I almost wrote, “the mentally ill people of America lost a hero on Sunday,” but that would not have been nearly adequate to contain this giant’s significance to our country.
Dj Jaffe, who succumbed to leukemia and other cancers at age 65 after stoically battling them for fifteen years, was a human beacon of hope and guidance and enlightenment to those who suffered from chronic brain diseases (“chronic” meaning genetically inherited and incurable). And to their caretaking relatives, mostly mothers, in practice; to their often overmatched doctors and therapists; to uninformed policymakers and corrections officers.
Dj was among the three most influential advocates for the mentally ill in the brief history of that calling, along with the author and blogger Pete Earley and the pioneering statesman of advocacy, E. Fuller Torrey, author of many books and the founder of the Treatment Advocacy Center. The TAC website is the largest, most diverse compendium of m.i. information online.
Dj Jaffe was a skinny force of nature the likes of which the cautious mental healthcare world had never seen, and not everyone liked him. He walked away from an obscure career in advertising after the sister of his wife, Rose, was stricken with mental illness thirty years ago. Razor-sharp and pugnacious when he had to be, he transformed himself into an expert on the nosology, neuroscience, politics and policy issues surrounding the disease. Wearing his unrepentant bluejeans, ponytail, and oversize glasses (and a wrinkled suit when he had to), Dj mastered libraries of information, then cycloned through public hearings, press interviews, and panel discussions, rising to challenge the dignitaries who did not know what they were talking about—or didn’t care. He delighted in getting thrown out of hearings. Opponents were infuriated by his refusal to back down from a stance or a demand. Truth to tell, he was not always right.
He was right often enough. Boring in on our slipshod structure of criminal justice for the insane, he was instrumental in pushing the act known as Kendra’s Law, which allows courts to order treatment for certain mentally ill and perhaps dangerous patients even if they resist it. He worked with the Pennsylvania Republican congressman Tim Murphy to achieve the Helping Families in Mental Health Crisis Act. He demanded, and largely achieved, a long-delayed recognition that “chronic mental illness”—genetically inherited and incurable brain afflictions such as schizophrenia and bipolar disorder—differs on a quantum level from such lesser complaints as depression, alienation, alcoholism, and drug abuse.
In 2017 Pete Earley distilled the reasons why this distinction is essential:
“The problem, according to Jaffe, is that the focus, money and attention in our nation is focused on helping nearly everyone but those ten million [with chronic m.i.] and the result is at least 140,000 SMI Americans being homeless, 392,037 in jails and prisons, 755,360 on probation or parole and at least 95,000 who need hospitalization unable to find a bed.”
His politics were less doctrinaire than fluid, tuned to the needs of the dispossessed who consumed his passions. He founded the nonpartisan Mental Illness Policy Organization. As an adjunct fellow at the conservative Manhattan Institute, Dj spoke at a White House summit on mental illness in December 2019. His countless articles and appearances across the media spectrum testify that he was a zealot not for ideology, but for enlightenment and hope.
“Since 1998, when we first started making plans for what became the Treatment Advocacy Center, Dj has been the single most effective advocate I have worked with and a close personal friend. His dedication to improving the treatment of people with serious mental illness, based on his experience with his sister-in-law, has been extraordinary. The amount of time and energy he has invested in this mission, first at TAC and then at Mental Illness Policy Org, is legendary. Even as he knew he was dying, DJ said nothing and continued his advocacy efforts.”
On a personal note:
It took me a while to get comfortable with the idea of meeting Dj Jaffe. His reputation as a controversial know-it-all firebrand put me off. But when we did meet, the rapport was instant. We discovered that we could make one another laugh. (I nearly lost it in a hotel coffee house in New York when my friend got embroiled in an argument with the waiter. This was no ordinary waiter-customer spat: the waiter was yelling at Dj!) Over several breakfasts, dinners and drinks in New York, Washington, and in the Powers home in Vermont, and in many lively emails, we kept up a bantering style that could segue seamlessly into explorations of our passions and ideas.
His just-beneath-the-surface humor proved the key to Dj: The firebrand was a necessary tactic, not a character flaw. In fact, Dj Jaffe was an extraordinarily loving man, as his career shift after his sister-in-law’s illness demonstrates. He enjoyed a longstanding marriage to his wife Rose, a lovely, laughing woman whom he adored. When Rose died two years ago, his friends expected that Dj would be devastated with grief. He may have been, but he was back to his advocacy work in a day or two. He never mentioned his feelings.
He met a woman named Paula about a year and a half ago, via a dating app. She was the one who reached out to him, friends say. Dj probably knew at the time that he was dying. Paula and Dj were married on Friday in his hospital room. Paula wore white pajamas and stomped on a Styrofoam cup. By all accounts, the marriage was a happy one. Because that’s the kind of guy Dj Jaffe was.
In reprinting his essay below, I introduce a dynamic new figure in the front lines of men and women dedicated to reclaiming those whose lives have been blighted by mental illness. Geoffrey W. Melada is the new Director of Communications at the Treatment Advocacy Center, the leading organization for advocacy and reform in mental-illness issues. At age 42, Geoffrey has made this the latest stop in a career staggering in its diversity and accomplishments.
He is a former assistant district attorney; a reporter for three journals; an editor; and a writer of penetrating force on topics as varied as the arts, the law, health and science, and his personal history, which includes the suicide of his father.
His essay “In the Midst of Winter” (originally published in the periodical Creative Nonfiction) combines several of his passions and skills. It examines the horrific ordeal of Michael Mawhinney, who as a boy was subjected to brutal sexual abuse by his father. Geoffrey encountered Michael when clerking in the Child Abuse unit of the Allegheny County District Attorney’s Office. A decade later, Geoffrey could not get Mawhinney out of his thoughts. He laboriously tracked the young man to Alaska, where Mawhinney was living reclusively. He won Mawhinney’s trust and persuaded him to speak, over several fraught encounters, about what had happened to him.
Geoffrey describes this story as being about resilience. But it is about something more: it is about the near-obsessive determination and the rhetorical gifts necessary to extract one victim’s story from the galactic mass of human beings whose minds and bodies have been violated by mistreatment; and about their capacity to reclaim their souls under the truth-telling guidance of such rare paladins as Geoffrey Melada.
“In the midst of winter, I finally learned that there was in me an invincible summer.”
Michael Mawhinney toyed with his food. There was a pile of grilled prawns before him, which he pushed around in circles on his plate.
“I’ve been dreading your arrival,” he said, looking up at me. Shaking his head, he asked, “How did you find me here?”
Here was Anchorage, Alaska, in the middle of winter.
During the winter in Anchorage, it is light out for roughly six hours a day, and that light is surreal. Dim and yellow-green, it resembles neither day nor night, neither waking nor dreaming. Other things felt strange, too, like the moose that strolled down the sidewalk outside my hotel on my first morning in town.
Indeed, Alaska is a very different place than anywhere else in the “Lower 48,” as locals call the contiguous United States. It is vast, covering 586,000 square miles. That’s more than twice the size of Texas. There are more than 70 active volcanoes and 100,000 glaciers in Alaska, the largest of which are the size of Rhode Island.
Fifty separate rock masses make up Alaska, most of which traveled north “on a rock conveyor belt” from hundreds or thousands of miles to the south and collided with the northwestern corner of North America, according to A Naturalist’s Guide to Chugach State Park, an illustrated guidebook I picked up at the Anchorage Museum.
