HIS NEIGHBORS TRIED TO SAVE HIM. BUT THE SYSTEM WAS TOO BROKEN
They had no idea how hard helping their homeless, mentally ill neighbor would be
Kenyon Graham was a regular, if unsettling, presence in Oakland's Temescal neighborhood, where he often wandered the streets undressed and shouting at no one. He had spent years bouncing between jail, ineffective mental health programs and homelessness.
Last spring, four of his neighbors decided they were going to change that.
They spent hours learning about the county's mental health system, placing phone calls and sending emails, collecting stacks of records from Graham's court cases, attending his virtual hearings and making statements to a judge. They gathered 80 signatures on a petition titled “Keep Kenyon Graham and 43rd Street neighbors safe.” They convened an emergency meeting with representatives from the City Council, the county Board of Supervisors, the Police Department, the district attorney's office and the county's mental health system — seemingly everyone who would have power to give 40-year-old Graham the type of intensive, long-term care he needed.
The neighbors' message at that June meeting was clear: if nothing changes, Graham will kill someone or end up dead.
Six months later, their worst fear came true. Graham was beaten to death with a skateboard while sleep
ing on the sidewalk near 45th Street and Telegraph Avenue.
“The whole point of the efforts behind what we were doing was trying to prevent the exact thing that happened,” said neighbor Ellen Kim, 53, as she fought tears. “After my initial sadness, it was soon replaced by anger.”
The violent death exposes gaping holes in a mental health care system that isn't set up to help people as sick as Graham. Kim and her neighbors fault the people at the top of that broken structure, who they say failed to heed their warnings and act in Graham's best interest. Experts blame a lack of in-patient beds and other resources, as well as an opaque network of hospitals, jails, social workers and courts that relies almost entirely on patients accepting voluntary care. And at the heart of the case is a complex, morally and legally fraught question: Should society force treatment on people who don't recognize they need help?
There has been a recent push to ramp up involuntary mental health care in the Bay Area and beyond, a controversial undertaking that prompts concerns about protecting the rights of our most vulnerable people. Gov. Gavin Newsom wants to overhaul what he called the state's “fundamentally broken system,” by funding more beds in mental health facilities and launching a new Care Court that could order people into treatment.
In the meantime, the Bay Area is full of people like Graham, who are disheveled and raving and can't take care of themselves but who are left to remain homeless, getting sicker.
“It's definitely frustrating,” said L.D. Louis, assistant district attorney and vice chair of Alameda County's mental health advisory board. “You work very, very hard to make change, to help people. And you see what the need is, and you push for it. And you know you're pushing people who want to help. They just don't have anything to help with. If they don't have a bed, they don't have a bed.”
The people around Graham had known for years that he needed something different from what the county kept offering — a series of voluntary mental health and addiction programs that he could walk away from at any time. Graham's mother, who asked not to be identified, sent dozens of emails to the staff managing her son's care, begging them to give him more intensive treatment. His probation officer said in a 2020 email that Graham needed to be “committed” and promised to try to help make that happen. Three months before Graham's death, Assistant District Attorney Michael Nieto suggested the court explore putting him in a locked facility.
It's not clear why the county never acted on those suggestions, as Graham's medical records are confidential under federal patient privacy law. But what is clear is that despite the red flags, nothing changed.
Graham, who grew up in Marin County, was known by most people as Goo — a childhood nickname that stuck well into adulthood. He was younger than 5 when he started showing signs of mental illness, and 10 when he was sent to a psychiatric hospital for the first time. He eventually was diagnosed with bipolar paranoid schizophrenia.
His violent streak made him a nightmare to live with growing up, said his older sister, Nicole Amarante. She could always tell when he was going to a bad place mentally — his eyelids would flutter and he'd start chuckling to himself. Amarante walked on eggshells to avoid setting him off.
As an adult, Graham abused and terrorized his mother. In 2010, he dragged her down the front steps of her house in Temescal, and punched her in the head so hard she needed physical therapy, she said. Though she didn't report the incident to police, she stopped letting him into her house after that. Graham was later ordered by judges repeatedly to stay away from his mother's block. But he came back anyway.
Graham's mental state deteriorated further after his father died in 2017, and he became more of a nuisance in the neighborhood. Between July 2020 and his death in December 2021, officers responded to incidents involving Graham at least 24 times, according to the Oakland Police Department. Longtime neighbors Kim, Roy Alper, Don Stahlhut and George Spies worried about the impact he was having on their tightknit community, where local residents gather on the sidewalk for “corner cocktails” once a month. Kim and Alper fretted about their nearby business, the Temescal Works co-working space.
But they also worried about Graham.
To 77-year-old Stahlhut, a former community organizer, Graham represented an opportunity to change his own behavior. He often saw people in bad shape living on the streets, and like most people, he usually passed them by.
“I've literally walked away from people on the corner here and said, `Well, there's nothing I can do, I'm getting out of here,'” Stahlhut said. “And then the more I thought about it, I thought, `Well, I've got to try.'”
