Mentally invisible
Passage of the Murphy-Johnson bill could help those affected by illness.
It’s mid-morning on a weekday, and an African-American woman in a turquoise-colored floral print dress is lying on her side, presumably asleep, on a grimy concrete shelf beneath an Interstate 45 overpass near downtown; left-turn traffic passes within a few feet in a perpetual stream. About noon on the same day, a gaggle of men and women of various ages and races is sprawled on the trash-strewn grass or sitting on benches in Tranquillity Park across Walker Street from City Hall; their belongings are heaped in messy piles beside them or in purloined grocery carts stacked to overflowing. At evening rush hour on the U.S. 59 access road at Weslayan, a weathered older man in cut-off khakis and a soiled T-shirt holds up a hand-scrawled cardboard sign; now and then, drivers waiting for the light to change respond to his sign and his twisting, pleading grin; they reach toward him through their open window, a dollar bill between their fingers.
These people we see every day are our fellow Houstonians. They’re homeless, perhaps, but even if they have a roof over their heads at night, there’s no question they’re suffering from a mental illness of one kind or another. They’re so ubiquitous their presence doesn’t register; they’re unseen, so to speak, but they’re not the only ones. Most whose lives have been shattered by serious illnesses of the brain — some 11 million nationally — are unseen, literally. Often with family members trying desperately to get them the help they need, they suffer in private.
Chronicle staff writer Emily Foxhall told the story last week of Warren Muldrow, a young man whose mental state has become so precarious that his mother makes the agonizing decision to ask authorities to detain him. That decision transports Shelia Muldrow into the immensely frustrating bureaucratic maze almost impossible to navigate, as she seeks help for a young man who has struggled since his teenage years with bipolar disorder. Now 22, he pleaded guilty in a Fort Bend County courtroom last fall to making a terroristic threat during what seemed to be a psychotic episode. Now and then he lives on the streets.
Texas is not a good place to be mentally ill (as if any place could be). Despite the best efforts of caring and dedicated professionals and volunteers, this wealthy state has never provided anywhere near the level of comprehensive support we need for public mental health services, despite increased attention to the need during the last two legislative sessions.
Instead of funding community health centers, we choose to throw people in jail, usually for public nuisance violations or other minor crimes. Instead of providing sustained treatment with a range of services for those who cannot cope for themselves, we choose to spend between $90 and $200 daily per inmate in an atmosphere guaranteed to make their problems worse. Texas isn’t unique in its inability or unwillingness.
Norman Ornstein, a resident scholar at the American Enterprise Institute and an expert on the American political system, has written recently about the accidental death of his mentally ill adult son, whose psychotic break at age 24 began what Ornstein, writing in the New York Times, describes as “a difficult decade-long journey for him and for his family and friends.” Although it’s too late for his son, Ornstein is hopeful about a bipartisan piece of legislation in Congress that’s designed to improve the financing, treatment and delivery of services across the mental-illness spectrum. Called the Helping Families in Mental Health Crisis Act, its sponsors include U.S. Reps. Tim Murphy, a Pennsylvania Republican who’s the only clinical psychologist in Congress, and Eddie Bernice Johnson, a Dallas Democrat and psychiatric nurse.
It’s a bit ironic that Ornstein, whose recent book explores the chronic dysfunction in Congress, now finds reason for hope under the Capitol dome. He cites a component of the bill that provides incentives to fund expanded outpatient treatment, or A.O.T., for those with a long history and pattern of proving a danger to themselves or others. With A.O.T., judges can order patients to undergo treatment while they live in the community instead of in a prison or hospital.
The bill has broad support, but Ornstein reports that a majority of the Democrats on the House committee that will take up the legislation, Energy and Commerce, are opposed on civil liberties grounds. In his view, they fail to grasp “the deeper traumas that can destroy lives.”
Passage of the Murphy-Johnson bill could make a real difference in the lives of the Muldrow family, maybe even for that anonymous woman sleeping under the I-45 overpass. Perhaps a dysfunctional Congress getting something done for a change can provide a model for Texas lawmakers too often focused on petty ideological matters and wilfully oblivious to the real-life concerns of their constituents.