When a Mentally Ill Child Becomes a Mentally Ill Adult

OC parents find they are out of care options unless Laura's Law is adopted

Until there is change in the system, Jennifer believes time is simply ticking—to what end, she doesn't know. "We're the ones screaming danger, danger, danger," she says. "My responsibility to keep him safe hasn't changed—I'm his mother, and he's disabled. But the controls I have to ensure his safety have ended. So I'm doing everything I possibly can to knock on every single door and ask the same questions: 'Why can't I keep my son safe? Why can't I keep the community safe from my son?'"

* * *

In the 1950s and '60s, mental asylums were ready to crack. Plagued by overcrowding, filthy conditions and abuses within the system (as memorably depicted in the Oscar-winning One Flew Over the Cuckoo's Nest), activists condemned institutions and argued patients should be integrated into society rather than isolated. One California organization, the Keep America Committee, put out a pamphlet that described mental-health treatment as a Communist plan "to transform a free and intelligent people into a cringing horde of zombies."

Advocate Brian Jacobs and his wife, Carla (not pictured), want Orange County officials to adopt Laura's Law, which they believe will help families such as the Hoffs
Kenneth M. Ruggiano
Advocate Brian Jacobs and his wife, Carla (not pictured), want Orange County officials to adopt Laura's Law, which they believe will help families such as the Hoffs

The Lanterman-Petris-Short (LPS) Act, therefore, was considered a victory for human rights. Signed by then-Governor Ronald Reagan in 1967, the California law put massive barriers on those who wanted to treat people without their consent. New medications restored reality in mentally ill patients without throwing them into a stupor, and the law gave them the right to take or refuse them as they desired.

But for the most severe patients, freedom ended up looking like abandonment. Today, three times as many mentally ill people stay in jails as in hospitals. According to the National Treatment Advocacy Center, people with untreated psychiatric illnesses make up one-third of the homeless population. Carla Jacobs, coordinator of the California Treatment Advocacy Coalition, says that while the LPS Act had "excellent intentions," it "became a bastion of neglect for the most severely ill."

"What had been overlooked was the fact that some people with severe mental illness don't have the ability to recognize they're ill," she says.

The medical term for this is anosognosia, also called "lack of insight," a symptom of brain diseases such as schizophrenia or bipolar disorder; stroke patients sometimes experience a similar impairment. "When the brain is sick, you can lose your mind and not know it," explains psychiatrist William Callahan. "We can actually measure a loss of cell volume in the hippocampus, the center for short-term memory. We all learn to trust what the brain tells us. If the brain says you're fine, you won't [seek] treatment."

With bipolar disorder or schizophrenia, most patients first experience clear symptoms in their late teens or early 20s, the Aliso Viejo-based doctor says. As patients near the age of 18, he says, there is a "feeling of urgency" to get them proper treatment to "save their brains." With the right care, people can and do improve, but serious mental illnesses are cyclical in nature, and when a disease calms down, some patients get tired of the side effects and stop taking their medication. That's when outside pressure is needed.

"With Alzheimer's patients, families have to step in and say, 'No, you're not safe' before they leave the stove on and burn down the house," Callahan says. "With children, parents need to drag them to the doctor's office to get their shots. Yes, it's coercive and against their will, but that's what we have to do."

While working as the facility manager at Orange County Children's Foundation, a county-funded home in Placentia for foster and troubled boys ages 10 to 17, Carmen Hugh often dreaded the day when residents would "age out" at 18. The six-bed house was a capsule of security for the young men, many of whom were diagnosed with ADHD, bipolar disorder and schizophrenia. They adjusted to routines of themed dinner nights, chores, supervised outings, mandatory psychiatry sessions and 9:30 p.m. bedtimes, she says. For patients on medication, employees would hand them their pills and a cup of water.

While not being able to offer specifics due to disclosure laws, "I can recall a couple of young men whom we just knew at age 11 or 12 that they needed serious help," Hugh says. "It was like, 'What's gonna happen when they get older?'"

She has followed the lives of residents years after they moved out. Many went on to find jobs or attend college. But others did not. One such patient was killed after becoming involved with gangs, she says, and another is serving a 20-to-life sentence for being connected with a murder.

"As much as you try to prepare them, sometimes they're just not ready [to face the real world]," Hugh says. "They go from 'I can't wait until I'm 18 and can get out of here' to 'Please don't make me leave.' They're overwhelmed, scared, on medication. We've seen it time and time again."

For some family members, after the clock strikes down on a patient's 18th birthday, it becomes a race against time. Philip Camacho, who lives in Santa Ana, says when he heard the story of Kelly Thomas, a homeless man with schizophrenia who died of injuries inflicted by six Fullerton police officers (one of whom was subsequently charged with murder, another with manslaughter), he thought, "That could be my son."

