WRITTEN & DIRECTED BY
Miri Navasky & Karen O'Connor
JERRY THARP: I've cut myself. I've ingested things like bed hooks, razor blades-
ANNOUNCER: Tonight on FRONTLINE-
JERRY THARP: I swallowed a cassette Walkman-
ANNOUNCER: -they are schizophrenic, out of prison-
MICHAEL GRISSETT: The voices, the devil- actually, they got a needle, a feather and a rope.
ANNOUNCER: -with nowhere to go-
BENNIE ANTHONY: I became homeless for two years. That was rough.
ANNOUNCER: -and no help to cope.
MICHAEL UNGER, M.D., Medical Director, Southeast Mobile Van: Psychiatric treatment for those that are coming out of incarceration is very poor.
COUNSELOR: What would happen if you stopped taking those medications?
LYNN MOORE: I start hallucinating.
ANN MCALLISTER, M.D., Psychiatrist: You can decide to not take the medication anymore. In an instant, all the good can be erased by a relapse.
ANNOUNCER: Many of these mentally ill offenders wind up back in prison again and again.
KEITH WILLIAMS: Going back and forth to jail, back and forth to jail, back and forth to jail.
SHERRI SULLIVAN, Program Director, Bridgeview Manor: I see the whole community mental health system as a huge social failure. A person is going to get a better level of care while incarcerated than they're going to get if they live in the community, and that's really sad.
ANNOUNCER: Tonight, the unending cycle of tragedy for The Released.
JERRY THARP: I was in state hospital before prison and diagnosed then at the age of 16 as a schizophrenic. I go through cycles where I, you know, don't take my Thorazine willingly and stuff. And then I really- you know, as I say it, my mind snaps.
I've cut myself a lot, and I've ingested things like bed hooks, razor blades, ink, pens, pencils, toothbrushes. I swallowed a cassette Walkman, AM-FM radio, and just crushed it up in chunks and slivers, and just bend my head back and push it down my throat and immediately drink water and swallow it. You know, I'm like my own worst enemy. I'm really, you know, in a sense, you know, destroying myself psychologically and physically.
INTERVIEWER: Do you think you're mentally ill, Mr. Tharp?
JERRY THARP: No. No, I don't think I'm mentally ill.
INTERVIEWER: What do you think you are?
JERRY THARP: I think I have a spiritual illness, you know- maybe, you know, as I say, a spiritual insanity. That's the extent of it.
GUARD: Tharp, ready?
NARRATOR: We first met Jerry Tharp in 2004, when we made a film in Ohio about the mentally ill in prison.
JERRY THARP: And I will be a headache to you no more, B.
NARRATOR: After serving 10 years for aggravated robbery, Jerry was about to be paroled.
PRISON OFFICIAL: I need you to sign this copy saying that you received these medications. It goes in your chart.
NARRATOR: He was released to a halfway house with $75 and two weeks worth of medication.
PRISON OFFICIAL: That's your Thorazine.
JERRY THARP: OK.
PRISON OFFICIAL: If you have any problems, you can follow up with your primary care physician or your local health department.
JERRY THARP: If I was a betting man, what would be the odds of me coming back to prison? Zero. It's been a long time and I'm finally free. I feel good, you know, about leaving and I'm going to be gone. Stay gone. [laughs]
NARRATOR: Our hope was that Jerry would "stay gone," as he put it. But only three months later, he stopped taking his medication, robbed a pharmacy and went back to prison.
We also found out that, like Jerry, almost all of the inmates we met five years ago had since been released and rearrested.
REGGIE WILKINSON, Fmr. Director, Ohio Dept. of Corrections: Any person who leaves prison without a pretty good support system will have a very difficult time at trying to stay out of prison. And if you're mentally ill, that compounds the possibilities of you being successful in the community. I think the community knows very little about the fact that we're treating thousands of persons in our prison population with mental illness, and serious mental illnesses. And they are a population that would be a risk not only in the institutions but when they leave the confines of our correctional facilities.
