Summary:

They roam the streets bemusing and frightening passersby with their antics.  Many mentally ill people can be helped but have been left by a crazy system to their own sad devices.

Text:

A paranoid schizophrenic with violent tendencies was listed "critically missing" from St. Elizabeth's Hospital in Washington for two months this summer.   A young Park Police officer found him on the street a few weeks ago and returned him to the hospital.

Despite the patient's status and despite the fact that the officer was taking time from his duties to help, hospital officials said the patient couldn't be admitted.  Rather than leave him on the street, the officer spent 16 hours completing the paperwork to have him recommitted. Twenty-four hours later, the officer saw the violent man wandering the neighborhood again, released after a meeting with his caseworker.

In the shadow of the White House, the young officer slouches back on his patrol bike, shaking his head with frustration after telling this story that experts say is all too common in America since the deinstitutionalization programs of the last decade.  Once seriously ill mental patients refuse treatment or leave home on some paranoid expedition, they cannot be forced to receive treatment. And without treatment, their civil liberties protect them from intervention - until they commit a crime.

Take Russell Weston, accused of killing two U.S. Capitol guards on July 24, 1998.   He's another diagnosed paranoid schizophrenic, newly infamous, who traveled from his Illinois home to strike back at the government, which he believed had implanted a device in his head and was sending him messages through the fillings in his teeth.  The voices began haunting him when he stopped his medication two years ago.

"From the interviews I've seen of his parents, I think his story is practically archetypal," Xavier Amador of Columbia College, a nationally respected expert on schizophrenia, tells Insight.  "The inability to see how ill he was and how much he needed medication is repeated every day all over America."

To many in the nation's capital such street people are as familiar a sight as the national monuments.  But usually they are regarded not as suffering human beings but as part of a great social abstraction.  "Americans don't really have a good understanding of the homeless," says Bryan Thompson, who works on the front lines of the homeless-relief effort as executive director of the capital's Central Union Mission.

For instance, there is the woman who calls the thick yellow pigment streaked on her dark face "the new look" as she models her idea of fashion every day on the steps of the fountain at Union Station near the foot of Capitol Hill. People call her the "Tattoo Woman" and laugh, stare or just wonder. Few notice that her mouth -painted with bright pink lipstick that melts into the creases of her chin in the heat of the day - twists crazily when she talks or that the hollow eyes behind her dark glasses are full of sadness.  The "Tattoo Woman" is Ann, a 39-year-old former employee of the Government Printing Office, who has sisters and brothers in the district and a mother with a heart condition.  But passersby only see her tiger-striped skin, her red turban, her pathetic bags.

Then there is the scraggly preacher.  He prefers to be known as "Bosco Pinko" or even "Speed" from his days as a meat packer in Columbia, Mo.   He says he plans to run for president in 2000. Current campaign headquarters?   Lafayette Park, on Pennsylvania Avenue across from the White House. His platform?   If elected, he declares, he will have 20 million people reading the Bible. Even now he stops passersby with unfathomable questions: "If you're so smart, tell me what it means to pray without ceasing.  You think you're so high class:  Look at you, you're cleaner than Jesus - Jesus didn't have shampoo."  Park police say he arrived in early June.  By now they have heard his sermons "way too many times" and lament about how badly he needs a shower.

On the streets a few blocks away from the U.S. Capitol a less innocuous wanderer pauses by a bronze statue.  He is young, blond and has rotting teeth.  American flags are visible through the grime on his T-shirt and cap.  He looks like a derelict patriot. Far from it, he says, introducing himself as Mike Fisher.

Fisher believes he is being held hostage in Washington, where he arrived about five months ago hoping to get work. As a captive, he explains, he "legally" could shoot to kill anyone at any time. Not that he would, mind you.

His story began five years ago, when he thinks the government at an Army intelligence base in Charlottesville, Va., poisoned him. He has gone to the FBI, to the White House, to the state of Virginia, to the Secret Service. He is sure they all are in on a conspiracy against him, because for five years they have told him nothing.

He figures he's a human guinea pig for American technical experiments similar to Japanese efforts to control cockroaches with high-tech electrodes.  Tapping the base of his skull and his tailbone, where he believes chips were implanted, he shakes his head.   "That's the way I got it figured. I can feel a contusion about that long," he gestures, "on the base of my spinal cord.  It sounds stupid, but it's not. It's like living in a nightmare."

