Guest Speaker Ron Powers at the Pathways to Hope Conference

EXPLANATORY FOR THE TEXT OF THE TALK BELOW

Below is the text of the talk I delivered to the 2018 conference of Pathways to Hope in San Antonio on Friday. Pathways is an exemplary nonprofit outreach organization that has set new standards for reclaiming and treating victims of mental illness and addiction.

Because of a last-minute scheduling conflict, the venue for my talk was shifted from an auditorium furnished with audio-visual recording equipment to one that lacked same.

In one sense, that is a good thing: people who are curious about what I had to say can find out without having to watch the image of my homely mug flapping its gums for half an hour.

In another, it is not so great.

I’d designed this talk as a forceful message—a call to arms, if you like—not only for the Pathways attendees but as a video document that could be distributed on the Internet to advocacy groups around the country, to access stations in towns and cities, to educational and religious groups, to judges and the law-enforcement community, and to state and federal political leaders with the power of policy-setting over our country’s broken mental-healthcare system.

My talk includes a look into the broken lives of two sufferers whose hellish plight epitomizes the rank obscenity of the ignorance, indifference, and neglect at the extreme edges of our judicial and municipal authorities. These victims’ images and encapsulated stories may be found near the end of my talk.

Finally, my remarks conclude with two proposals that will be difficult to achieve and can be fulfilled only via a sustained and broad-based outpouring of activist passion. One proposal is the enshrinement of mental-illness reform as the predominant civil-rights issue of our time. The other is the establishment of a new Cabinet-level federal department: the Department of Mental Healthcare.

I cannot overstate the urgency I feel for the necessity of these goals, and for our sustained witness of those unfortunate people who exemplify the atrocities in our dealings with the insane. Nor can I overstate the frustration I feel (I seldom mention this) at the societal inertia that enshrouds progress and muffles the voices of reform.

I realize that the remarks below are not for everyone. Except that they are.

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TEXT OF MY TALK TO THE PATHWAYS TO HOPE CONFERENCE, AUGUST 24, SAN ANTONIO, TEXAS

My wife Honoree and I would like to thank you members of Pathways to Hope for inviting us to this enlightened and important conference.

We are grateful in particular to your inspirational president, Doug Beach; his associate the Rev. Carol Morehead, and their All-star array of board members. Including your great county judge Nelson Wolff, who has so brightly illuminated your path.

You have reached out to a couple of chilly Yankees from the People’s Democratic Republic of Vermont—and got us down here to enjoy a little sunny weather.

Honoree was actually kind of rattled yesterday when I read her the temperature here. I told her not to worry; it would probably warm up.

I hope you know how special you are. Three years ago Pathways to Hope did not exist. Today, you are a piston in a great city’s emergence as a dynamo of human reclamation: the reclamation of the most helpless and vulnerable and overlooked people among us. I speak of those who have been stricken with mental illness.

And I speak of the families and friends who have interrupted their lives and often their livelihoods to protect them.

Something big is going on here in San Antonio and Bexar County. Has been for a while. At about the time Pathways was getting organized, in December 2016, the Boston Globe had this to say about the civic revolution you were joining:

“San Antonio has done in Texas what Massachusetts has not come close to: making mental health care a community priority, a real system built with creativity, humanity, and sustained commitment. A national model, saving lives and money.”

And you are now a central part of this. Your work embodies what has come to be known as “the San Antonio way.”

Let’s examine what “the San Antonio way” means, for the benefit of those who are not aware of it.

It means a great and rare coming together. A spontaneous combustion of civic will that rebukes our long national apathy toward mental health reform. A galvanizing of public agencies and private businesses and healthcare providers and churches and ordinary people—teachers, volunteers, and victims of mental illness themselves. A drive to finally seize control of our broken care and judicial and enforcement systems that too often intervene in the shattered lives of afflicted people only to make things worse.

San Antonio has said “Enough of this! Let us intervene in these systems and rebuild them from the grass roots up!

And let me be more specific still:

In this city it has meant creating special mental health units within the police force: handpicked officers who are rigorously trained to ease themselves into crisis situations and tamp down psychotic behavior, using words and gestures instead of guns. Incredibly important!

It has meant achieving national prominence in the practice of jail diversion. Gilbert Gonzalez and his Bexar County mental health staff have used jail diversion to identify more than 20,000 people with serious mental illness and divert them from jail into treatment. It has saved Bexar County more than fifty million dollars and counting!

That is just incredible! Cost-efficient—and more importantly, humane! Why is the San Antonio Way not the American Way?

I want to help make that happen!

