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Outpatient commitment works

by John's wife

July 2003

The author of this piece preferred to remain anonymous - but her story of the struggles that she and her husband faced is not an isolated one. Others who read this may see themselves. Thanks to her for her courage in sharing this important story, an example of the importance of assisted treatment.

My husband has a chemical imbalance in his brain. He was diagnosed with schizoaffective disorder four years ago. John has a disease that is treatable, but incurable. This is a truth that we have to live with every day. However, it took four years for my husband to realize this truth.

When I met John, I was the happiest girl on earth. He was just what I was looking for-a smart, good-looking, funny guy (perfect husband material!). Our relationship blossomed very quickly and within a few months of dating, we decided to share an apartment. John was somewhat mysterious and sometimes possessive, but these traits attracted me to him even more. I knew little about his family or his history. But, it really did not matter to me at the time, because I was so in love. When I found out I was pregnant, we were happy, but anxious. We wanted to do the "right thing" and decided to get married. Since my family and friends were unsupportive of our wedding plans, we decided to elope. My parents were devastated. They did not understand how their sweet daughter could have ruined her life so badly. My parents had such high hopes for me. My unplanned pregnancy and shotgun wedding went against all of the Baptist values that they instilled in me as a child. My father stopped talking to me for three months. My friends were also worried. Everyone saw John as an unsociable, possessive brute that got me into trouble. Regardless of their feelings and my own doubts, I was excited to marry him.

Shortly before our planned trip to Reno, John and I had our first big argument. He totally lost control and destroyed several things in the apartment. I was very frightened and called 911. The police arrived and calmed down the situation. This was a very scary incident, so I went to Reno with even more doubts about our upcoming wedding.

We ended up getting married in a lovely chapel in Reno. We were both tearful and happy. We set off for Lake Tahoe for our honeymoon and were truly enjoying ourselves. It did not take long for things to go horribly wrong. On a sightseeing cruise, I accidentally taped over a portion of our wedding video. When we got back to the room, John went ballistic. He destroyed the tape and all our wedding mementos. We fought for the rest of our honeymoon and tension was high. The flight home was absolutely unbearable. I swore that when I got back, I would have the marriage annulled. I had finally come to the realization that something was very wrong with my new husband.

After we got home, things went from bad to worse. John started acting very strangely. He would unplug all the household appliances and then plug them back in. He would stand in a trance in front of the television and touch the screen. He would talk about the government and people trying to kill him. He would curse and call me the most horrible names. He picked fights with perfect strangers. He became paranoid if a bell went off when he walked into a store. He could not hold down a job. He would leave for hours at a time. He burned pieces of paper with a lighter. I could go on and on. I kicked him out a few times and even paid for him to stay in a hotel for the night. However, I would always take him back. He had no one to turn to. Although his mother was sympathetic, she did not know what to do. None of his relatives would help him, either. Who wants a "crazy" relative living with them?

One night, he came home after I had gone to bed. I woke up to find him standing in the doorway with a knife. When I asked him what he was doing, he looked at the knife in his hand and slowly walked back to the kitchen to put it away. It was like he was in a trance and truly did not know what he was doing.

I knew he desperately needed help, and I started calling mental health agencies. I learned that he could be involuntarily committed to the hospital if I could get him there, but they would only be able to hold him for 72 hours involuntarily.

I found my opening one night when John came to me with a very concerned look on his face. He had a small cyst growing on his chest and he said it was killing him. I told him we should go to the hospital and have it looked at. While we were waiting, I told the nurse that I thought he was mentally ill. I told her that someone needed to talk to him because he was in desperate need of psychiatric care.

After the doctor talked to John for five minutes, the decision was made to hospitalize him in the psychiatric ward. He fought and kicked and had to be restrained by several hospital staff. He yelled at me and told me he hated me.

It was the worst night of my life. What had I done? How could I do this to my husband? I cried and prayed and cried and prayed some more.

I visited him in the hospital every chance I got. Sometimes he was nice and other times he was mean. He would call me often. He started sounding better and was making some sense again. Could it have worked?

John was released after 72 hours because he was cooperative with the medication and was stabilized. Once more, things went well until he decided not to take his medication anymore. As soon as he would start feeling better, he felt he did not need the medication any longer.

I begged and pleaded with him, but he refused to listen. John quickly decompensated.