Even Alaska ran away to become Alaska.
I had last seen Michael in Pittsburgh, nine years earlier, when he was twenty. I was a law student then, clerking in the Child Abuse unit of the Allegheny County District Attorney’s Office. Commonwealth v. Gerald Mawhinney—Michael’s father—was one of the most horrific cases I had worked on. Michael had been the prosecution’s lead witness in the trial.
Almost a decade later, I wanted to know how Michael’s life had turned out. More broadly, I wanted to know how victims of childhood trauma tend to fare later in life. I had worked with many as a law clerk and later as a prosecutor, and I wondered about their fate. Were they destined to develop mental illness and other problems? My need for answers went beyond the law, beyond academics, beyond journalism. It was personal, too.
When I was sixteen, my father committed suicide. As an adult, I was still plagued by night terrors and feelings of guilt. If Michael and some of the other children I had worked with proved resilient after all they had been through, perhaps I could find hope for myself as well, and a path out of grief.
I began by trying to find Michael.
Resilience—the trait that seems to determine how likely people are to transcend adversity—has been a controversial theory ever since it emerged in the 1980s and ’90s. Bright minds cannot even seem to agree on a single definition of the term. Some in the field say resilience is the absence of psychological symptoms after trauma. Other experts, like Columbia University professor of clinical psychology George A. Bonanno, say it takes more than avoiding mental illness to be resilient.
Bonanno prefers to think of resilience as a life trajectory, as “a relatively stable pattern of healthy functioning coupled with the enduring capacity for positive emotion and generative experiences.” In other words, a resilient person, despite day-to-day fluctuations, can love and work.
Bonanno is one of a growing number of scientists who believe that most people—even those who experience an adverse childhood experience (ACE)—are likely to be resilient. In fact, Bonanno has garnered a lot of attention by arguing that resilience, rather than an adverse outcome such as post-traumatic stress disorder (PTSD), is the most common result of experiencing trauma.
After conducting numerous scientific studies of mourners and those who have been exposed to highly stressful events, including combat and the 9/11 terrorist attack on New York City, Bonanno concluded that people’s response to trauma takes one of four common trajectories. According to his research, roughly 10 percent of us experience “chronic” grief that requires therapy. Another 30 percent experience an initial spike in suffering and gradually recover. Between 50 and 60 percent remain steady. “Most people are resilient,” he says. “Humans are engineered to withstand adversity. Otherwise, humans would not have made it this far.”
His lecture at the annual International Society for Traumatic Stress Studies (ISTSS) conference in Philadelphia in 2013 was one of the best attended and most controversial sessions. After his talk, he ran from a small mob of scientists eager to debate him on the prevalence of resilience.
Inside an empty hotel ballroom, Bonanno explained to me why he causes such a stir at these gatherings. “This is a conference for people who love PTSD. They have a hard time not thinking that way. When I show them my graphs, they keep trying to push PTSD back in there.” But, said Bonanno, “a world in which most people develop lasting distress as a result of trauma is not the world I live in.”
Michael Gillum, a clinician who treats survivors of childhood trauma, blasts those opinions as ivory-tower thinking. “If you’re in the academic world, doing a lot of research, you lose sight of what a lot of clinicians are saying. If you spend time with a lot of victims, as clinicians do, and talk to them, these numbers don’t compute.”
Child-rape victims in particular, said Gillum, “do not usually transcend this sort of trauma easily.”
Gillum points to three of his current patients, all victims of former Penn State assistant football coach Jerry Sandusky. Two of them, he says, have developed drug addiction. Another, Aaron Fisher—the first victim to come forward in that high-profile case—cut himself and frequently contemplated suicide after Sandusky started molesting him at the age of eleven.
Today, Aaron works as an umpire for children’s baseball games and as a security guard on a remote gas-drilling site. “He has good days and bad,” says Gillum. “Sometimes, he is anxious and depressed. He does have some residual PTSD symptoms.” Gillum also diagnosed Aaron with conversion disorder, a rare syndrome in which the mind converts psychological distress into physical symptoms.
Dr. Judith Cohen, medical director of the Center for Traumatic Stress in Children and Adolescents at Allegheny General Hospital in Pittsburgh, Pennsylvania, acknowledges Gillum’s point about the difficulty of relying on statistical models. “There is no one prototypical child, no one answer, and no one description that fits all. I have seen many children who have ten different traumas who do beautifully and some who do not.
“With a single traumatic event, some kids don’t do well. We’re still trying to untangle that.”
Finding Michael wasn’t easy. The prosecutor on his case, attorney Dan Cuddy, quit the DA’s office in 2007 and joined a law firm specializing in railroad litigation — about as far as one can get from trying child-rape cases.
While Cuddy had no contact information for Michael, and neither of us had access to the district attorney’s files any longer (I quit the office in 2011 after a five-year stint as a prosecutor), he remembered which local police department had handled the investigation, as well as the lead detective’s name. After a current supervisor in the DA’s office made a call on my behalf, the Ross Township police were willing to retrieve the case file from storage for me. But it contained no addresses or phone numbers for Michael Mawhinney.
The trail had run cold.
I called Cuddy back, hoping to jog his memory further. He remembered that Michael’s mother, long since divorced from Gerald Mawhinney, lived in Alaska. I ran a Google Images search of “Michael Mawhinney.” A Facebook profile picture of a man who appeared to be in his late twenties, holding a coffee cup, flashed across the screen. The man in the picture was wearing a winter hat, and it was hard to make out his face. On the sleeve of the coffee cup was a logo: “Middle Way Café, Anchorage.”
I googled the Middle Way Café, scribbled the phone number down on a yellow legal pad, then called and asked to speak to the manager. When the manager got on the phone, I asked him if Michael Mawhinney was an employee there. He informed me that Michael used to work there, but that he had quit his job only two weeks before. From the man’s tone of voice, I could tell there had been a falling out between them. He offered to call Michael, but he would not give me Michael’s phone number. After we hung up, I thought to myself, I’ll never hear from Michael Mawhinney.
Five minutes later, he called me from Alaska.
After I explained the article I was intending to write about resilience, Michael agreed to a phone interview. For the next four months, I tried calling and texting him to set up an interview, but he mostly ignored my messages. When he did respond, he would invariably ask for a postponement, explaining that “summer is the busy time in Alaska,” a statement I would later confirm when I went there and spoke to other residents. When you’re hunkered down for a long Chekhovian winter, you want to fill the fleeting summer with as much activity as you can.
Still, I sensed Michael was avoiding me, and I could understand why. When the Robert Wood Johnson Foundation gave me a grant to travel to Alaska to track Michael down for a face-to-face interview, I was relieved when he confirmed that he would meet me in Anchorage.
When I walked into the Suite 100 Restaurant in January and found Michael sitting alone at a booth, looking pensive, pale, and skinny as a stick, I was not at all surprised to hear that he’d been dreading my arrival. When I explained to him that our interview could one day be published, and his story widely read, he looked like he would throw up.
I reassured him that I would be in Alaska for several more days and that he could take another night to think about whether to be interviewed. I put my notebook away and we began to talk like regular people. I took out my phone and showed him a recent picture of Dan Cuddy. He studied it for a long time, smiling.