My tools are limited. I’m a bereaved father and a writer—not a policy-maker or a neuroscientist or the leader of a great movement. Just a writer.

But as Elie Weisel said, “Words can sometimes, in moments of grace, attain the quality of deeds.”

So let me pray for grace, and not mince words.

American mental health care today is in a crisis.

I will speak to you of this crisis, but I also want to speak through you . . . to all those Americans, good and solid citizens, who may not yet have been poked and prodded to see our mental illness crisis for what it really is.

It is a crisis that takes many forms:

It is a landscape . . . a landscape of humiliation and grief and ignorance and shame. A hell on earth for too many of the most helpless, the most dispossessed, the most misunderstood, the most feared, and too often the most brutally confined and punished for the crime of existing while insane.

The crisis is a graveyard . . . a graveyard of hope, where we bury our complacent myths of compassion and loving community. These qualities are just not evident in society’s dealings with the mentally ill.

And all too often, it is a literal graveyard—where we bury the bodies of our brothers and sisters—our sons and our daughters—whose lives have been needlessly sacrificed to the appalling indifference and outright cluelessness of the very institutions designed to protect them.

The crisis is a swampland: an economic swampland whose quicksand drains and drains our national treasury. America spends about as much as any country on mental healthcare. Around $230 billion a year, in federal, state, local and private funds. That is nearly twice the amount spent in 2012.

And we spend it worse than just about any country.

The great advocate and my friend Dj Jaffe lays it on the line: our government, spurred by lobbyists, pours money into treating high-functioning patients and on treatments that lack evidence.

I know that Pathways to Hope reaches out beyond the borders of chronic mental illness to help those with behavioral and addictive issues, and simple bad luck. Yet you take care of the core group, the chronically insane, as well.

But at the national level, Jaffe and others have a point.

The powerful blogger Pete Earley adds that we squander even more money by over-spending on emergency systems: jails and prisons, for example. Meanwhile, state mental hospitals are being closed.

Politicians love to build jails because voters think jails keep them safer. Politicians love to close hospitals because voters think this will save them tax money.

This gets it exactly backwards: housing an inmate with mental illness in jail costs $31,000 annually, while state and community mental health services cost about $10,000.

Those are NAMI estimates from three years ago.

Folks, America is getting fleeced! And America can’t or won’t see it! And so it goes on: a jail is built. A hospital closes. Fewer beds. less care, treatment, and medication. But more cells. And hundreds of thousands of chronically ill people—bipolar and schizophrenia sufferers—go untreated because the money doesn’t stretch to them.

Now I want to move to an area of spending on mental illness that is even less examined than the squandering of public dollars—but is perhaps even more catastrophic and dangerous to our social fabric down at Ground Zero.

I’m talking about the uncounted millions of dollars sacrificed each year by private households. By families. By parents who have no choice but to empty their bank accounts and their life savings, and often quit their jobs, to protect an afflicted child from going under.

I can’t give you statistics. There are no reliable statistics; not yet.

But I can tell you a couple of stories. Stories that represent hundreds of thousands of similar stories. Stories that I use with permission from the mothers and wives who shared them on a private Facebook site.

Here’s one:

“I have no way to go back and detail the cost to me and my family. I can say that the cost was tremendous. The expenses of traveling to the hospitals, the days lost at work because I had to be in the emergency room, or at a treatment team meeting, or in court. These things caused me to lose my job. More than once. So, how do you account for that? Thousands? Tens of thousands? And this is not counting paying for attorneys and doctors, neurologists and neuropsychologists. And medicine! And a locked safe to keep the medicine.

It’s tremendous, just a tremendous reality.”

This mother concludes:

“I retired way early because I am not able to work anymore.”

Here’s another, from the wife of an afflicted husband:

“Many years of paying rent and utilities before finally getting public assistance. Raising his children while his ex-wife recovered from breakdown due to his illness. Full time work cut to very part time, so I could be there for the grandchildren and to advocate endlessly for any kind of help.

Early retirement related to my own stress. Retirement pension a third of what it should have been. Paying for others to clean his apartments. Automobiles totaled at least twice. Expenses to keep him out of jail. Paying others to shovel out his filthy apartments so he doesn’t have his section 8 housing taken away. Vet bills for his dog. Transportation costs numerous times to get him home from yet another place he’s run away to. The long-term financial repercussions have been devastating.”

I think these two examples give us enough to think about. Or should.

So let’s move from the crisis of foolish spending into the crises of our hospitals, our caregivers, and criminal justice system itself.

