Thursday, March 22, 2018

Thank you Kevin Love, but its time to advocate for understanding!

     Kevin Love, the Cleveland Cavaliers All-Star forward made national news for something other than being a well-known athlete. It was when he disclosed that he recently suffered a huge panic attack and ended up with severe anxiety which was hampering his day to day life. Soon thereafter, he sought help and came to understand that he had unresolved issues involving a family tragedy, which triggered his mental health plight.
     His revealment brought praise not only from the sports world but also high-profile celebrities and many community leaders. As a longtime mental health advocate, I join others in the field in giving him not only credit for facing this challenge, but also for being open about his personal struggle. He confronted the genesis of recovery which is two-fold; acceptance and treatment, and in that, he should be proud.
      As positive as his efforts have been to be open to his condition, it can easily become a double-edged sword. His celebrity status risks overshadowing the plight of those suffering in silence with symptoms far beyond those of anxiety and panic attacks.
     With his acknowledgment as a back-drop, it is hoped that Kevin Love, and those close to him, begin to understand that the life of those afflicted with severe mental illness is not as smooth as he has faced. In fact, for many, it is not only life-limiting but deadly and very destructive, as these conditions bring with them, a high human cost. Additionally, the stigma opens them up to ridicule, abuse, and often leaves the patient alone as social outcasts. Only those who have suffered the indignities of a being afflicted realize that the stigma of mental illness is significantly more painful than the disease itself. Countless individuals wake up to the knowledge that they will have a ‘Scarlett letter’ of being categorized after bouts of insanity. I have experienced all those indignities first hand.
     Fortunately for Kevin Love, he will not face numerous roadblocks that add to the challenge of recovery that many others do encounter. His public disclosure was met with overwhelming support from teammates, other players, and the national media. Many have spoken about his courage in facing his challenge. His powerful support system along with the resources he has available for treatment are an added benefit to help him maintain emotional stability. Again, this is not the case with a significant percentage of those who suffer in unbearable pain.
     To elaborate further, he has the good fortune to never confront suicidal ideation in the manner many individuals, myself included, struggled on a day to day basis. He will not understand the constant challenge to avoid placing a gun to one’s head and pulling the trigger. He is unlikely to be found dying along the road of a suicide attempt motivated by an unimaginable pain associated with the symptoms of an untreated bipolar disorder. He cannot possibly understand that many of these poor souls have suffered the same debilitating insanity of paranoia, mania, and depression, which brings about feelings of hopelessness. These are some far more forceful manifestations than battling anxiety.
     His family will not suffer the enormous loss that two residents of Vermillion Ohio experienced when their 16-year-old daughter, Jessica Fernandez, lost her battle with mental illness by standing in front of a moving train.  Jessica’s two wonderful parents, Dave and Nancy Fernandez, did everything humanly possible within their means to save their daughter from her tragic outcome. They had her in the emergency rooms or hospitalized over a dozen time in the year and a half leading up to this tragedy, all to no avail.
     Even fewer people can understand the daily devastation that Jeannette Halton-Tiggs constantly relives. Years ago, lacking the resources of a professional athlete, she was desperate to secure treatment for her severely mentally ill son, Timothy Halton. She worked two jobs to provide for his treatment and still ended bankrupt. Finally, after being charged with a serious crime, Timothy was placed on a mandatory three-year treatment protocol by the Cuyahoga County Court of common pleas. which became the miracle Jeannette had been seeking. He soon began to prosper as he began a job and made efforts to enter a local college. She was finally relieved that he was getting the assistance he needed, but that was to inexplicably and prematurely end.
     One year into his mandatory treatment probation, Timothy was removed from this stipulation by this same Cuyahoga County Court of Common Pleas. This was rendered despite Jeannette pleadings he eventually kills someone once his violent symptoms reappear. Her desperate imploring was completely ignored.  About a year later, in a violent and psychotic rage, he murdered Cleveland Heights police officer Jason West.
     These stories are a more a true narration of what the families of those afflicted suffer daily than what some luminary faces while presentencing minor symptom. They never receive the accolades that Kevin Love has had bestowed on him. They writhe with burning questions such as ‘what if, or if only’. They often face constant reminders of the deadly consequences such that Jeannette Halton-Tiggs faces as she makes her daily drive to work on Jason West Memorial Parkway, in memory of the Police Officer that her son murdered.
