No One Cares About Crazy People

by Ron Powers

  A 2015 report issued by the Vera Institute of Justice pointed out that the mentally ill are put at further risk by the very design, operation, and resources of most jails. “Characterized by constant noise, bright lights, an ever-changing population, and an atmosphere of threat and violence,” the report points out, “jails are unlikely to offer any respite for people with mental illness. Coupled with the near-absence of mental health treatment, time in jail is likely to mean further deterioration in their illness.”11

  The institute added that when lack of treatment—the plight of 83 percent of jail inmates—is factored in with a “chaotic environment,” the illness typically deepens, and such inmates “are more likely to be placed in solitary confinement, either as punishment for breaking rules or for their own protection since they are also more likely to be victimized.” Of course, these “chaotic environments” also describe those at state hospitals shut down for abuses. These disgraceful human-storage barns also featured patients in rags or naked; twenty-four-hour-a-day lights; neglect; and victimization including rape by other inmates—and by staff.

  The institute might have added that solitary confinement is among the most soul-destroying, desolate, madness-inducing, and morally barren of punishments that can be visited upon an insane person. Or any person.

  On January 21, 2013, six weeks after the massacre of schoolchildren and staff members at an elementary school at Newtown, Connecticut, by a deranged and suicidal young man, Forbes magazine editor Steve Forbes seemed to come within an eyelash of demanding that the big public hospitals be filled once again with the insane and presumed insane. “Instead of… accepting the commonsense notion that people with serious mental problems can’t rationally decide what is best for themselves, we have largely emptied our public psychiatric hospitals,” wrote the normally reliable proponent of free-market solutions.12

  Two years later, three ethicists at the Perelman School of Medicine at the University of Pennsylvania proposed exactly that.

  Acknowledging that President Kennedy’s bold experiment had proceeded from legitimate concerns about genuine problems—overcrowded hospitals, the protection of the civil rights of patients, the prospects of more efficient economics—the three academics declared that time had shown the remedies had failed. And they pointed out how drastically the times, and the demographics, have changed in the past fifty years: a doubling of the United States population since 1955 and a mentally ill population of ten million (not all of them chronic), yet a shrinkage of inpatient psychiatric beds to forty-five thousand (a 95 percent loss) to create “a wholly inadequate equation.”

  They declared that “deinstitutionalization has really been transinstitutionalization. U.S. jails and prisons have become the nation’s largest mental health care facilities. Half of all inmates have a mental illness or substance abuse disorder; 15 percent of state inmates are diagnosed with a psychotic disorder… This results in a vicious cycle whereby mentally ill patients move between crisis hospitalization, homelessness and incarceration.” They called for a return of medical facilities that would house the mentally ill in a “safe, modern and humane” way, and proposed that “the term ‘asylum’ should be understood in its original sense—a place of safety, sanctuary and healing.”13

  Perhaps a return to large-asylum care is indeed a feasible means to end the outsize costs of criminalization and social disruption, not to mention the countless individual and family catastrophes fueled by our present broken system of mental health care. Yet any visionary or movement that seriously proposes launching such a gigantic and complex countermigration—such a towering payload of good intentions—must be equipped with a detailed map for avoiding the road to hell.

  Any such enterprise would have to be founded upon a thoroughgoing program of public/private planning and agreements: on design and construction and upkeep of new hospitals; on screening and surveillance procedures for doctors and staff; on nutrition, cleanliness, and counseling ensured by vigilant oversight and enforceable (and enforced) by bipartisan law. It would have to find ways to bring together the “abolitionists” and the “paternalists,” whose entrenched mutual opposition has shown, at this writing, no sign of willingness to abandon absolutism and seek compromise. This could be brought about only by a public leader or leaders blessed with wisdom, deep knowledge of psychiatric and technological theory, and the capacity to inspire people toward a greater good. Such leaders have not been conspicuous on the American scene in recent years.

  All this of course would require an ongoing public and private investment of tremendous proportions. Which, in turn, would require an equally historic mobilization of unified public will, perhaps on a scale equal to that of preparing for war.

  Can such an all-encompassing and permanent reformation of mental health care be expected to happen?

  It hasn’t happened yet.

  14

  “Hey Fam—”

  Kevin emailed us after his first performance on the Interlochen campus. He played a guitar-piano duo with his roommate at a coffeehouse, an informal evening venue. His message was filled with exuberance and wonder at all that was unfolding in his life.

  Subject: !!

  Date: Tue, 28 Sep 1999 08:50:55 PDT

  From: “Kevin Powers”

  To: ropo@sover.net

  Hey fam—

  Well heres how the coffee house went. The Interlochen Jazz Combo went first and of course they were smokin’ and everyone went nuts, me and jesse [his roommate] went about 10th and played Equinox and a lot of people said we stole the show which is supposedly incredible since even having enough courage to play the first Interlochen Coffe House was in and of itself pretty amazing, not to mention being sophmores. There was pretty impressive talent and i guess even though I was not thrilled with my performance everyone loved it. I am still getting compliments so I’m pretty excited. Also the other big news is last night I met my girlfriend and her name is Ali, so theres another one of my missions accomplished. Whats new with you all? Everything is great here obviously. Talk to you later

  Kevin

  He had less than two years of sanity left.