America harbors two million, three hundred thousand incarcerated citizens at any given time. One-point-three million in state prisons. A little over half are serving time for violent crimes. The rest are in for property theft and drug convictions, and they should be somewhere else. Treatment, supervised community service. More humane, less expensive.

But no: lock ‘em up.

Jails and prisons breed psychosis like the Tropics breed mosquitos and grass breeds ticks. The Kaiser Foundation estimates that about eighteen percent of these populations live with serious mental illness. Serious meaning chronic. Incurable. Leaving the victim essentially helpless. I’m talking about schizophrenia. Bipolar affliction. And the rest of that happy little family. That amounts to three hundred eighty-three thousand insane inmates. Or about ten times the number of patients in our dwindling state hospitals.

I think everybody here can recite the following sentence in their sleep: “We are criminalizing mental illness.”

And yet, with the exceptions of certain oases such as San Antonio, we just keep on doing it.

We buy ever more cells, but never enough, and more solitary confinement: in my opinion, the cruelest, most unethical, most psychologically damaging and most worthless form of legalized torture in our criminal-justice system. Think of the descriptive nicknames: “The box.” “The hole.”

Yet jail inmates, most of whom have not been convicted of anything, keep getting shoved into solitary. Why? Because it’s there. A handy space in an over-crowded jail. And why are jails over-crowded? Mainly because of the stream of mentally ill kids who do not belong there. But are crowded out of hospitals.

Time in the box deepens psychosis. In Florida two years ago, a psychotic young man who’d been in solitary for two years tore off his penis with his bare hands.

One in eight jail prisoners in Florida lives in solitary. One in eight! About twelve thousand total. Out of eighty to a hundred thousand American inmates at any given time.

And the circle goes round and round. And solitary confinement goes on and on and on. Why? Because there is no substantial reform movement. So most Americans hardly ever give it a thought.

Solitary confinement is a national disgrace, and it must be abolished!

A couple more stories now. Stories have a moral force that statistics usually lack.

This from a mother whose brain-damaged son did some time in jail:

“First of all, everyone said that he should not be there. Doctors and other staff. It was known that he needed a real neuro psychological environment. To sum up years of suffering: The state knew, the state hospital knew, and no one did anything until I threatened a lawsuit, even then nothing, until I caught the division in a big lie with a brain injury facility.

The lack of training is unbelievable. State hospital employees don’t keep up with new findings, because they are not encouraged to do so. When I did find a good person, I made sure to tell the top administrator. Then that person was actually told not to talk to me anymore. Yes, buck passing and leaving my son to be secluded for years. I truly believe that the disdain is the word that tells our story. I would say to staff, ‘How can you sleep at night?’”

Listen to this message from the mother of a young psychotic son:

“One of the most shocking remarks said to me was when I tried to get our local hospital psych ward to keep our son over the 72-hour hold period. He was psychotic and refusing treatment. The nurse I pleaded with said, ‘You are his mother and he has a right to be crazy if he chooses.’”

This was said by a professional nurse in a hospital psychiatric ward. How many of you have heard variations of this remark?

Here’s another testimony from the mother of a psychotic child:

“The hotline sent two police officers to my house. When I asked them how they would approach the situation, one of the officers said, ‘If I feel threatened, I will shoot him.’ Based on this interaction, my husband and I declined their offer to do a ‘wellness check’ on my son.”

I will close off with two cases that have literally kept me awake at night. Because I cannot square either of them with any vision of an enlightened and just America.

Tyler West of Fruitport, Michigan

You know about Tyler if you‘ve been reading this blog.  I’ve written several times about him and his family. Tyler is the adopted son of Kimberlee and Dan West, two of the best and most civic-minded people I know.

Tyler was already suffering from brain-related afflictions when the Wests took him in as a small child. He is a small and dark-skinned and sweet-natured young man, and he has cognitive processing problems, including with language that is spoken to him. Later he was diagnosed with schizophrenia and autism.

These traits made him a target for repeated beatings in his childhood. Yet Tyler remained gentle, and developed talents for music composition and computer programming. He carried a comic doll around with him.

Still, his symptoms of psychosis deepened and he had trouble grasping reality. Two years ago, when Tyler was 16, he disappeared for about eleven hours with a 14-year-old girl. They both denied having sex, and no traces of semen were found. Still, a judged sentenced Tyler to five days in jail on a charge of statutory rape.

This sentence put Tyler in the crosshairs of local law enforcement. I will skip over several harmless misdemeanors and suicide attempts, not to mention futile efforts to have him civilly committed in a hospital or care center. Bed shortage, you see.

