"Their Last Good Chance to Get Better"
(Page 4 of 4)
BUT THAT IS PRECISELY THE PROBLEM. There is barely a semblance of a mental health system waiting for them. Not long after my conversation with Cuppett, I heard from some staff members that a young man in Beaumont had just been arrested for murdering a young woman, stealing her car, and driving it to Arkansas, where he shot a man while committing a burglary. The young man, who had a long juvenile record, happened to have spent time at the Corsicana Residential Treatment Center, where he was treated for serious mental illness. During his time at Corsicana, he did improve, but as Boynton pointed out, "As much as the kids might improve while they are here, little of that improvement will stay with them if there is no supportive community health program available to them when they leave. There have to be people who make sure these kids are getting and taking their medications and staying in some form of treatment."
But as Boynton well knows, neither money nor staffing is available to make sure those kids are helped. There is a new state-run program to help juveniles with serious mental illness after they are released from TYC facilities and local probation programs, but it has enough funding to treat only 1,300 kids out of a total need of 13,000—and then only briefly. MHMR certainly can't do it; the Legislature slashed its budget by another $100 million this year.
The mental health crisis is evident in every corner of the state. In Harris County, 25,388 children have been identified as at-risk, but only 6,334 get some form of services from the agency. In Dallas County, the number is 4,672 served of 16,129 at-risk. In Tarrant County, it's 1,185 of 10,507. In Bexar County, it's 2,023 of 10,147. Thirty-three rural counties serve less than 10 percent of their at-risk children who are eligible. A hodgepodge of local mental health programs picks up some of the slack. But as the number of children in Texas continues to increase (6.5 million Texans aged nineteen and under in the year 2000, compared with 5.3 million in 1990), the programs are swamped by the demand.
Intensive inpatient public mental health care for severely troubled kids is practically nonexistent: The state runs only one residential treatment center for children, an 81-bed facility in Waco. A parent who wants to get his child into the Waco home must wait at least six months for an opening. As a result, Texas parents, at wits' end, find themselves forced to plead with social workers and emergency-room psychiatrists to help them with their mentally ill children. And it's not just lower-income Texans who cannot find assistance. Because of the rise of managed-care health insurance programs, even middle- and upper-class Texans find themselves with limited coverage for mental health services, which translates into curtailed stays in private hospitals and diminished access to clinics for their children.
Some parents are so desperate to get help that they have taken the ultimate step: appearing before a family-court judge and giving up custody of their child to Texas's child-welfare agency, the Department of Child Protective Services, which by law must provide mental health care for any child it is supervising. Last year, the parents of 241 mentally ill Texas children relinquished their parental rights after telling judges that they had no other alternative.
THROUGHOUT THE SPRING AND SUMMER, I watched various kids get shipped out of the CSU. Some had stabilized enough that they were allowed to go to regular TYC campuses. A few who were so apparently lost in their own private worlds were shipped to state hospitals after Boynton and his staff figured they could do nothing more for them. As soon as they were gone, others were at the door ready to take their place; one of the new arrivals had hijacked a Dallas city bus, telling the police he did it because he wanted people to stop eating meat.
Grant Williams, on the other hand, seemed to be one of the CSU success stories. After tinkering with Grant's medications for weeks, Boynton finally found the right combination and dosage of drugs to help him, and by the summer, Grant was acting differently from the Grant who came to Corsicana, telling people about the fifty-headed snake in his room. No one was under the illusion that Grant was "normal." His mind still drifted away, and he was intellectually slow. Nevertheless, the therapy sessions with Boynton and others had clearly helped: Grant loved to talk about how he now understood what his disease had done to him and about his new attitude toward life. "I've learned you can't make easy money by stealing. You have to get a job and work for it," he told me one afternoon. He did admit that the voice still came around to talk to him on occasion, "but I know it isn't real anymore. I know that it isn't right for me to listen to it."
Because Grant had served his minimum time for his criminal-mischief sentence and because he showed no more criminal proclivity, the Corsicana staffers decided in June that it was time for Grant to be moved to a state hospital in Wichita Falls, where his grandparents and uncle lived and where his mother was hoping to move from San Antonio as soon as she found a new job.
His transfer to Wichita Falls occurred under a state program designed to help mentally ill juveniles leaving the CSU. It allows Corsicana officials to go to a local court so that their most acutely ill kids—those who clearly are in no mental condition to go to a regular TYC state facility to complete their sentences—can be discharged directly to a state hospital for further treatment. About twelve to fifteen CSU kids are discharged to state hospitals each year, and just about all the kids that I met in the CSU were likely candidates for such a discharge: just one more sign of the increasing number of disturbed juveniles who now come to the TYC. But again, because the state hospitals no longer have the funding for long-term treatment, their staff is under pressure to release the kids within weeks. "And then it isn't long before these kids are back to their old behavior and very likely back in jail," said Linda Reyes, the TYC's head of rehabilitation.
Grant said he was ready to return to the real world, but he was nervous. The last few nights in the CSU, he squeezed on his stress ball, talked to the guards and the therapists, and told them he was going to miss them. "I worry about not having Miss Hindman and Dr. B," Grant told me. "They talk to me. They have regular conversations with me. No one else has had regular conversations with me."
In one of his final group-therapy sessions, he listened intently as the social worker, Barnes, asked, "So, guys, tell me, what does it mean to be gentle with someone?" Barnes looked directly at Grant and said, "Grant, if someone does something to upset you, can you still treat him in a kind and gentle way?"
Grant pursed his lips, straining for an answer. "Like Mr. Rogers on television?" he finally said.
"Mr. Rogers?" said Barnes, his eyebrows rising. "What an excellent example."
"Mr. Rogers is a gentle man," Grant said. "I could be like him."
Finally, in the last week of June, Grant shook hands with Hindman, Barnes, and then Boynton, the father figure he had never before had. Boynton told him to remember just what a good kid he was. Boynton also reminded Grant to stay on his medication. "I worry about kids who get stabilized here, leave, and then get off their medication and become unstable again," Boynton later told me. "That kind of change in their lives, that return to those old hallucinations, can be very difficult for them to deal with. And sometimes those kids will start acting out, and it's Katy bar the door."
To no one's surprise, Grant was not at the state hospital in Wichita Falls for long: just three weeks before being released, on July 18. When I talked to his mother a few days later, she said he was "doing okay," working part-time at a construction job with his uncle, busting up concrete with a jackhammer and looking into how he could get a job as an engineer on a train. "I think he's really going to make it," she said.
I called back in late August and got Grant on the phone. I could immediately sense that something was bothering him. The drugs his doctors had prescribed had run out. The only drug he was taking, he said, was an herbal medication his mother had seen on TV. He said he hadn't gone by the local MHMR clinic. His mother had arranged for him to see a Wichita Falls psychiatrist every three weeks, but he wasn't receiving any other kind of therapeutic services.
When I asked how he was feeling, Grant said he liked his job, "but I get kind of sad at night in my house, being alone, you know." I asked him if the voice had come back. For a moment he was elusive, as if there was something he didn't want me to know. Then he said, "Yeah, it's back."
"What's it been telling you?"
"It's been talking to me about the end of the world coming. And he says that all the other people who disobey him are going to be killed by a fifty-headed snake."
"The fifty-headed snake is back?" I asked.
"Yeah, man, it's back."
"Grant, are you sure you are okay?"
"I'm a little scared," he said. "I'm a little scared. The voice is telling me I need to watch out for people that are coming after me. He talks to me about that a lot, telling me to be ready. But I'll be okay. I know I'm going to be okay . . ."