NARRATOR: This year alone, over 700,000 inmates are being released, the largest exodus of prisoners in America's history, and over half are mentally ill. So we went back to Ohio to find out why so many mentally ill offenders aren't making it on the outside.
MICHAEL GRISSETT: The Parole Board let me go. The Parole Board said, "Well, we think you're rehabilitated, honest, abiding citizen, hard working class person, honest, abiding citizen, believe you did the right thing, taught you a lesson by giving you 21 years, over 21 years." So they said, boom, "We'll let you go." And here I am.
I got big plans. Me and God got big plans, beautiful plans, too. Keep doing the right thing, try to better myself and abide by the laws, keep your nose clean, stay out of trouble.
NARRATOR: Michael Grissett was paroled eight months ago. He spent 21 years in prison for murder and has been diagnosed with paranoid schizophrenia.
INTERVIEWER: Do you have voices going on right now?
MICHAEL GRISSETT: No, they don't talk all the time. They- they listen. They can hear y'all, but y'all can't hear them. I can hear them and what's inside me can hear them.
INTERVIEWER: And what are they saying to you right now?
MICHAEL GRISSETT: They ain't saying nothing right now, they're listening. They're kind of scared, you know what I'm saying?
INTERVIEWER: And then when we leave, what will they- will they start to talk to you again, or what will they say?
MICHAEL GRISSETT: They ask me, say, "Mr. Michael Grissett, we know you're the father of God and"- because God come in and beat them about. They say, "Where's our cornbread at? You going to feed us today?" Say, "Get the [deleted] out of here. Hell, you wasn't born with nothing to eat and no money, so die." That's what I tell the voices, the devil, the voices. So they start crying. They got a needle. They got a needle and they got a feather and they got a rope. God give it to them, a needle, a feather and a rope.
NARRATOR: Grissett is one of 50 offenders lucky enough to get into a reentry program in Cleveland. It's one of the few programs in Ohio that helps the seriously mentally ill transition back to the community.
JAMES RODIO, M.D., Psychiatrist: The program is designed for people who have a severe mental illness or a psychotic-level illness, which means they're going to be having auditory hallucinations or fixed false beliefs, delusions, and require anti-psychotic medication in order to stabilize and function in a regular way.
NARRATOR: While in the program, Grissett has access to mental health treatment and sees a psychiatrist once every two weeks.
Dr. JAMES RODIO: Give me an update for today. Right now today, how are you doing as far as the voices go?
MICHAEL GRISSETT: Fine. Good. Real good- 100 percent, 100 percent. Greater power. Greater power.
Dr. JAMES RODIO: OK. So you don't feel at risk for hurting yourself or somebody else right now?
MICHAEL GRISSETT: That's me and God's business, what we do.
Dr. JAMES RODIO: When you have someone who's disorganized and irritable and hearing voices and may be paranoid, the risk for negative behavior is much higher. These really are medical illnesses that require daily compliance with the medication in order to adequately treat it. We see plenty of people who, depending on their condition, can decompensate quite quickly off the medications. And certainly in the course of days sometimes, or certainly weeks, people can be quite disorganized and hallucinating and under a full spell of delusions and really incapable of functioning in the community.
Dr. JAMES RODIO: All right. Nice seeing you today.
MICHAEL GRISSETT: Same to you.
Dr. JAMES RODIO: Have a good day.
MICHAEL GRISSETT: Same to you.
NARRATOR: But unlike Michael Grissett, most mentally ill offenders go untreated and are more likely to commit another crime.
JACQUELINE EDMONDSON: I was upstairs, getting ready for Thanksgiving dinner. And I was up there cleaning my chitlins and trying to, you know, get my stuff done prior to the next day. And I heard him with beer bottles and bricks, breaking her windows and kept calling bin Laden out in the middle of the street. So me and my daughter was upstairs and we kept looking out the window because I was scared as hallelujah. So we called the police.