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23 comments
katiechapman
katiechapman

The real problem for families is waiting until the mentally ill person finally hits bottom and is willing to do what it takes to get better.  Unfortunately, families have often been burned so many times that they are afraid.  Plus staying in the same environment it is difficult for the mentally ill person to stay away from old friendships and habits.  It takes a really good psychiatrist who is accessible and willing to adjust meds AND extended family who can care for the person in a different environment. Many California  counties now have Wellness Centers that are drop-in centers, peer run, and free for those with mental health diagnoses.  They work in conjunction with county mental health, but are not the same as.  Also, for those receiving SSI there is a company called PRIDE Industries that provides employment opportunities for the mentally ill.

Hope this helps someone.

caujul
caujul

My son is 27 and mentally Ill. He was diagnosed at the age of 16. He is paranoid schizophrenia, bipolar, and manic depressive.   He spent the last 6 month in and out of hospitals psych ward. I tried filing commitment papers to have him institutionalize, but court decided he did not need it and placed him on 90 days probation outpatient treatment. Treatment plan included taking medication and see his therapist. I finally had him institutionalize for 14 days for non-compliance. He's out and not taking his medication daily. It is only a matter of time before he have another episode and I will have to called the police because he gets very violent. They usually hold him for a few hours and release him because they are very familiar with his condition. Sometimes, I feel as if I am the one with the mental problem. I have no help or support from family.  They feel that I am just making excuses for his behavior.

yfuji60
yfuji60

carlsbadvillage

There are ways... see a lawyer IF you can pay the fee... if not either way, you could go broke.

If YOU call in for a 5150... YOU pay the bills.   You try to get help like Med-cal or financial assistance from social security... You need permission to speak on their behalf.  You pay their bills and when there is a refund the refund in payable to the adult child.. You need to have a Psychologist to help you get financial or medical assistance.... how do YOU get it if the adult child will not seek medical help...No where to go.

debbie_jane_goff
debbie_jane_goff

This could be my story the names and locations different but this is my story I'm living thru. Right now and the last 3 years. How many times he has gone missing months even a year. Always waiting for the phone to. Ring and tell

JaySea
JaySea

Very informative and well written, Ms. Woo...covered all bases and educated me about a serious impending problem in our society, thank you...I wish all the best for these families.

Gericault
Gericault

Moorlach is being disingenuous with comparing the size of Nevada County with the size of Orange County. Nevada county has a budget of 729 million. Orange County spends more than that just on social services now, out of a total budget of 5.6 Billion ( with a "B").Everyday, OC Supervisors wade through a sea of homeless people living at the Civic Center, can't he see that?

Adam Goldman
Adam Goldman

An interesting article about mental health issues in O.C.

Jyates
Jyates

Thanks Ms Woo for writing about this subject. Maybe more people will come to understand that mental illness is not a character flaw - it's a biological brain disorder! It's especially frustrating when our laws now prevent parents from getting needed help for their adult children. I certainly hope Laura's Law will be enacted in Orange County.

Shiv825
Shiv825

Great article Michelle. In elementary school we see some kids who don't get help because their parents are in denial. It's sad to see the other end, once the kids reach 18, and they are unable to get help because of the law.

ALBERTA
ALBERTA

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Tcpasquini
Tcpasquini

Thank you Michelle Woo and the OC Register for this illuminating and powerful article.

My Danny was hospitalized on his 18th Birthday and our world changed just like the families in this article. Overnight we were told that we could not help him unless he wanted our help. Even though his brain told him he was ok, he wasn't ok. He needed help from a system that no longer allowed his mom and dad to keep him safe. To keep him safe we had to abandon him, put him in harms way and then fight the world to provide him treatment. Why does it have to be this way?

I met Jennifer Hoff on Facebook during her search for her son. She is a force. We moms and dads are on a team that we never wanted to join. We will continue to tell our stories and burn them into the collective conscience of our California communities.

I live in Contra Costa County where we have had numerous parents murdered by their children with psychiatric disabilities. All were preventable tragedies. Alameda County is our neighbor and had a recent preventable murder in the Berkeley Hills. An innocent family of our community was destroyed because a young man was not kept safe by a sick system. His family tried valiantly to get him the help he needed.

Our California counties and communities are connected by the slender thread of hope that one day there will be sanity restored to the mental health system. Civil Commitment Law Reform must happen. We don't want "special laws," we just want laws that are already exist to be implemented.

