Mental Illness Pushes
Families to the Limit

Across the country, the families of the seriously mentally ill are stuck in an all-consuming struggle to save the sick from themselves.

(Dec. 19, 2004) - Bill Weaver Jr. could see the devil in his old man's eyes. Weaver lashed out at his father's every move and turned his retirement into an endless misery.

Alone together in their condo in western Miami-Dade County, they were locked in a pitched psychological war. One night, Bill, who is schizophrenic, leapt out of the dark and tried to smother 77-year-old William Weaver with a blanket.

Weaver escaped his son and called police, hoping the criminal justice system would help him -- a move he will forever regret.

In the psychiatric ward of the Dade County Jail, Bill dived headfirst from his bunk bed in a manic fit, hit the rim of the toilet and broke his neck. Doctors don't know if he will walk again.

Like so many others, the tragedy lays bare the perils of untreated mental illness and highlights the desperate struggle of relatives to get a disturbed family member into treatment.

Florida's poorly funded and fragmented mental-health system, combined with laws that protect the rights of people to refuse treatment no matter how dysfunctional they are, all but block the path to sanity.

"The law protects the right to be psychotic," said Rachel Diaz, who runs a group in Miami called Families of Untreated Mentally Ill Persons. "Even though, by definition, they are not able to think clearly, we give them that choice."

At a time when new medications can do more than ever, an estimated 92,000 adults and 79,000 children in Florida with serious mental illness do not get the treatment they need.

The social consequences are disastrous: rampant homelessness, suicide, drug abuse, prostitution, overcrowded jails, tragic police shootings.

But one consequence of a deficient system is kept vigilantly behind the closed doors of thousands of homes: the ceaseless, all-consuming battle families fight to keep those they love from becoming a part of these statistics.

They give up jobs and personal lives. They secretly slip their children medication. They battle to convince the afflicted that they are sick, only to be berated, accused of persecution. They pray when their troubled children disappear for weeks and brace for the storm when they come back.

PROTRACTED ORDEAL

Years and decades pass and their adult children are still at home going through the same tortured cycles.

"It's living with a person who insults you, who doesn't obey you, who doesn't appreciate you, who doesn't love you," said Diaz, 80, whose husband is schizophrenic. "It's a miserable life."

Weaver tries to roll with his son's hostility. Since the accident last year, he visits Bill, now 44, at a nursing home in Allapattah three times a week.

Thursday, he took him a lottery ticket. Bill appreciated the visit at first. But his thoughts quickly took a turn.

"I wish you would die," he said, rasping through a dry throat. "Go home and die. You ruined my life. I really think you are the devil."

The two argued for a half hour.

"Maybe I'm wasting my time," Weaver sighed. "He doesn't seem happy to see me."

NOT COMPREHENDING

Nationwide, an estimated 4.5 million people suffer schizophrenia and manic depression. Half do not have the ability to understand that they are sick, experts say.

"It's a real dramatic inability to see what's so obvious to everyone else," said Xavier Amador, a Columbia University psychology professor and author of the book I Am Not Sick, I Don't Need Help!

"You hear the same stories over and over and over."

The last year of Maria Santos' life has been a case study in how a family gets stuck in a psychiatric sinkhole.

No matter how many people tell her 28-year-old son Frankie that he is schizophrenic, no matter how many times he ends up in a crisis center, no matter how many times he is locked in jail for disorderly conduct, he refuses to believe he is sick.

"They call me a schizo," he whispered to a reporter in November. "I think I'm just thinking outside the box."

He lives at his parents' Southwest Miami-Dade home, cannot hold a job and considers himself a "scholar warrior." He thinks God "inserted" him on Earth for a divine intervention. He is festooned with grandiose tattoos -- the words "King One" cover the side of his neck.

Frankie experienced his first psychotic episode at 18, and he lay naked in a fetal position in his bedroom for days.

Santos is at her wits' end. She watched Frankie's schizophrenic father drive himself into homelessness.

To keep Frankie from the same fate, she is a full-time mom with no end of her work in sight. She has no friends, no hobbies, no job. She's always strategizing, slipping him medication, anticipating the next eruption. The schizophrenia never rests.

And on Dec. 5, 2003, it detonated out of her reach.

A PAINFUL CASE

The family was flying back from a wedding in Spain. Frankie began acting up on the plane. Before anyone could restrain him, he punched a passenger in the face several times.

The U.S. attorney indicted Frankie for assault. He was placed under house arrest until his sentencing, scheduled for June 1 of this year.

But for someone with a deteriorating state of mind, rules and court conditions are abstractions easily lost in the throes of psychosis. And that's what happened to Frankie just weeks before his hearing.

"He started going crazy," said his stepfather, William Santos. "He was convinced he was Jesus Christ."

Frankie stormed through their home, kicking walls, slamming doors, screaming at voices. He took a steak knife to the electronic monitoring device on his ankle.

William called 911.

