Fort Wayne Journal Gazette oped: When mental illness invades a marriage 4 5 02

The last few months have brought to the public the opposite extremes of the experience of the biological brain malfunction called schizophrenia.

Psychotic persons roam our cities and live under our bridges. We refuse to force medication because we respect their capacity for free choice. That capacity doesn't exist in a biologically damaged psychotic mind. We cannot demand or expect rational choices and we must not inflict punishment.

On the one hand, we have experienced an amazingly accurate and powerfully heroic depiction of schizophrenia as it impacted John and Alicia Nash in the movie "A Beautiful Mind". Mental health advocates are ecstatic. This movie is educating viewers about the truth of the experience of schizophrenia and the hope of recovery.

The lives of John and Alicia Nash are a soaring triumph of truth in the face of this devastating catastrophe. NAMI members view Alicia as a hero for staying with John. The elements of recovery were there for him: initial accurate comprehension of the affliction, attentive doctors who allowed the family to partner in care giving, good medications, a loving and supportive caregiver/wife, and finally a job - a reason for being.

On the other hand, we have experienced the horror of schizophrenia in the lives of Andrea and Russell (Rusty) Yates and their five children. Her five children are dead, she has been sentenced to life in prison, and Rusty is left to deflect the daggers of blame thrust at him from everywhere. All that was present (at least in the end) for John Nash was absent for Andrea Yates.

NAMI Fort Wayne has a wonderful spouse/partner support group. We help well spouses cope with the serious mental illness of the partner. First, we honor them for their profound commitment to the ill spouse. We don't believe much in the theories of "enabling" or "co-dependency".

Given that, we try to provide the tools to do it well, and not be lost in the chaos. We provide education.

We help spouses learn to cope with the mental health system, including the doctors. We help them set reasonable, bottom line boundaries about treatment compliance and behavior. We turn them into tenacious bulldogs, demanding good treatment and holding the system accountable when it is not forthcoming. We teach them to protect their children.

Rusty didn't have that help. Sure, he didn't do everything right. Sure, he was in denial. And certainly the mix of fundamentalist religion and schizophrenia is a time bomb. But you can't know what no one has told you. Hind sight is always 20-20. No one believed she would harm her kids.

Rusty experienced a total breakdown in medical care. I can't believe the doctor took Andrea off the anti-psychotic medications and let her go home, even though Rusty told them she wasn't well enough - and even worse, to let her go home to five small children.

I must rephrase - I can believe it. Such has happened to many of us. I wish the general public knew how hard it is to have someone hospitalized for psychiatric illness, and to keep the person in the hospital until it is safe to come home. We're talking about safety here! Where was the accurate comprehension of the affliction? Where were the attentive doctors? The hope of recovery will never be for Andrea and Rusty Yates.

And finally, we have a dark ages legal approach to this terrible event. If Andrea suffered from heart disease, had a massive heart attack, and ran the family van off the road killing the children, there would be no murder conviction for her. But if she suffers a devastating heart attack of the brain that results in the death of her children, "well, let's get out the ax and cut off her head!"

When will this culture abandon our worship of the icon of free choice and self-determination. We have taken this to new heights.

Since we believe our freedom provides everyone with the right of free choice and that all persons are capable of intelligent free choice, we also believe there must be harsh consequences for bad choices. We fill up our prisons. We seem incapable of understanding that psychotic persons are not rational enough to exercise any meaningful free choice. There is no logic. There is no comprehension of right or wrong or truth or lie or action or reaction or choice or consequence.

Maybe in the case of Andrea Yates, the free choice was with the doctor who insisted she go home. Where are the consequences for that choice?

Kathleen A. Bayes is vice president of NAMI Fort Wayne (National Alliance For The Mentally Ill). NAMI Fort Wayne is winner of Outstanding Local Affiliate Award, 2002 from NAMI.