Programmes offer people with mental illness a place in society
FREDERICK, Maryland: It’s a little after noon. Usually by this hour, David Weiss would be waking for the second time, still groggy from his anti-psychotics. He’d have gotten up once at dawn, maybe made himself an egg with toast. He might have gone into the back bedroom to scan his ham radio or played a few chords on his guitar. Then he’d go back to sleep.
But on this day, he had somewhere to be. It’s easier to get up on days like this, days with a purpose.
And so at noon, he is sitting in an abnormal-psychology class at Shepherd University in Shepherdstown, West Virginia, his arms crossed and a plate of pizza balanced on his lap. At 64, Weiss still has a full head of wavy silver hair and a broad, kind face and a bulbous nose that make him a dead ringer for a mall Santa. He wears a Hawaiian shirt that smells faintly of incense.
He’s giving a talk to the students about life with mental illness.
Weiss talks about his hallucinations. He’s seen tigers in the trees and black triangles in the sky. He’s heard his late mother’s voice and ringing bells. He makes a motion like he’s stabbing himself with a pitchfork.
“The devil was on my ass,” he says. There was a time in the United States that a person talking about visions and voices may have been condemned as crazy and removed from society. But in 1963, President John F. Kennedy set in motion the deinstitutionalisation of patients in psychiatric hospitals and called for community-based programmes to take their place.
An unintended consequence has been that people with mental illnesses have increasingly ended up without access to services at all, living on the streets or in jail.
This was the case for Weiss, who for a time was homeless. But eventually, Weiss wound up lucky.
Weiss is a client - there are no patients, only clients - at Way Station Inc. run by Sheppard Pratt Health System in Frederick, one of the first programs of its kind in the country to use social support systems to integrate people with mental illnesses into their communities.
Way Station gave him his own apartment as well as a case manager who checks in with him daily. It even helped him enrol in community college, where in 2010 he realised his teenage dream and graduated with an associate degree in music.
But slowly, funding has stalled for the programme he has come to rely on, and a part of it that was improved by the Affordable Care Act is threatened by the Trump administration’s plan to dismantle health-care reform.
And so Weiss, who has been emboldened as an advocate by his experience with Way Station, feels even more urgency on this afternoon as he tries to explain to these college students what the programme has meant to his life.
He shares the accumulation of experiences that brought him here: Depression as a child. Obsessive-compulsive disorder as a teenager.
Major depression and paranoia in his 40s. Then, recently, bipolar disorder. He checked himself into the hospital five times last year with mania. Depression makes you loathe yourself, he’ll say, while mania makes you rage at the world.
There’s no hint of self-pity. Way Station has given him a voice. It’s given him a life. “The inmates ran the asylum, and I loved that. We had a hand in our own future. I liked it. I liked the freedom,” he recalls of his first impression of the programme.
“This is a good time for mental illness, if there ever is a good time.”
As the psychology students pack up after class, a male student approaches Weiss and shakes his hand. “Thank you for everything,” he says.
“Good luck, brother,” Weiss says, placing a hand on the undergrad’s shoulder. “That’s a great thing to help people out of their suffering.”
Way Station is part of the fabric of the community here. Local businesses hire its clients. Treelined residential neighbourhoods are dotted with houses and apartments occupied by people with mental illness.
A community centre where some clients gather for a day programme is located just several blocks from the bustling downtown of antique shops and boutiques.
“We all need to feel like part of a community. We need to feel meaning in our life. These programmes acknowledge these basic human needs,” said Jackie Goldstein, a retired psychology professor at Samford University in Birmingham, Alabama, who spent years travelling the United States identifying programmes that take a similar approach. She found them scattered in places big and small - from New York City and Chicago to Cuttingsville, Vermont, and Crozet, Virginia.
No matter the severity of clients’ illnesses at Way Station, they can have jobs, real homes and control over their lives. Jim Kreuzburg, who was diagnosed with paranoid schizophrenia and depression, lives alone in his own basement apartment and clears carts in a supermarket parking lot twice a week. On days off, he’ll go to work anyway just to see his co-workers. Susie MacMullen, who has serious cognitive disabilities in addition to her mental illness, prepares trays once a week for kids’ night at Roy Rogers restaurants. For the first time in her life, she sees herself as a winner, she said.
Over the years, there has been some resistance, particularly from those wary of living in a neighbourhood with Way Station housing.
Joe Fitzgibbon, his two children then quite young, was devastated when Way Station converted a house in his neighbourhood into one of its group homes.
To win his acceptance, Scott Rose, Way Station’s chief executive director, met with him for monthly breakfasts and gave him his personal cellphone number.
“Looking back on it, it was ignorance on my behalf,” Fitzgibbon now says.
Weiss talks about his hallucinations. He’s seen tigers in the trees and black triangles in the sky. He’s heard his late mother’s voice and ringing bells. He makes a motion like he’s stabbing himself with a pitchfork.“The devil was on my ass,” he says.