But I will tell you that Tyler’s brain continued to decompose. Disaster struck on a February night in 2017, when Tyler, in a mild psychotic state, wandered across his family’s lawn to a neighbor’s house, opened an unlocked door, and fell asleep on a sofa.

The neighbors discovered him and had him arrested on a charge of home invasion.

Tyler West entered the Muskegon County Jail on February 19, 2017, until June 29, 2018. Sixteen months, as his hearing date got postponement after postponement, During that time, he suffered concussions from at least four beatings from violent fellow inmates. He did stretches in solitary, and could be heard beating his head against a wall. He was deprived of regular medication.

Last June, Tyler finally got his sentencing hearing. The judge moved him to quarantine in a reception center for a month. He is now an inmate at the Richard A. Handlon Correctional Facility in Ionia, Michigan. Length of stay, undetermined. But he may be facing an 18-month sex offender class.

The whereabouts of Tyler’s comic doll are not known.

Okay, I have saved the worst for last. I ask you to please brace yourselves.

James Mark Rippee

This is James Mark Rippee.  He has lived on the streets of Vacaville, California, for nearly twelve years. He is schizophrenic. Thirty-one years ago, Mark Rippee suffered a motorcycle accident that left him blind, with head trauma, brain loss, and a shattered right leg that is kept in place with a metal rod. He has endured more than fifty surgeries. He is beaten and robbed regularly.

Mark Rippee’s brother and twin sisters cared for him for eighteen years, until they could no longer control his violent behavior. They have since petitioned every service agency available to them for help get Mark into a protected and therapeutic environment. Or at least a legal guardian, someone who would look after his finances and his needs for shelter, and food, and medical care, and safety.

Every agency has told them “No.”

Why?

The bedrock answer is that Mark Rippee has his RIGHTS!

He enjoys the “right,” the civil “right,” to refuse care and treatment. And in his disordered, shrunken state of reasoning, he exercises that right.

And that is all the caring agencies need to hear in order to turn their backs on this hopelessly brain-damaged man.

Here is Mark’s brother, Joseph Privatte.

“I have contacted lawyers, Adult Protective Services, The Public Defender, The Public Guardians Office, the police and fire departments, Mission Solano, five hospitals, several case workers, Laurel Creek Mental Health, the Vacaville Homeless Roundtable, the Solano County Health and Social Services Administration, the Vacaville mayor . . .”

..and he goes on. I’ve left out about half the agencies he has contacted.

And now listen to Mark’s sister, CJ Hanson, after she attended a meeting of the Solano County Board of Supervisors. They were seeking to have Mark designated as “gravely disabled” so that he could be involuntarily committed and receive protection from the county.

California law defines “gravely disabled as being unable to provide for one’s basic personal needs for food, clothing, or shelter.

The siblings’ mission failed. The Board of Supervisors, CJ told me in an email, “consider him self-sufficient if he can eat out of dumpster. They consider him self-reliant if he knows to cover himself with newspapers, or to sleep under a bush to try to stay warm. They consider him self-sufficient if he can panhandle.”

CJ wants to get the state to re-define what it means to be Gravely Disabled. “If my brother is not aware or capable of seeking medical attention, then he is not capable of being self-sufficient. The criteria now in use is archaic! It is disgusting! It is inhumane!”

And it is likely to remain in use for the foreseeable future.

I can’t predict the fate of Tyler West or James Mark Rippee. Or the tens of thousands of Tyler Wests and James Mark Rippees who suffer atrocities today because institutions of justice and reclamation have turned their backs. I’ll repeat it: suffer atrocities, in the landscape of ignorance and shame, the graveyard of hope, or the swampland of wasted resources, that make you wonder at times how far we have really progressed from the era of Bedlam Asylum in the London of the Fourteenth Century, where torture, demonic superstition, and shackles ruled the brief lives of the so-called idiots and lunatics and morons trapped inside its filthy cells.

I am tired of wondering. I am tired of passively complaining. I am tired of giving talks around the country that aim to stimulate the passion for reform, yet result generally in kindhearted applause and handshakes.

I am angry and frustrated, and I want action! I have chosen this gathering of Pathways to Hope as the occasion for two specific action proposals that I am willing to fight for, if enough committed people will rally along with me.

Proposal One is my call for the establishment of a federal Cabinet-level department, the Department of Mental Illness!

This Department will have broad powers of oversight and policymaking into federal, state and county levels of criminal justice: establishing and enforcing standards of education in mental illness among judges. Ensuring speedy trials for jail inmates and accountability in sentencing. Demanding accountability from jails in consistent, humane treatment and medication of inmates in psychosis.

