After Closing Psychiatric Hospitals, Michigan Incarcerates Mentally Ill

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(Courtesy of The Detroit Free Press)

Pattie Charleston, 50 of Detroit shows off a picture of her son William Rhymes, 20 who is currently locked up in the Wayne County jail for three counts of armed robbery. Charleston is a peer support specialist and facilitator at Detroit Central City Community Health Agency and feels that her son should have been receiving mental health treatment when he started getting into trouble.

Wayne County Sheriff Benny Napoleon spoke for most sheriffs when he said, during a community meeting earlier this year, that his jail had become his county’s largest mental health care institution.

Over the last two decades, changes in state policy and big cuts in funding for community mental health care have pushed hundreds of thousands of mentally ill people into county jails and state prisons.

Between 1987 and 2003, Michigan closed three-quarters of its 16 state psychiatric hospitals, including Northville in suburban Detroit. The state now provides the sixth-lowest number of psychiatric beds per capita in the nation, reports the Treatment Advocacy Center.

“We closed too many (hospitals), too quickly,” Mark Reinstein, president of the Mental Health Association in Michigan, told me this month. “It wasn’t done in a planned, rational way.”

Community mental health agencies — which were supposed to take up the slack but never received the resources to do so — face continuing budget cuts. The state has resumed warehousing its mentally ill — this time behind bars.

A University of Michigan study last year found that more than 20% of the state’s prisoners had severe mental disabilities — and far more were mentally ill. The same study found that 65% of prisoners with several mental disabilities had received no treatment in the previous 12 months.

The problem is even worse in county jails, where psychiatric treatment is virtually nonexistent. In 1999, a Department of Community Health study — conducted by Wayne State University — of jails in Wayne, Kent and Clinton Counties found that more than half their populations were mentally ill and one-third were seriously afflicted, suffering from schizophrenia, bipolar and other psychotic disorders. If anything, the crisis has worsened since then.

Sometimes, the results are tragic. In 2006, I reported that Timothy Joe Souders, a mentally ill 21-year-old serving one to four years for stealing two paintball guns and threatening a police officer, had died of heat and thirst after spending four days strapped down in a hot isolation cell, naked and soaked in his own urine.

Since 2008, the state has slashed $50million from community mental health agencies, with Wayne County absorbing more than half of the cuts.

The annual budget for the nonprofit Detroit Central City Community Mental Health one of Detroit’s largest community mental health agencies, plunged from $11.2 million in 2008 to $8million. President and CEO Irva Faber-Bermudez said the cuts have forced her agency to close an urgent care clinic and end an effective transitional housing program. Gov. Rick Snyder and the Legislature should reconsider these cuts if they really want to improve mental health care and remove mentally ill people from prisons and jails.

Treating one client in a community program costs about $10,000 a year, compared with $35,000 a year to house one prisoner. Detroit Central City’s jail diversion and prisoner re-entry programs report recidivism rates of less than 10% — at least four times lower than the overall state average.

Serving 4,600 people a year, Detroit Central City, headquartered at 10 Peterboro, reaches only half of those needing community mental health services. Statewide, more than 200,000 people a year use community mental health services, but experts say at least twice that many need them.

The return of hope

Homeless, Michael Squirewell, 56, came to Detroit Central City three years ago with nothing more than the clothes on his back. In the early 1980s, the former gang member had nearly $175,000 in cash.

Growing up in the Brewster Projects, Squirewell dropped out of school in the third grade. One of his friends on the northwest side was now famous writer Michael Eric Dyson, who cited Squirewell as a peer who “sought to protect me from some of the worst elements in our neighborhood.”

Later, as a founding member of Young Boys Incorporated, Squirewell sold drugs and recruited other gang members — some as young as 8 — on Detroit’s west side. He was stabbed and shot while witnessing nearly a dozen shootouts and murders.

By the mid-1980s, Squirewell had become his own best customer. Mentally ill and addicted to crack, he ducked into Dumpsters, hiding from the cops and getting high. “I didn’t care about anything or anyone, even me,” he said. “For a while, you get the cars, the girlfriends and the money. But a lot of pain and suffering go with it. It’s not worth it.”

By the time he got to Detroit Central City, Squirewell was broke and almost out of hope. The agency sent him to a transitional housing program for two months and helped him apply for Social Security benefits. It diagnosed his mental illness, put him on medication and taught him how to pay bills and cook meals. It gave him a new sense of hope and self-worth.

Today, in his two-bedroom apartment on East Jefferson, he looks out at Belle Isle and the Detroit River, instead of boarded homes and dope houses. He plans to marry Jackie Taylor, 47, of Detroit, next year. The two met at a state jobs program 13 years ago. “She walked this mile with me,” he said.

