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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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Last year, Aunt Terri died in her yard. My Aunt Paula came to pick her up for the weekly grocery shopping and found her dead in the cold winter grass. This isn't as bad as it sounds, I tell people when that lands on their face as horror. It was, in fact, pretty much the best-case scenario. She died in her own yard, of her own home, where she lived her own life, young at 52, yeah, but not a terrible age for a body doused in antipsychotics and incessant cigarettes, giving out too early, but from the ever-desired "natural causes." Yet more and more these days, Aunt Terri's best-case scenario is an unlikely one. It took a lot of work, on the part of my grandma and Aunt Paula, and 23 years of dedication by a caseworker, work I didn't even want to do for a 15-minute car ride, work nobody wants to do, work counties and states are increasingly not paying for.
 

The hospital my mother checked Aunt Terri into no longer exists. Neither does the state hospital, CPI—Cleveland Psychiatric Institute—that she was taken to later. Had it not closed a few years after her break, she may have ended up living in it for the rest of her life. But the changes in Terri's brain coincided with massive changes in mental-health policy.

In the 1950s, more than a half million people lived in US mental institutions—1 in 300 Americans. By the late '70s, only 160,000 did, due to a concerted effort on the part of psychiatrists, philanthropists, and politicians to deinstitutionalize the mentally ill. Today there's one psychiatric bed per 7,100 Americans. The motives behind this trend were varied, to say the least. Emptying the asylums was going to save money. Who needed asylums anymore, anyway, with all the great antipsychotics now on the market? Deinstitutionalization was going to restore citizens' rights and protect them from deplorable conditions popularized by movies and memoirs and often all too real. "We were totally creeped out," my mom remembers of walking into CPI to visit her sister. "It was exactly like One Flew Over the Cuckoo's Nest. People just sitting around talking to themselves and staring into space in hospital gowns"—a place where a sane person would go crazy and the crazy were unlikely to be cured. Wouldn't it be better if the mentally ill were treated at home, given support and therapy and medication via a network of community clinics? Anyone who visited even a "good" mental hospital found that message appealing.

My grandparents tried bringing Terri home. They weren't medical professionals, and for years she was in and out of the hospital as they struggled to get her to take her medication and to take care of her when she wasn't stable. Once, when doing the dishes with Aunt Paula after dinner, she smashed a frying pan into Paula's head, causing her to see stars and their brother to tackle Terri to the floor, the single act of aggression anyone ever saw him commit. Several months later, after she started a fight that ended with my grandmother's arm broken, she was moved to a group home owned by a nonprofessional but sympathetic woman in Madison, Ohio, 20-some miles from my grandparents' house.

The constant presence of other people continued to agitate Terri; within six months she was thrown out. Using Terri's Social Security income and Section 8 housing assistance, my grandparents got her a duplex in Painesville. She was evicted. She got another apartment, and was evicted again. Two more group homes in Cleveland, evicted. She would go door to door, "bothering" tenants. She would lie on the sidewalk in her bathing suit. And she would always, always, always be blasting music. Another apartment, in Mentor: evicted. With CPI long since closed by now, and hospitalization no longer an option, Terri was running out of places to go.

 
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