'These people need help, not jail'
Published: Tuesday, February 11, 2014 at 3:23 p.m.
Last Modified: Tuesday, February 11, 2014 at 3:23 p.m.
It was December of 2012 when 33-year-old Petaluma resident Nick Xydas first saw things that weren’t real and heard voices in his head.
“It was frightening,” said Xydas, who was diagnosed with bipolar disorder years before when he was 17. “I’d hear voices telling me to do things and see flashes from my past appear on the television screen — as if they were part of the show I was watching. I didn’t want to give in to the images and voices, so I’d start to cry, but no one could help me.”
Though his family offered words of support and rides to the psychiatrist, Xydas was often inconsolable. On the evening of Dec. 7, 2012, he reached his breaking point and physically pushed his father.
“We were arguing, one thing led to another and I shoved him,” said Xydas.
Like so many who struggle with mental illness, Xydas’ holiday breakdown caused his family to call the police for help. When Petaluma police officers arrived at the eastside home, they arrested Xydas for assaulting his elderly father — catapulting him into the criminal justice system that has become a de facto first response for treating the mentally ill.
Although the days of locking mentally ill patients in an institution like the one depicted in “One Flew Over the Cuckoo’s Nest” are long gone, exactly how to handle the mentally ill is an issue that continues to plague American society. While other diseases receive public support and empathy, mental illness is haunted by negative stigma, a lack of dedicated resources and the continued criminalization of those who suffer from it.
According to the California Healthcare Foundation, one in six California adults are diagnosed with a mental illness, but only about one-third are receiving treatment. And with so many falling through the cracks, law enforcement agencies are struggling.
Hospital to lock-up
Xydas was diagnosed with bipolar disorder during his junior year of high school. Prior to that, he was a student at Casa Grande High School battling severe bouts of depression.
“I remember asking my parents to take me to a doctor because I was so depressed,” recalled Xydas while on a break from his part-time job at the Goodwill in Santa Rosa. “I told the doctor I wanted to kill myself and he put me on a three-day psych hold. I was strapped to a bed, restrained tightly. I was terrified. The experience was extremely traumatic.”
Soon after doctors at Kaiser Permanente diagnosed Xydas as bipolar and prescribed him a drug regime of Lithium, Zoloft and Ziprexa — strong antidepressant and anti-psychotic medicines that left him exhausted, but unable to sleep.
“Still, the drugs killed the voices and the hallucinations, so I stuck with them,” he said.
The next two years, Xydas attended classes at the Santa Rosa Junior College in Petaluma, and began planning his future. He considered joining the Greek-Orthodox diocese or teaching music. But a family vacation in Greece derailed those plans when Xydas suffered a severe psychotic break that left him unable to return to school.
“My family accused me of not taking my meds, but I swear I was,” he said emphatically. “What they don’t understand is that even when I’m on my meds, things can change.”
That’s precisely what happened in December 2012, according to Xydas. After spending several years struggling to cope with his mental illness, Xydas said his medication quit working — a fairly common occurrence with mental illness, often remedied by a minor adjustment in medication or dosage. But this time, instead of just feeling depressed and suicidal, Xydas began to hallucinate. He spent hours in his room at his father’s home, crying as he tried to understand what was happening to him.
“I knew something was wrong, but I didn’t know what it was,” he said, “it was terrible.”
The hallucinations continued and the stress of the situation ultimately led Xydas to lash out at his father, with whom he had always had a contentious relationship. When officers arrived at his father’s home last December, they arrested Xydas for assault and elder abuse — though he claims his father wanted police to take him to a mental hospital. Members of Xydas’ family declined to be interviewed for the article.
“The police took me away, even though my dad wanted them to admit me for a psych hold,” said Xydas. “But I wasn’t going to hurt myself or anyone else, so they had to put me in jail because I fought with my dad. But when my family found out the district attorney was charging me, they didn’t want that.”
And therein lies the problem facing so many law enforcement agencies and families across the country: What to do with mentally ill people who commit crimes?
Law enforcement plagued with calls
In 2013, the Petaluma Police Department responded to 313 calls involving mentally ill people, according to police records. Of those calls, almost 75 percent resulted in a recommendation for a 72-hour psychiatric hold — known in police terms as a “5150” — at the Psychiatric Emergency Services facility in Santa Rosa.
In order for a person to be held on a 5150, they must be deemed a danger to themselves or a danger to others, or be completely unable to care for themselves — criteria that Petaluma Police Lt. Tim Lyons said can be difficult to ascertain.
“By the time an officer spends two hours with a person, drives them up to Santa Rosa and checks them into the psych hospital, they may have calmed down or realized that if they keep talking about hurting someone they will be locked up, or the episode may have passed,” said Lyons. “So the hospital has no grounds to hold them and they are released. But there is no treatment for their underlying issue. And they wind up right back in the system a few days later.”
Lyons added that most mental health calls are lengthy for law enforcement, often requiring two of the department’s four on-duty officers to spend up to three hours on a single call. Police protocol dictates that at least two officers respond to calls involving mentally ill people. Lyons said that officers often find themselves engaged in impromptu discussions that involve reasoning with the person for long periods of time.
“Almost every day we have at least one 5150 call,” said Lyons, who added that the department is currently understaffed and struggling to cover all its shifts. “I think it’s one of our biggest challenges right now.”
