“Two months in jail and put back out the streets.  At least he was fed at the jail.”

Photo by Dev Asangbam

(11-25-19) Anyone who advocates for persons with mental illnesses quickly begins receiving emails and telephone calls from desperate families seeking help. In Montana, those pleas end up being directed to Dr. Gary Mihelish, a recipient of the highest award given by the National Alliance on Mental Illness -its’ Distinguished Service Award.  I am posting this recent exchange between Dr. Mihelish and a Montana family NOT because it is extraordinary but because it is so common. 

11-14-19
Hi Gary,
I thought I’d give you a quick update about my brother who is in jail.

The Center for Mental Health said they are willing to work with him but all we got back from them is a big stack of paper work to fill out. Upon seeing the papers and remembering that they basically fired my brother as a client several years ago (I’m not saying it was unwarranted-but that he’s been with them before) we called Aware. (A mental health provider.) The woman there was very nice and helpful and she is going to try to get my brother to consent to work with them. It sounds as if they have great resources and at the very least if they could help with the payee work then my mom wouldn’t have to be the one giving him money.

We are crying tears of joy because someone offered us a ray of hope by saying they are willing to help and to not give up on my brother. You can’t believe how important and how good it feels just to have someone say they are willing to help and to tell us don’t give up.
As it stands now Aware is going to try to get my brother to agree to work with them. It’s the first sign that something may get done.

11-18  4:52 pm
Hi Gary,
Aware received the consent paperwork that I signed as power of attorney and their workers are going to have a weekly referral meeting tomorrow to discuss my brother’s case. After the social worker discusses it with her supervisor, she will get back to us.
I think this may be good news. She hasn’t said “no we can’t do anything.” I suppose they could tell us that tomorrow but at this time I am hopeful.

Same day, 5:54 pm
Hi Gary,
I just got word that my brother was released from jail today before Aware could take him as a client. The jail called my mom and she and my dad hurried into town from their ranch to get him and he ran away from them at the jail. They went to the house they provide for him and he was there but when he heard them he ran away. They gave up and went back to their ranch. Hopefully, Aware can still help us. Two months in jail and no treatment only to have them drop all charges against him and dump him back on the street.

If this isn’t the definition of a crazy cycle, I don’t know what is.

11-19-19 7:28 a.m.
Hi Gary,
I wanted to give you a bit of background. Unfortunately for my brother, life has not been kind to him for the last twenty or so years. His mental illness has been creeping up on him year after year, progressively making it harder and harder with each successive year to know what is real and not real. He has gone from a really smart kid getting straight A’s and graduating Cum Laude in Engineering from Colorado State, to basically being shut out of nearly every store and eating establishment in his home town. Even St. Peter’s hospital where he used to volunteer for several years has placed a restraining order against him because of his erratic behaviors due to his untreated mental illness.

In the past I have placed some responsibility on him to take care of himself and get treatment. But I have realized with his illness he doesn’t realize he has a problem. Even after spending two months in jail he thinks nothing is wrong.

He was released on the 18th as I mentioned in an earlier email and upon release he literally ran away from my parents when they arrived at the jail to be there for him.

We weren’t able to get him any help in jail because he wouldn’t talk to anyone or sign a consent to treatment form.

Back in 2012 my dad had both himself and my mom and I assigned to have Durable Power of Attorney for Health Care for him because we knew that with this illness he wouldn’t be able to care for himself. I had it all signed last week and sent in while he was still in jail but they released him anyway without any sort of treatment plan in place.

He returned to his apartment where he heard voices and saw people in the walls so he tore the sheetrock off the walls of the house my parents provide for him. He is now alone.

We all know that he will be arrested again. How can he not be? What should we do next time? I’m asking because we do not know what to do. Maybe before the next time he is in jail we can get a plan in place to help him get treatment.

11-19-19  8:16 a.m.
Hi Gary,
Thank you for continuing to advocate for my brother. Even though you and NAMI have done so much to educate people about mental illness we remain stuck with a bureaucracy of a judicial system/criminal justice system that seems content to remain reactive or worse, inactive, with respect to people caught up in their system who have mental illness. Add to that the misplaced false compassion of the civil liberties crowd and we are stuck with a situation where every single group with an interest in supposedly finding a solution to this problem and yet the end result again for my brother is that absolutely nothing was done.

Two months in jail and put back out the streets.  At least he was fed at the jail.

But help me to understand how it makes sense to keep my brother locked up after the charges were dropped and then release him out to the community. We had a semblance of a plan in place to get him help with Aware but it never got implemented-initially because he didn’t voluntarily consent to treatment. But after I sent the paperwork indicating we have durable power of attorney for medical care, we still were unable to get anything done while he was in jail, which I thought would be our best chance to get him some help. It just seems that for the poor folks with mental illness there ought to be a way to get them treatment.

And I would think the jailers and judges and others would tire of the hand-wringing and come up with something that could work for the mentally ill in our community.

11-21-19

Hi Pete,
I am forwarding you a string of emails – with permission – that I received last week.

A middle aged man in Helena suffers from schizophrenia and maybe anosognosia.  He is not treatment compliant.  He leaves restaurants without paying, has a restraining order for several reasons and mostly important has failed to appear for court appearances.

I have come to learn that failure to appear for a court appearance is one of the most serious violations a person can commit.  He was in the detention center for 26 days without treatment or medication.  Eventually he was released for time served without a treatment plan or transitional service.

Two months ago he was rearrested for the same violations.  He spent 8 weeks in the detention center without treatment or medication.  He was released this past Monday without any follow up and he is now on the street.

We tried to get the criminal justice system here to initiate Assisted Outpatient Treatment.  The State Mental Health Agency is willing to fund AOT as a “pilot project” and we have  a mental health provider who is willing to try to administrator AOT.  The judges here do not trust the mental health providers and they do  not feel community commitment is a viable option.  The City would be responsible for the charges to commit him to the State Hospital for an evaluation and they do not have the money because they think it is too expensive.

We have to do better.
Dr. Gary Mihelish