Here was an adult who had believed Michael’s story and had fought for him. As a surrogate father figure, Cuddy had earned Michael’s trust. I was beginning to see that I had gained some of that trust by extension, as Cuddy’s former law clerk. Slowly, Michael began to relax and eat his dinner, and then he told me he was ready to go on the record. Over the next four hours at the restaurant, he began to unfurl his story.
“Seeing you again brings up a lot of good feelings, and also bad ones,” he told me. “You’re asking me to remember the past I’ve tried to lock in a vault. But as much as I’ve been dreading your arrival, I needed you to come here. I feel it’s about time a reporter is asking me about this story.”
Michael Mawhinney was roughly six years old when his father began molesting him by performing oral sex on him. At the time, they were living in Texas, along with Michael’s mother and younger sister. Michael’s parents later divorced, and Gerald Mawhinney was granted custody of Michael. They would eventually move to the northern suburbs of Pittsburgh. For nearly ten years in all, Gerald Mawhinney forced oral and anal sex on and took nude photographs of his son.
Michael came forward to authorities in 2001, when he was seventeen, and the Allegheny County District Attorney’s Office chose to prosecute the abuse that had occurred while Michael and his father were living in the jurisdiction, a roughly three-year period starting when Michael was twelve.
During the prosecution’s case, Michael testified that at the urging of police, he had worn a wire to capture his father’s confession. Gerald Mawhinney didn’t take the bait the first time, when his son called him on the phone. The second attempt, a coffee meeting at Ross Park Mall, a crowded shopping center, also failed.
But the third try was a success. Michael visited Gerald Mawhinney at his apartment, “where my father felt safe and in control of everything, in control of me.” Yes, I molested you, Gerald Mawhinney told his son—and the police listening in from an unmarked van parked across the street—“but at least I taught you what good sex is.”
Courtrooms in the Allegheny County Courthouse are generally raucous places, but during Michael’s testimony, judge John A. Zottola’s courtroom was silent, save for the humming of the air conditioner in the window. While Michael described for the judge the years of rape and forcible oral sex he had endured at the hands of his father, Gerald Mawhinney scowled at him from the defense table.
On cross-examination, Mawhinney’s court-appointed defense attorney, a bulldog in a Brioni suit, came charging at Michael: “You liked it, didn’t you, the sex with your father?” Michael recoiled in the witness chair, stunned. But he held up on the stand.
After Michael finished testifying, Attorney Cuddy led him into the hallway to tell him that he would never have to speak publicly about the abuse again. “I made him repeat that fifteen times until I believed it,” Michael remembered. When Cuddy returned to the courtroom, Michael sat on a wooden bench in the hallway overlooking a sunny courtyard.
I stopped at that bench before heading back into the courtroom. “I think you are the bravest man I have ever met,” I told Michael.
Michael’s father was convicted of involuntary deviate sexual intercourse, sexual assault, and other related offenses. Three months later, he was sentenced to a prison term of ten to twenty years. Michael did not attend the sentencing hearing.
When he was fifteen, Michael fled his father’s one-bedroom apartment north of Pittsburgh to live with his mother in Anchorage. Although free from his father, he still wore heavy emotional chains. He felt depressed and ashamed. He dropped out of high school and began abusing alcohol and drugs — “weed, acid, ecstasy, and psychedelics, anything I could get my hands on.”
When he was sixteen, his mother sent him to a fully locked down drug rehabilitation center in Boise, Idaho. He was there for nine months and spent his seventeenth birthday in rehab. Looking back on that time, he said, “I was on such a self-destructive path. I was suicidal. I just wanted to sink into non-existence. Without rehab, I don’t think I would have made it.”
In rehab, Michael spent a lot of time trying to make sense of what had happened to him. Every day in rehab, he asked himself, “Why me?” Eventually, he realized that there was no point in asking the question any longer.
Still, life is a daily struggle. “I have feelings as strong now as I did ten years ago,” he told me at the restaurant. “At some point tomorrow, I may feel that I can’t take it anymore and want to say goodbye and check out of this life. That thought will cross my mind.
“What I went through had a serious impact on me. Sometimes I hit a wall. But I know I have to keep moving. That’s my motto. Keep moving. The longer I am down, the harder it is for me to get back up. So it is important for me to keep moving.”
After getting out of rehab, Michael followed his mother when she moved from Alaska to Presque Isle, Maine, for the sake of a new boyfriend. But Maine, some eight hundred miles away from Pittsburgh, still felt too close to his father, whom he still feared, even once Gerald Mawhinney was behind bars. So, at age twenty-one, without a job or a plan, Michael packed all of his belongings into a rusty Subaru and headed back to Alaska, a place he associated with endurance, independence, and the ability to make a fresh start in life.
The morning after our dinner, Michael sent me a text message to say that he’d decided to fully participate with my story. He even joined me on a Saturday hike up Hatcher Pass, a 3,886-foot-tall mountain pass in the Talkeetna Mountains north of Anchorage, near Wasilla, the hometown of former Alaska governor Sarah Palin. That morning, we met for coffee at Kaladi Brothers, a chain of popular coffee shops in the area. Michael brought his live-in girlfriend, Rosie Klouda, to meet me.
The twenty-six-year-old college student with a shock of red hair and piercing brown eyes studied me closely and was slow to warm up. I could tell she was being protective of Michael. The couple met when they were both working at Middle Way Café, where he “taught me how to make coffee,” she said. Hearing this, Michael smiled a guilty smile. “I turned her into a coffee snob,” he said. Indeed, they had brought their own coffee from home to the coffee shop. Rosie at least bought an apple fritter, which she fed Michael with her hand.
After coffee, Michael and I said goodbye to Rosie and headed north in my SUV. As we drove, I saw Mt. McKinley (now officially renamed Denali—“the Great One” in the Alaskan tongue of Athabascan) out of the driver’s side window. The highest peak in North America, the mountain stands at a staggering 20,310 feet. Seeing Denali sparked a memory for Michael, who leaned over to tell me that, when he moved here on his own from Maine, “I cried, thinking about all the metaphorical mountains I had climbed in my life and would still have to climb.”
For Michael, one of those metaphorical mountains, after getting sober, was to discover healthy sexuality.
Part of his abuse had consisted of early and ongoing exposure to pornography. “While I was with my dad, we watched a lot of porn. I continued to watch porn after escaping from him. I think I might have [developed] an addiction to sex, but I was much too shy, ashamed of my body, and awkward to have sex with a girl. So I developed an addiction to porn.” Having a serious girlfriend has helped him to break his pornography addiction, he said. “Still, I have developed a love/hate relationship with sex. I love having sex, but oftentimes I find it difficult to take control. I was never really the initiator in a sexual situation, more often the follower.
“Something that still sticks with me today is the fear of sounding like my dad. I’m afraid that if I let go too much, I might say something to a woman that my dad would say to me,” he said. “That fear has faded significantly during my two most recent relationships. The more I learn how to really make love, the more confident I become.”
Beyond learning healthy sexuality, Michael has faced other challenges. To his shame, he is both a high-school and college dropout, having withdrawn from junior college in the first year. “It was a new place and not easy for me to make friends,” he said. “Still very early in my recovery process, it was difficult for me to adapt to a new environment. I reacted with fear and doubt, and eventually ran away.” Today, he wishes he could complete his education, “but there is still a fair amount of fear, fear of failure.”
