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Archive for Sunday, April 9, 2006

Mentally ill falling through cracks

Those who refuse treatment and break the law end up in jail

April 9, 2006

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Editor's note: This is the first in a two-part series about the mentally ill in the Douglas County jail.

Robert "Simon" Gilmore is in jail. Again.

He's been arrested eight times in the past three weeks. The last time - April 3 - he asked the judge to leave him in jail for 90 days.

"He said if they let him out, he'd just get arrested again," city prosecutor Jerry Little said. "So the judge set his bond at $500. He's still in jail."

Gilmore, who will soon turn 50, is the homeless man who's often seen sitting or sleeping on the sidewalk in front of either Weaver's department store or The Replay Lounge downtown.

He's known for wearing white socks on his hands and, when it's cold, wrapping himself in a thrift-shop blanket. Legally blind and intensely private, he rarely says more than a few words to strangers.

Family members say Gilmore has been diagnosed as paranoid schizophrenic.

Mental health advocates and law enforcement authorities say he has become a prime example of how the mentally ill, especially those who refuse treatment, are falling through ever-widening cracks in the social service network.

Since moving to Lawrence in the early 1980s, Gilmore has been arrested more than 50 times, usually for wandering on private property, urinating in public, disobeying a police officer or obstructing traffic.


Lawrence Police officers arrested Robert "Simon" Gilmore at Seventh and New Hampshire streets.

Lawrence Police officers arrested Robert "Simon" Gilmore at Seventh and New Hampshire streets.

"He can't see very well, so he tends to walk in the street," Little said.

Gilmore's latest troubles stem from a new city ordinance that prohibits camping on a downtown public right-of-way. Sleeping on the sidewalk in considered camping.

City commissioners passed the ordinance in response to downtown merchants' complaints of people sleeping in doorways, sidewalks and alleys.

The ordinance was not aimed specifically at Gilmore, Mayor Mike Amyx said.

"The ordinance is very fair," Amyx said. "It concerns all kinds of folks, not just him."

'The only place'

Little said jail wasn't the best place for Gilmore. But for someone who's mentally ill and who insists on breaking the law, it's the only place.

"We're at a loss as to what to do with him," Little said. "He's very independent."

Gilmore has refused help from Bert Nash Community Mental Health Center.

Recent efforts to have him committed to Osawatomie State Hospital have been denied, Little said.

To have Gilmore committed, Little would have to prove that Gilmore is a danger to himself or others and incapable of making reasoned decisions.

"I could probably get one - 'danger to himself or others' - but I can't get both," Little said, noting that in the past, Gilmore's mental illness hasn't been considered severe enough to hinder his decision making.

Under the law, Gilmore has the right to choose to be mentally ill.

"I'd be glad to work with any agency in town that thinks it can work with Mr. Gilmore," Little said.

Bert Nash stands ready to help, but Gilmore has rejected the mental health agency's overtures.

"I cannot comment on this or any other individual's circumstances," said Dave Johnson, Bert Nash executive director. "But I will say that people have the right to refuse services. You don't lose your rights because you're mentally ill.

"But when that's the case," he said, "we don't have a solution."

Gilmore's troubles are fast becoming a burden on jail staff, Douglas County Undersheriff Kenny Massey said.

Lawrence Police officers arrest Robert “Simon” Gilmore at Seventh and New Hampshire streets in this Dec. 30, 2005, file photo after fielding several calls about him walking in the streets. The city of Lawrence says information about officers involved in complaints, the specific allegations they faced, and how the cases were handled should not be public.

Lawrence Police officers arrest Robert “Simon” Gilmore at Seventh and New Hampshire streets in this Dec. 30, 2005, file photo after fielding several calls about him walking in the streets. The city of Lawrence says information about officers involved in complaints, the specific allegations they faced, and how the cases were handled should not be public.

"He can be very demanding," said Massey, who is in charge of jail operations. "He becomes upset, he trashes his cell, he makes a lot of noise."

Gilmore's being in jail serves no long-term purpose, Massey said.

"We manage him," he said. "We don't treat him."

'Overwhelmed'

John Tucker, 41, has battled schizophrenia most of his adult life.

"I've been in treatment," he said. "I deal with it now."

Tucker, who lives in Lawrence and is active in the Douglas County chapter of National Alliance on Mental Illness, said he sympathized with Gilmore. Tucker said he, too, has felt "overwhelmed" by his illness and unable to find "virtue" in his life.

Still, he said, people who are mentally ill have an obligation to themselves and to society to seek treatment.

"If (Gilmore) chooses not to do that, then that decision should be made for him," Tucker said. "That may mean having to go to Osawatomie State Hospital and being kept there until he's ready to get better."

He added, "Jail isn't the answer."