911 OPERATOR: 911, what's your emergency?
JACQUELINE EDMONDSON: There's a guy that's trying to break into this lady's house, trying to open the screen windows and banging on the door.
911 OPERATOR: Does he have any type of weapons or anything in his hands?
JACQUELINE EDMONDSON: He's throwing bottles and bricks and carrying on.
NARRATOR: When police arrived on the scene, a suspect was arrested but was released the same day. Twelve hours later, he was back, still looking for Osama bin Laden.
911 OPERATOR: 911, what's your emergency?
JACQUELINE EDMONDSON: Please come to my house! Somebody's trying to get in my door. Please hurry!
911 OPERATOR: Ma'am-
JACQUELINE EDMONDSON: He's trying to get in!
911 OPERATOR: Who is it?
JACQUELINE EDMONDSON: Please hurry.
911 OPERATOR: OK.
JACQUELINE EDMONDSON: Thank you. Thank you.
NARRATOR: Lynn Moore was sentenced to eight months for breaking and entering. He'd been arrested and released over 20 times, and this was his fourth time in prison.
LYNN MOORE: Well, I had delusional thoughts about bin Laden, thinking that he was in Canton, Ohio, going to blow up different schools and different places. I hoped that he would have came out or he'd be exposed and that he would be captured.
I was going to stay on my meds, it's just- it just didn't seem to- I mean, it was working, but it just- I just got tired of taking it. I figured I was- I was cured, I was healed from it, you know? I figured I don't have no more delusions. But it- it popped back up, saying that bin Laden was still in town, you know? And that's what the problem was. I wish I stayed on it now.
NARRATOR: Moore, a paranoid schizophrenic, was medicated and stabilized in prison. This is his last meeting with his treatment team before he's released.
COUNSELOR: How do you feel now?
LYNN MOORE: Pretty good. Yeah.
COUNSELOR: What about the delusions?
LYNN MOORE: I don't have any.
COUNSELOR: None at all?
LYNN MOORE: None at all.
COUNSELOR: OK. You really need to make sure you take those medications-
LYNN MOORE: Yes.
COUNSELOR: -because you know what happens when you stop. What are some of the signs that you would look for? What would happen if you stopped taking them?
LYNN MOORE: I start hallucinating different- just start getting into the past of what I used to be, thinking about the terrorists and different things.
COUNSELOR: OK. Make sure you take those medications because once you stop taking them, that's when you get in trouble. You don't want to wind up back in prison again, OK? You don't want to be waking up in some stranger's house looking for bin Laden or- right?
LYNN MOORE: Yeah. That was terrible.
COUNSELOR: Yeah. Yeah. OK.
NARRATOR: Moore has served his full sentence, so he's being released with no parole or supervision.
DEBBIE NIXON-HUGHES, Fmr. Chief of Mental Health, Ohio Dept. of Corrections: For inmates released on parole, at least there's somebody that's tracking that person, that's still working with the community to try to get them involved in services, whereas the person that maxes out, they're pretty much on their own. You try to help make the connection to mental health services in the community, but mental health services are limited, so that person is out on their own to be able to advocate for themselves.
PRISON OFFICER: OK. You're free. Good Luck to you.
LYNN MOORE: All right. Thank you.
DEBBIE NIXON-HUGHES: When you talk to some of the mental health staff, they talk about it being very difficult. They get real concerned that people that we let out, are they going to really have a chance out there?
NARRATOR: On his first day of freedom, Lynn Moore is heading home to Canton, Ohio. But home is now a place called the Refuge of Hope, a shelter where he's stayed before.
SCOTT SCHNYDERS, Program Director, Refuge of Hope: When I see guys come out of jail, generally, there's no support or buffer there to, like, kind of cushion their falls, just kind of a hard drop into reality. They've kind of broken down every other relationship they've had, whether family or friends, so they don't- you know, there's no other place to catch them, so they end up falling here.
LYNN MOORE: They take breathalyzers?
