drugs? . . . If I locked my teenage son in his room and tased him I would go to jail. If it is not o.k. for me to do it, then why can they? . . .

 

We unconsciously assume that those thrown into solitary confinement are exclusively men. This letter, from the mother of an adopted daughter, attests otherwise:

 

[Our daughter] has been in solitary confinement several times in NYC and another urban area. One time, she was merely transferred and they automatically put her in solitary for 3 weeks. We got to visit her once for 1 hour. We drove 5 hours to get there. Most depressing visit I can recall. All metal, no touching, no hugging or human tenderness allowed.

When people do not “jump” as requested, they put you in solitary to “teach you a lesson,” as they have told her many times. You get 1 free hour per day, to shower, but that is it. No calls either. Just letters. That is the only form of communication. Another interesting fact is that many, many, many prisoners are adoptees. Many of them have mental health issues, but instead of dealing with that outside the system, thy are remanded to jail/prison. [Our daughter] spent over 2 years in federal prison and is now in a county jail, awaiting sentencing. She is hoping to get out in a month or so. But then she will serve 1.5-3 years on federal probation. If that gets violated, they frequently use it as a means to “throw you” back into prison.

The criminal “injustice” system is a travesty in its present state. I say, “tear it apart and start all over again,” building a system that treats those with medical and/or mental health issues as human beings first, and criminals last. Criminals are not born. They merely took a wrong turn. I do not believe they should be punished for life and/or altered immeasurably. Climbing out of the “hole” society has created for troubled souls is fraught with hazards, roadblocks, and generally impassable terrain.

 

I will be posting more parents’ testimonies regarding solitary confinement as time goes on. I welcome any repostings of this that readers care to make.