In January alone, Petaluma police responded to 72 calls involving mentally ill people. In one of the more extreme cases, the same man was recommended for a 5150 hold seven times in 60 days. Last week, officer Paul Gilman was called to the Petaluma Valley Hospital after emergency room staff asked for police assistance handling this man.
“The patient said he was planning to get a gun and shoot his mother, then shoot his brother and then kill himself,” said Gilman. “I took him up to the county’s Psychiatric Emergency Services and requested a 72-hour psych hold — which obviously didn’t happen because I responded to another call involving him two days later.”
Even if the county’s emergency psych hospital had taken the man for 72 hours, Gilman said he would have most likely been released quickly, since county services can’t hold anyone who isn’t considered a danger to themselves or someone else. Lyons, who also had an encounter recently with this same man, said that the case perfectly illustrates the difficulties officers encounter when working with the mentally ill.
Xydas is another example of someone who can’t seem to escape the merry-go-round of mental illness and the criminal justice system. After his 2012 arrest, Xydas pleaded guilty to a lesser misdemeanor assault charge with mandatory probation and treatment at Buckelew — an organization dedicated to helping people with mental illness lead independent lives.
In mid-January, after months of treatment, Xydas hoped to get his own apartment, “since Buckelew has helped me so much with treatment, medication and counseling services,” he said. But just last week, Xydas allegedly violated his probation by visiting his father’s house in Petaluma — sparking another trip to jail.
“If he wasn’t already on probation, our officers could have worked with the family and with Nick, and maybe the outcome would have been different. But, as is often the case, our hands were tied,” said Lyons
Sonoma County Superior Court Judge Gary Nadler, a longtime Petaluma resident who has presided over family and criminal cases, said that people like Xydas are all too familiar.
“I remember one man who came into my courtroom, swearing and cursing at me — trying to attack me while he called me every name in the book,” said Nadler. “This same man appeared before me a few weeks later, fully medicated. And he was the nicest, most polite person. He was engaging and intelligent. The only thing that had changed was that he was on his medication.”
According to Nadler, the criminal justice system is overrun with mentally ill people who commit crimes while struggling with their illness. He is appalled and saddened by the lack of resources devoted to treatment in America.
“And the hardest part is that many who suffer from mental illnesses don’t know they are sick,” said Nadler. “Because they don’t know they’re sick, they keep getting caught up in the web of committing crimes.”
Needs outweigh the resources
So what’s the answer? In the off chance a mentally ill person realizes a psychotic break is coming, local resources are available to support them. For every 100,000 people, there are 20 psychiatrists in Sonoma County — for those who can afford it or qualify for medical assistance.
But what about the people who don’t realize they are sick? Or those who refuse help? Or those who can’t afford help? As Nadler pointed out, with almost two-thirds of the mentally ill population in California not receiving treatment, it’s obvious that the system has cracks that fall to law enforcement to patch.
Erika Klohe, family services coordinator at Buckelew, said that many problems in the mental health care system have to do with policies that are outside a caregiver’s hands.
“Unfortunately, once law enforcement is involved, it’s a brand new situation,” she said. “And many times it takes law enforcement getting involved to get people to realize they need help.”
Petaluma police officer Bill Baseman, who helped start a local coalition of professionals from a range of backgrounds that meet monthly in town to discuss mental health issues, said that he often hears from families who say that a sick relative won’t take their medication.
“Parents call us and say their child refuses to take their meds,” said Baseman. “Then they go off and do something that’s against the law because they haven’t accepted that they have a mental illness. Oftentimes, the only way to get them help is to go through the criminal justice system. But it’s really the last thing we want to do. These people need help, not jail.”
Klohe agreed, but pointed out that families are often ill-equipped and unaware of how to help someone struggling with mental illness.
“It’s not illegal to be mentally ill,” she said. “There are people who just behave strangely, and their families call law enforcement looking for a psych hold. But the person doesn’t qualify. And because they can’t afford private care, they don’t know what to do or where to turn to. They want their loved one to get help, but they can’t force them to. They don’t know what to do. The whole mental health care system is very complex.”
From the eyes of law enforcement, it’s not only complex; it’s also broken. Gilman said that the gaps in mental health care have left law enforcement struggling to help people without the resources needed to address their underlying issues.
“As a society, we haven’t addressed mental health in general,” he said. “Until we do — until we devote the kind of resources we devote to other major issues — it will continue to be problematic.”
Buckelew Program Director Kristi Toprakci called for more funding and resources to help fight the problem.
“Mental illness is very treatable,” said Toprakci. “But there’s a lot of people in need and sometimes we just don’t have the full resources to serve everybody.”
Toprakci said that of the more than 170 clients her office assists, 93 percent maintain independent housing and receive the tools to live a normal life. She said some of the program’s clients come to them by way of the criminal justice system.
"We need the resources to treat people with mental illness so we can avoid them having unnecessary interactions with the legal system,” she said.
Nadler agreed, and said with proper mental health resources, a variety of other social issues would improve.
“It’s literally the most underfunded and ignored problem in our country,” he said. “But until we recognize that, until we increase funding for programs that treat the whole person — that treat every person — it won’t change. But if we did dedicate the money, find the resources, make the effort, we’d see many other problems, like crime and homelessness, (relieved) too.”
(Contact Janelle Wetzstein at firstname.lastname@example.org.)
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