Two stories in the Mail Tribune in recent days underlined the sad state of affairs in mental health care in the Rogue Valley and Oregon at large. The seriously mentally ill have too few options, the result both of chronic underfunding of services and the good intentions of advocates who resist any form of institutionalization.
In Sunday's paper, we read the story of Rachel Rice, a former high school honor student and cheerleader, whose family watched as she descended into the hell of mental illness. And a hell it was, at least in part because there are so few options for people such as her in our society.
Rice, a paranoid schizophrenic, has been dead since 2005. But she made the news this month after her body finally was found, deep in the woods where she apparently had fled more than seven years ago as she tried to escape her demons.
As with many of the very seriously mentally ill, there were no easy answers in dealing with Rice. Her paranoia made her suspicious of people trying to help her, caused her to resist taking medications, and to run away repeatedly. Foster home caregivers eventually said they were no longer willing to care for her. So she was largely left to her own devices, with predictable results.
Wednesday, we read about 17-year-old Mariah Piatkin, who committed suicide Friday in Albany, despite the best efforts of her father, who lives locally, and the Medford-based Hearts With a Mission shelter for teens.
Plagued with bipolar disorders, attention deficit hyperactivity and substance abuse, Mariah, like Rice, routinely ran from those who would help her. A residential treatment program for children was not a good fit for the teen and she ran away. Hearts With a Mission desperately tried to help her, but she ran away. Her father would find her, bring her home, and try to provide a safe environment. She repeatedly ran away.
And then she died.
There are no easy answers and rarely happy endings with cases such as these. But whatever chance the seriously mentally ill have to survive and thrive are particularly long shots in a state and a region that provide so few services. The Oregon State Hospital has 655 beds in Salem and Portland for patients in need of long-term intensive psychiatric treatment. That's 655 beds for a state with a population approaching 4 million people. Take a number and good luck — you'll need it.
Locally, the chance of finding treatment facilities is an even longer shot. Jackson County has a handful of short-term beds for the mentally ill and virtually no facilities for minors with mental issues.
That leaves it up to overwhelmed families and social service agencies to try to keep them alive and functioning. If you're a parent with a mentally ill child, your best hope is to ship your child hundreds of miles away, if a spot can be found.
For those who consider themselves lucky to have escaped the consequences of mental illness in their families, think again. We all pay on a regular basis, as police officers, paramedics and employees from other public and private agencies routinely respond to calls ranging from public disturbances to crimes and suicides. Many of the mentally ill who are not under supervision also end up self-medicating with illegal drugs or alcohol.
We need more money in the system, some of which should be spent on secure facilities where the seriously mentally ill can live — against their will if they prove to be a danger to themselves or others.
The move to deinstitutionalize the mentally ill and others with chronic mental disabilities was a good thing taken too far. Yes, for many, many of those who were once locked up in institutions, their lives were vastly improved by being moved into community-based services. But for some, it means a life on the streets, with nowhere to turn for help. Those who demand the end to institutions are not dealing with the reality that these people and their families deal with on a daily basis.
Money would help cure many ills in this state — the list of needs is long and expensive. But in most other publicly funded areas, those who are critically in need of help are getting it. That's not true for far too many of Oregon's mentally ill people. And that needs to change.