In contrast to drifters like Fisher is the African-American man with a bushy beard who has stood waving a tree branch along New York Avenue from dawn to dusk for about 15 years.   Known as "Tree Man," he says he waves his branches to bless the people who pass under his bridge.  He is Catholic, he tells Insight, and when he noticed that the bridge across the road formed a shape similar to the small cross he wears knotted around his neck on sweaty strips of blue rag, he became convinced that God had given him a sign.  By his estimation, everyone in the world eventually will pass by him and be blessed en route to Riggs Bank, a mile or so down the road.  His blessing, it seems, is important in the battle against evil crack dealers, who actually are aliens in human form, and land on the roofs of Georgetown houses in blue spacecraft that he personally has observed.

Around his left wrist, like a shackle left when he broke the chains of reality, is the remnant of a dirty cast.  "Yes, I want it off," he says. "The person who put it on me did it while I was unconscious.  But I won't go to no hospital where they'll cut my arm off. You wouldn't trust no one like that."  And with a suspicious look over his shoulder toward the wooded ditch where he spends his nights, he warns, "Look out for those space people.  I believe they're from Mars."

Park Police officers tell of a man named Stacey Abney who protests every week in a restricted zone at the corner of the White House property where he knows he'll be arrested.  Every time they pick him up they find $6,000 to $7,000 in cash stuffed in his clothes.  Though he can take only $100 into jail, he never reclaims the remainder from the personal-property holdings desk and eventually it reverts to the U.S. Treasury.   No matter how many times it happens, police soon find him again in the same restricted zone with several grand in his pockets.

The police patrolling Lafayette Park who tell such stories do so with a wary look.   So many strangers drift through this beat - tourists, protesters ... and those separated from reality. The stories reflect frustration, humor, compassion and a bit of something else.  "This is a scary place," one officer says.  Find someone who has come to Washington to carry out a vendetta against a public official, and odds are that person has been in the park.

Some come for a day, some for nights on end.  A handful are like nuclear protesters Ellen and William Thomas, who are not homeless but go home at night to a commune with an office and technology to support their antinuclear World Wide Web site.   They have kept vigil for almost 18 years.  But for the most part, every season the faces are new.

Another officer explains, "You don't know who they are or what they're doing until it's done."  Also, he says, the street people of Lafayette Park have "strong convictions."

Yad B. Fantu, age 55, for example, came from Nigeria to warn the American public that President Clinton, House Speaker Newt Gingrich and Microsoft founder Bill Gates are "cutting babies' throats in the White House."  He claims that the head of the FBI has tried to silence him, but he is immortal. ("You know that agent who killed himself in 1994?  He was trying to shoot me, but the bullet bounced off my skin and killed him.")

Nearby is Dwight, a handsome, gray-haired, 47-year-old in a ratty leather flight jacket.  Another Lafayette Park regular, he came to Washington about 10 years ago to protest what he calls the "Secret Classified Gestapo."  As a "communist opposed to the system," he objects to chemical preservatives and red dye, which he says the government is putting in "all foods at about 100,000 times the legal amounts."

Dwight says he was a husband and father working in real estate in Indianapolis when he became aware that he had been under "surveillance-harassment" since high school because his ancestors were communists.  At that time, his family "became hostile," encouraging him to get treatment, so he knows they are aligned with government officials.  "They, like everyone else, lie about it.  They think it's nonsense, some sort of political dream.  They think I'm paranoid, but I'm not.   See me?  I'm living on the streets.  No one does that for a long time unless they have to."

He claims it's hard to be a communist in Lafayette Park.  He gets attacked or arrested many times a year and says he will seek political asylum in Russia.  "I hate the American people. I hate Americanism. I hate the people that believe all this," he says.  "You go nuts out here after awhile."

In the meantime, the police do their job, which includes everything from protecting the street people and the public from interfering with each other to awakening the bench sleepers in the mornings to make sure they are not sick or dead.  And these people know their rights: "It's a public park and I am the public.  So let me be," is a common refrain.

The police are committed to upholding those rights unless - as the language of the law puts it - the street people show themselves to be a "danger to themselves or others."  It is in defining this "danger" that conflict arises.   "It's not against the law to have mental problems; it's not against the law to be homeless.  You've got to remember that," says one officer.  "We're not trying to get them locked up."

