Mental health: Broken system, shattered lives

Miller Jordan Jr. never gave up on his only son.

The Clarke Central High School assistant principal tried for years to get treatment for Miller Jordan III’s mental illness.

But the younger Jordan stabbed his father and grandfather to death Dec. 30 – hours after doctors sent Jordan home from a hospital where he told them he was having homicidal thoughts.

One in seven people suffer from “severe and persistent” mental illness nationally, according to Cindy Darden, executive director of Advantage Behavioral Health Systems, a publicly funded social services agency that serves Athens-Clarke and nine other area counties.

Local tragedies highlight what can happen in Georgia’s overburdened and underfunded mental health system.

“When you run into a situation where someone doesn’t want treatment or isn’t deemed to be at imminent risk, there’s not enough resources to implement,” said Chris Settel, a psychiatric assessment specialist in the emergency room of Athens Regional Medical Center.

Wake up call

Jordan, 22, has schizophrenia and was diagnosed with mental illness while in middle school.

Since then, he was hospitalized in 10 different psychiatric facilities and at least 20 times at a single hospital in Atlanta, said Claudia Saari, the DeKalb County public defender who is representing Jordan.

His father and grandfather probably would be alive today if the system hadn’t failed Jordan and his family, Saari said.

“His illness definitely was the cause of the murders, and the mental health system failed him,” she said. “Had he been in a residential program that met his needs, then this would not have happened.”

Jordan’s case in many ways shows what’s wrong with Georgia’s mental health system.

“Mr. Jordan is a very sick young man, and from what we can tell from the records we’ve received so far, his mother and father did everything they could to get him into every program that’s out there,” Saari said.

On the night of Dec. 29, Jordan went to an Atlanta emergency room, complaining he was thinking of killing someone or himself, Saari said.

Doctors sent him home with a prescription for Depakote – commonly used to treat bi-polar patients going through a manic or depressive phase – and hours later Jordan went to his parents’ home in Decatur and stabbed his father and grandfather, Saari said.

“It’s just jaw-dropping that a doctor would do that,” said Eddie Whitlock, executive director of Mental Health America of Northeast Georgia.

“If someone comes in and says they’re thinking of killing themselves or others, they should be kept for a 72-hour assessment. You certainly don’t give them a prescription and send them home.”

Whitlock wondered how any other people know stories like Jordan’s.

“This kid was from a family of educators who obviously had the financial wherewithal and knowledge, and it still resulted in tragedy,” he said. “Can you imagine the families that don’t have that kind of ability?

“We’re talking about working people who don’t have the money to put their kids in private hospitals, who have to let them live in the home or in the street,” Whitlock said.

Juggling act

Eddie Haynes stormed out of his College Avenue apartment one day last October and pummeled a neighbor in the parking lot with a tree limb so many times the wood splintered into several pieces.

“He’d been on medication for his mental illness for years, and he was not taking it when he beat that girl,” said Harold Davis, Haynes’ brother-in-law.

Athens-Clarke police charged Haynes with aggravated assault, and after Haynes spent three months in jail, his attorney told a judge that Haynes suffered from delusions, couldn’t control violent impulses and should have a psychological evaluation.

The judge agreed and ordered a psych exam for Haynes, 49, at Georgia Regional Hospital in Augusta.

Haynes and many people like him end up in jail or prison because of their illnesses, especially when they’re not being treated.

“If you have a person who has a mental deficiency, you can only expect there will be some irrational or illogical action by this person at some time, and if they’re not getting (medication), you have a compounded issue,” Davis said.

Sixteen percent of the state’s nearly 55,000 prison inmates have some form of mental illness, according to the state Department of Corrections.

About twice as many prisoners at the local jail, or 30 percent, have been diagnosed with mental illness, Clarke County sheriff’s Capt. Eric Pozen said.

Mentally ill people all across Georgia are warehoused in jails, most of which do not have psychiatric units, according to Brett Hart, former commander of the Clarke County Jail.

“Yet because the public demands protection, and because jails are in most cases the closest physical structure capable of providing a physical barrier between the mentally ill person and the public, the same mechanism used for sane offenders – public call to police, police to scene, arrest made, offender taken to jail – is repeated for the insane,” Hart said.