     As much as Kevin Love deserves many of the accolades he has received, the public will mistake words and motion for progress. His future efforts can help alleviate the stigma of mental illness as a monstrous roadblock to recovery. We forget that primitive beliefs perpetrated by a lack of understanding exacerbates the stigma and leads many of its victims to hide in plain sight.
     This is not a condemnation of Kevin Love’s struggle or his disclosure, it is asking that something tangible becomes the result. What is truly needed is a serious dialogue on mental illness, to encourage the public to grasp the biological basis for the maladaptive behavior which is the only diagnostic tool available to begin recovery. Also, it is imperative that treatment on the level that wealthy individuals such as Kevin Love can afford, be made available to everyone.
     If the public commits itself to creating a mental health system that is open to all, we would witness some miraculous changes. We would see less disability associated with many afflicted, we would see a decrease in chemical dependency and even avoid another mass murderous rampage by someone who is left untreated such as the individual who murdered 17 High school students in Florida.
     My challenge to Kevin Love is simple, and it is to use his celebrity status to advocate for real change in understanding mental illness. I would hope for him to call for a dialogue of understanding and demand for better treatment from those Government leaders empowered to enact the needed enhancements. That would make him a hero to many who suffer in silence, and that would create a legacy that would be a source of pride. Time will tell if he accepts that challenge.

Tuesday, June 28, 2016

Police Officers James Kerstetter and Jason West, victims of the hidden cost of untreated Mental Illness!

     May 26, 2007, appeared to be a typical morning for Jeannette Halton-Tiggs. It began like all others with having coffee and preparing for her daily commute to work. When she turned on the television, she was horrified to learn that Cleveland Heights Police Officer Jason West, a native of Avon, was brutally gunned down while answering a disturbance call several hours earlier. What she witnessed next was a life changing event that was the culmination of her desperate attempt to save her son and sadly, it was the outcome she predicted several months prior.
     As Jeannette watched the story unfold, she stood shocked as she saw a familiar SUV  confiscated as evidence from the scene. It was then she knew that her son, Timothy Halton, who struggled for many years with severe mental illness, and who owned the vehicle, was the perpetrator of this horrific deed.
     Nearly four years later, on March 15, 2010, the radio dispatcher in Elyria heard the final chilling words from Officer James Kerstetter, “I’ve been shot as he was murdered answering a disturbance call. Like Halton, his assassin, Ronald Palmer, suffered from untreated and self-medicated mental illness.
     On the surface, it seems that the linkage connecting these mournful events would be both killers afflicted with mental illness. However, a backstory focusing on preventive steps that should have occurred, are more complex and spotlights how the public at large often views this segment of society as disposable commodities. These killings highlight that often it is the “cost burden” of treatment that ultimately becomes the main culprit of these and many other tragedies.
     As one examines the foundation of these horrific events, it is important to examine them through several different viewpoints. The keys are families of the killers, the police, those who struggle with mental illness who can give first-hand accounts, and government advocates.
     As one delves into the root causes, the first thoughts that would come to mind are what kind of person becomes a monstrous individual who would perpetrate such violence? Analyzing the lives of Halton and Palmer, they both tended to exhibit Dr. Jekyll and Mr. Hyde personalities.
     Timothy Halton was not born to be a killer; he spent his young age singing in a church where his Grandfather was a Bishop. He was known as a very sweet kid who was described by many as being both nerdy and overly religious. He was a quiet and unassuming young man. However, during his teenage years, along with the onset of schizophrenia, his life veered off on a path of violence and eventually murder.
     In the ensuing years, his mother began a fruitless quest to procure an effective remedy and most importantly, funding for his medication. Time after time, she came up empty which turned her life upside down. Despite working multiple jobs, the high cost of his treatment forced her into bankruptcy, and Timothy would routinely fail to remain on medication. During the nine years from diagnosis until that fateful meeting with Jason West, he was hospitalized nearly twenty-five times. In spite of his violent behavior which led to numerous criminal charges, he managed to escape punishment for vicious assaults with two successful not guilty by reason of insanity pleas. Jeannette, who found herself a victim of her son’s violent rage, was living a nightmare and found no place to turn for assistance.