SCOTT SCHNYDERS: We have guys who've been here for over a year. I think we even may have one or two have been here over two years. All we ask is that they are making progressions towards getting themselves out of here, whatever that may be, however small those steps may be.
We'll put you in bed 15.
>Everyone that comes in here has to take a breathalyzer before he's admitted. If he fails, he's dismissed for 30 days and then welcome to come back. We also ask that they don't do drugs. It is an expectation, but we don't have any way of enforcing it, so-
>Clear. So if you want to just get sheets, Doug will get you a free bed. And then it's- bed 20 is the second bunk. You'll see it at the end of the-
LYNN MOORE: All right.
SHELTER WORKER: I don't think we have any pillow cases left, but-
LYNN MOORE: Oh, don't worry about that.
SHELTER WORKER: I don't know if there's a pillow on there or not.
LYNN MOORE: All right.
SCOTT SCHNYDERS: I don't think people understand how hard it is to transition from prison life back to everyday life. There's some dignity that's lost with coming here and saying, like, "I have nowhere else to turn. You guys are kind of my last option." You're kind of at the end of your rope. You're hoping this will be a place where you turn around.
[www.pbs.org: Lynn Moore's life story]
SHELTER WORKER: All right, fellas, lights out.
NARRATOR: Homelessness is often part of the cycle for the mentally ill coming out of jails and prisons. And once homeless, receiving and sustaining treatment is almost impossible. So outside a homeless shelter in Columbus, Ohio, an outreach team is bringing psychiatric care to those who would otherwise fall through the cracks.
GARY BROWN: It's under the wire. I know what you're saying. I'm not [deleted]
MICHAEL UNGER, M.D., Medical Director, Southeast Mobile Van: The realities of psychiatric treatment for those that are coming out of incarceration is that it's either nonexistent or very poor. People are being released with maybe one or two weeks' worth of medication and told that they should follow up at this time and this date with this agency, which assumes that they have the judgment that they need to continue their medications as prescribed, and also assumes that they have the cognitive capacity to be proactive with phone calls, making appointments, discussing how many days of their medications they have left. So it assumes a lot.
NURSE: How come everything is still in here the way I fixed it? You haven't been taking them.
GARY BROWN: Yes, I have. I'm the one refilled it.
NURSE: OK. But today is-
Dr. MICHAEL UNGER: Today's Thursday, so-
NURSE: Thursday. OK. So you shouldn't have these for Monday, Tuesday and Wednesday. They should be gone.
GARY BROWN: Well, they ain't.
Dr. MICHAEL UNGER: This isn't a population that's going to come with their planners and their organizers and keep track of their appointments, and seamlessly integrate their own physical health care issues with their mental health issues and be compliant with their medications and keep them in that perfect little medication box, as they live, you know, behind a dumpster somewhere.
What's more likely is that they'll come out, they'll take their medication for three, four, five days, you know, run out of it or lose it. Eventually, they may get into trouble for something again. And it's a chronic cycle for the people that we're seeing.
PRISON COUNSELOR: Is this what you wanted me to have? OK. And this is what we've been talking about on numerous occasions. You want PC because you don't feel safe.
BENNIE ANTHONY: Yes, ma'am.
NARRATOR: We first met Bennie Anthony in 2004 on the mental health unit of a prison in Orient, Ohio. A classic repeat offender, within weeks of his last release, he'd set his girlfriend's house on fire. This was his third time in prison.
PRISON COUNSELOR: We discussed this, Mr. Anthony.
BENNIE ANTHONY: I want protective custody.
PRISON COUNSELOR: You're in your own cell.
BENNIE ANTHONY: I want protective custody.
PRISON COUNSELOR: All right.
BENNIE ANTHONY: [laughs] I want protective custody because I'm scared.
PRISON COUNSELOR: OK. And what are you afraid of?
NARRATOR: Even medicated, Anthony still struggles with paranoia and believes people are trying to kill him.
BENNIE ANTHONY: They was from Texas. They was coming out of Texas. And some of them have syringes of poison, electric- electric battery- battery-powered volts on them, where they can pierce your heart or your stomach. And some of them have wooden- wooden bats, like, and guns.
