"Their Last Good Chance to Get Better"
(Page 3 of 4)
He was deemed not ill enough to need special treatment, and he quietly served out his time in a state school in the North Texas town of Vernon, before being released in July 2002. But three months later, police officers found him at a public park in San Antonio, standing next to a pile of burning clothes. Grant admitted that he had broken into the concession stand at the baseball field, stolen some baseball uniforms, and started the fire by igniting the uniforms with a cigarette lighter. The police charged him with criminal mischief, a relatively minor crime, but because the arrest had violated his TYC parole, he was returned to the TYC. This time, it was obvious that mental illness was taking over his life. Grant wouldn't bathe. He talked about lizards and a fifty-headed snake coming into his room. He also began to talk about a voice in his head, one that he said had been with him for years. It was the voice, he said, that had told him to steal things when he was a teenager and to punch that guard in the county jail and to start the fire at the concession stand. Grant was sent straight to Corsicana, where he was diagnosed with schizophreniform disorder, a precursor to full-blown schizophrenia.
IN ONE RESPECT, GRANT WAS LUCKY: He got arrested before the "voice" commanded him to seriously hurt and possibly kill someone. And unlike so many other Texas teenagers afflicted with severe mental illness, his arrest landed him at a rare institution in the state that provides intensive mental health treatment seven days a week from a full-time team of professionals—the kind of attention normally reserved for patients in the most expensive private psychiatric hospitals.
TYC's Corsicana Residential Treatment Center is so respected that some parents of mentally ill children who have committed crimes have filed charges against their own offspring and then begged juvenile judges to send them to the TYC in hopes that they might end up in Corsicana. The superintendent of the treatment center, Don Brantley, is not a bureaucratic veteran of the juvenile correctional system but a psychologist who has spent much of his career working with mentally ill kids. And unlike the typically reserved psychiatrist who quietly nods as patients talk, the bearded Dr. Boynton—or Dr. B, as he is known to the kids—unhesitatingly plays the role of the gruff but good-hearted father figure, wearing plaid shirts and blue jeans and constantly ambling into the kids' cells just to check up on them. On the day I spent walking the hallways of the CSU with him, he dropped into one girl's room and noticed that she had carved the initial of another girl into her arm. "Darlin' child, that was pretty stupid, wasn't it?" he said. He noticed that a girl in another room had begun to bite herself on the arm. "Now why did you start doing that?" he asked. When the girl replied, "It helps a little to get my frustration out," Boynton said, "Look, you're going to get frustrated all of your life. So what are you going to do? Chew your arm off before it's all over?" He then walked over to the boys' side of the building, popped into a boy's room, and asked him if the rumor was true that he was hiding the medications he was supposed to be taking and trading them to another boy in return for sexual favors. When the boy quickly said, "Oh, no, sir, Dr. B. I'm not," Boynton shook his head and said, "Come on now. Don't you start lying to me."
One of the enduring myths about mental illness is that it is a disease that cannot be controlled. True, it is not curable. But it is manageable, especially for those who are treated early. Because of the new generation of antipsychotic medications now available, the majority of mentally ill kids can get stabilized much faster than ever before—if they get into treatment soon enough. According to Boynton, many of the kids who come to Corsicana get better simply because it is the first time they have been studied and diagnosed and then subjected to a treatment plan, in which they get the proper medications as well as therapy programs that teach them how to deal with their illness and keep their moods under control. Many also get better, he says, because it's the first time in their lives they have a sense of hope. "We forget that so many of these kids, from daylight to dark, have been living in their own delusional world," Boynton told me. "Then they get to a place like Corsicana, and they finally get a chance to feel safe. They have someone to talk to every day. They have someone who says, 'We're going to help you so you won't end up a bum or dead.'"
Day after day, I watched Boynton take his CSU kids back to his cramped office, the cinder-block walls of which were covered with photos of his grandchildren along with a poster of a famous Peter Paul Rubens painting of a pensive young girl. Leaning back in his chair, he'd ask them how they were feeling and whether they were having any hallucinations or thinking about hurting themselves. Some days he'd act exasperated with them for not trying hard enough to get better. Other days he'd throw his arm around their shoulders and tell them that he knew they were going to get better. On one visit I listened in as a boy said to him, "I'm not all that crazy." "Good Lord, you sure as heck are crazy," Boynton said, chuckling. "But you don't have to be crazy, you know. You can have a decent life if you want one." Tears filled the boy's eyes, and he quietly said, "That's what I want, Dr. B."
When I first met Grant, it was clear that that was what he wanted too. "I want the voice to go away," he told me. "I don't want to hear him anymore. Every night, I say to the voice, 'No, no, no. Please leave me alone.' But it keeps talking to me. It just keeps talking, always talking, always telling me what to do. It says, 'Come on, Grant, you know you could hurt some people. You could hurt them, Grant.' Or it says to me, 'Come on, Grant. Isn't it time to give it all up? Isn't that what you want to do?'"
During Grant's time at the CSU, under the watchful eyes of guards, he had a daily routine: wake up, eat breakfast, attend school, eat lunch, spend some free time outdoors in a fenced area, perform exercises in the hallway outside his room along with the other CSU boys, and participate in group-therapy sessions, in which he was encouraged to identify such concepts as self-respect. Throughout the day he would talk to Emily Hindman, a young therapist assigned to the boys' wing of the CSU, and to social worker John Barnes, who ran the group-therapy sessions, and of course, to Boynton, who was constantly trying to figure out exactly what to do to diminish the voice in Grant's head. Whenever Grant felt anxious, he would practice breathing exercises that Hindman had taught him, or he would squeeze a "stress ball" made of a spongy material.
But I always kept wondering, Was it too little too late? Was Grant, like so many of the other kids there, just too emotionally broken for Boynton and his staff to make a real difference in his life?
Among the other CSU kids I met during my visits was a boy with a severe bipolar disorder who had been beaten mercilessly in his early childhood by his father and starved to the point that he had developed rickets. The boy who had broken into 25 homes had been sodomized by his biological father since he was an infant. Whenever I was around him at the CSU, he was pinching himself in the face, almost involuntarily, as if he had no idea what he was doing. Over on the girls' side was an emotionally disturbed pregnant teenager who had taken any kind of drug she could get her hands on. When I saw her, she was spitting into a cup and then drinking her own spit, believing that she was maintaining her own water and thus helping her unborn baby. "Someone had to know these kids needed significant intervention long ago," Boynton said. "But obviously, nothing ever happened. Or there was no place to send them. And now we're supposed to clean up the mess."
What adds to Boynton's difficulties is that he is not given much time to clean up the mess. The Corsicana Residential Treatment Center is part prison, part mental hospital: Boynton cannot keep the kids there as long as he wants, until they are rehabilitated and ready to make their way in the world. What's more, because of the high cost of treating a kid at Corsicana—$262 a day versus $151 a day at a regular TYC state school—CSU officials are under pressure to move the kids out to other TYC facilities as soon as they are somewhat stable, so that the facility can handle the continual onslaught of new arrivals who are in dire need of treatment. When I asked Paul Cuppett, a psychologist and the clinical director of the CSU, if he was worried about letting kids out too early, he said, "Are you asking if we are letting loose some ticking time bombs?" He paused. "There are kids who leave here who will have a likelihood for future violence if their mental needs go untreated. But we can't legally keep them because of that. When they have fulfilled their duty to the correctional system, then that's it. They now belong in the mental health system."