The four neighbors started meeting once a week in Stahlhut's backyard. As they researched Graham's history, a pattern began to emerge. Graham, who had various convictions on his record — including a 2016 assault charge for hitting a woman and taking her cigarette — would get arrested for behaving belligerently and violating his probation, and sent briefly to Santa Rita Jail or John George Psychiatric Hospital. A judge would refer him to one of the county's voluntary behavioral health or addiction treatment programs. After a few days or weeks of treatment, Graham would leave and end up homeless again in Temescal. And the cycle would repeat.
In jail, Graham often took his medication and was more lucid, his mother said. When he was released, he left with a list of numbers to call for treatment — but he didn't have the capacity to call, navigate the phone trees and set up an appointment, she said.
Last year, a scathing report by the Department of Justice found Alameda County sent people with mental illnesses to jail or psychiatric facilities without adequately treating them. This year, a federal judge approved a settlement to force Santa Rita Jail to improve its mental health care under court oversight.
When Graham was out of jail and living on the street, he had social workers assigned to his case by Telecare, a company that contracts with Alameda County to offer mental health services. But they struggled to track him down and break through the paranoia that prevented him from accepting help.
“It's very difficult in certain situations to help someone help themselves,” said Laura Wolff, regional director of operations for Telecare, who declined to comment on Graham's specific case.
Most treatment is voluntary, but voluntary care can't help those who are too sick to realize they need it — a medical condition called anosognosia, which Alameda County estimates affects more than half of schizophrenic and bipolar patients. So Graham's neighbors began advocating for the court to assign him a conservator who would control Graham's medication and treatment and likely confine him to an in-patient facility. To qualify for a conservatorship, someone must be “gravely disabled” — meaning they cannot keep themselves fed, sheltered or clothed — or pose a danger to themselves or others.
Conservatorships are controversial. They conjure harrowing images from the first half of the 20th century of the mass institutionalization of patients in dismal psych wards, or more recently, Britney Spears and the “free Britney” movement. Groups like Senior and Disability Action, a Bay Area organization of people with disabilities, argue voluntary treatment is better.
But Graham met all the criteria for a conservatorship, said many of those who knew him. He refused treatment, couldn't hang onto the clothes or blankets people gave him, and often rejected food because he thought it was poisoned. Though his mother gave him a broken-down Ford Explorer to shelter him from the elements, he slept on the sidewalk next to the car instead.
Even so, Alper, Kim, Stahlhut and Spies quickly ran into roadblocks. No matter how much evidence they provided of Graham's inability to care for himself, it never seemed to reach the hands of someone who had the power to help.
Louis, with the DA's office and county's mental health advisory board, wouldn't discuss Graham specifically, citing the open prosecution around his murder. But there are several ways people who could benefit from conservatorships fall through the cracks, she said. For example, when evaluating a patient with an addiction and a mental illness, a doctor sometimes decides their primary problem is drug use, which makes the patient ineligible for a conservatorship.
But the biggest problem, Louis said, is a lack of resources.
“There's just not enough capacity,” she said. “So what that does is it feeds really bad habits because everyone is in constant triage mode.”
Louis said the need to free up beds for new patients encourages the county to practice what she calls “catch and release,” where the system holds, treats and medicates people until they are just barely stable, and then discharges them without enough support.
Alameda County has roughly 200 long-term psychiatric beds, with a typical wait time of two weeks, according to Janice Adam, spokeswoman for Alameda County Behavioral Health Care Services, which oversaw Graham's care.
As pressure mounts to help people like Graham, a handful of new solutions have surfaced. Alameda County offers two alternatives to a traditional conservatorship — “assisted outpatient treatment” and “community conservatorships” — both of which order patients to participate in treatment without sending them to a locked facility. But their scope is tiny. Together, they serve a total of 55 people at a time.
Santa Clara County started a similar small program this year.
At the state level, Newsom wants to spend $1.5 billion over the next two years to house people with mental health conditions and improve compulsory treatment via his proposed Care Court. But some experts wonder if the new program would have the teeth to help people like Graham, who may flout even courtordered treatment.
Graham was found dead around 12:45 a.m. on Dec. 13, blocks from his mother's house. Joshua Stroman, who had been accused of hitting another man over the head with a skateboard last summer in Palo Alto, was charged with his murder. Stroman knew Graham, said police, but they haven't released many additional details.
After receiving the devastating news, Alper, Kim, Stahlhut and Spies returned to Stahlhut's house to process their grief and anger.
“It was Alameda County Behavioral Health's responsibility to prevent something like this,” Kim said. “And they failed big time. And that is just maddening.”
Adam, with Alameda County Behavioral Health Care Services, declined to discuss Graham's death in detail.
“We recognize that any tragedy for an individual or family, is a tragedy for an entire community,” she wrote in an email.
The neighbors couldn't save Graham. But they hope his death can inspire changes that will help others like him.
“That makes our efforts feel more worth it,” Kim said. “We weren't able to help Kenyon, but it would be amazing if something different happens.”