Families of Mentally Ill Struggle for Services
By Corey Lyons
Contra Costa Newspapers
May 25, 2003
In his final days, John Henry Kahler, a mentally ill man with a history of violence, was meeting with a county psychiatrist for 25 minutes a month -- mostly to review his medications.
"We need so much more, but we're broke," said his father, Dave Kahler.
"Our problem is societal. We do not have the political will to fund this. People are still terrified by mental illness."
Last week, John Kahler dropped to his death from the Golden Gate Bridge a day after a fatal trailside beating in Concord. When police started focusing on the troubled man as a possible link to the May 13 slaying, mental health advocates were particularly disheartened.
Kahler, diagnosed as manic depressive nearly a decade ago, has not been identified as a suspect in the killing of Kathleen Aiello Loreck.
His suicide, though, has raised difficult questions about people like him: mentally ill adults set adrift in a fast-growing county with a critical and costly shortage of services.
He was the product of a "broken system," as his father put it.
"The mental health system is mostly a dysfunctional system," said the Rev. Chet Watson, a board member of the National Association for the Mentally Ill California.
"If we'd had the services a year ago, John may still be alive today."
In Contra Costa County, where the elder Kahler constantly fought for resources, an estimated 45,000 people are mentally ill, a biological brain disorder that touches one in four families.
Yet the county's mental health system grinds along with glaring deficiencies. It's racked by a tight budget, overwhelmed case workers and a limited number of beds for the mentally ill.
Every day, more than 100 Contra Costa patients are sent to contract facilities in other counties up and down the state at a cost of nearly $6 million a year.
That's because there are only 28 county beds available. None offers long-term residential treatment options.
"We have hundreds of people, county residents, who are waiting for a bed today," said Donna Wigand, the county's mental health director.
In addition, the county provides only 16 beds for "dual diagnosis" consumers, or people with a substance abuse problem and mental illness.
Health officials contract for two more dual diagnosis beds with Bonita House Inc., a 15-bed treatment center in Oakland. The waiting list is always long.
Rick Crispino, Bonita's executive director, said about two-thirds of people ensnared in the public mental health system also grapple with substance abuse issues.
"If you do not have programs designed to address both issues simultaneously, you will not have the outcomes you are looking for," Crispino said.
Mental health advocates also argue that recovery is prolonged for ill people who must be separated from their families because of the shortage of local services.
It explains why they have pushed for a proposal calling for an unlocked mental health rehabilitation center in Pleasant Hill, an issue that has galvanized the city.
The proposed 80-bed treatment and recovery center, the first of its kind in the county, would offer three distinct programs in trying to help ill people learn to live independently.
Residents have protested the location and size of the facility in the Poets' Corner neighborhood as experimental and dangerous. They do not trust the operator, Crestwood Behavioral Health Inc., nor its ability to manage its mentally ill clients.
"The pathology of mental illness is complicated," said Cindy Rubin, who is against the facility. "Combine that with an overtaxed mental health system, an experimental treatment facility and a for-profit company -- and you have a recipe for disaster."
Julia Bonacich, of Pleasant Hill would love to see her 26-year-old daughter get treatment inside a place so close to home. Her daughter, whom she wants to remain anonymous, was diagnosed with schizophrenia while in college seven years ago.
It was a "full-blown breakdown," Bonacich said, an incident that jarred the family because it was so unexpected.
Seven years later, the family is dealing with a county case worker they never see and still cannot track down an affordable psychiatrist.
Their daughter, meanwhile, is living independently in an apartment in Pleasant Hill -- but still heavily dependent on the family to schedule appointments and ensure her welfare.
Bonacich, a 56-year-old Realtor, teaches a 12-week course twice a year in Lafayette that teaches people how to help their ill loved ones.
"The trick is you spend years trying to find the services out there. It's not as if there is a book to tell you what to do," she said. "You have to go out and connect."
But for many mentally ill people without a support system and with a brain out of balance, the challenge is overwhelming.
"You lose all of your self-esteem. You eat in soup kitchens, and, if you're lucky, you beg in a church," Bonacich said. "With other illnesses, people raise money for you."
Marie and Floyd Overby of Lafayette share the same frustrations.
Their 28-year-old son, Paul, who double-majored in economics and accounting at Claremont McKenna College, was diagnosed with bi-polar disorder two years after graduating.
Bi-polar, or manic depression, is a serious brain disorder that incites wild mood swings, affecting about 1 percent of the adult population.
"It's a very difficult thing for someone diagnosed. It has been for Paul," Marie Overby said. "It's taken away what he thought he was going to do in life."
Paul Overby spent three months earlier this year at a locked treatment center in Napa County, run by Crestwood. His parents would try to visit once a week, a one-way drive of 90 minutes to two hours.
"The first time I left there, I cried," Marie said. Her son is now at an unlocked facility in Vallejo.
"It was hard having him so far away from his primary care physicians, who had kept care of him."
The push for improved services comes as the state wrestles with a $10.7 billion budget deficit this year. County mental health budgets are especially lean.
In response, parents are often pressed into places they could have never imagined going, trying to navigate their ill loved ones through life with scant mental health resources.
It's what Dave Kahler said he did over and over, becoming his son's own case worker.
It meant dealing with his son's "inexplicable rage" and loss of interest in life. But the possibility of some kind of recovery? That's what kept Dave Kahler going.
"He could have sat in my back yard for the rest of his life," the father said. "And I would have been perfectly happy with it."