Making friends has been challenging for Michael, as it has been for other survivors I’ve talked with. Many have trust issues and struggle with relationships. “You can’t expect others to understand unless they’ve been through this experience,” said Alexandra Colicchie, a child-rape survivor whose case I prosecuted back in 2009. It’s a catch-22: research suggests that strong relationships can be a factor in supporting resilience.
Michael’s childhood trauma has made him intolerant of people’s complaints about life’s petty annoyances. “I do sometimes find it difficult to listen to their drama. As much as I would like to tell them to shut their mouths and realize how good they have it, it’s best for me to be sympathetic and listen.”
Michael attempts to regulate his emotions with the help of exercise. He bicycles to work every day, even when the temperature drops to five degrees Fahrenheit.
In the summer, he often takes thirty-mile-long hikes along Alaska’s Eagle River Trail with Rosie and her father. Fording the Eagle River means wading waist-deep in frigid, rushing water. “We lock arms, everybody’s in pain, and it gives me a sense of joy. We are all miserable. But we’re all in it together. It’s so cold we can’t feel our legs. This is what they call the ‘hiker’s high.’ You might have an injury, but you keep moving. You take that struggle and turn it into something good.”
At other times, Michael prefers to hike alone in the Chugach Mountains bordering Anchorage to the east. On these solitary excursions, Michael may see golden eagles, grizzly bears, gray wolves, red foxes, caribou, boreal owls (“they don’t like to be stared at”), bald eagles, or ptarmigan.
The ptarmigan, Alaska’s state bird, sports a mottled red-brown body and white wings. According to A Naturalist’s Guide to Chugach State Park, its call has been interpreted to sound like either “look out–look out” or “go back–go back.”
I asked Michael about the ptarmigan’s cry, whether he is tempted to heed its advice and give up. I chose this moment to remind him of his father’s boast that he had shown Michael the meaning of “good sex” by abusing him as a child. “How does a child survive that kind of trauma?” I asked.
Hearing this, Michael lurched forward in the passenger seat. His pale cheeks turned purple-crimson, the color of a crowberry. “I had forgotten that. I must have completely blocked that memory. My father did say that. Who would believe it? It sounds so incredible. Sometimes, I can’t believe it happened to me.” We drove on in silence.
After another ten miles, I pulled over at a gas station. Michael pointed to a large sign on the center of the door. “There’s my answer to your question,” he said.
I’ve never felt more engulfed in waves of simultaneous despair and hope than I felt as I read “‘I Couldn’t Do Anything’: The Virus and an E.R. Doctor’s Suicide” in the New York Times last Saturday. Dr. Lorna Breen, the emergency-department supervisor at New York-Presbyterian Allen Hospital who took her life on April 26, embodied all the good, all the agape (selfless unconditional love), all the standards of learning, noble achievement, selflessness, and joy that Americans once congratulated themselves on (uniquely) possessing.
America is crumbling before our eyes. There seems to be no counterforce. As white nationalists brandish powerful weapons on the streets and in statehouses, and fire them into crowds and churches, the left . . . topples statues. Statues on both sides of our historic ideological divide.
Dr. Breen trumpeted no ideology, but she did something more than topple statues. Something noble and life-affirming. She was part of a nationwide, overwhelmed band of sisters and brothers—emergency workers—who do the brutal work of saving plague-afflicted lives. She paid for her agape with fatigue, despair, the vile illness that gripped her as it has gripped so many of her fellow front-line workers. Ultimately she paid with her life, at her own loving hands.
Americans who consider themselves “progressive”—well, all Americans—need to get beyond the narcissistic pleasures of virtue-signaling. As we tilt Quixote-like at our statues, we might do well to recall a couple of ideas from Abraham Lincoln—one of whose statues is on the good-liberal removal list. Lincoln’s ideas apply to Dr. Breen and her colleagues, and to our pathways of response to her sacrifice.
At Gettysburg in November 1863 Lincoln said: “Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure.” He said: “It is for us the living . . . to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced.” He said: “It is rather for us to be here dedicated to the great task remaining before us–that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion.”
And now we are engaged in a new civil war. We are in a new test—several tests—to see whether our nation can long endure. Dr. Lorna Breen and her sisters and brothers have fought and too often died while struggling with their unfinished work against one collateral facet of this war: the national political indifference to the coronavirus plague.
We the living can advance that unfinished work by building on the legacy of Dr. Lorna Breen.
There are so many ways to pursue this work: ways that require commitment and courage and patience on a scale that most of us have never confronted.
This fine piece by Jocelyn Wiener appears in the February 26 edition of CalMatters, a probing independent journal based in Sacramento, California. Yet the horrific saga of Mark Rippee, the symbol of mental healthcare decadence in America, a bit of human wreckage stranded on the streets of Vacaville for 13 years, remains mostly hidden in plain sight.
The voices of the growing grass-roots movement to reform mental healthcare are at last rallying to demand justice for perhaps the most dispossessed victim in America.
In a town in America, here in the Twenty-first century, a man has been left to die. A maimed and blind and deeply mentally ill man.
He has been left to die in this town for thirteen years. Right out in public, on the city streets, where everybody can see him. And beat him and rob him when they feel like it. And nobody with any statutory power over his predicament seems to give a damn.
A technical clarification: this man is not on the streets of Vacaville as I write these words. He is in critical condition in a hospital, bandaged and splinted and broken after being struck by a car at a traffic intersection at dusk on February 12. (It is the second time this man has been hit.)
His injuries include a fractured skull and bleeding from the brain, facial lacerations, lung contusions, a dislocated shoulder, a shattered elbow, a decimated leg, and bruises that blanket his body.
But it’s a safe bet that after the surgeons have him all fixed up—it could take months—he will be ushered back out onto the streets, where the cars he can’t see and the thugs whom he cannot fend off will help him resume his accustomed existence.
The man has a name: (James) Mark Rippee. The city has a name: Vacaville, California. The situation has a name: depraved indifference to the survival of a human being.
I just made that name up. Actually, I borrowed it from legal parlance. Its definition: “Conduct which is so reckless, wanton and deficient and lacking in regard for the lives of others as to warrant the same culpability as the individual who actually commits a crime.”
Here is the crime that Mark Rippee has committed: the crime of existing while crippled, blind, and insane. Are there any questions?
I’m sure there are lots of questions. I have lots of questions myself. Or I used to. I have written so often about Mark Rippee since I became aware of his plight that the words I write about him seem to turn to dust. I have written blog posts about him here and here and here. I have written speeches to mental-health reform groups in which I summarize his story. I have written directly to media outlets, to lawmakers, and to civic leaders in Vacaville and elsewhere. And the streets still claim Mark Rippee.
The bare-bones story—as it were—is that Mark Rippee was involved in a terrible motorcycle crash in June 1987, at age 24, that left him nearly dead, with bits of his brain scattered near the site, his eyes and his right leg destroyed. You can read the details in my links.
Somehow he survived. But over the years, his traumatic brain injury (TBI) has morphed into schizophrenic-like thoughts and behavior. His power to reason vanished. His mother and his twin sisters Linda Privatte and Catherine J. Rippee-Hanson tended him in the family household for eighteen years, until his deformed brain turned him into a raging menace. He left the household and has made his way on the streets, where his sisters—both of whom have developed serious illnesses of their own—bring him food, clothing, canes. Vandals keep stealing all of it, and often also the money given him for food and other needs.
Why doesn’t somebody rescue Mark Rippee? Why doesn’t some agency . . . why doesn’t . . .
