There have been many nights over the past 28 years when Judy Wilson of Albany has lain awake, staring at the bedroom ceiling until the darkest hours of early morning. The aching knot in her stomach has grown tighter and tighter as she has prayed for the telephone to ring.

Perhaps the most trying nights, though, were when the phone didn’t ring.

Would this be the day her son, Bruce, diagnosed with schizophrenia at age 19, chased away imaginary demons by driving his car off a bridge in Portland? Or would he be robbed of his meager Social Security check, his lifeless body left on cold, iron railroad tracks by another homeless soul also struggling that day to discern between reality and make-believe?

Like one out of every five families in America, Judy and Virgil Wilsons’ lives are entwined with a mentally ill family member. Their son, Bruce, now 47, lives on his own in Corvallis and works part time at Oregon State University, but the Wilsons, both retired, know that a portion of every day must be devoted to his well-being.

That may mean budgeting monthly expenses, ensuring that he has — and takes — the proper medications that keep his life on an even keel, or lobbying politicians in Salem to protect the rights of the mentally ill.

“I remember when Bruce was diagnosed as paranoid-schizophrenic. He had just turned 19. It was a horrible shock,” Judy said. “I drove down the freeway thinking ‘Oh my gosh, what did I do wrong?’”

Frank Moore, director of the Linn County Mental Health Department, said that too often it’s not until the mentally ill reach the stage where they are a threat to themselves or others in the community — either by acting out or by repeated conflicts with law enforcement — that they receive care.

Such was the case recently when Richard Dean Townsend, 50, was shot and killed by Corvallis police officers after his outbursts escalated over several weeks and numerous interactions with the law. As with many mentally ill people, alcohol and other drugs may have been a factor in Townsend’s behavior and ultimately his death.

In an affidavit for a search warrant filed in Benton County, District Attorney Scott Heiser said, “Mr. Townsend was seen by a caller ‘mowing the street’ and waving rags at passing motorists.” Officers reported that Townsend was armed “with a piece of metal rod” and he was “in a combative and agitated state.”

Heiser said that after 16 years as a prosecutor, his experience with the mentally ill shows they often “have health issues that have not been successfully managed or treated and often times leave signs of their mental distress, and even the degree to which their mental health has been compromised, in the manner in which they live, including, without limitation, signs of how they keep their house, evidence in the form of writings, journals or other logs.”

Other signs include “prescribed medications that have not been consumed; and illegal street drugs that mentally ill persons will use to ‘self-medicate,’” he said.

Judy Wilson said she was saddened by news of Richard Townsend’s death and wondered aloud, “What can we do for his mother?” Often, the families of people with mental illness suffer without a place to turn to for help.

There are hundreds of people like Bruce Binkley or Robert Townsend in Linn and Benton counties. About 2,500 received outpatient treatment or support from the Linn County Mental Health Department in 2004. Others don’t get help until their condition becomes severe enough to warrant interaction with law enforcement agencies.

Still others fall through the cracks, especially the working poor, who make too much money at minimum-wage or part-time jobs to qualify for state and federally funded care but too little to afford the hundreds or thousands of dollars their medications cost each month.

“I am Bruce’s housing advocate, and I was just preparing his budget,” Judy said, pulling out several pages of white notebook paper. “Bruce gets $851 a month from Social Security Disability and he averages about $405 per month working at OSU. That’s $1,256 per month, or $15,072 per year. His housing costs average $473 and his out-of-pocket medical expenses are $530. His medications cost about $1,250.”

Since 2003, when the government’s Medically Needy Spend Down Program was eliminated, Bruce has benefitted from the Pharmaceutical Patient Assistance Programs offered by some drug companies.

Judy and other advocates are now trying to understand how the new Medicare Part D regulations will affect the mentally ill beginning in January. They have many questions about how medication costs will be covered under the new plan.

Over the years, Bruce has been homeless many times, Judy said. It’s a great fear for the mentally ill. If they are fortunate enough to have an apartment or house, they are often taken advantage of by others who move in and sleep on their couch, or use their phone to make long distance calls without paying for them.

Frank Moore agrees with Wilson when it comes to the working poor.

“People working 40 hours per week for minimum wage get little, if any, health care,” Moore said. ” What we need is a 24-7 crisis service that would provide treatment including children and family mental health programs, adult mental health, crisis services and pre-commitment services.”

“Bruce was involved with alcohol and drugs until 13 years ago,” Judy said. “Many times, mentally ill people drink or do drugs to try to make the voices they hear go away. In time, they have two problems — mental illness and addiction.”

Moore said Linn County’s alcohol and drug program provided outpatient treatment services to 410 chemically dependent adults, 145 substance abusing youth and their families and 67 adults and youth with gambling problems.

Unlike some parents, who become frustrated by a maze of government rules and regulations concerning their children, the Wilsons have educated themselves to become mental health activists. Virgil is Bruce’s stepfather and his career was in the aerospace industry. Judy has degrees in sociology and psychology.

From 1994 until September of this year, Judy headed up Mid-Valley Housing Plus in Corvallis, which provides support for mentally ill people in the area. When she retired, the group was assisting 60 people to find housing or employment, plus provide general support. The Wilsons also are co-chairs of the local chapter of the National Alliance for the Mentally Ill.

Judy said there have been major advances in medicine in recent years that have greatly aided the mentally ill. That is if they can afford the medications and — just as importantly — if they will take them every day.

“For many mentally ill people, the cost of medication is so high they often have to choose between their meds and eating,” Judy said. “Or, when they get to feeling better, they don’t think they need their medications anymore. It’s an endless circle.”

Bruce has been helped by a drug call Clozaril. “It has made such a difference in his life,” Judy said. “It helps him think rationally, more clearly. He hasn’t been in the hospital, or jail, since he started taking it.”

But, she acknowledged there are still times when Bruce has to struggle with depression, or when an anxiety attack sets in.

“There is no cure for mental illness, but we do know what things help,” Judy said of recovery. “The key is finding the right combination of medications that work for the individual to find their particular balance.”

Thanks to medication and a job coach, Bruce has held a job at OSU since 1992, first on the grounds maintenance crew and, more recently, three hours a day in the lock and key department. Over the years, he has been hospitalized 30 times, including stays at the state hospital in Salem.

As thankful as they are that things seem to be going smoothly, the Wilsons admit that changes in government programs such as Medicare could greatly affect their son’s life.

For example, Bruce now pays $62 for twice-monthly blood tests associated with the use of Clozaril.

Some mentally ill people, who depend on rent subsidies from the Department of Housing and Urban Development, are frightened those subsidies may be reduced. Yet rent continues to escalate in Oregon and across the country, far outstripping the minimum wage earned by many mentally ill people, Judy said.

“Twenty-five to 30 percent of homeless people have some form of mental illness,” Judy said. “About 1992, we got a call from Bruce, who was still living in California. He had been sleeping near the railroad tracks and some guy picked him up, drove him into the desert and threw him out. There are people who like to do those things to the mentally ill.”

Bruce has lived off and on with his parents over the years, but even those times can be difficult for family members.

“He would pace the floor all night long. We were afraid to go to sleep,” Judy said. “There are many families who don’t have a clue where their loved ones are every night.”

Alex Paul can be reached at alex.paul@lee.net or 812-6076