     Finally, he was arrested and charged with assaulting a South Euclid police officer. In an ironic twist, this crime produced a positive result. As part of his sentence, he was given four-year probation, which required him to attend treatment, and included an injection to control his symptoms. For the first time, he would be provided something close to seamless therapeutics for his condition. The results bordered on miraculous.
      Almost immediately, he began to function free of violence and with some realistic goals. He applied for and was approved for funding to attend college. As he recovered, he began a job working six days a week and was once again the soft-spoken son Jeannette once knew. This medication regimen was effective in controlling both his paranoia and violence and most importantly, was carefully scrutinized by the courts.
     Just over a year later, his path towards murder began not in the form of his symptoms, but at the hands of the Cuyahoga County Court of Common Pleas. At a routine meeting with his probation officer, he was deemed rehabilitated and recommended to be removed from his community control sanctions, which included his mandatory treatment. When informed of this intention, a now panic-stricken Jeannette realized the inherent danger this posed and began a vain attempt to prevent this action.
     Her first move was to contact the officer who made the determination to shorten the probation. She pointedly informed this official that if her son were left untreated, he would soon “kill” someone.  This officer of the court, Ann Marie Gardner, quickly dismissed her advocacy and coldly ignored her pleadings.
     Next, she attempted to meet with Judge Christine McMonagle, who had the final say on this decision and discovered that the Judge would ‘not’ meet to discuss her concerns. With all avenues exhausted, Jeannette was now forced to await the inevitable violent outburst. Her belief in the possibility that he would eventually kill someone came to fruition.
      In the aftermath of this killing, and as the story unfolded, neither the Probation Officer Gardner nor Judge McMonagle ever rationally explained the reasoning for both ending his probation nor to consider taking Jeannette’s pleadings seriously. Through the media, the Judge insisted there were no “Red Flags” to indicate that Timothy had the potential to be a killer. However, with numerous past acts of violence, and countless hospitalizations, it is hard to fathom the justification for her decision. Both Ann Marie Gardner, now a supervisor in the adult probation department, and Judge McMonagle failed to return phone calls for comments on this article.
.    A little-known piece to this tragedy is the Timothy Halton himself was alarmed at the prospect that his medication regiment would end. He knew that neither he nor his Mother had the resources to continue on his own. To his credit, he applied for different treatment programs but was not accepted until several days after this killing.
     As she mulls over a true belief behind terminating his probation, Jeannette minced no words in blaming economics. She said, “You have a young black man with a history of violence on four years’ probation, and the only way probation would have ended sooner would be if there were a cost factor involved.” She went on to elaborate that “the price tag for the injection of Risperdal Timothy was taking was alone over $700 a month!”  
.    A missed opportunity was lost on Timothy Halton, as had he been forced to remain on probation, it is highly unlikely that this killing would have occurred. Additionally, it would have been important for care to be available after his sanctions did end, but we will never know. This type of missed opportunity is not uncommon, and a similar incident occurred about thirty miles away.
     In Elyria, Police Officer James Kerstetter was executed while answering a disturbance call from a man named Ronald Palmer. On the surface, this appears to be a murder that took place by a madman who had a history of mental illness, namely bipolar disorder, as many of his co-workers have acknowledged. However, the prequel to that murderous action paints another ominous picture of the how the needs of those afflicted go unfulfilled.
     As one examines the life of Ronald Palmer, some eerily similar traits of him emerge that match up with Timothy Halton. When on their psychotropic drugs, both had been described as upstanding individuals, but when off, the dark side of their sick minds emerges.
      In the immediate aftermath, the life of Ronald Palmer was scrutinized to determine exactly how this autoworker transitioned into an assassin. The only red flag that emerged, and it was one where an opportunity presented itself, took place nearly a year before this event. It was then that he held his wife at bay during a domestic violence confrontation and was arrested by the Elyria Police, and pled guilty to disorderly conduct persisting. In reviewing his adult life, Stuart Canfield the records officer for The Lorain County Sheriff’s office stated, “Except for the domestic violence charge in 2009, there was no evidence that Palmer was a threat in any manner!”   
     It is here that further linkage between James Kerstetter and Jason West exposes the shortfall that exists within the methodology the local courts use in dealing with the specific needs of the mentally ill.