Those are very good questions, and I’m glad you asked them. But the answers are buried within the folds of incoherence that comprise so much of the American mental healthcare system. Or systems. Or “systems.”
Mark Rippee is a victim of a perfect storm of gothic bureaucracy. The pertinent bureaucrats at Solano County and California state levels have exhibited no discernible interest in finding any way to counter the bureaucratic snafus with a humane solution that would get this man into supervised care and treatment.
One might even say that they are hiding behind a “humane solution” that actually exists. This solution would begin with a declaration from a psychiatrist that Mark Rippee’s accident left his brain with “diminished capacity.” This ruling would permit Mark’s family to place him in an appropriate facility and/or to establish a conservatorship that would give them discretion over his affairs, including psychiatric care.
No dice: hospital psychiatrists have consistently, and weirdly, denied that Mark Rippee has “diminished capacity.”
And the reasoning behind this confounding denial? Well, it’s none of your business what the reasoning is. The hospital is protecting Mark Rippee’s rights, you see. Protecting them by way of the cartoonish Health Insurance Portability and Accountability Act. HIPAA was designed to ensure a patient’s “privacy.” “Privacy” that prohibits even family members from learning the medical procedures and condition of a patient. There’s an irony there, in case you missed it.
Catherine and Linda have fought tooth and claw, over parts of three decades, to tear through the self-serving laws and policies that keep Mark in a near-feral state. Two years ago, Catherine plunged into work on a petition in support of a California bill known as AB 1971. AB 1971 would have expanded the existing definition of “gravely disabled” to include medical treatment for a patient if the lack of treatment “may result in substantial physical harm or death.” It would have secured treatment for Mark Rippee. Catherine collected 82,000 signatures in favor of the petition.
In April 2018, the Disability Rights Education and Defense Fund, one of several lobbies that oppose conservatorship and deny other needs of the mentally ill, signaled that it disapproved of AB 1971. The California Hospital Association also weighed in on the negative side.
AB 1971’s sponsors pulled the bill.
The sisters’ determination would be the stuff of heroic legend, if we lived in a country that valued heroic legend. In the wake of Mark Rippee’s second brush with death by an oncoming car he couldn’t see, Catherine has released a new petition. It demands intervention from California Governor Gavin Newsom to rectify this travesty of public policy. It reads in part: “While we hold the County of Solano and many officials, departments and agencies responsible for not preventing this second tragedy that we told them would happen – We also demand that the State of California and in particular – Governor Gavin Newsom – whom we have previously attempted to contact – PAY ATTENTION TO THIS SITUATION and ACT accordingly!”
Moreover, thanks to the sisters and the Internet, word of Mark’s ordeal is spreading at the grass-roots level. Activists around the country, alerted to the nightmare, have begun writing letters demanding justice for Mark.
Here are two. Their tone of indignation and urgency is echoed by many more.
From Donna Erickson of Massachusetts:
“Hello, I’m writing to voice my concern, in regard to a homeless individual named James Mark Rippee. As you probably know, he is severely disabled both mentally and physically. Being blind only further complicates his poor condition. The real tragedy here is that none of this is his fault. Severe mental illness is a disease nobody chooses. Many who are afflicted are unaware of how sick they are, because of anosognosia, which is lack of insight, a condition that is a manifestation of the illness itself. It is not his fault that he repeatedly walks into traffic.
“His brain is broken, and he cannot see. Someone in this condition should never have been put on the street. So now he is hospitalized for another accident, resulting in critical injuries, including a skull fracture, brain bleed, and broken bones. He will need many surgeries.
“His family is devastated, because they tried so hard to get him off the streets. But the laws get in the way. This poor man requires a hospital, rehab, and eventually a long-term residential facility. If he is an elopement risk, then there are locked facilities. Mark’s value as a person is no less than any of us on Earth. He has fallen through the cracks of a very broken system.
“How would you feel if this was your family member? Mental illness can strike anyone. He is not a nobody. He is a family member of caring individuals who have tried everything in their power to help. The tragic part is that this all could have been avoided, if only someone had truly cared and listened. Keeping someone on the streets in his condition is disgraceful. And it shouldn’t matter what he says. He is unable to make a rational decision, which is in his best interest, due to his illness.
“The system has failed him, because no one intervened, even though the family had begged and pleaded. I had to voice my concern, because this could have been my son. This could have been anyone’s son, and we need to start taking care of our most vulnerable citizens!”
And from the Maryland advocate Laura Pogliano:
“My friend [Catherine] Hanson and her sister Linda Rippee have been trying to help their brother Mark for 13 years; a motorcycle crash left him with no eyes, a severe brain injury, broken bones all over his body, a metal rod in his leg, and as a result of TBI, schizophrenia. He’s been on the streets for years, being victimized, robbed, beaten and neglected. They’ve been denied help for him over and over by the county they’re in, by hospitals.
“He’s been admitted to, by group homes, by every support service you can think of. He was hit by a car a few months ago and while inpatient, one sister’s medical power of attorney was revoked, and the psychiatrist sided with his delusional raging patient, that he was capable of making his own medical choices and caring for himself (blind and floridly psychotic). He was discharged to a group home and lasted about a week.
“Now, living on the streets, Mark’s been hit by a car again! Only this time, he was thrown into the air and smashed his face against the driver’s windshield. He’s in bad shape, has another brain injury, the leg with the metal rods is shattered, his shoulder is dislocated and he might lose what’s left of his teeth.
“He’s going to need months of hospitals, multiple surgeries, and extended care. And guess what? He’s in the same damned hospital that battled back against his family and discharged him to the streets.
“Mental health care in America. You stand a slight, very slight chance of making it, if you’re healthy enough to ask for help and participate in it. If you’re really, really sick, you’re screwed.”
In a city in America, here in the Twenty-first century, a man has been left to die. But in America, the voices of reclamation are arising to insist on his right to live.
In the aftermath of two traumatic mass shootings, the president re-invokes a horrid, distorted falsehood about the mentally ill.
And there it is: history’s defining damnation of sufferers of incurable damage to the brain, distilled into a three-word phrase of transcendent ugliness and stunted understanding.
The phrase was uttered on Monday. It was uttered to identify the provenance of the weekend’s massacres by shooters using legally purchased high-capacity semi-automatic weapons toward their collective harvest of 31 people dead and some 50 wounded.
The phrase was uttered by the President of the United States. It left stains, stains which, in moral and intellectual terms, replicated the stains of blood shed by the shooters’ victims.
Blaming “mentally ill monsters” (or “nut jobs,” or “wackos,” or “lunatics”) for such carnage is a morally repugnant, if time-tested device for shifting the public’s passion for safety away from gun control and toward the presumed demons in our midst. The president could not have been more transparent in exploiting the device. “Mental illness and hatred pulls [sic] the trigger, not the gun,” he instructed us, going on to label one of the shooters as “another twisted monster.”
In fact, it is a settled truth in psychiatric research that victims of brain afflictions are no more prone to violence than the general population. The prominent advocate Dj Jaffe makes an important stipulation: that the untreated mentally ill—those not stabilized by antipsychotic medications—can be more likely to cause harm to themselves or others. Still, implying that mental illness itself equates to degenerate aggression serves only to further isolate and punish the most helpless members of our society; to herd them back toward the dark corners and confinements of “insane asylum” days.