Comments

angel4dennis 8 years, 8 months ago

Even though he refuses treatment from Bert Nash, if he willing asked the Judge to keep him, I believe he is asking to commit him. Wouldn't he be considered a danger to others when he could easily walk out in front of a car and get killed. The person who hit him would go to jail for unintentional vehicle homicide, is that fair to society to set us up like that? I am not for condeming an ill man, just get him help. His actions alone appear to me to be a cry for such help.

lunacydetector 8 years, 8 months ago

"Under the law, Gilmore has the right to choose to be mentally ill." say what? nothing like letting a mentally ill person make decisions.

is this why lawrence has so many problems?

ForThePeople 8 years, 8 months ago

Simon truely needs help and is unwilling to get it himself. With the closing of so many mental facilities, this is what we are left with....a homeless society of mentally ill individuals. Personally I would think the fact that he has been arrested 8 times in 3 weeks says loud and clear that his decision making skills are severely impaired. And as someone else already noted there is no doubt at this point that he is a danger to himself and others when he walks down the middle of the street oblivious to the traffic and the danger he poses!

lori 8 years, 8 months ago

What do you envision will happen if he is committed? Have you ever been in a mental institution? You STILL can refuse certain services within, and those that can't be refused are given by force. So, they are going to drug him until he can't resist. Then, he'll take his meds for a while, he'll get alittle treatment, and then he'll be released. Unless he is criminally insane, they can't keep him forever--our government and insurance companies don't pay for that. They will only be able to somewhat help him while he is there. Then he will be back in the community, and back where he started.

Is it asking too much to accept that some people just are not going to fit into our current society and culture no matter what opportunities are available? This might just be a situation where we do the best we can for him, and let him do his own thing. Legally and medically, there aren't alot of options available, and those that are aren't long-term.

littleme 8 years, 8 months ago

I lived next to someone (in a duplex) that was obviously mentally ill. She was an adult who's parents left here there and paid for everything. It was awful! In the time that I lived there I couldn't count how many times I called the police after hearing her destroy the place inside, scream unbelievable obsenities (at herself), and sound like she was trying to kill herself! And she drove!!!..while trying to run down the neighbors on foot! I called Bert Nash, the Heath Dept, The Police Station, anyone and everyone and ended up with no help. No one could do ANYTHING! We feared our lives and our home (since we were attached by a wall!) I thought it was awful that her family knew she was like this and allowed it to happen. She obviously can't make the decisions for herself...I just think that it's a shame, that she didnt' have to live like this..she needed and should get help. I would hope that if I go mentally ill, someone would try to help me out, if my family wasn't around, and I didn't know what was going on..but it doesn't sound like are able to look out for one another like that! What a joke!

janeb 8 years, 8 months ago

There is a serious problem where people who suffer mental illness get thrown in jail.

janeb 8 years, 8 months ago

you are correcty marion and there is no magic pill that will cure, at best one can only subside the symtoms.

Rhoen 8 years, 8 months ago

Some areas have established "mental health courts" which try to meet more constructively the specific challenges of assisting the destabilized mentally ill.

That could be a truly "progressive" approach to a situation that poses a danger not only to the individual involved, but to the community as a whole.

Though the primary focus of this article, Simon is a comparatively mild and relatively harmless example of a mental health crisis. While he is a local character and many readers can probably visualize him (especially recalling his red-shirted vendetta against Dillon's grocery several years ago), he is not an accurate icon for the problem presented by a "system" which cannot handle the reality of active mental illness, and apparently does not want to.

Recent news items told the story of the woman who murdered her baby daughter by taking her to the kitchen and cutting her arms off.

Also in the recent past and closer to home, a man with severe untreated bipolar disorder wrecked his car containing his several surviving children against a Lawrence tree shortly after stabbing his profoundly disabled son with a screwdriver and leaving him in the middle of the highway to be run over by passing vehicles and killed.

Here, Lawrence Memorial Hospital is absolutely the last place you'd take someone in a mental health crisis. It cost-cut its mental health unit some time back, leaving only a crowded emergency room with a long wait and seemingly untrained personnel to handle sometimes violent, dangerous mental health problems. If you have sat there with a sick child for a couple of hours waiting to see a doctor, you'd agree that this is not the place to transport someone in crisis.

You also would not want to call the police, probably, if your child were upset and in her or his bedroom with a knife contemplating suicide ... One local family can testify that it could come to pass that when the police arrive, they may make your child's decision for her or him.

Bert Nash has shown some "clients" that, in crisis, don't bother to call them. Often, no one in that beautiful and artfully decorated facility can handle a "client" in need of stabilization. Furthermore, it would be rare if Bert Nash personnel on duty were able or willing to arrange for other intervention or provide useful advice in an active crisis after hours or on weekends.