The mentally ill prisoners are either released to fend for themselves or placed on probation with the condition they receive treatment, which they often fail to get.

When a mentally ill person in Athens hits a critical point, he can spend as many as five days at a stabilization center on Miles Street that is run by Advantage.

Once the patient is stable, doctors can send him to a hospital with a psychiatric unit, but the closest are 40 to 50 miles away, in Gainesville and Duluth. And if the person doesn’t go voluntarily, “it takes months and months to get an outpatient (commitment) order,” said Settel, the ARMC emergency room social worker.

“We can only have someone committed when they are an imminent risk to themselves or someone else, but we get calls daily from people who say they need treatment now,” Settel said. “The answer we give is they need to get that through their primary care physician or private counselor, but there’s a waiting list and it often times it takes six weeks to see a psychiatrist or receive individual public mental-health counseling.”

Through the cracks

Steven Eberhart, a paranoid schizophrenic, was in and out of psychiatric institutions since his mid-20s, and he had been ordered by the courts to get treatment at an Advantage clinic.

But relatives said he stopped taking medication when he felt better, or when he believed the pills were poison.

Doctors and counselors can’t keep close tabs on potentially dangerous clients when they are overloaded with patients and paperwork, Settel said.

Eberhart, 44, was not on medication on Dec. 11 when he went to the Kroger store on Alps Road, took a large kitchen knife from a display and began cutting open packages of meat and praying over meat he thought was poisoned.

Athens-Clarke police Sgt. Courtney Gale, who was working off duty as a security guard at the store, went to check on Eberhart, who stabbed Gale 10 times and nearly killed her.

The attack “should shed great light on a very strained system,” Settel said.

“The state of mental health care in this country is appalling at every level,” he said. “As a social worker who works on a daily basis with persons with severe mental illness crises, I get a bird’s-eye view of Athens and the surrounding areas.”

Settel often sends patients he considers dangerous to psychiatric hospitals only to see them released.

“If I send them to a state hospital and they say they’re not suicidal or don’t want to hurt anyone, the hospital determines they’re not an imminent risk and they don’t feel obligated to keep them,” Settel said. “A number of people are quite cunning and say they’re not going to kill themselves or anyone else, and when the doctors say, ‘It’s here in your records that you said that,’ they say, ‘Well, that was just a passing thought and I don’t feel that way anymore. I want to go home.’ ”

Chasing money

The mental health system is failing because it relies on people who are trying to do more with less.

Advantage is one of the community-based programs in Georgia that are funded by state and federal governments in the move away from institutionalizing mentally ill people. It runs group therapy meetings, has psychiatrists, social workers, nurses and an “assertive community treatment” (ACT) team that monitors the most seriously ill clients.

The agency treats more than 3,000 clients a month, according to Darden, Advantage’s director.

But because the client base is more than just mentally ill people – Advantage also serves people with developmental disabilities, and drug and alcohol addictions – the agency’s resources are stretched thin with less funding.

That means many severely mentally ill people aren’t getting the attention they need, from making sure they take medication to seeing their doctors and receiving therapy.

“It’s not the fault of mental health, it’s the fault of those who fund it,” Settel said.

Georgia spends $26.67 per capita on mental health services, compared to the national average of $89.19, Darden said.

And while Advantage’s budget has grown from $22.9 million in 2000 to $27.7 million this year, government funding dropped by $4 million, leaving the agency to rely more on Medicaid reimbursements, federal grants and other funding sources, according to Darden.

“You are always chasing money,” said Settel, a former Advantage social worker. “The resources as a whole are lacking.”

Taking money from more sources means more paperwork, so local agencies have had to cut the number of caseworkers and other mental health professionals to grow its administrative staff.

“Places like Advantage have a hard time keeping staff because of the burden of the paperwork,” said Whitlock, the Mental Health America of Northeast Georgia’s director.

Advantage and other mental health agencies aren’t likely to get relief from the government anytime soon, according to ARMC’s Settel.

Politicians who are quick to take on high-profile issues that touch average constituents seem loathe to make improvements in the mental health arena, he said.

“They have made the drought a priority because that is something that effects everyone,” Settel said. “It’s usually when something effects the masses or when there’s a high-profile case of injustice that they seem motivated to take action.”
____________
source: Athens Banner Herald
http://onlineathens.com