Contra Costa Newspapers
May 25, 2003
In his final days, John Henry Kahler, a mentally ill man with a history of violence, was meeting with a county psychiatrist for 25 minutes a month -- mostly to review his medications.
"We need so much more, but we're broke," said his father, Dave Kahler.
"Our problem is societal. We do not have the political will to fund this. People are still terrified by mental illness."
Last week, John Kahler dropped to his death from the Golden Gate Bridge a day after a fatal trailside beating in Concord. When police started focusing on the troubled man as a possible link to the May 13 slaying, mental health advocates were particularly disheartened.
Kahler, diagnosed as manic depressive nearly a decade ago, has not been identified as a suspect in the killing of Kathleen Aiello Loreck.
His suicide, though, has raised difficult questions about people like him: mentally ill adults set adrift in a fast-growing county with a critical and costly shortage of services.
He was the product of a "broken system," as his father put it.
"The mental health system is mostly a dysfunctional system," said the Rev. Chet Watson, a board member of the National Association for the Mentally Ill California.
"If we'd had the services a year ago, John may still be alive today."
In Contra Costa County, where the elder Kahler constantly fought for resources, an estimated 45,000 people are mentally ill, a biological brain disorder that touches one in four families.
Yet the county's mental health system grinds along with glaring deficiencies. It's racked by a tight budget, overwhelmed case workers and a limited number of beds for the mentally ill.
Every day, more than 100 Contra Costa patients are sent to contract facilities in other counties up and down the state at a cost of nearly $6 million a year.
That's because there are only 28 county beds available. None offers long-term residential treatment options.
"We have hundreds of people, county residents, who are waiting for a bed today," said Donna Wigand, the county's mental health director.
In addition, the county provides only 16 beds for "dual diagnosis" consumers, or people with a substance abuse problem and mental illness.
Health officials contract for two more dual diagnosis beds with Bonita House Inc., a 15-bed treatment center in Oakland. The waiting list is always long.
Rick Crispino, Bonita's executive director, said about two-thirds of people ensnared in the public mental health system also grapple with substance abuse issues.
"If you do not have programs designed to address both issues simultaneously, you will not have the outcomes you are looking for," Crispino said.
Mental health advocates also argue that recovery is prolonged for ill people who must be separated from their families because of the shortage of local services.
It explains why they have pushed for a proposal calling for an unlocked mental health rehabilitation center in Pleasant Hill, an issue that has galvanized the city.
The proposed 80-bed treatment and recovery center, the first of its kind in the county, would offer three distinct programs in trying to help ill people learn to live independently.
Residents have protested the location and size of the facility in the Poets' Corner neighborhood as experimental and dangerous. They do not trust the operator, Crestwood Behavioral Health Inc., nor its ability to manage its mentally ill clients.
"The pathology of mental illness is complicated," said Cindy Rubin, who is against the facility. "Combine that with an overtaxed mental health system, an experimental treatment facility and a for-profit company -- and you have a recipe for disaster."
Julia Bonacich, of Pleasant Hill would love to see her 26-year-old daughter get treatment inside a place so close to home. Her daughter, whom she wants to remain anonymous, was diagnosed with schizophrenia while in college seven years ago.
It was a "full-blown breakdown," Bonacich said, an incident that jarred the family because it was so unexpected.
Seven years later, the family is dealing with a county case worker they never see and still cannot track down an affordable psychiatrist.
Their daughter, meanwhile, is living independently in an apartment in Pleasant Hill -- but still heavily dependent on the family to schedule appointments and ensure her welfare.
Bonacich, a 56-year-old Realtor, teaches a 12-week course twice a year in Lafayette that teaches people how to help their ill loved ones.
"The trick is you spend years trying to find the services out there. It's not as if there is a book to tell you what to do," she said. "You have to go out and connect."
But for many mentally ill people without a support system and with a brain out of balance, the challenge is overwhelming.
"You lose all of your self-esteem. You eat in soup kitchens, and, if you're lucky, you beg in a church," Bonacich said. "With other illnesses, people raise money for you."
Marie and Floyd Overby of Lafayette share the same frustrations.
Their 28-year-old son, Paul, who double-majored in economics and accounting at Claremont McKenna College, was diagnosed with bi-polar disorder two years after graduating.
Bi-polar, or manic depression, is a serious brain disorder that incites wild mood swings, affecting about 1 percent of the adult population.
"It's a very difficult thing for someone diagnosed. It has been for Paul," Marie Overby said. "It's taken away what he thought he was going to do in life."
Paul Overby spent three months earlier this year at a locked treatment center in Napa County, run by Crestwood. His parents would try to visit once a week, a one-way drive of 90 minutes to two hours.
"The first time I left there, I cried," Marie said. Her son is now at an unlocked facility in Vallejo.
"It was hard having him so far away from his primary care physicians, who had kept care of him."
The push for improved services comes as the state wrestles with a $10.7 billion budget deficit this year. County mental health budgets are especially lean.
In response, parents are often pressed into places they could have never imagined going, trying to navigate their ill loved ones through life with scant mental health resources.
It's what Dave Kahler said he did over and over, becoming his son's own case worker.
It meant dealing with his son's "inexplicable rage" and loss of interest in life. But the possibility of some kind of recovery? That's what kept Dave Kahler going.
"He could have sat in my back yard for the rest of his life," the father said. "And I would have been perfectly happy with it."
posted by Corey at 7:56 PM
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