NARRATOR: A year after we first met him, Anthony was released. He did well under supervision, but as soon as he went off parole, he moved to Pittsburgh, stopped taking his medication, and within a month became homeless.
JENNIFER HOWISON, Probation Officer, Allegheny Co.: In the past two years, Bennie's been arrested 10 times. Sometimes he would have, you know, three arrests in one month- retail theft, loitering, harassment, a lot of defiant trespass - he broke into several buildings just to get food - open lewdness because he was urinating in the park that was his home. But the major thread, similar thread through all of them is that they were all related directly to his mental illness.
NARRATOR: After a series of misdemeanors, Anthony was arrested again, this time for assault, and was held in the Allegheny County jail.
JENNIFER HOWISON: Bennie was very sick when he hit the jail. You know, he was yelling loudly, unintelligible words. He just looked very confused. It was very clear that he was actively psychotic.
NARRATOR: Anthony was so psychotic that he was diverted from jail to the Allegheny County mental health court, a program that believes mentally ill offenders should be treated rather than punished.
[www.pbs.org: Full chronology of his arrests]
JUDGE: We talked about your case in chambers, and I think it appears that you haven't been taking your medication.
NARRATOR: In mental health court, mentally ill offenders are given probation instead prison time, but mental health treatment is mandatory.
JUDGE: OK, Mr. Graham. See you then.
COURT OFFICER: Bennie Anthony?
NARRATOR: The next time we saw Anthony, he had been on probation for four months. Once again, under supervision, he was doing well.
JUDGE: Good. You look great.
BENNIE ANTHONY: Thank you.
JUDGE: It's a major difference, sir. A major, major difference.
COUNSELOR: Your Honor, this is a positive hearing for Mr. Anthony. Mr. Anthony resides at Gibbs Personal Care Home and he's been maintaining his treatment and doing everything he needs to do.
JUDGE: That's excellent, Mr. Anthony. You know what you need to do. You figured it out, so you just got to keep it up and keep taking your medication and you get closer and closer to graduating from the court.
BENNIE ANTHONY: Yes, sir.
[www.pbs.org: More on mental health court]
BENNIE ANTHONY: You know, I've been a mental patient since 1974. You know, that's about 32 or 33 years ago, you know. And I- I mean, I know what make me paranoid and what don't, you know? If I get paranoid or something, I just go sit somewhere and think it out. And I've been working on it over the years and I handle it pretty good. I handle it pretty good. I handle my paranoia pretty good. Yeah, I handle it pretty good.
NARRATOR: With the court's help, Anthony found a room at a group home for the mentally ill in Wilkinsburg, Pennsylvania.
ALAN HOLLAND, Owner, Gibbs Residential Home: In the past, we used to have mainly senior citizens. They're gone. Now we have mainly mentally ill, mostly men, now mostly minority men. Most of them are on public assistance of some kind. Some have been to jail. Most have been in a mental hospital. Some have been homeless and they have nowhere to go.
Of course, they get a room, their board. We provide meals for them. They get assistance with their medications, everything that they may need assistance in. But a person may refuse their meds. And if they refuse them, there's nothing we can do. We can talk to them about it, let them know what could happen if they decompensate, but they have a right to refuse their medications.
NARRATOR: Although the court can't force him to take medication, Anthony has to see a psychiatrist once every two weeks.
ANN MCALLISTER, M.D., Psychiatrist: All right. I had the opportunity to go through some of your old history.
BENNIE ANTHONY: Yes, ma'am.
Dr. ANN MCALLISTER: And you've been through a revolving door.
BENNIE ANTHONY: Yeah, I have.
Dr. ANN MCALLISTER: Yeah. There's a pattern to it, about kind of when you're off your meds.
BENNIE ANTHONY: Yes, ma'am.
Dr. ANN MCALLISTER: What happens?