Laderamommy
Laderamommy

Michelle, thank you so much for your time spent shedding light on Matts story and an issue that continues to be sidestepped by our elected officials, despite a growing public consciousness burning low and slow.... as a community and culture we have not seemed to get a grip on how to prevent "preventable" tragedies. Without serious Civil Commitment Law Reform (Laura's Law, Kendra's Law and much much MORE) we will never see a decrease in violence to our sick loved ones nor a change in the horrific collateral  damage associated with untreated severe chronic psychiatric illness.  This issue is not being properly addressed in Orange County by our County Board of Supervisors or Director of Behavioral Health. They know it. I do not know what they are waiting for next to happen before taking any clear action or position. How many more families have to loose loved ones to these illnesses before our leaders realize that ignoring severe mental illness does not make it go away.Thank you again for caring enough to take action.Warmly,Jennifer Hoff

Tron Carter
Tron Carter

Sprawling Ladera Ranch home and she can't provide for him???These kinds of people are dangerous and should be off the streets.

CarlsbadVillageOrthodontist
CarlsbadVillageOrthodontist

Ah so he chose to leave the care of his parents? But shouldn't there be a special law for people with mental disabilities, that gives certain powers to their parents at least medically? It's such a sad thing to happen to anyone.

MommyDissident
MommyDissident

@Gericault We have been at End Homeless Comission meetings where our local non profit groups have actually debated with the county because they know our Health Agency under estimate the actually homeless count by design. Our non profits in Santa Ana are the lifeblood for most homeless while our County chioses to ignore the "gravely disabled" portion of the LPS Law despite many at the civic center "thinking they are from the sky"...instead of saving lives with our 6 billion (MHSA/Prop 63) they tout their "successes" in self made pie charts at dog n pony shows ... their "outreach and engagement" for folks who could otherwise navigate the system of Recovery Model FSP bs. I am sickened by the greed that permeates our top administration and how they Publicity Reject Laura's Law.

bgipson1
bgipson1

As I read these stories, that story is about me, his mom and my 25 year old son who wad diagnosed with bipolar disorder. He refuses help. He was in the hospital, got out and disappeared. After filling a missing persons report, he was found in Miami, even though we live in Atlanta. Once the police in Miami, the sent him to Mt. Sinai Hospital. They refused to tell me anything. After driving 10 hours, they refuse to release my son to me because he didn't want to see me so they released him back on the street. They purposely sent him out a different exit. Now, he is on the street and I have no idea where he is.

Jonmurra
Jonmurra

How to you argue with"Stupid"?

Jyates
Jyates

Get educated on mental illness before you judge something you have not experienced.

Dave Lieberman
Dave Lieberman

You're demonstrating your complete lack of ability to grasp the concept of the article. She could be Melinda Gates and control a multi-billion-dollar foundation and she still would have exactly the same amount of power over her age-of-majority son as the poorest day laborer: zero.

But if you believe these kinds of people are dangerous and should be off the streets, stretch your hands and write a letter to your Orange County Supervisor to adopt Laura's Law, which would do exactly that.

opinion33
opinion33

its amazing how you can read this article and miss the whole point..you only focus in on their home...no amount of money can house or contain a mentally ill child who refuses medical care and the care of their parents. Their 18 yr old son has the civil liberty to refuse-even when hes incompassitated and unable to make rational decisions on his own behalf due to being cognitively impaired. Its not against the law to be psychotic and delusional-only of that behavior becomes a danger to self and other, which we keep witnessing in the headlines of the newspapers is way too late (the irag mentally vet stabbing homeless people, the Seal beach hair salon massaquere, the Kelly Thomas story) there is no way in this county to stop a potentail tragedy-most patients with brain disorders are down at central jail..same place Kelly Thomas was headed before he was beaten to death. Its nearly impossible to live on the streets and not commit or be victimized. But all mental health care s 100% voluntary-and 50% of the patients are uanble to access that system due to being too ill to understand their need for medication. Their sick brains tell them they are fine.

Luvssinatra
Luvssinatra

Really "Tron" you are basing a big problem in the govenment with your prejudice against people who have made a good living? These "people" are trying to get their son help and you post this kind of stuff? Ask yourself this, "If my son was an adult who could do anything he wished... despite YOUR monitary situation, what would you do?" You have no right to judge. God is the ultimate Judge and you have no right to say anything until you have walked at least a mile in their shoes.

yfuji60
yfuji60

@CarlsbadVillageOrthodontist 

There is, if you seek a lawyer's help...pay the big fee.  Interesting part, if you call in and get the adult child for 5150, you end up paying the bills.  If you try to get assistance, like medi cal... the adult child need to speak or give parent permission to talk to agent..You pay their bills, but you can't speak on their behave... you get a refund,it's written to the adult child... Hello? 

No where else to go

 
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