And pursuing, with remorseless intent, the agenda of wiping out the great moral blight that continues to infect our jails, our prisons, and our claim as a civilized nation. I am talking about solitary confinement. It destroys minds! It does not rehabilitate! It is bestial! It must go!

That is Proposal One. A Cabinet-level Department of Mental Illness. Here is Proposal Two:

We must recognize mental healthcare for what it so clearly is: the civil rights issue of our time!

I’m not talking about symposia or a holiday or public-service commercials. I am talking about a national movement! Built around a charismatic figurehead. Someone who can ignite and fuel an ongoing national movement. A galvanizing male or female member of Congress, perhaps. A retired statesman. A member of the clergy. A leader from the world of business. Someone from the ranks of Project Hope. Or someone we have not yet heard of.

It is a civil right to live with hope and dignity. Other movements have recognized that and have broken through. Now it is our turn.

In 1939, the great John Steinbeck published his novel The Grapes of Wrath, on his way to winning the Nobel Prize in Literature.

The novel was an indictment of cruelties visited upon American migrant farmworkers, traveling west to California to find survival work in the Great Depression.

One of its immortal passages described the shock—the sense of violation—that these starving migrant workers felt as they looked upon acres and acres of rich ripe fruits and vegetables that had been strewn across the land to rot, because the owners did not want to pay decent wages to the migrants for harvesting them.

Here is what Steinbeck wrote:

“There is a crime here that goes beyond denunciation. There is a sorrow here that weeping cannot symbolize. There is a failure here that topples all our successes.”

Do those lines remind you of anything going on today? We have work to do; the work of reclamation. Let’s get to it. Thank you.

Top 10 Books of the Year

The Best Books of 2017

People magazine just named No One Cares About Crazy People one of The Best Books of 2017.

Click here to order a copy today.

 

Another Solitary Confinement Atrocity

This horrific story, originally reported by the excellent Milwaukee Journal-Sentinel and picked up by Slate a couple days ago, is yet another demonstration of my assertion in NO ONE CARES ABOUT CRAZY PEOPLE that “too many of the mentally ill in our country live under conditions of atrocity.” Terrill Thomas’s death by slow, deliberate, guard-induced dehydration while in solitary confinement at a Milwaukee County jail is an abomination, and a part of a larger national abomination. Our society must demand an end to solitary confinement!

Via Slate.com

Guards Who Left a Prisoner to Die of Dehydration, After Water Was Cut for Seven Days, Could Face Charges

Read the full story here: http://www.slate.com/blogs/the_slatest/2017/04/24/guards_who_left_milwaukee_prisoner_to_die_of_dehydration_in_cell_could_face.html

A Penetrating Review From a Dear Old Friend

Mike Miner and I were inseparable buddies in our last year in the School of Journalism at the University of Missouri. In those lamb-white days of spring 1963 that meandered innocently toward the world-shattering assassination of the following fall, we rollicked through the kind of friendship that has mostly gone missing in the present world of dread and suspicion and the bristling arsenals of hip.

We played some college pranks. One of them I think involved a football in a classroom; I can’t remember much more than that. We covered sports together for the J-school daily newspaper, we got permission to resurrect the campus humor magazine, Show Me (recently banned for, horrors, profanity). We saved our quarters and pooled them to treat ourselves once a month to a $1.50 pizza in town. We went to the movies and entertained grateful patrons around us by shouting wisecracks at the screen. We showed our Brando-esque wildness (“What are you rebelling against?” “Whadday got?”) in other ways: by sliding saltshakers across restaurant table surfaces, hoping they would hover on the very edge, until one didn’t and the waitress rushed at us.

You know. Wild stuff like that.

And we talked and talked. About the “future.” About what we would “be.” And we wrote and wrote. Newspaper articles, jokes for the humor mag, stuff.

We kept the friendship together after graduation. Mike went into the Navy and I wangled a magazine assignment to Hawaii that coincided with his ship docking at Honolulu, and we did that town. (Saw the John Wayne/Patricia Neal navy movie “In Harm’s Way” together; walked out of the movie theater verklempt, although we’d never heard of that word then. Drowned ourselves in chocolate milkshakes.) Then I went back to Chicago and Mike went off to the South China Sea.

He made it through. After his tour was over, we newspapered together in St. Louis and then Chicago. Toured Ireland and London, and my easy, delightful companionship tested the limits of Mike’s capacity to long-suffer.

And then. . .you know. . .time is the longest distance between two places. . .I headed to New York; Mike stayed in Chicago.

I always believed that Michael was destined to be the major writer between us. He knew theater, and knocked out several good plays and wonderful poems. His wit was sly and dry, and his literary gifts even then were enormous. He was better than I ever was. Still is.