But when people are freezing because they can't be convinced to wear more than shorts in subzero weather, or when they show violent tendencies the officers believe could lead to a tragedy, detaining them overnight on mercy charges seems grossly inadequate.   The officers often wish some of those they must watch would commit some offense serious enough to warrant a longer incarceration and a psychological evaluation – which might help them find a way out of the maze.

Scientific advances in diagnosis and treatment have helped many mentally ill people.   And many services ranging from soup kitchens to literacy programs are available.   But those whose minds are too crippled even to recognize that they are ill are "protected" by current laws from receiving help against their will.  Some civil-liberties groups say that is how it should be – that involuntary treatment would deny the mentally ill their human rights.  Others say that when patients are so ill they can't recognize their own condition, the only way to preserve their human rights may be carefully to mandate their treatment.

It is a public-policy issue, but it cannot be decided apart from its social and humanitarian context. Roughly one-third of America's homeless are like Weston - suffering from mental illnesses such as schizophrenia and manic depression.  While the recent shootings have inflamed public perception, advocates of both the homeless and the mentally ill say neither group inherently is dangerous. Experts claim that only about 5 percent of the mentally ill exhibit violent behavior and then usually in cases in which treatment is rejected or not available.  Those cases most often are among the homeless.

"They need so much in terms of connecting with the community," says Rutgers University professor Nancy Wolff, associate director of the Center for Research on the Organization and Financing of Care for the Severely Mentally Ill.  Beyond a stable residence, such people need accountability and interaction.  For this to occur, law-enforcement and mental-health officials must establish clear lines of communication.

As things stand now, police officers, charged with defending public health and safety, will pick up an offender and transport him to the hospital.  The hospitals will cite civil-commitment laws that require evidence of being a danger to self or others, very narrowly defined.  So law-enforcement officials find it easier to incarcerate than to commit.

"Our jails, whether we like it or not, are becoming our largest mental-health facilities," says Wolff. "D.C.'s [law enforcement] has an extraordinarily good mental-health-services program. Unfortunately, once they are released from the jail, they are without their medications."

The courts now occupy the border between medicine and law. Some mental-health courts are using a therapeutic rather than a punitive jurisprudence.  They create "preconditional release arrangements" restoring defendants to the community on the condition that they receive treatment and stay on their medication.

It's a new mechanism, Wolff says, and still needs closer examination in terms of legal, clinical and social-welfare consequences.  "We put the seriously mentally ill in the community because we believe they are full citizens, but we also need to expect them to live within the social norms and the laws of our system."

E. Fuller Torrey, president of the Treatment Advocacy Center in Arlington, Va., says that the same involuntarily enforced protective measures should apply to schizophrenics and manic-depressives as to patients with Alzheimer's disease.  "Why allow them to put themselves in very dangerous situations?  We rationalize that as defending their civil liberties."

The laws are interpreted too narrowly, says Torrey, who believes intervention should be more common.  It has come to the point, he says caustically, where "'dangerous to self' means committing suicide in front of your psychiatrists and 'dangerous to others' means trying to kill your psychiatrist."  Torrey says the untreated mentally ill commit 1,000 homicides every year that could be prevented if involuntary treatment and commitment were allowed.

The need for a more cost-effective approach to treatment is acknowledged across the board: The average per-patient annual cost for managed care to the mentally ill is $70,000. Costs in the district exceed $100,000 per year.

Amador, the schizophrenia expert, says one key to resolving the dilemma between laws that are so broad that they easily can be abused and so narrow that they leave whole segments of the population without hope is to dispel some of the myths surrounding modern psychology. "It is pure myth that a person can fake psychosis or manipulate the system in such a way to make others believe that somebody has a psychotic disorder when they don't." Also, new drugs have less severe side effects than commonly is believed, and minimum effective dosages are prescribed.

Many mental-health professionals say that what is responsible for foot-dragging by policymakers is a combination of justifiable love of liberty and unjustifiable ignorance. "Lawmakers, lawyers and judges in the system need to be brought up to date," Amador says.

For now, the famous buttoned-down craziness of Washington's lawmakers is rivaled by the stories of the people in the shadows - dangerous or not -driven like the tragic Don Quixote to attack the windmills that are but voices in their minds.