And herein lies the “intellectual” stain that President Trump’s words help spread: most people—like the president himself—do not understand mental illness: what it means, how it occurs, how it differentiates, why its victims behave as they do, and how even its most abject sufferers can be aided, often stabilized, by medications and therapy. In this vacuum of understanding, people tend to substitute prejudice, false science, myth, and hostility toward “crazy people.”
“Serious” mental illness—the kind in question here—is rare and unique. And incurable. Unlike alcoholism or anger or depression, serious mental illness is rooted in genetic flaws of the brain. Its various names include schizophrenia, schizoaffective disorder, bipolar disorder—similar yet not interchangeable conditions. It results in a loss of reason and rational control; hallucinations and the hearing of voices; alienation from family and friends; and, yes, sometimes—rarely—violence.
My wife and I have educated ourselves about serious mental illness because we’ve had to. It invaded our family several years ago, causing the suicide of a beloved son. Unfortunately, this is the painful route to understanding for most people: a loved one is stricken.
The costs of this cluelessness describe a cone of destruction that widens from the stricken individual through society.
The cone draws in and ravages parents and siblings of the stricken. It can cripple the finances of families without adequate insurance to cover treatment and medications. It drains human capital from the workforce, and thus economic revenue. It reduces the budgets of hospitals that can’t get reimbursement for their mentally ill patients. It overburdens police, whose lack of training and, sometimes, self-restraint, can result in death by gunshot of unarmed people in psychosis. It coarsens our criminal-justice system: think of schizophrenic adolescents hustled into jail by untrained or uncaring judges, where they await trial—often for weeks and months—while their unmedicated psychosis deepens. Think of solitary confinement. Think of a brain-afflicted child, perhaps your own (as countless parents must) ensorcelled in a cell, abused by fellow inmates and guards, with no end in sight, no comprehension. No hope.
Now think about “mentally ill monsters.”
Mentally ill monsters are not the source of our current crisis of public massacres. The monster is the gun: too many guns, with too little restraint and oversight regarding purchase. To his credit, President Trump gave lip service to keeping guns away from those “who pose a grave risk to public safety,” and to strengthening gun laws generally.
But leave the gun issue aside. Part of any president’s duty—a foundation of his “bully pulpit”—is to educate his fellow citizens on matters of complexity and urgent public import. The nature of serious mental illness, and the reclamation of its victims, comprise one such matter. The president could make a great, galvanizing contribution to ending the centuries-old oppression of “crazy people.” He could lead us in that direction. He could educate us. But first he must educate himself.
QUINCY — After Ron Powers’ youngest son committed suicide in 2005, the Pulitzer Prize winner and prolific author swore that he would never write about the “hellish” pain that he and his family went through.
“I was in a daze in the first five years, then the healing began, and I realized after reading more about the disease (schizophrenia) that I really had to do this,” Powers said.
Powers’ book starts with the words: “This is the book I promised myself I would never write.” But as he began going back through photos, emails and other items that belonged to his youngest son, Kevin, Powers saw the need to tell the world that ignoring mental illness is a terrible mistake and a social injustice.
National statistics indicate that more than 10 million Americans will suffer a serious mental illness each year and with more than three people in the average home, more than 34 million American lives will be disrupted.
Powers’ older son, Dean, was diagnosed with schizophrenia only months after Kevin’s suicide. Thanks to informed treatment choices, Dean’s illness has been controlled.
But too many people with mental illnesses are sent to jails, Powers said.
“The moral necessity for us as individuals, and for our country, is to reclaim these people,” Powers said.
“There’s primal fear and prejudice against the mentally ill and because of that, (society) punishes the mentally ill when we should be treating them.”
Since his book was published, Powers has been scolding the government for spending $31,000 per year to jail the average person with mental illness, rather than spending the $10,000 needed for treatment. He also has promoted programs that help those with mental challenges.
“Organizations around the country, like Transitions, are taking up the slack, and I’m so gratified that people are doing what they can to help,” Powers said.
Barb Baker Chapin, director of development at Transitions, hopes that Powers’ visit will help people see mental illness in a new light.
“One in five of us will suffer from a mental illness at some time in our lives, and yet there’s still such a stigma associated with it,” she said. “I hope Ron Powers’ very personal story can help us have a dialogue about the changes we need to see in the mental health system and the way we’re funding it.”
Powers has written 16 books, including “White Town Drowsing,” which looked at his hometown of Hannibal during the 1980s. He also wrote a biography of Mark Twain, “Mark Twain: A Life” that was a New York Times best-seller and a finalist for the 2005 National Book Critics Circle Award. In more recent years, Powers was co-author of “Flags of Our Fathers” and “True Compass,” which were both No. 1 New York Times hard-cover nonfiction best-sellers.
He was awarded the Pulitzer Prize for his critical writing about television for the Chicago Sun-Times in 1972. He also won an Emmy Award in 1985 for his commentaries on “CBS News Sunday Morning with Charles Kuralt.”
Several of Powers’ books will be available for sale. A complementary copy of “Flags of Our Fathers” will be presented to those who buy tickets to a social hour with the author, and he will do a book signing.
Ticket information for “An Evening with Pulitzer Prize-Winning Author Ron Powers on April 26
Meet and greet tickets are $75 for the 6:30 p.m. social hour, complementary copy of ‘Flags of Our Fathers,’ the chance to meet Powers during a book signing and preferred seating.
Preferred seating tickets are $25 each.
General admission tickets are $15, with doors opening at 7:30 p.m.
Tickets are on sale at the Oakley-Lindsay Center box office at 217-222-3209, or online at http://www.1qct.org/.
As the father of two sons with schizophrenia, author Ron Powers is familiar with the pain and frustration of dealing with a chronic, incurable disease of the brain.
Powers’ younger son, Kevin, was a talented musician whose struggles with schizophrenia began at age 17. Just before his 21st birthday, in 2005, Kevin took his own life.
A few years later, Powers’ older son, Dean, started experiencing symptoms of schizophrenia and had a psychotic break.
Ron Powers, a Pulitzer Prize-winning journalist and media critic, wrote Flags of our Fathers, which was adapted into a film by Clint Eastwood.Sarah Junek/Hachette Books
“There is no greater … feeling of helplessness than to watch two beloved sons deteriorate before [your] eyes, not knowing what to do to bring them back,” Powers tells Fresh Air‘s Terry Gross.
Powers’ new book, No One Cares About Crazy People, is both a memoir about his sons and a history of how the mentally ill have been treated medically, legally and socially. Although Dean is now medicated and doing well, Powers notes that many people with schizophrenia don’t receive the treatment they need — in part because they often don’t believe they are ill.
“This unwillingness to believe that one is afflicted has led to tremendous problems,” Powers says. “To force that person into being helped is a violation of his or her civil rights … and the law may penalize the care workers who give [people with schizophrenia] medications or admit them to a hospital against their will. … That is the great reigning Catch-22 of the way our society deals — or fails to deal — with schizophrenia.”
On why symptoms of schizophrenia often surface around the age of 17
It has to do with the maturation of the brain. … In order to start functioning as an adult brain, the brain must undergo a period of what is called “synaptic pruning,” really a cleansing away of all of the neurons, all of the connective material that is built up since infancy. That is no longer useful and it’s quickly replaced, but there is a period of vacancy, almost, in which the brain is very vulnerable to any kind of disruption. It’s unprotected, and this is the period of life, roughly clustered around the age of 17, when the disease can make its appearance.
