A decline in services leaves families struggling to get help for their loved ones

By Gwyneth Gibby

Corvallis Gazette-Times

A person with serious mental illness may find it easier to get a bed in jail than in a hospital. According to mental health professionals, there has been an erosion in services to help those with mental illness over the past 25 years - with no end in sight.

U.S. Bureau of Justice statistics indicate that 49 percent of inmates in state prisons have symptoms of mental illness. In local jails, the figure is 60 percent.

Unless people have private insurance, there are stringent requirements to be met before they can be admitted to a hospital's mental health facility.

"Somebody has to be determined to be a danger to themselves or others," said Mitch Anderson, director of Benton County Mental Health Services.

Such questions as whether they are voicing threats of suicide during an evaluation and whether they have access to weapons are considered. With the decline of funding for services, Benton County, like other jurisdictions, has to "triage people in crisis," Anderson said.

It can be a heartbreaking problem for families. But there is help out there.

One organization that can help is the National Alliance on Mental Illness. NAMI offers a class called Family to Family that gives relatives and friends of people with mental illness information, support and a network of people who are going through the same tough times. The next 11-week class begins this Thursday.

MaryAnne Sellers has personal experience with these issues. After taking the NAMI class last fall, she wanted to tell her story to help more families. She has a family member who is mentally ill and has been suicidal.

Sellers has asked the Gazette-Times not to use the relative's real name to protect her privacy. We will call her "Katherine."

On March 12, Katherine put a knife to her own throat and threatened suicide. Sellers called the police, but by the time they arrived, Katherine had taken off in her truck. She was gone all night.

"The next morning, she came back and a police officer managed to talk her into going to the emergency room," Sellers said. "They let her go after the mental health person from Benton County Mental Health said she didn't need to stay because she wasn't being actively suicidal at that moment, even though she had been the night before."

Sellers was dismayed.

"I was so naïve. I thought you go to the hospital when somebody's that sick - they take them. Well, they don't. Especially if they don't have health insurance."

A few days later, Sellers and a friend talked Katherine into going back to the emergency room.

"And the doctor came out to me and said, 'She's really - she's going to stay, I'm sure they're going to keep her.'"

But the same county mental health worker again released her, this time with the plan that she would either sleep outside or go to the Community Outreach shelter. Several days later, Katherine reappeared - dirty, scratched and looking exhausted.

"You know, you get your hopes up, and it's not like it's for a Porsche or something - all you want is help," Sellers said. "It's the same thing the police officer said to me. He said, 'You know, it is so frustrating' - cause he called me after they let her go when he took her in - he said, 'We finally get these people in, we don't know what to do with them. We take them to the hospital, they let them go. We see them more times.'"

A few days later, Katherine went to confess to law enforcement officers that she had killed someone. Officers realized that she was delusional and let her go.

A week later, Katherine was in Eugene leaving suicide notes at the home of another relative.

"That morning I got a call from her saying that she wanted me to buy her a rifle," Sellers said. "And she hung up."

Oakridge police pulled her over for a traffic violation, and Katherine tried to grab an officer's gun. When they talked to Sellers, they told her that in view of Katherine's history she might have been trying to "commit suicide by cop."

A mental health facility in Eugene also refused to take her. So she went to jail.

Katherine pleaded guilty but insane to charges of unlawful use of a weapon and assaulting an officer. She was sentenced to 10 years of psychiatric review.

Katherine has been in the Oregon State Hospital forensic unit for more than nine months. Although a Benton County mental health worker had decided she was well enough to be released repeatedly from Good Samaritan in February and March of 2006, by May she was under 24-hour suicide watch, with two attendants. That watch continued for almost nine months and was reduced to a one-person watch last week, according to Sellers.

Sellers said she was told by psychologists at the state hospital that Katherine was likely to be there for at least two more years.

"She's gradually improving," Sellers said.

Mitch Anderson said when Medicaid funds were cut in 2003, a large number of people who had been receiving treatment were knocked off the rolls. And counties ended up picking up the costs.

Lt. Scott Jackson, commander of the Benton County Jail, said he has seen more and more mentally ill people brought in over the past few years. People with obvious symptoms are housed in isolation cells where they can be closely watched. As long as they're in jail, they are not a danger to themselves or anyone else. So those people will not be admitted to an inpatient facility.

Corvallis does have shelters for homeless people who are mentally ill. Rich Donovan, executive director of Community Outreach, a nonprofit social services agency that operates several emergency housing programs, said they do take people who were taken to the emergency room but not admitted to the hospital - but they can't take everyone. Particularly since Community Outreach houses women with children, it's not always appropriate to take women who are in a mental health crisis.

Donovan also emphasized that having insurance helps in trying to get people into a hospital.

"A lot of times the benefit of the doubt will go to the patient if Blue Cross is there," he said.

Sellers and Anderson suggested that mental illness is still considered shameful in our society. People don't want to talk about it. But it affects all of us.

"It's not in society's interest to have people wandering around who are that mentally ill, either," Sellers said. "I mean, if we start putting the money in at the beginning of the problem instead of at the end of the problem, I'm sure it would be economical."

For more help

The NAMI Family to Family Education Program will meet at 7 p.m. Thursdays starting this week in a ground-floor conference room at Good Samaritan Regional Medical Center in Corvallis. The free course is intended primarily for family members of mentally ill persons. For more information or to register, call Dianne Farrell at 745-5070.