Life, Interrupted

Written by HealthyPlace.com Staff Writer

"This notice is about an important change," the letter from the state begins. A few weeks later, she was dead.

On New Year's Day, Farrah Russell peered into a video camera.

"I made this sorry tape about how I wanted to commit suicide," she said, adjusting the lens to meet her eyes. "I'm recording over it now." At age 22, she'd endured schizophrenia for more than three years and had considered taking her life more than once, if only to quiet the voices in her head. But on this gray January day, she embraced the future.

Farrah had found an apartment she could afford on the $314 a month she received from the state. It was to be a new beginning, so she labeled the videotape "Farrah's Plans for a Better Life."

And then came a tersely worded letter from the state.

"This notice is about an important change," said the computer-generated form letter that arrived six days after Farrah moved out of her parents' home and into her own apartment.

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"The program which allows you to get a cash payment and medical card each month is ending. . . . The state no longer has the funding to provide this program. It will end on Jan. 31, 2003."

Farrah was terrified but put her hope in Measure 28, a temporary income tax increase she thought could save the program. But voters overwhelmingly rejected the measure on Jan. 28, and the money Farrah needed to pay her February rent never arrived.

On Feb. 5, the manager of Farrah's apartment building gave her a 72-hour notice of eviction.

Less than 24 hours later, Farrah swallowed a 30-day supply of her antipsychotic medications and died alone in her bedroom.

Oregon's Department of Human Services is investigating whether her suicide and three others are linked to the letters and the cuts in benefits.

People who suffer from mental illness are far more likely to attempt suicide than the general population. Many, like Farrah, live day to day fluctuating between black despair and fragile hope. Studies show that 60 percent to 90 percent of U.S. suicides occur in people with significant and diagnosable mental illnesses.

But a close look at Farrah's life, drawn from her handwritten personal budget, mental health records and the videotape she recorded during her last year, shows that the loss of state assistance played a significant role in her death.

The program that helped Farrah pay her rent was created in 1961 as part of Oregon's effort to move mentally ill people out of state hospitals. It was eliminated as part of a larger effort to balance last year's state budget that slashed $1 billion, much of it from spending for schools, state police and programs for the needy and disabled.

Jean Thorne, director of DHS, said she warned lawmakers that cutting programs such as the one that supported Farrah could have particularly serious, perhaps even lethal consequences. Even so, lawmakers cut $140 million from her agency's budget.

State officials are examining whether the cutoff in benefits played a role in the four suicides and an attempted suicide. Officials said that all five people acted after receiving a letter that notified them of an end to their financial or medical benefits. DHS mailed 11,279 such letters in early January, many to people with chronic mental illnesses.

Officials said they suspect even more mentally ill people took their own lives after losing services.

State law requires investigations only in the deaths of mental health clients enrolled in public services. But thousands of clients have been thrown off the rolls since January, and mental health officials say county caseworkers probably are unaware of all who have died.

Richard McKeon, clinical director of the American Association of Suicidology, based in Washington, D.C., said Oregon's cuts to social services, characterized by the National Conference of State Legislatures as the sharpest in the nation, "fly in the face of science."

He also criticized the letters that notified clients of those cuts as "cold and confusing."

Although no rational person would have committed suicide after receiving such a letter, McKeon said, someone such as Farrah would be at a much greater risk.

"We can never know what would have happened in her life if this hadn't happened, whether she might have committed suicide at some other place or time," he said. "But this is an example of an already vulnerable person who worked incredibly hard to build a life for herself and had it all taken away."

Elizabeth Lopez, administrator of the DHS Office of Employment and Financial Benefits, acknowledged the letter "could be interpreted" as terse and insensitive, but she defended it.

"It had to meet a readability standard so individuals could understand what was happening," she said, adding that the letter had to be translated into 13 languages. "We wanted to be very clear."