And lo and behold, he did become the major writer. At a weekly paper called The Reader, he has built a name for himself as an institution of superb, intrepid reporting and a writing style that could keep company with Ben Hecht, Mike Royko, all those Windy City giants. Whereas I was kind of a nomad, Mike committed himself to a place, and mined it deeply for story. Some other pretty good writers have done that. Faulkner.

We kept in touch a little. Facebook made it easier when it came along. Still, it was sporadic.

In July 2005 the “future” arrived for me. Right between the eyes. My younger son Kevin, deep in schizoaffective disorder, hanged himself in the family basement.

A decade later I got it together enough to write my book about mental illness: NO ONE CARES ABOUT CRAZY PEOPLE.

And then, this week, my old friend Mike showed up again. In the form of the review that you will find below.

You talk about verklempt. You talk about friendship.

Thanks, Mike. Game of saltshakers sometime?

In No One Cares About Crazy People a father addresses his sons’ mental illness

COURTESY RON POWERS
Ron Powers’s sons Dean, left, and Kevin, right, pictured here as children, both later suffered from schizophrenia.

As you read No One Cares About Crazy People you might think it’s two books or you might think it’s one. There’s the book author Ron Powers tells us that he set out to write—a critical history of societal responses to mental illness—and there’s the personal story that compelled him to write this book—the raising of two sons who became schizophrenic, one of whom killed himself. An agent told Powers that to write one he must write the other. And so he has.

For a time beginning in college and continuing to the Sun-Times—where he won a Pulitzer Prize for TV criticism in the early 70s—Powers and I were close and had the forward-looking conversations young men have. Never—I repeatedly thought as I turned the pages of Crazy People—did anything cross our imaginations close to what lay in wait.

Crazy People is his response to that rendezvous. It draws on the wit and anger I remember, on research compelled by circumstance, and on paternal devotion then untapped in either of us. Powers has collaborated before—with Ted Kennedy on Kennedy’s memoir, and with James Bradley on Flags of Our Fathers. In Crazy People, Powers, the reporter and stylish writer, collaborates with himself, the father with a story.

The social history of mental illness, no reader will be surprised to learn, is doleful.

“The world of mental illness,” Powers writes, is everywhere; it hides in plain sight. “Its camouflage . . . little more than the human instinct to reject engagement with the pitiable, the fearsome, the unspeakable.”

Rather than illness we’d see witchcraft; rather than humans in need we’d see menace, and we’d feel a duty not to assuage agony but to hide it from sight. The places where the mad were hidden gripped the public imagination for their gothic mystery. Powers tells the centuries-long history of the London madhouse known as Bedlam; in Saint Louis, as he surely remembers from his years there, an institution for the mentally ill was known to one and all simply as “Arsenal Street.”

You kept your distance from Arsenal Street.

Mental illness can hide in plain sight because we don’t like to think about it. But take your own inventory as I take mine. Two members of my book group have grown schizophrenic children. One daughter’s closest childhood friend is schizophrenic; another daughter’s grade school Spanish teacher lost her husband when he was stabbed to death during a psychotic breakdown by their schizophrenic son.

Powers and his wife, Honoree Fleming, raised sons Dean and Kevin in Vermont, where Powers wrote and Honoree, a professor, taught biochemistry and did research. Both sons were bright and creative, and Kevin was a guitar prodigy. The instructors his parents found for him soon threw up their hands—they had no more to teach him. But he was not yet 21 when he hanged himself in the basement of his family’s home.

Do madness and creativity go hand in hand? Powers devotes a chapter to this ageless question, to which there are correlations to be cited but no clear answer. Asked by a teacher in grade school to identify human needs, Kevin wrote, “I need music.” He inhabited, his father tells us, an “inaccessible” inner world of music, though the yield of that world can still be sampled today, as in a concert at Interlochen and an album the two brothers recorded together.

Powers places emphasis on the power of stress to trigger psychosis, and much less emphasis on the role of genetics, though years earlier his own younger brother had killed himself. Creativity and stress were palpable presences in the young lives of Dean and Kevin, and it’s those lives that preoccupy their father.

One Friday night toward the end of Dean’s junior year of high school, he took a curve too fast and his car slammed into a tree. The understanding around town was that Dean had been drunk, though he wasn’t. The girl next to him suffered injuries she was years recovering from, and her parents crusaded to see Dean thrown in prison. The high school principal banned Dean’s picture from the yearbook. Awaiting sentencing, prison a clear possibility, Dean wrote, in an essay, “my life is like a river and I am being swept away helplessly.”