  Honoree’s message to Dean several weeks later, on the birthday that he and I share, offered a rare insight into the anxiety that she had kept under tight control throughout Dean’s ordeals. The anxiety, it seems, did not end with the judge’s decision.

  Subject: Happy Birthday

  Date: Thu, 18 Nov 1999 05:50:37 -0500

  From: Honoree Fleming

  To: Dean Powers

  Well dear,

  I woke up in the middle of the night again so I thought I’d get up and send you happy birthday wishes. I hope it’s a great one for you. Someday I suppose I will get beyond this dread and insomnia that I’ve been feeling. It will be nice when you and Kevin are home and I know that you are safe.

  I love you—happy birthday.

  MOM

  As for Dean, his intellectual development, interrupted by the pariah status he’d suffered at Middlebury Union High School, flowered again at the Gould Academy. He had composed several perceptive, vigorously written school assignments on topics including Shakespeare, the Constitution, Thomas Jefferson, and—with bittersweet innocence—mental health:

  Good mental health is important in anyone’s life if they hope to enjoy it. Someone who is mentally healthy can maintain a more positive outlook on things… People who maintain a balance of good mental and physical health seek intellectual stimulation, and human interaction, and make creative use of their time through work and volunteer activities. This promotes self confidence and an overall good feeling about themselves.

  Stress is the punishing our bodies experience as we adjust to our continually changing environment… [It] can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems… With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience
stress as we readjust our lives.

  Identify the causes of stress in your life. Sharing your thoughts and feelings with a family member, friend, co-worker or counselor can help you see your problems in a different way. Try not to get depressed. Depression can make you feel miserable…

  Set short-term and life goals for yourself… Realize that drugs and alcohol don’t solve life’s problems. Develop a sense of humor and make time for fun. Schedule time for play and become involved in activities that make you laugh.

  Near the end of his first semester, Kevin wrote to us about the breakup of his second romance. (We hadn’t known there had been a first romance.) But he wrote with his usual optimism, coupled with a sense of eagerness to get home for the holidays. He asked, as he always did, after his grandmother. In my response, I reminded him that he, Dean, and I had tickets to see the musical Rent in New York during their winter breaks in January.

  Old Vermont and Old Maine, decked out for the holidays, enveloped Honoree and me as we headed east to Bethel along two-lane roads on the Friday before Christmas. In the early twilight, the farmhouses and large cedar trees came ablaze with colored lights, many of them surely preserved in newspaper wrappings and stored in cardboard boxes over the decades until the season. Styrofoam candy canes and giant plastic candles festooned the telephone poles of the small towns. Merchants had set up miniature manger scenes in their display windows. Wreaths decorated the lighted doors of the Congregational and the Catholic churches.

  Arriving on campus, we were greeted by a smiling Dean. He led us to the auditorium and then disappeared backstage, and we settled in amid the other parents to watch the evening’s program. It included, besides Dean and some other instrumentalists, a robed boys’ choir that sang hymns and holiday songs. They sang with the timeless cherubic, O-lipped earnestness that seems the hallmark of school choirs everywhere.

  Then the parents and their children filed out of the auditorium and got into their cars for the holiday drive home. Two nights later, one of the robed young carolers, an earnest and intelligent boy with soft round cheeks, walked out of the darkness into his parents’ farmhouse kitchen, raised and aimed a shotgun, and decapitated his mother. The boy later explained to a tutor who had befriended him in a Vermont jail, “I love my mother. If you saw what I did, you’d understand.”*

  The four of us enjoyed a warm Christmas, and I took my sons down to New York by train for the early-January performance of Rent, as I’d promised them.

  Dean had grown intensely interested in politics and the news in general:

  Subject: Re: (no subject)

  Date: Wed, 01 Mar 2000 05:28:32 PST

  From: “Dean Powers”

  To: ropo@sover.net

  How’s it going Dad? You wouldn’t believe what Ive been doing the last few days, reading the newspaper. Ive been keeping up with the primary rhetoric and it looks like a religious race lately huh? Did you hear about all the Bob Jones U. stuff? Also there was another school shooting, in Michagan. I wonder how close Kevin was. did I tell you I been out riding snowmobile trails, Ive been out five times. I also have been ravin! RAves are a blast (techno music) I want to go to one in NYC or Boston. I got a band now and we’re jamming to alice in chains, and singing it sounds pretty good. I got exams this week then IM out I will see you this weekend. see ya - jr.

  Several weeks later, an anguishing motif resurfaced: a renewal of the estrangement that had been growing between Dean and myself. The tensions seldom had an understandable cause. Dean would erupt in fierce anger, for example, over nothing that I could perceive. In hindsight, I believe that his edginess was being fed by the long prodromal stage of the disease that was slowly overtaking him.