On how denial impacted his sons’ treatment
Each of our sons was afflicted with this companion condition called anosognosia. … [It’s] defined as an inability to understand the self, a blockage of insight into what is happening. Many, perhaps most, of schizophrenic victims deny that they are schizophrenic, and this has led to many important social and legal and ideological conflicts. … The denial that took place, with Kevin the symptoms occurred before he reached the age of 18, meaning he could be treated without his consent. He was a juvenile and he was taken into care and custody without his consent.
Dean was over the age [of consent] and resisted treatment, denied that he needed to be treated, and it was only after a series of psychotic breaks that he came around to the understanding that he needed help.
Dean is accountable to a clinician. He has to report; there is a record of him taking his meds. Kevin was taking oral medication only on his own consent and we weren’t sophisticated enough to perceive that instead of taking the meds Kevin might be hiding the meds. This happened in the later stages of his descent and it was after he finally announced to us, “I’m fine. I’m healed. I’m OK, I’m not going to take my pills.”
Within a few months after that, Kevin hanged himself in our basement.
On trying to understand the degree of Kevin’s suffering
He was hearing voices. We know that. We could watch him through the kitchen window as he walked out of the house and toward the hot tub that he loved to sit in. We could see him climb into the hot tub and sit down, his profile was to us, and we could see him laugh. He would laugh, he would giggle. … Something was talking to him, and I think because of that happy response we saw from him we told ourselves that he had made friends with the voices, that the voices were beckoning him, they were coaxing him into their world, and that he finally decided to join them. I don’t know whether that’s true or not. I’ll tell you that it got me through the first five years of trying to figure out where Kevin’s mind had gone.
On still having dreams of Kevin
In the dreams Kevin is alive. He’s a small boy, around 10, 11, 12 years old. We know he’s a gifted guitar player, but he’s stopped playing his guitar, and he won’t start again. The odd thing is that both Honoree and I have had this dream. It might be a metaphor for his death, but he shows up, almost every night, as I say. … I’m glad to see him. In the dreams he is etched so perfectly. The reality of him, the physical sharp-focused reality of Kevin is overwhelming and all of his kindness and his goodness are there.
The advent of the so-called “wonder drugs” like Thorazine … were touted as cures for schizophrenia — they weren’t. At best they were cures for symptoms. But on the strength of Thorazine and its great consumer success and promise, President Kennedy, seeking to do the right thing, signed legislation … in 1963 … that authorized the emptying out of mental asylums and the transferring of their patients, their inmates, hopefully into community care centers that were going to be built around the country to receive them.
Deinstitutionalization was a catastrophic social experiment, one of the worst we’ve ever had. It ended up creating the [mentally ill] homeless population that still plagues us today.
The second terrible effect of deinstitutionalization was that many of the people never ended up in the community centers. The government ran out of money. They couldn’t build enough to contain this outflow of patients, so they ended up on the streets, and from the streets they ended up in prison. Many of them. Today our prisons are overflowing with the mentally ill. Prisons are our de facto mental hospitals.
Tyler West is in a prisoner in the Richard Handlon Correctional Prison in Ionia, Michigan. Mark Rippee, blind and severely disabled, as well as severely mentally ill, is at large on the streets of Vacaville, California, where he has somehow survived for twelve years. He is regularly beaten up and tormented by street punks. His sister Linda Privette told me that in addition to food and clothing, she recently provided him with his eighth walking cane in a twelve-month period–the other seven had been taken from him.
You may read about Tyler and Mark, and the grossly inhumane reasons for their medieval persecution, elsewhere on this blog. In brief, each is an unconscionable victim of an American state’s official contempt for the mentally ill, contempt that festers from ignorance, indifference, and a lack of organized public pressure to rescue them and their families from their living hell.
I’m sure that many relatives of the mistreated mentally ill would like to see equal attention devoted to their loved ones. My inadequate response is that there are not enough megabytes in cyberspace to tell the story of every American sufferer of mental illness who has been further victimized by our systems. We need to make mental-health reform a massive civil-rights issue. We need a revolution of conscience.
I am posting below a heartbreaking, eloquent message from Tyler’s adoptive mother, Kimberlee Cooper-West. (She submitted it to the Facebook site Circle of Comfort and Assistance Community, and I reprint it with her permission, and it bears close reading.) You can find comments from Mark Rippee’s sisters, Linda Privette and CJ Hanson, elsewhere on this blog.
Wish I had good news to share with ya all’ Love my CCA family! Some have asked, so here it is! Today is our son Tyler’s 20th birthday! We were unable to say Happy Birthday, as he is in lock down for 5 days. We drove a little over an hour, to Richard Handlon Correctional Prison, in Ionia, Michigan. This was last Monday. He is number #113697. We had cake with him. He made a cake from 2 honeybuns, smashed peanut M&Ms(sprinkles) and a melted Snickers bar on top. He is inventive. We sang Happy Birthday to him. He is still our boy! Few mention him. Our heart breaks for what, we have lost. This Will be his 3rd year, away, for his Birthday. Next he will miss Thanksgiving and Christmas. He hasn’t been given counseling, education, training, or the proper medications. He was beat up 4 times, since he was incarceration. Why, couldn’t these mental health professionals, keep him, in an, inpatient psychiatric hospital? For the love of God, there was no good reason, to release our son. His safety compromised. No one responsible. He was nearly shot at for trespassing. He was inpatient, 5 days prior, to his arrest.. He was delusional and hearing voices. What is wrong with this country? Why is there, no long term treatment? This is a brain disease, ya all’ Maybe we should start locking up every Grandma and Grandpa who is violent, or disorderly from Alzheimer’s. Serious mental illness a disease. It is prodromal to Alzheimer’s. Prisons are corporations. Their goal is money. They need prisoners. Caught up in the system, it is a real thingl. We are receiving, a criminal justice system education. Months are now years. One caseworker, Ms. Williams, calls many people names like dumb, retarded, idiots and pedophiles etc. Everyone in Ty’s facility is either mentally ill or autistic. She told Tyler a 19 year old kid, who was only supposed to be there for 2 months, your doing 15 years. It leaves me to wonder, how many, have given up from her words.. He is not even provided an inhaler for asthma, and chronic lung disease. He has autism and a serious mental illness. When he was in school he was never suspended. He was a target for bullies, which was, Our main concern. Incarceration, never crossed our minds. Today on his birthday, I sent his appeal papers, certified to a judge. Hopefully he will give him an apeallate lawyer.
This excellent Mother Jones piece by Samantha Michaels pinpoints one of the worst ongoing atrocities in our criminal-justice system–the indefinite pre-trial incarceration of young mentally ill defendants. This broken system cries out for restorative, enlightened oversight at the federal level.
By the time he turned 15, Jesus G. was hearing voices and having suicidal thoughts. It was early 2013, and he’d been living at the Central Juvenile Hall in Los Angeles for more than a year, though he’d never been tried or found guilty of a crime.
In late 2011, Jesus’ younger brother accused him of molesting him, but Jesus denied the allegations. The clock stopped on his case months after that, when a doctor decided that, due to his hallucinations and immaturity, he wouldn’t understand what was happening in court.
