Until this month, my friend had a neighbor (I'll call him “George”) who clearly has a serious mental illness. Despite all the time I spent at my friend's apartment, I never saw George. But I heard him. Through the thick plaster walls that separate their units, I heard George raving long into the night, usually swearing up a storm and babbling nonsense at apparently no one in particular—or perhaps the TV. My friend occasionally saw George, usually when he was returning from the store with a six-pack in hand.
In February, George smashed out several of my friend's and another neighbor's windows. My friend was mad as hell for having broken windows during a harsh Cleveland winter, but he did try to get George help. He tracked down George's mother, who owns the apartment (but not my friend's). All she could do was apologize for her son's behavior, as she is living in a long-term care facility and dealing with her own disabilities. George's brother, who administers the trust fund that pays George's bills, lives in Colorado. The police showed up when my friend reported the broken windows, but they were reluctant to do anything. When my friend called the county mental health board, they asked for George's phone number, offering to give him a call. I don't think George would have answered.
I jumped in and called the nearest community mental health center—with an office only a third of a mile from where George lives. The person who took my call said George could voluntarily come in on a Monday or Thursday to be assessed, but there was little else they could do if he didn't want to seek help on his own.
After two more window breaking incidents, my friend decided to move. Only a couple days after my friend told his landlord of his intentions, George broke a neighbor's window, and the police removed George, wielding a crowbar and a knife, from his unit in the middle of the night. This wasn't the first time the police have dealt with George, and I doubt it will be the last.
I shared this story with some attendees at the annual conference of the National Council for Community Behavioral Healthcare in March, and everyone shared my sense of frustration. Here clearly was a man who needed help, but the system is not set up to help him unless he either requests it or is arrested (and if he remains in the justice system, we know the help he receives will be minimal). Despite everything I have learned about mental healthcare during the past seven years, all the experts I have talked to, and all the reports I have read, I was powerless to help George. And that really bothers me.
P.S. As we were wrapping up this issue, the tragedy at Virginia Tech occurred. In its wake, many ordinary citizens and national leaders are asking what can be done to transform the mental health system. Thought leaders in the field will share their insights in upcoming issues.
Douglas J. Edwards, Editor-in-Chief