  In early April 2000, Kevin flew home from Michigan for spring break, and the two of us drove to Bethel, where Dean had lined up a gig on the Gould campus. It was the boys’ first performance together in front of a sizable audience, and it was a smashing success: hard-driving gutbucket rock ’n’ roll, with the amps all the way up to eleven. Dean had long dreamed of kicking it onstage with his phenomenal brother. He was almost giddy at the chance to show off Kevin’s gifts, and his own. The performance room was filled, and the boys did not disappoint. Kevin played with his usual intense, fiery brilliance, but kept his trademark poker face. Not so Dean. He laughed and shouted and his eyes sparkled and his dark mop of hair bounced and he leaped into the air as he hit his chords. I had not seen him in such a state of wild pure joy for years. The prolonged cheers and whistles and applause at the end would have awakened the Grateful Dead.

  The joy did not survive the rest of our day together. The tension overtook it shortly before Kevin and I departed the campus for Vermont. I cannot recall the cause; there probably was no cause. At any rate, both Dean and I were seething as my car pulled out of the campus.

  Back in Middlebury, after having crept home through a late-winter blizzard with Kevin wide-eyed in the passenger seat, I tried to repair things via email—which succeeded only in revealing my cluelessness and perhaps giving grim satisfaction to the demons that had lodged inside my son:

  Subject: the visit

  Date: Sun, 09 Apr 2000 18:05:22 -0400

  From: Ron Powers

  To: Dean Powers

  Dean,

  Got home about an hour ago. Brutal snowstorm the second half of the trip, nearly a whiteout between Montpelier and Burlington; mountain routes out of the question. But we are safe.

  I know how frustrated you are and have been with me. I know your feelings that I have not made a connection with you.

  I guess I wasn’t ready for the changes that took place in you when you hit adolescence. Mom and other people have often said that you and I are a lot alike, and that’s one reason why there is so much friction between us. I think that you are an extremely good kid, and at your best you are nothing short of heroic.

  I don’t want us to be at war forever, Dean. I look forward to us being friends sometime. There’s so damn much I want to talk to you about that doesn’t have anything to do with our problems. I hope that someday, when all this anguish settles down and you and I are both a little older and wiser, that we can make peace and enjoy one another’s company again. I love you, Dean. I would stand in front of gunfire for you.

  Please believe that.

  Dad

  In spite of our increasing friction when we were together, I remained determined to keep up a friendly tone in my emails to Dean. He largely returned the gesture. Emails replaced the times together we had once enjoyed as a mode of friendship.

  By May 2000, the first phase of their time away from home was drawing to an end. Dean had made his college choice: Fort Lewis College in Durango, a town of seventeen thousand that lay beside the Animas River and nestled in the San Juan Mountains. It boasted incredible mountain-and-wilderness scenery and five ski areas, which may have played a part in Dean’s decision.

  Meanwhile, Kevin prepared himself for leaving Interlochen, if just for the summer, the dreamlike little universe that had embraced him and claimed his soul.

  That summer breezed along in what I recall as a mellow haze of guitar music and dinners, grilled chicken and corn on the cob, with friends on our screened back porch, the Woods Tea Company in concert now and then. Our sons off in the Middlebury night with their friends and supposed friends. Someone in that group almost certainly was sharing marijuana, a substance that, as we now know, can gravely exacerbate the symptoms of schizophrenia. Several months afterward, we came to believe that the equally destructive LSD had been introduced into the circle. At the time, we remained innocent. A book that I had cowritten was published to good reviews and large sales, and the family financial crisis, acute to the point of credit-card juggling since Honoree and I had left the college, was over. It was the last summer of the old millennium.

  In September, Kevin and I packed up his belongings in the family van for the long drive back to Traverse City. Honoree flew with
Dean to Albuquerque. They rented a car and drove north to Durango, where Dean began his first year of college. Kevin was ecstatic to learn that he had been invited to join both the jazz combo and the larger jazz ensemble at Interlochen. A few days after that, we learned that Kevin was not only learning at Interlochen; he was teaching: acting as a tutor for some of his fellow students. Honoree and I drove to the academy for Parents Weekend. The jazz ensemble was to perform, and our son had won the first guitar chair. On campus, we joined the early-evening flow of gussied-up parents heading toward Corson Auditorium, past the Marshall Fredericks sculpture in front of the entrance, a bronze piece that depicts two bears resting back-to-back, one large, the other small. We produced our tickets and filed into the auditorium, a bright, curving panorama of nearly a thousand red-covered seats on a polished hardwood floor that inclined downward toward the stage.

  The stage was bare. No scaffolded rows for the musicians to sit on. No microphones. Nearly a thousand of us looked into the empty brightness and curled and uncurled our programs and waited.

  There came a rumbling noise. Part of the stage floor slid back. We heard the ensemble before we saw it: a muffled thump of a big-band number from the depths. The ensemble levitated into view, twenty young men and women, all in black, in stacked tiers, blowing and drumming and tickling the ivories and strumming and playing the hell out of Duke Ellington’s “Take the A Train.” The lights made the trombones and the drum fixtures shine like gold, and there was Kevin, down low at stage right in his black tux and bow tie; the lights blazed off the gold trim on his black Martin, and turned his blond hair gold, as bright lights always did. Poker-faced, one polished black shoe resting on the arch of the other. Head bobbing just a little to the big-band beat.