And in Crazy People his father writes, “These were the days and months and events, I am convinced, that launched my eldest son into his rendezvous with schizophrenia.”

But today, Powers reports, Dean’s last psychotic episode a few years behind him, “he seems in possession of himself, aware of his limitations, and ready to live on his own in the wider world.”

Powers also introduces readers to a word I’d never heard or read before: anosognosia, or, “the false conviction within a person that nothing is wrong with his mind.” Powers calls it a “cruel joke.”

I’ve always supposed the joke is that when the meds work they make the patient feel so clear-headed he decides he doesn’t need them any longer. So he hides his meds, as Kevin did, or flushes them down the drain. Then he reverts. Confronted, he lies. But Powers says changing a patient’s ways isn’t as simple as screaming sense at him or waiting for him to learn from experience. He says anosognosia is actually a physiological condition disrupting the brain’s ability to recognize the condition it’s in; it shows up in 50 percent of schizophrenia cases and 40 percent of bipolar cases.

As his book concludes, Powers puts anosognosia to use as a symbol of obliviousness and denial—our own. He has seen what the mentally ill ask of the world—which is simply a place in it.

“The mentally ill people in our lives, as they strive to build healthy, well-supported, and rewarding lives for themselves, can show us all how to reconnect with the most primal of human urges, the urge to be of use,” Powers writes. “To put it another way: the mentally ill in our society are awaiting their chance to heal us, if we can only manage to escape our own anosognosia and admit that we need their help.”

Does putting the shoe on the other foot this way seem a sentimental stretch? I would say yes—if Powers were writing only about a set of issues he wanted to wrap up in a fancy ribbon. But the project’s too personal for that. He’s told us stories about the mentally ill burned at stakes, chained in dungeons, flogged and lobotomized, and treated to à la mode theories that they’d do just fine if turned out onto the streets, that they aren’t really ill at all because crazy people are the only sane ones. This is the history of society’s predisposition not to give a damn about Dean and Kevin!

And Powers won’t have it. They speak and we must listen. They are his sons.

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Adventures in Audioland

ron powersBack in the Friendly Confines (credit to Ernie Banks) of Castleton after completing work on the audiobook version of NO ONE CARES ABOUT CRAZY PEOPLE. The project was accomplished at a beautiful, hilltop, state-of-the-art recording sound studio, Guilford Sound, in the woodsy Green Mountains of Southern Vermont. http://guilfordsound.com/ The owner is the innovative former rock drummer Dave Snyder.

ron powersFar from an easy job (imagine filibustering a bill for four and a half days, or being Chris Matthews), yet worth the throat-tearing effort on a number of levels.

The process put me back in touch with the book in a far more concentrated, analytical way even than the process of writing it, which was strung out over more than two years.

Also, it amounted to a good prep (I hope) for any interviews that might come my way.

Finally—a bit of inside baseball here—no more foolproof method exists for detecting flaws in one’s work than reading it aloud. And yes, dammit, I came across some passages that cried out for further attention–including matters of repetition, which is one of my bad habits. Including matters of repetition, which is one of my bad habits. Ha-ha! a little writerly humor there!!
The process is highly physical. Reading aloud involves the entire body, even when one is sitting down. (I was often distracted by the vigorous circling motions of my own right hand as I read; and my creaking chair caused an unseemly number of re-takes.) The strain of it makes you aware of certain muscles in the throat that you seldom use to the point of stress. You become aware in part because, late in each day, you find that you cannot count on these flabby muscles to form the sounds you expect them to; they’re tired of it. Your mouth might be forming an “O,” but what comes out is a measly little “eeeee.” So you pause to go back and do it again, hoping to get there before the producer blares in your headphones, for about the eight hundred nineteenth time, “COULD YOU GO BACK AND DO THAT AGAIN?!”

A sip of water helps, but the price of sippage is seepage. Audible seepage. You must sit still for several seconds while the sip makes its way through your digestive system, every drip and gurgle of the journey dutifully recorded by the CIA surveillance-grade mic in front of your face, put there to ensure that no sound gets lost in the telephone-sized booth in which you are being held without bail.

You realize—horrors!—that the process does not stop when the workday ends. When at last you are ensconced in a booth in a local diner, reading the newspaper while spooning up the chili con carne, you come to a Twilight-Zone kind of realization: as you silently read the words on the page, you can hear yourself narrating them through your mind’s ear, in the same annoying singsong voice you have been spewing forth all day, as you involuntarily calibrate which syllables just ahead need theatrical stressing.

And here you thought showbiz was pretty.

