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Schizophrenic. Killer. My Cousin.

It's insanity to kill your father with a kitchen knife, but it's also insanity to close hospitals, fire therapists and leave families to face mental illness all on their own.

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Obviously, lots of violence is perpetrated by the "sane." And most violence committed by the severely mentally ill is committed against themselves. Even in the range of schizophrenia narratives, which commonly include suicide or dying on the street, Houston's took an extraordinarily unhappy turn. But happy endings are getting harder for even the nonviolent mentally ill to come by. And as states and counties pare back what few mental-health services remain, we're learning that whether people who need help can get it affects us all.

 

On October 12, 1773, the first patient was admitted to the Public Hospital for Persons of Insane and Disordered Minds in Williamsburg, Virginia, the first North American facility of its kind. The governor, an Enlightenment man, had prevailed upon the assembly to create a place where "a poor unhappy set of people who are deprived of their senses and wander about the countryside, terrifying the rest of their fellow creatures" could, with the help of experts, reclaim their "lost reason." Over the next 100 years, the rest of the country followed suit, taking "lunaticks" out of cages in jail basements after Boston schoolteacher Dorothea Dix happened into one such dungeon in 1841 and launched a fact-finding and activism rampage that led to the establishment of 110 public psych hospitals by 1880.

About a hundred years after that, in 1977, my mother—Mark's second cousin—dragged her 16-year-old baby sister kicking and ranting into Woodruff Psychiatric Hospital in Cleveland.

The day my Aunt Terri had a psychotic break, she just appeared in my mother's backyard. The neighbor who was over babysitting my then-infant older sister didn't know how long Terri had been out there when she finally noticed her, but she'd been pacing back and forth, long and hard and  fast enough to wear a rut into the lawn. Raving in outer-space language. Flailing and swinging wildly.

"Do whatever you have to do to get her in the car," the general practitioner said when my mom phoned him, after the babysitter called her home from work. The doctor had asked my mom to describe the scene. He'd asked my mom if she'd ever seen anyone act like that on any kind of drug. He'd told her to hold on and he'd call her right back after he contacted a special hospital in nearby Cleveland, and now he was telling her she had to get her sister there by any means necessary. So my mom told my Aunt Terri that she would take her to the airport, because the only discernible thing that Terri was babbling about was that Chris Squire, the bass player of Yes, was sending her messages that she needed to meet him in Canada right away.

It took five white coats to contain Terri as she tried to scream and fight her way out of the hospital lobby. The admitting doctor didn't know—no one who saw her in the first months she was in and out of hospitals was able to decide—if Terri, straight-As bright and talented but a party girl, went crazy because she was doing drugs or if she was doing drugs to self-medicate symptoms of oncoming crazy. By the time I'd been born and grown old enough to understand what adults were talking about, it didn't matter. Aunt Terri was schizophrenic. Period. When I was younger, I was afraid of her. Or on some level, I was afraid of being her, more likely, of not being able to tell the difference between real voices and voices in my head, of being pulled so deep into my imagination that I'd never get out. When I was a teenager, I gave her rides home from family gatherings, but only after hanging back and hoping someone else would offer first.

 
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