BENNIE ANTHONY: I was homeless almost two years, and I wasn't taking no medication. I was around all types of cutthroats, too, you know? But I made it through without the medication, you know?
Dr. ANN MCALLISTER: Did you want to be on your medication?
BENNIE ANTHONY: No, I didn't want to be on it.
Dr. ANN MCALLISTER: Bennie knows well, from our conversations, that he cannot do well for any consistent period of time unless he takes his medication. And each time I meet with Bennie, we go through that again and again and again.
Symptoms have quelled. He can sit calmly. The agitation is completely gone. And I'm happy that he's responded so nicely to the medication. But just as quickly as that happened, he can decide to not take the medication anymore. And in an instant - in an instant - all the good can be erased by a relapse. All bets are off.
NARRATOR: When William Stokes last left prison, he also stopped taking his medication. Unmedicated and out of control, within a month he was back behind bars.
OFFICER: This is inmate Stokes. He has been very agitated. He punched a brick wall and he also threatened staff. So the order's been given for restraints.
NARRATOR: Stokes has been in prison three times. He is a schizophrenic with a long history of refusing medication.
WILLIAM STOKES: I'll start fighting! [unintelligible]
OFFICER: This is inmate Stokes 421895 being placed in four-way restraints and given emergency medication.
WILLIAM STOKES: [deleted] you!
I have psychotic episodes sometimes when I'm not taking my medication. I can be a real jerk, a real jerk. I take Clozaril. It's an anti-psychotic. It's like a miracle drug. I'm a totally different person on it. I mean, I'm able to function, abide by rules set here and everything, and it's the medication that I need to be on. I take Depakote also. I take Effexor also. And I also take Trazodone and Vistaril. But the other medications, they're OK, but they don't work as well as the Clozaril does. That's the main one.
NARRATOR: Stokes has just completed a 21-month sentence for theft and is about to be released again.
COUNSELOR: Hi, Mr. Stokes.
WILLIAM STOKES: Hello.
NARRATOR: This time, he's hoping things will be different. With the prison help, he's been accepted into one of the few group homes in Ohio that provides mental health treatment.
COUNSELOR: Is that exciting?
WILLIAM STOKES: Yes, it's- very. Yeah. It alleviates a lot of stress.
COUNSELOR: I know. Last time you left, you were pretty stressed about it.
WILLIAM STOKES: Yeah.
SHERRI SULLIVAN, Program Director, Bridgeview Manor: We were contacted about Mr. Stokes following his release from prison. He has a horrendous history of self-mutilation. He's a spitter. He's a cutter. He's a biter. He's very, very hostile. He has been seen, I would hazard to guess, upwards of near a hundred times in the emergency room. He's isolated from his family. He doesn't have a lot of support. And he's not on probation or parole. If we didn't take him this time, he would be at the homeless shelter.
WILLIAM STOKES: I'm going to try to do better this time, not make the same mistakes. I want to do good. I don't want to fail again. It's actually, I'm at that point where failing isn't even an option, so- I'm lucky enough to be going to a place specifically made for mental health. And there'll be a case manager, nurses there, staff, all kinds- you know, all the people you need for- to help you make it, you know? And this time, since I'm going through all this programming and stuff, they're going to make sure I stay on my medication.
NARRATOR: William Stokes will be living at Bridgeview Manor in Ashtabula with 15 other schizophrenic men. There's nothing else like it in Ohio. It's the only residential facility that accepts the indigent mentally ill and offers them treatment.
SHERRI SULLIVAN: If you just want to grab your box, we'll get it inside.
COUNSELOR: Your room is the first door.
JONATHAN LEE, Executive Director, Bridgeview Manor: Bridgeview Manor is our residential facility. And it was born out of frustration, really.
COUNSELOR: You share the room with two other gentlemen.
WILLIAM STOKES: First one on the left?
JONATHAN LEE: Here we had very severely ill people that needed residential kinds of services and we simply couldn't find them.
COUNSELOR: Clean towels and washcloths are kept up here.