When police arrived, Frankie shouted obscenities and kicked in the air, as if he were a martial-arts master. Miami-Dade police shot him with an electrical stun gun, handcuffed him and took him to Jackson Memorial Hospital's crisis center.

U.S. marshals removed him the next day. Frankie's acts of psychosis violated the terms of his house arrest.

He spent the next five months in federal custody -- shipped from Miami to Atlanta to North Carolina to Oklahoma -- getting psychological evaluations for an illness everyone knew he had.

His time in custody cost taxpayers at least $10,000, and Frankie came out unmedicated and on the same destructive trajectory he was on before.

At his sentencing hearing on Oct. 15, Maria Santos took the stand and begged the judge to not give Frankie probation. She knew he would violate it.

"He is very, very sick," she cried in broken English. "He is crazy. He need medication for a long, long time. Please, please."

She wanted the judge to commit him to a state hospital.

She continued: "For 10 years, he goes to the jail. He goes to my house. He goes to jail. He goes to my house."

But U.S. District Judge Alan Gold didn't have a legal reason to hospitalize him, and he didn't want to release him altogether. Gold gave Frankie 2 ½ years' probation and ordered him to see a psychiatrist and call his probation officer every day.

He was released that day.

"Back to square one, back to square one," William Santos sighed.

At home, Maria Santos immediately began slipping medication into Frankie's Malta Goya drinks. She had no other choice. This kept Frankie marginally in control. But by the end of the month, he spotted some sediment in the glass. He stopped eating and drinking anything his mother gave him.

Earlier this month, Frankie holed up in his room, blasting music. Maria opened his door. Beer was all over the place. He had defecated on the floor.

He was yelling and cursing.

"Get out of my life! Leave me alone! I'm sick of this life!"

"We don't know what to do," said William Santos. "Nobody seems to know what to do."

Frankie landed -- again -- in Jackson's crisis center, where doctors forcibly injected him with Depakote, a mood stabilizer. His mother took him pizza and clothes, but he glared and blamed her for his confinement.

He was released Wednesday -- back home.

PERSISTENT STIGMA

Even as science increasingly reveals that schizophrenia and bipolar disorder are medical conditions, mental illness still carries the false stigma of moral defect, flawed character, weak emotions, murky souls -- Boo Radley locked up in his home in To Kill a Mockingbird, a shame to his family and a boogeyman to everyone else.

"We're a religious society," said Irene Darmstedter, of Miami. "A lot of people think it's evil, that it could be demon possession."

Darmstedter has to fight to make people understand that her daughter Denise, once an honor student and drill-team leader, didn't choose to drop out of college and sleep on the streets of South Beach.

'My mother is always saying, `Why don't you just give up? She's a bad girl,' " Darmstedter said.

Denise first showed signs of schizophrenia as a freshman at Florida International University. Her thoughts became bizarre and paranoid. She told her mom one day that the clubs in Miami Beach were drugging young people so the government could control them.

Within weeks, she plunged into psychosis and took off on a bicycle in the night.

No one knew where she was until someone found her, days later, walking along Florida's Turnpike covered in blood. She had cut her wrists.

Denise was taken to the hospital, where she was diagnosed with schizophrenia.

"All she would do is pray Hail Marys and Our Fathers and stare at light," Darmstedter said.

Denise was given medication, but she refused to take it. After her release, she drifted into homelessness.

There was nothing Darmstedter could do to stop the decline. She was still grieving over the loss of her son, who died of bacterial meningitis at 15. Now her daughter was dirty and homeless, her nails long and curled "like a troll."

"It was a horrible time," Darmstedter said. "We'd see her muttering to herself on Lincoln Road."

Only when Denise became totally psychotic could Darmstedter get her briefly hospitalized under the state's Baker Act. But each time she calmed down and was no longer a threat, she was released, as the law requires.

Back on the streets, she hurtled toward the next breakdown.

"My son's death was devastating, but this is harder," Darmstedter said. "It goes on and on and on."

UP AND DOWN AND UP

The most painful part for Darmstedter is that she has seen how well her daughter does on the medication. Three years ago, Denise was injected with a long-lasting antipsychotic, Prolixin, and the results were dramatic.

She came back home, applied for a federal Pell grant, went to Miami-Dade Community College and was back to getting A's.

Then a boyfriend convinced her to stop taking medication. "He told her diet and exercise would take care of it," Darmstedter said.

Denise ran away, moved back home, ran away again. She blamed her mother for everything. She broke into her house, vandalized her car, had fits of forced vomiting.

"It was like the scene in The Exorcist," Darmstedter said.

Denise bottomed out in November. As Darmstedter and her husband were heading out to a prayer group, she showed up at the door saying she wanted to come home.

Denise, now 29, agreed to take medication. This month, she got a job as a waitress.

Darmstedter is hopeful, but always wary. Lucidity brings its own brand of pain.

"Now she's just so embarrassed and ashamed of everything she did," Darmstedter said.

Source: Miami Herald

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