     As Palmer's domestic case made its way through the Elyria Municipal Court, he was ordered to undergo a psychological exam. Though it is solely conjecture, a possibility remains that this could have uncovered a high propensity to being non-compliant with medication, suffered frequent psychosis, and forced the courts to take a more preventative action, such as mandatory treatment with a rigorous probation monitoring. Inexplicably, this examination was never completed, and no follow-up ensued. He just paid his penalty and moved on.
     When confronted by this, the Elyria Municipal Court responded with what is a metaphor for how society on the whole view the mentally ill, as they stated: “It (the psychological exam) just slipped through the cracks!” In simple terms, his case was deemed not a high priority.
     Historically, the police were considered collateral contacts with the mentally ill. The severe cases, such as Timothy Halton, were routinely institutionalized for long periods of time. With the implementation of deinstitutionalization along with severe budget cuts, more untreated individuals who are in need of help find themselves outsourced to discover limited treatment on their own. Now, the police have become the new mental health crisis responders, which is not an enviable task and filled with numerous asks his
     When examining shortfalls in the mental health system, it is important to look through the spectrum of law enforcement. Lorain Police Sargent Robert Brown, who was instrumental in establishing specialized training in dealing with the severely mentally ill into Lorain County, stands as an authority on the challenges they face. He says: “The problem is the courts want to treat them (Mentally ill) as ordinary citizens and only have a limited ability to enforce restrictions on them.”
      Sargent Brown also went on to decry the decay of the mental health system as a cause for the court system failing in these two cases. He pointed out the severity of the lack of treatment. “We have some very very sick people and no place to put them!
     In their defense, the Elyria Municipal Court, like many others, were ill-equipped to deal with the issue of the needs of people such as Palmer. It is highly possible that like the situation involving Timothy Halton, the cost associated with monitoring and mandated treatment made preventive steps prohibitive. Additionally, the courts were limited by statute to exercise many preventative steps.
.    A positive step in Lorain County is that even with limited public health beds, a problem nationwide, the Board of Mental health contracts with private hospitals for additional beds”. Again the serious cases have an increased opportunity for treatment.
.    In the aftermath of these tragedies, many peripheral issues rise to the surface. The first of which is the art of “Self-Medication.”
.    An often overlooked challenge which contributes to the number of police contacts with this group is often used as a method of the afflicted to relieve themselves from the painful symptoms. With many, rather than a pharmacist being the dispenser of medication to control the symptoms, the local liquor store or drug dealer becomes the one that provides a demented treatment protocol. Once again, this illuminates an additional linkage between these two murders.
     As Jeannette Halton-Tiggs reflects, she remembers when Timothy stopped his medication; he would head directly to alcohol and marijuana, which often preceded a violent rage. He would then begin an all too common cycle of wellness, psychosis, violence, criminal charges and back to treatment and stability. Inevitably, this cycle would repeat itself. Jeannette admitted that Timothy was self-medicating at the time of the killing.
      Ronald Palmer’s actions and behavior mirror those of Halton. According to the Lorain County Coroner’s office, he had a significant level of Marijuana in his system. The records officer went on to add, “He was definitely high the night of the deadly encounter.”
     It is vitally important to understand some contributing factors through the prism of those who struggle with a mental illness. From a first person point of view, it is critical to clear up some myths. First and foremost, the mentally ill are NOT more likely to commit violent acts, though when they do, they tend to be exploited in the media. They are more likely to be victims of crimes, not the perpetrators.
     Next, many tend to develop an irrational fear of the police. Many often believe that law enforcement will be the ones to cause harm, which leads to combative situations. New de-escalation programs such as Crisis Intervention Team training have greatly reduced the numbers of violent confrontations, but more work on education throughout the legal system needs to be implemented.
.    One important point is that many of the laws dealing with those in psychosis were enacted before these conditions were discovered to be a physical disorder, not strictly behavioral. However, many inroads have been made on this issue.
       Charlie Neff, the Director of the Lorain County Board of Mental Health explained that since these two police officers death’s, the legislature has enacted significant changes regarding civil commitment and monitoring of patients; He explained The Court could order an individual to comply with their outpatient treatment program or face sanctions including hospitalization.”
     Before this change, the courts only had the power to order people to hospital confinement if they were an immediate threat to themselves or others. This change has given the courts more latitude in monitoring those in need of mandatory treatment. Mr. Neff pointed that “This is an important new tool available to the community that we hope will work with a number of individuals to help keep them compliant with their treatment plans.”