JONATHAN LEE: Literally within an hour drive, there were no residential facilities that could house mentally ill clients.
GEORGE: William, I'm George.
WILLIAM STOKES: Hi.
GEORGE: I'll try to help [unintelligible] I've been here almost two years.
WILLIAM STOKES: OK. All right.
GEORGE: My room number's 3.
WILLIAM STOKES: OK.
GEORGE: How old are you, about 30?
WILLIAM STOKES: Twenty-nine.
GEORGE: Twenty-nine. Nice to meet you. The staff is really good here. They take good care of you.
WILLIAM STOKES: All right. OK.
GEORGE: They give you good meals and everything. Nice to meet you.
WILLIAM STOKES: Yeah.
COUNSELOR: Jake, this is William.
JAKE: How're you doing, William?
SHERRI SULLIVAN: Most of our residents, before living here, were living in various states of squalor and disarray. They were isolated. They were lonely. We've had other clients who've come from having been incarcerated. But primarily, they've been homeless or living in a homeless shelter.
COUNSELOR: This is also the area where I think Sherri told you about having groups in the morning.
SHERRI SULLIVAN: So what we tried to design here at Bridgeview Manor is a place where housing needs are met, first and foremost. So they live here. They have no predetermined length of stay. And whatever the client has for income, whether it be from Social Security, Social Security disability, they pay 70 percent of that income in rent. And clients have access to individual mental health therapy, partial hospitalization programming, which is group treatment, and case management all within the house.
COUNSELOR: For those of you who haven't met William, he is our new resident today.
RESIDENTS: Hi, William.
WILLIAM STOKES: Hello.
COUNSELOR: Let's give him a welcome. Does everybody- [applause] William, in the morning, we do a morning meeting. Everybody takes part in it. Some people are assigned some tasks. This is the part where we what?
GEORGE: Positive for the day.
COUNSELOR: Say something positive. Frank, how about you, something positive?
FRANK: I keep myself clean.
COUNSELOR: OK. How about something else, something about you? What are you?
FRANK: Hope everybody has a nice day.
COUNSELOR: OK. Let me give you an example. Are you a nice person? Are you happy person, funny person?
FRANK: I'm happy.
COUNSELOR: You're a happy person?
COUNSELOR: You definitely are that. OK. William?
WILLIAM STOKES: I'm a nice person.
COUNSELOR: You're a nice person. OK. Dennis?
WILLIAM STOKES: Didn't know what to expect. And the guys here, they're good people. So lots of personalities, lots of different people. It's all right. You know, nice room, nice beds, good food, people that seem to generally care. And that's what I need right now.
[www.pbs.org: More video of Bridgeview Manor]
SHERRI SULLIVAN: There's a huge segment of the population of people that are diagnosed with severe and persistent mental illness that will need care for the remainder of their lifetime. It's not just a matter of, "OK, take some medications and learn some skills, and then you can go live on your own." These clients need this level of care consistently, day after day after day, if we want them to function at this level.
Of course, the danger is that when this level of care isn't available anymore, they immediately are thrown back into the situation where they're re-hospitalized and re-incarcerated, and the cycle kind of starts all over again.
SHELTER WORKER: Six o'clock wake-up. Six o'clock wake-up. Everybody up. Six o'clock.
SCOTT SCHNYDERS: Living in a homeless shelter, there's not a ton of success that you're going to see. People will make it out. They will probably not be your average story, you know? They will be the exception, rather than the rule. I mean, the reality of Lynn's situation- he's got a history of alcohol and drug abuse coupled with a mental illness. You know, the hardest thing for him will be staying clean. If he's able to stay clean, the next hardest thing will be permanent affordable housing, and then, you know, finding work.
You know, the combination of three very difficult things kind of converging and happening is unlikely, at best. And staying mentally on even par will be very, very difficult just because of the environment here, coupled with already being paranoid schizophrenic. Yeah, it's difficult for people with mental illness, for sure.
INTERVIEWER: How much money do you have today?