As with adults, when a kid like Jesus is declared incompetent to stand trial, the state can detain him while trying to improve his mental functioning and knowledge of court procedures. But while California law limits the amount of time adults can be confined—often in hospitals—during this process, no such cap exists for children, who are regularly held in juvenile hall instead. As the months passed, Jesus and his attorneys wondered when he would ever get out.
In California and across much of the country, children with cognitive problems routinely languish in custody for months or years while judges determine whether they’ll be able to pick up the skills needed for a fair trial. Most states don’t have comprehensive programs to help these kids become “competent,” as the courts call it, referring to someone who has the ability to assist their attorney with their defense and possesses a solid understanding of the charges and proceedings against them. In one egregious case, according to a legal director at the National Juvenile Defender Center, children were asked to watch episodes of Law & Order to prepare for their trials.
According to California Assembly member Mark Stone, about 300 of the estimated 7,000 wards in California’s juvenile justice system last year were not getting the help they needed to become competent for trial. Now, lawmakers in Sacramento are considering a bill that would limit how long kids are detained after a judge finds them mentally unfit. And it would spell out the services they can receive to get up to speed. Gov. Jerry Brown vetoed a similar bill last year after critics protested that dangerous, emotionally unstable teens might be let loose.
But this year Stone hopes a compromise will be more palatable: In his new bill, most kids could be detained six months while trying to become mentally competent, but those accused of certain violent crimes could be held for 18 months. Some advocates say a year and a half is still far too long to hold a child without trial, but others say it’s a step in the right direction for a system that often feels haphazard at best and an absolute mess at worst.
Before he got to juvenile hall, Jesus was struggling at home. He’d recently moved to California with his mom and told adults at school he was depressed and wanted to die; he tried cutting his wrist because he claimed his stepdad abused him. At age 14, after he was locked up, a medical examiner found he was functioning in some ways like a six-year-old. “For him to understand the reality of what’s transpiring and understand the process, what people are doing with him and what he needs to do in his own defense…those are going to be difficult things for him,” the doctor told the court.
The fight for better juvenile competency laws has roots back in the 1990s. Across the country, a jump in homicides led to a superpredator panic, and delinquent teens were depicted as dangerous criminals. New laws made it easier for them to be transferred to the adult system, where a third strike could land them in prison for life.
By then, courts already had procedures for dealing with adults who weren’t mentally fit for trial, and many states started to apply the same standards to children. But that hasn’t worked out well, says Thomas Grisso, a psychologist in Massachusetts and a leading expert on these issues. Like adults, kids can struggle to understand court proceedings because of a mental illness or an intellectual disability. But many kids aren’t ready for trial simply because they’re immature. Their brains haven’t developed fully, or they haven’t picked up the average knowledge an adult would have about courts, Grisso says, so they require different types of services to get up to speed.
California does have a separate competency law for juveniles, and back in 2007 it was the first state to acknowledge that immaturity could make someone unfit for court. But since then it has lagged behind. “California ended up with one foot moving forward and the other one stuck in the mud,” says Janet Warren, a psychiatry professor at the University of Virginia who helped develop procedures in her state for juvenile competency that are now hailed as a model.
National guidelines written by Grisso and his colleague Kimberly Larson encourage lawmakers to keep kids in the least restrictive environment possible while they study to become competent—ideally at home. In California, however, “juvenile halls have become an unfortunate default holding place for incompetent youth,” public defenders in Los Angeles wrote in an amicus brief, noting that the state doesn’t use residential group homes enough. And California has no hospital beds for these kids, says Jim Salio, president of the Chief Probation Officers of California. “Because there’s no other place to house them, we end up with these minors in juvenile hall. They really should be in some other place.”
Experts recognize that locking them up can worsen their mental health problems, make them less likely to graduate high school, and boost their odds of committing crimes later. In 1972, the Supreme Court ruled it was unconstitutional to detain anyone indefinitely during treatment for competency problems; a person could not be “held more than the reasonable period of time,” the justices wrote. But what’s reasonable? In California, Salio says, some teens are held two or three years.
According to a study in Virginia, most kids can develop the skills needed for trial within three months by studying court procedures with an expert and receiving treatment for any mental health problems if needed. After six months, if a child has not become competent, it’s unlikely he ever will.
During his year-plus at juvenile hall, Jesus continued his schooling but received no services to prepare him for trial, his attorneys told the court, including no ongoing treatment to deal with his hallucinations, depression, and suicidal thoughts. The probation office explained a committee focused on competency programming was still “in the planning stages” and that Jesus probably couldn’t start until the following year.
Albert C., a 15-year-old accused of assault and gun possession, was also locked up in Los Angeles after a judge found him unfit for trial. His programming, according to an amicus brief, involved just 90 minutes a week of going over worksheets with court vocabulary, followed by a quiz. The person who administered the worksheets hadn’t graduated from college or received much training. “He was essentially warehoused for a year with no therapeutic services or treatment,” wrote the Pacific Juvenile Defender Center and local public defenders, noting that doctors recommended he take medicine for attention deficit hyperactivity disorder.
It doesn’t have to be that way. In Virginia, most kids with cognitive problems stay at home while they prepare for their trials. The state has hundreds of trained forensic evaluators who meet with them there a few times a week, typically over three to four months, using an individualized curriculum with interactive animated software, flashcards, workbooks, coloring books, board games, verbal conversation, and role playing. Florida, Louisiana, and Maryland also have comprehensive, state-wide programs for incompetent kids. But some states like California face pressure to spend their money on more hospital beds for the growing number of incompetent adults left languishing in jails. “To put juvenile competence as a financial burden on top of that makes me pessimistic about a lot of states suddenly getting on board,” Grisso says.
Virginia experts counter that it’s cheaper to do it their way. Warren estimates children in her state become fit for trial at a cost of about $5,000 each, while it takes $200 a day to detain a kid in juvenile hall and $600 a day to keep someone in a psychiatric facility. In other words, a few months of treatment and education could cost three and a half times more in juvie than at a kid’s home.
Jesus and Albert both fought their pretrial detention. Neither kid had much luck. Jesus was held in juvenile hall for about 16 months before he was finally released. Albert stayed for about a year until a judge declared him competent and he pleaded guilty to his crimes. In his case, a judge ruled that although local protocols suggested kids shouldn’t be held for more than about four months during competency treatment, that didn’t carry the force of law in California.
Last year, the California Legislature passed a bill that would have put a six-month cap into law, with support from the Chief Probation Officers of California, but the governor vetoed it amid concerns that kids with aggressive behavior would get out of custody too soon. Assembly member Stone tried to put more teeth into the bill this year, with a six-month cap for most kids and an 18-month cap for those accused of certain violent crimes, including murder and rape as well as certain acts of sexual abuse, like the ones Jesus was accused of.
The new bill would lay out the types of services that courts could consider for incompetent kids, things like therapy and medication instead of just workbooks with court vocabulary. And it would encourage courts to look for options besides juvenile hall while still considering public safety, and require them to dismiss the cases of incompetent kids who are only accused of misdemeanors. Lawmakers have until Friday to vote on the proposal.
In the meantime, children are waiting. Dale Major, an attorney in San Francisco, says one of his teen clients has spent about three years locked up without trial, spread out over multiple arrests, after being declared incompetent because of post-traumatic stress disorder, paranoia, attention deficit disorder, and developmental immaturity. “Even though he’s in juvenile court, he’s now 18, sitting in a county jail, getting no services,” he says. “The kid has had no childhood.”