I read many books and talked to several mental health agencies. The outlook was bleak. John had to be a danger to himself or others to be held for longer that 72 hours. He was not dangerous, yet. What could I do?

I felt very alone. I had alienated my family and most of my friends. I was pregnant and constantly worried. I came to the heartbreaking decision to kick John out (again). I paid for one night in a hotel and said good-bye. I learned I was not strong enough to just let him go like this. He had no job and no money and was mentally ill-how could I not feel guilty? I ended up letting him come back to do his laundry and then I sent him on his way again this time at the Greyhound Station. He bought a one-way ticket to Louisiana and we said good-bye once again.

I did not hear from him for two days and I was worried sick. I felt guilty, but I knew I could not live with him when he was like this. I was afraid for myself and our unborn child. I was especially afraid for John.

I finally heard from his mother in Texas. Somehow, he had managed to get to Corpus Christi and his parents were leaving to pick him up at the bus station. John stayed with his parents for a week and I talked on the phone with him every day. However, things did not work out there and I received a frantic phone call from his mother saying that he had packed his things and took off with nothing but the clothes on his back. A few hours later, he called me from the San Antonio Airport and said he wanted to come home. Of course, I made immediate arrangements to fly him back with the whopping price tag of $600.

When he got off the plane, John looked horrible. He had none of his belongings with him. He apparently hitchhiked to the airport and decided he did not want to carry his suitcases anymore. Therefore, he left them on the side of the road.

Once we got back home, his condition deteriorated and I was truly frightened. I tried to get help for him, but he would not talk and would not open the door to the mental health workers. I again heard the mantra that he needed to be a threat to himself or others in order to be helped.

John called me at work constantly and if I did not return his call immediately, he would report me missing to the police. His weird behavior continued and the fighting got worse. I found myself pushing him to fight me just so I could get him the help he needed.

Finally, he got extremely upset with me and pushed me across the room. I was six months pregnant at the time and stumbled, but did not fall. The next day, I called the mental health agency and told them what had happened. They immediately went with the police to pick him up and transport him to the hospital.

After his 72-hour hold, we went to court. I had filed to have him probated as mentally ill and the Judge ordered him to a stay in the state mental hospital. John became very angry with me in the courtroom when I testified against him and he even threw his wedding ring at me. It was devastating.

John was in the hospital for three months, two months of which I was not allowed to visit. I did not understand why they were keeping me from my husband at the time that he needed me the most. I fought for visits, but my pleas were ignored. I did not understand until later that this was exactly what he needed. My absence in his life gave him motivation. He desperately wanted to be with me and he especially wanted to be a father.

He cooperated, took his medication, attended counseling, and became stabilized. I was then able to visit with him and John returned home the first week of July a changed man. We were so happy.

John has great respect for the court system and he continued to take his medication and attend therapy because he knew that if he didn't, he would be sent back to the hospital. He mainly was taking medication because he was afraid of the consequences. He still did not have a full understanding of his disease. That would take time.

Out first child, a boy, was born on July 25th and it was the happiest day of my life.

Things were going extremely well for us and I found my husband was a wonderful father. John began receiving Social Security Disability Benefits. His construction job was just getting to be too much for him. He became a stay-at-home dad and loved his new job. John began to get regular visits with his two other sons and seemed content with his life.

He went to court monthly and talked to the Judge. John enjoyed these visits and looked forward to seeing the Judge. It took a while, but John finally started understanding his need for medication and he realized that it was not just because the Judge wanted him to.

After two years of being probated, the Judge was considering releasing John from probate status. Shortly after we heard the news, John decompensated. His medication simply stopped working. He was hospitalized once again, but recovered quickly with a change in medication. A year later, John was no longer on probate status.

Today, John is thriving. We had another child, a girl, and John is a wonderful husband and devoted father. We are so very happy and sometimes my love for him is so strong, it feels as if my heart will burst. We live in a beautiful home and are looking forward to our future together.

Without the help of a strong probate court system, devoted mental health professionals, and a very empathetic Judge, we would not be where we are today. My husband and I are grateful for the law that allows involuntary hospitalization. It was an important part of John's treatment and was what was needed to make John a happy, productive citizen.

I am under no illusion that things will always be this good. John may decompensate again. He may be hospitalized again. I cannot predict the future. However, I do know that there is help out there for those who seek it. I now know that the system is behind us and it works.

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