Enrolled in a literacy program, Squirewell continues to work on his GED and mentors people going through the same struggles he did. “Detroit Central City saved my life,” he told me. “I’m moving forward, and I’m not looking back.”

Diagnosed in prison

Some clients don’t reach Detroit Central City until after years of incarceration, said Norris Howard, manager of community re-entry.

Jerry Zillner of Detroit didn’t know he was mentally ill until after he started serving a 13- to 50-year sentence for second-degree murder, a crime he committed in early 1986, when he was 19, after a neighborhood man assaulted his mother and sister on Detroit’s east side. He was diagnosed in prison with paranoid schizophrenia and bipolar disorder. Zillner, 44, was paroled on April 5, after serving more than 26 years in prison.

Before prison, Zillner worked as a disc jockey, mainly at after-hour parties. He dropped out of Southeastern High School in the 10th grade.

“I always knew something was wrong, but I didn’t find out I had a chemical imbalance until I went to prison,” he told me. “When I got upset, I was like Dr. Bruce Banner (the mild-mannered comic-book physicist who involuntarily turns into the raging Hulk). I had racing, manic thoughts. I could go from 1 to 1,000 in moments.”

After sentencing Zillner, Judge George Crockett III ordered a psychiatric evaluation. Zillner spent seven months in a prison forensic unit.

In prison, Zillner earned a GED but was sometimes out of control. Following a beef in 1994, he stabbed an inmate multiple times with a homemade shank. (The inmate survived.)

Zillner started taking psychotropic medications to even his thoughts and moods. He joined the Nation of Islam. His newfound faith gave him strength but also forced him to look at himself. He knew he was lucky to get a second chance.

“I can never use (mental illness) as a crutch or excuse,” Zillner told me. “It doesn’t lessen my responsibility as a man. I deserved that punishment. I’m just thankful I’m still alive.”

On parole, Zillner came to Detroit Central City to get a monthly injection of Prolixin, an antipsychotic drug. He also found other ways to help himself. Now he spends two to three hours a day at Detroit Central City, attending group meetings and counseling sessions and talking to peer specialists — mentally ill people who serve as mentors.

Detroit Central City helped him settle at Cass Community Social Services. At home, Zillner exercises, reads and meditates. At 6-feet-4 and 185 pounds, he’s slim and cut. He has lined up a job as a sanitation worker or, as he puts it, “garbage man,” and continues to work with the Nation of Islam.

Without Detroit Central City, Zillner said he would probably be back in prison. “This place helped me become stable,” he said. “I have a support system. I’m doing well, and I’m about to do better.”

Cries for help

Pattie Charleston, a certified peer support specialist at Detroit Central City, has spent most of the last six years helping other mentally ill people avoid the criminal justice system and get the community treatment they need.

“Every day when I come in, I see me,” said Charleston, 50, who spent a total of 24 years locked up for various offenses, including check fraud, larceny, prostitution and drugs.

A manic-depressive, Charleston became a Central City client in 2003, after decades of mental illness, severe depression, incarceration and substance abuse. She started drinking at 11. By 19, she was using crack. She tried to commit suicide by slitting her wrists, overdosing on pain killers, and hanging herself.

“It was really a cry for help,” she said. “I couldn’t understand why my life was such a roller coaster. Even when I was off drugs, this cloud would come out of nowhere.”

After Detroit Central City diagnosed her mental illness, she had to confront the stigma. “You’re labeled as crazy,” she said. “I felt that if I had a mental illness, my life was going to be limited.”

Charleston worked with a treatment team and learned how to manage stress and mental illness. Her therapist helped her cope with the pain and trauma of childhood molestation.

Impressed with her progress, the agency hired Charleston two years later. She later became a certified peer support specialist, working as a mentor and role model.

This year, her work with jail diversion became even more personal. She visits her 19-year-old son, William Rhymes, in the Wayne County Jail, where he awaits trial for armed robbery. Charleston believes her son is — like her — bipolar, but he hasn’t been diagnosed or treated. He attempted suicide in 2008, according to court records.

Last month, I went with Charleston to visit her son in jail. No chairs were available for visitors, who had to practically shout through small glass partitions.

Rhymes told me he asked to speak to a psychologist a week earlier but had heard nothing. “I feel overwhelmed,” he said. Charleston works with a social worker, trying to make sure the court evaluates her son’s mental illness.

As she left the jail, Charleston placed her hand on the glass, where her son placed his, and held it there. “He’s slipping through the cracks,” she said as we walked away. “I don’t want them to count him out.”

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