The mother of one young woman described in an LJWorld story a little while back tried to get help for her daughter from both Bert Nash and the LMH emergency room. They were sent home, apparently to wait until a more convenient time to seek treatment. Once home, the young woman drank a poison and died.

In Douglas County, the people at the jail seem to be both the most humanitarian and the competent when this type of help is needed. They should be paid more, because this was likely not in their job descriptions.

City and county officials: MENTAL HEALTH COURTS - please research and consider.

Baille 8 years, 8 months ago

"some town, this lawrence"

Marion,

This isn't a Lawrence law. It is a Con Law issue. Rhoen has some good stuff in his/her post above, but it is important to note that this debate has been going on under the radar for years. Organizations such as NAMI and one like NAMI for family of those with mental illness have been going over this ground since well before I got my undergrad. There is a crisis in mental health services ever since we deinstitutionalized and went to "community mental health centers." As usual, our government "leaders" took an interesting idea, ran with it to the point of gutting the institutions and the never funded the "community centers" part. What we have now is inadequate on all levels. The sad part is that sick people die because the only intervention we have as a society are cops and jail cells. No ding on the cops, but they just aren't qualified to handle mental illness and shouldn't be asked to do so.

Do a little research on this, Marion. Everyone has an opinion, but the facts belong to no one.

Jamesaust 8 years, 8 months ago

The origin of this problem is the Community Mental Health Centers Act of 1963, which deinstitutionalized care for the mentally ill and switched to a preventitive, community-based, outpatient approach. While having gotten rid of some of the prior failures, it brought about it own.

Local communities have proved to lack the resources and the will to address these issues. Despite federal intervention, D.C. doesn't provide locals with adequate money (maybe 10% of the total cost), and ever-present budgetary problems have led to cronic underfunding locally (after all, who makes up the voting constitutency for the mentally ill?).

Forced medication might perhaps - in a limited number of circumstances - be a necessary reform. More likely, it is seen as an easy way out for government - and the people - instead of the more difficult approach envisioned in policy.

What this article represents (but downplays) is the bizarre choice that Kansas makes - 'to pay' for the mentally ill via law enforcement instead of health services. That's the liberal point.

This article also represents a situation where the subject matter is a state and local concern but the federal government intervenes to mandate or restrict state policies but then fails to provide resources or to acknowledge failure later. That's the conservative point.

Confrontation 8 years, 8 months ago

By not forcing these people to get help, we are forever making Lawrence the #2 meanest city for the homeless. Maybe the nicest cities force pills down the throats of homeless.

lori 8 years, 8 months ago

After the aforementioned suicide, LMH established a short-stay mental health area in its ER. So you won't be sitting next to someone in a psych crisis in the waiting room; people who are having a mental health issue are taken to a different area. It is staffed by ER personel with assistance from Burt Nash.

The economics are that LMH cannot support an inpatient facility; the ER facility is a compromise--pts are admitted to it for a short term, until a placement in a longer term facility is found. Sometimes those pts are even admitted to the floor (usually medical floor), if suicidal, then they have one-to-one care until they are transported. It's a shame that it took the death of a young woman to initiate this, but at least the hospital and Bert Nash responded to provide some sort of interim care. It's not perfect, but it's a start.

Baille 8 years, 8 months ago

Essentially, the constitutional right to be free from unreasonable seizure of the person.

The whole idea of not being able to institutionalize someone who is not an imminent danger to themselves or others, or not being able to force medication of someone absent the imminent danger, comes back to the right to be free from bodily intrusion by the State. On the other hand, there are issues around a mentally ill person being able to make decisions in their best interest, such as whether to take medication or not live in a gutter; issues around public burdens being created by those who make bad decisions because of mental illness; and issues around "imminent" and "danger."

The issue certainly does have local and state components, but there are also considerations regarding constitutional law that must be factored in as we talk about potential approaches.

Oh, not to mention the burden on local budgets. There was a pretty valid rumor running a few years ago that Johnson County was appointing guardians for those people who qualified due to mental illness because of funding "problems." One of the consequences of unfunded mandates and good intentions without financial responsibility.

lawrencechick 8 years, 8 months ago

Rhoen, it seems you think treating the mentally ill is as easy as putting a band aid on someone. I have seen countless mentally ill people try to be helped by Bert Nash, ER, etc..(all workers who are being WOEFULLY UNDERPAID for dealing with the violence and aggression they have to deal with from many of these people.) Many have been committed and "treated" and come right back. So I don't see what the difference would be if they were treated at LMH, except you would be paying for all of it. It sounds like you and many other people have pointed out all the problems of the mentally ill, but have no solution. Maybe you should be called three times in the middle of night to screen a mentally ill individual and then maybe you would have some experience to tout.