What I liked best about the experience was the collaboration: with the very cool young sound engineer Matt Hall across the window in the Vermont studio (see photograph), and with an amazing blithe spirit and gifted producer named Bob Walter, who directed everything through our earphones from his own studio in Los Angeles. Bob immersed himself fully in the nuances of the book, and coaxed me gently into more fitting intonations at several points. The three of us were Very Professional and Serious in the early going, until we (inevitably) stumbled upon the realization that we were all born world-class wiseasses; at which point every “COULD YOU GO BACK AND—” break in the narration was filled by an interlude of wacky voices, improvised shtick, name-dropping and outrageous insults. Our antics kept the inevitable tension at a minimum and made the hard work go easier.

All of this in the service of an audiobook that I hope will convey my full measure of love for my beautiful sons, Dean and the late Kevin, and my passion for illuminating the great human tragedy of schizophrenia, the affliction that took over their lives yet did not manage to extinguish their soaring human spirits.

The audiobook is in post-production as I write. Plans are to integrate excerpts from the boys’ guitar performances as they coincide with elements of the narration.

A GIFT OF WRITERLY UNDERSTANDING—THANKS, MS. CAHALAN!

People tend to believe that writers write to make money. There’s actually something to that, given the givens. But dollars are not the only motive. Not all writers are obsessed with chasing the Golden Fleece of the Best Seller—not after building up the scar tissue of a few published-but-obscure books, anyway.

It has been my experience that writers who survive their shattered early dreams and press on are writers who care about the craft of writing. These writers write mainly to be understood.

This is why the endorsement of NO ONE CARES ABOUT CRAZY PEOPLE, written by Susannah Cahalan and posted below, means something special to me.

Photo Credit: By Pam Margolis [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons
Photo Credit: By Pam Margolis [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons
Ms. Cahalan is the author of the 2012 New York Times bestselling memoir BRAIN ON FIRE: MY MONTH OF MADNESS. I have never met Ms. Cahalan, so I can’t say for certain whether or not she set out to write a best-selling book. My instincts tell me that this was a secondary consideration at best. My instincts tell me that she wrote this book for the reason most writers write good books. She wrote it because it was a book that she could not not write. She wrote it to be understood.

Susannah Cahalan was a young rising star of New York journalism and an avatar of the Fabulous life when at age 24 she was blindsided by a hideous brain affliction—triggered by a mysterious pathogen—that inflamed her brain, drove her to grotesque behavior, and threatened to obliterate her very identity. She was saved, and restored, through the intervention of an acutely observant physician after nearly everyone else had decided that she was a hopeless schizophrenic. In a sustained act of will nearly as arduous as the attack on her brain, she traced the narrative of her temporary madness by interrogating her own damaged memory and those of her relatives and friends. The result is a raw, eloquent, unsparing narrative of personal witness that now stands as a beacon for those who don’t understand the forces that can ravage our fragile brains, but who want to understand. Susannah Cahalan wanted to understand, and then to be understood.

I’m going on here a bit because I want to make it clear how much I value Ms. Cahalan’s notice, on two levels: first, as one “citizen” of the mental-illness sub-nation reaching out to another, and second, as a writer reaching out to a writer. We writing creatures are a lot less secure in our self-evaluations than you might expect by looking at our, uh, deathless prose. We spend a lot of time wondering whether we are making an imprint on the world, or even making sense.

Susannah Cahalan, you understand, and you deserve to be understood. Thank you.

 

SUSANNAH CAHALAN’S NOTICE:

“No One Cares About Crazy People” is a woefully necessary kick in the teeth to society’s understanding and treatment of mental illness. Reading Ron Powers is always an event — you can expect expert research and rich reporting in an engrossing style — but what makes this book soar is the passion of Powers’ conviction based off his own intimate experiences with schizophrenia. I put this book down days ago and I’m still reeling. It’s the rare book that breaks your life into a before and an after.

Kevin and the Perfect Playboy Woman

Kevin Powers
Ron’s favorite photo of Kevin

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

Ron Powers/VPR Commentary

Kevin and the Perfect Playboy Woman

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

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

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

BULK RATE U.S. POSTAGE PAID BY PLAYBOY

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

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

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

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

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

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

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

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

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

“Pretty. . .” he added.

“Who doesn’t smoke.

“A very nice attitude.

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

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

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

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

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

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

“It’s gross.”

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

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

SOMETHING IS—MISBEGOTTEN—IN THE STATE OF OREGON

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

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

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

But why?

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

But is Oregon really suffering a budget pinch?

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

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

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

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

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

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

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

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

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

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