.    This court intervention programs that should have continued in the case of Halton are now getting much more attention. If looking at it simply as am an economic factor, not just the human side, it cost approximately $12,000 a year for his treatment. The results were he was working, was going to attend school to improve himself and had a realistic goal of becoming a productive member of society. Instead, a young police officer is dead, and society will spend over three times that amount per year, to incarcerate him for life. In a paradoxical twist, he is now receiving that same treatment inside the prison walls and has no chance to contribute to society.
.    In Lorain County, the Mental Health Board led by Charlie Neff have taken a very proactive approach to treatment. He said, “Typically, mental health assessments and therapy are available within 14 days or less and some agencies are doing same-day walk-in assessments.”
     These actions open the door for courts to be able to order treatment to those deemed serious cases.
      A question that begs to ask is how can deadly confrontations such as there be prevented? What are the roadblocks to reducing the number of police interactions with the mentally ill?
     The most basic barrier for those seeking recovery and a rescue from an empty social death originates with the stigma of mental illness. This current climate is one of little empathy and understanding which causes the afflicted to feel a strong sense of detachment from social contacts and drifts into a world of depression and anger.
.    Charlie Neff points at this social detachment from being stigmatized as a contributing factor in many tragedies and calls for more action awareness on the issue. “We as a society need to be brave enough to talk openly and honestly about mental illness. We need to help everyone understand what it is, what it is not, how to recognize it, and how to help someone get connected to the proven treatments that will enable them to live a full and productive Life.”
     Once again from a first person viewpoint, the stigma is indeed worse than the illness itself. When one is a member of this group, they discover a lonely dark existence that breeds painful depression and resentment from the lack of understanding and acceptance.  People once close to that individual shutter at the mere mention of the afflicted name and have as false sense of foreboding of any social contact. These factors contribute to anger and isolation, at a time when support is desperately needed. The awareness that Charlie Neff talks about can help alleviate a major roadblock for one to seek treatment and understanding. More importantly, it will help the public understand it is a disease that is treatable, and not in itself a crime!   
     Jeannette Halton-Tiggs spends her time both as an advocate and reflecting as a parent contemplating the what-ifs and should have been. She remembers the trial, and how all she wanted to do was meet with the Mother of Jason West, and tell her how sorry she was and that she tried everything to prevent the killing. His Mother declined to meet her, and Jeannette understood. She now advocates strongly on behalf of those who are in desperate need for assistance as she was for her son.
     An area that touches her nerve occurs after highly publicized killings is that is the media and politicians always blame the gun, not an illness. She has disdain for those who cry out for gun control, and she wants the energies placed on providing treatment and updated laws to prevent other similar tragedies. She has disdain for politicians who exploit the guns used in tragedies, and not their failures to provide the resources needed for treatment and prevention. What she says next speaks volumes; “Sane people do not kill people!
     To paraphrase Albert Einstein, the definition of insanity is doing the same thing time after time, and expecting a different result. Society continues to ignore those homeless individuals who go without treatment. As mentioned, many tend to stigmatize this group who become afflicted with a brain disorder. Once trapped in ostracism, an “Invisible Minority emerges with many misunderstood victims of a disease. Additionally, many deaths from chemical dependency can be traced back to an underlying mental illness.  
     A key avenue that begs to explore is to have a serious dialogue on mental illness as a method to bring awareness and to assist understanding of why an investment in treatment is beneficial to everyone. In Lorain County many positive steps have been taken. If there are concerns of a loved one, please go to the website of the Lorain County Board of Mental health and look up the many resources available.
      There are so many misconceptions about mental illness, and an open dialogue will assist in bringing understanding. The media uses gimmickry to describe and exploit how one who perpetrates murder’s such as these with headlines that read “Mad Gunman on a rampage! “If someone just snaps and commits something dastardly, the headline never reads ‘Normal person is pushed over the edge and kills!’
     The first step that needs to be taken is one that Charlie Neff mentioned, and that is there needs to be more awareness, which will breed understanding. Inroads have been made, which police work, with making treatment more readily available, the judicial system now providing mental health and drug courts, and with more people educated on the causes. However, the stigma remains, and until we come to understand what is needed, because, in the current environment, we echo the words of Albert Einstein, and continue to do the same thing over and over again, with the same result.