Rhoen 8 years, 8 months ago

lawrencechick - I did pose some possible solutions:

  1. a mental health court to deal with issues of the destabilized mentally ill other than demonizing them by funneling them through the criminal justice system (at great expense, by the way).

  2. a networking connection among whatever resources exist at Bert Nash and whatever resources exist at LMH and others involved already in handling this issue, so that some USEFUL information could be provided to family members and others dealing with a loved one in crisis.

  3. a plan of ANY kind that would be disseminated to clients, their families, first responders, and second responders so that a crisis situation could be dealt with in a way that is not reminiscent of playing Hot Potato, or That's Not My Job, or Unfortunately I Just Can't Help You, when immediate help is urgently needed.

  4. a secure area at the Bert Nash facility where a person in crisis could be maintained in relative comfort and safety to herself or himself and others, while the elements of such a plan were put into place.

  5. use of available funds to actually PAY and train competent crisis personnel at Bert Nash so that they could implement such a plan - rather than using available funds to pay for nice art, a big pretty building, see-and-be-seen soirees, etc.

(Look at the big picture - the costs of dealing with destabilized mentally ill are VERY high and ARE paid elsewhere, and with public funds for the most part.)

  1. a mind-set at LMH at that realizes that medicine used to be, and could again be, a calling which benefits the community which pays it, rather than an industry that greatly benefits a thin layer of the elite - So that the bottom line is a focus on providing medical care to people who need it, and not to see how high the profits can go or crowning Board members who can grow profits while attending the above-mentioned see-and-be-seen festivities and whatever other little things they do. The LMH Board should put forth a little effort to see that the hospital provides better assistance to Bert Nash and the community at large.

(The "rival" hospital system which wanted to come into Lawrence might have actually provided some useful laissez-faire capitalistic energy to bring costs down or provide services that LMH can't or won't.)

  1. More training and PAY for the Sheriff's Department and others at the jail who end up taking care of these people who need help in a mental health crisis ... and so on ...

There's PLENTY that could actually be done, if anyone really wanted to actually do something.

lawrencechick 8 years, 8 months ago

"an industry that benefits the thin layer of elite" Are you serious??? Have you been to an ER lately? The uninsured or people on medicaid will get a Cat Scan at the blink of an eye and 9 times out of 10 it will be written off. I would have to wait a week to get that Cat Scan and then meet my deductible before I get any help paying for it. The way "medicine used to be" was that the mentally were locked up in an asylum and electrocuted. Is that what you want? People also didn't abuse the ERs like they do now. I would have to be half dead before my parents brought me to the "Emergency Room".

Baille 8 years, 8 months ago

"There was a pretty valid rumor running a few years ago that Johnson County was appointing guardians for those people who qualified due to mental illness because of funding "problems."

Should be a "not" between "was" and "appointing."

Rhoen 8 years, 8 months ago

easy-mark: great description and that is exactly what I was referring to in saying that an emergency room with sick children and a mentally ill person in crisis do not mix well:

<(A couple of them,friendly, taking it in stride, it's not the first time they've had to do this. They stand there, gentle but firm, talking, keeping things calm,just hoping the repeat patient doesn't get out of line, then when any one of them has to step out of the room, they are back to their regular diffused, friendly selves, shaking their heads,smiling, maybe tired, explaining to the parents of the child in the next room, "We're just waiting for a house-parent, or transport, or someone in charge of that person to come and take over for them.". Making it so the general public isn't alarmed.They do a great job, the times I've seen!) >

Some of the deputies should be sainted - but only after given a raise in pay.

kujayhawk83 8 years, 8 months ago

We should thank LMH for providing the crisis stabilization unit. It is a step in the right direction. The bottom line is that society hasn't decided how to deal effectively with the mentally ill, nor has it agreed to pay the costs of ongoing treatment. LMH and Bert Nash do the best they can with the limited resources they have. That doesn't mean that we shouldn't strive for better. Call your congressman. In the meantime, "Lawrence is the second meanest city" is really bad PR but it is also far from the truth.

happygolucky 8 years, 8 months ago

Make him build roundabouts untill he sees the light.

Wallabe 8 years, 1 month ago

Hello Lawrence. I found this article to be of particular interest to me since I have been diagnosed as severely and permanently mentally ill. I know the man that everyone is talking about and I would be that man if it were not for my family here in Lawrence. I am educated, but when I am off my meds I am not the most desirable person to be around. I just don't fully think that people really have a grasp on mental illness. I have been hospitalized several times and while I have been stabilized I have a tendancy to get off my meds because I start to feel ok.

I just don't think that people should turn away mentally ill people because they can be great people like any other person you meet on the street. I just want to see some compassion. I have been jailed a couple of times because of my condition and no the county jail isn't the best place to be. Locked in a cell with absolutely no support groups or otherwise.

Maybe some of you have even met me on the street.

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