Your Tax Dollars At Work

From the August 16, 2008 Wall Street Journal, a sobering story of a young man with schizophrenia who was released from a mental hospital contrary to medical opinion:

On Christmas Eve, 2003, Joe says William had his first psychotic episode in a Target store, telling his father that the security cameras were monitoring him.

But he refused to seek treatment, and his family couldn't insist. Maine, like many states, requires that the mentally ill pose a substantial risk of harm to themselves or others, based on recent evidence, to be involuntarily committed.

In March 2005, after William threatened two men with a loaded AK-47 assault rifle -- his father is a licensed gun dealer -- William went to a psychiatric facility in Bangor. He was eventually released but stopped taking his medicine.

The next time around through the revolving door:

A few weeks after William Bruce's admission, psychiatrist Jeffrey Fliesser wrote that William was hostile, paranoid and "dangerous to others without additional observation and active attempts to treat him," an opinion he reiterated over the next five weeks. The doctor also wrote that he urged William, now diagnosed with paranoid schizophrenia, to take medication, but William refused. Dr. Fliesser declined to comment about the case for this story.

William began working with advocates employed by the Maine Disability Rights Center, which receives funding from the federal PAIMI program as well as state and private sources.

According to a nurse's treatment record dated March 23, Ms. Bailey, the advocate, told Riverview administrators she saw no documentation showing that William should remain hospitalized. Trish Callahan, another advocate, suggested that William "may actually be getting worse by remaining here," the nurse's record says.

So an advocacy group funded by the federal government got William Bruce released:

William was soon back home. He hid steak and butcher knives in his bedroom and spent hours pacing in the driveway, giggling and babbling unintelligibly to himself. Joe began calling to check on his wife several times a day. "It was the worst we'd ever seen him," he says.

On June 20, two months after his son's release, Joe Bruce returned home from his office to find his wife's battered, bloodied body. William was gone.

"My son has killed my wife," Joe told the 911 dispatcher, later adding that he was arming himself in
self-defense.

According to the medical examiner's report, Amy died of multiple blunt-force trauma and chop injuries to her head. She was 47 years old.

William Bruce is doing much better now.  He is on antipsychotics that allow him to recognize what he did:

William Bruce, now 26, is strikingly handsome, his dark hair slicked back. Sitting in a Riverview conference room on July 23, he spoke courteously but deliberately. It was the first time he has been interviewed about his case.

"I blame the illness, and I blame myself," William said of his mother's death. "The guilt is...," he paused, struggling to find a word "...tough."

William said the first time he came to Riverview, he refused to believe he was mentally ill and approached the advocates because he wanted out.

"They helped me immensely with getting out of the hospital, so I was very happy," he said. He later added, "The advocates didn't protect me from myself, unfortunately."

Unsurprisingly, the advocates for the mentally ill are convinced that they did the right thing.