LYNN MOORE: $19.75. It should last- it's supposed to last me at least a month. Trying to keep focused and, hopefully, find a job and hang onto it. Other than that, it'll be a wait.
NARRATOR: Lynn Moore used to receive $627 a month in Social Security disability, but his benefits stopped when he went to prison and it can take months to get them going again. So today he's meeting with a case manager, hoping for some help.
CASE MANAGER: So it looks to me like your symptoms are pretty well managed right now with whatever medication they have you on.
LYNN MOORE: Abilify.
CASE MANAGER: Abilify? All right. And this is good. You're feeling pretty empowered, seeing yourself as a capable person, have a positive attitude. All those are good things.
LYNN MOORE: Uh-huh.
CASE MANAGER: So right now, the main thing is going to be getting your benefits back, right? And what else? What other goals do you have for yourself?
LYNN MOORE: Just to find employment and- that's the main thing.
CASE MANAGER: The main thing? You want to get back to work?
LYNN MOORE: Yeah.
CASE MANAGER: What type of work would you like to do?
LYNN MOORE: Construction or restaurant work.
CASE MANAGER: OK. So the first step is probably going to start looking in the paper, putting in applications. How many applications do you think you want to do a week? You don't want to overwhelm yourself.
LYNN MOORE: No. No, I don't. At least a couple.
CASE MANAGER: At least a couple? Like, one to two?
LYNN MOORE: Yeah.
CASE MANAGER: OK. So we'll make that your first objective. So that means you're going to apply for one to two jobs per week. So that means that I'm going to encourage- I'll link you to whatever I can. OK.
SHERRI SULLIVAN: I see the whole community mental health system as a huge social failure and a huge moral obligation that we're not meeting because we went from institutionalization to nothing. And in many cases, a person is going to get a better level of care while incarcerated than they're going to get if they live in the community. And that's really sad, but it's what happens.
NARRATOR: When state psychiatric hospitals closed in the 1970s, the seriously mentally ill were left with nowhere to turn and prisons became the new asylums.
Keith Williams, more than anyone we met, represented the failure of deinstitutionalization. Years ago, he might have spent his life at a state hospital. Instead, he was sent to prison, and that's where we first met him. He had just finished a two-year sentence and was about to be released.
INTERVIEWER: Where are you going to go?
KEITH WILLIAMS: Toledo, Ohio. St. Paul's. Yeah, pretty much.
INTERVIEWER: And is your family there?
KEITH WILLIAMS: No. I'm not close with my family no more. Been away too long. I'll just go to St. Paul's, and then after that somewhere else, be with my people.
INTERVIEWER: Who are your people?
KEITH WILLIAMS: My mommies, angels, cats.
INTERVIEWER: And where are they living?
KEITH WILLIAMS: They live all over the world. If I'm not mistaken, they live all over the world, all over the world, all over the world.
NARRATOR: Williams was taken to a homeless shelter, but within a month he was back in jail. Five years later, we found him again, at one of the last remaining state psychiatric hospitals in Ohio.
KEITH WILLIAMS: I'm doing a whole lot better. I feel great. I feel happy. I have the confidence to stay out of jail and move on, push on, you know, because I want better things to go on in life than this, you know, going back and forth to jail, back and forth to jail, back and forth to jail, back and forth to the hospital, back and forth to the hospital, back and forth to the hospital, back and forth to the hospital. So, yeah. Yeah, so- I feel like- I feel like a million bucks, a million 250 bucks- 250 dollars. [laughs] Yeah. I feel great, feel great, feel great.
1st STAFFER: We're here this morning to discuss Keith Williams. Mr. Williams has an extensive history of psych admissions and a variety of diagnoses over the years, including the present one of schizoaffective disorder, schizophrenia, bipolar disorder, anti-social personality disorder. And this is his 18th admission to our facility.
NURSE: Keith is on Depakote, Seraquil and Risperdal. But the typical thing is, he does well, he responds to medication, but once he's discharged, he's non-compliant and he ends up either back here or in jail.
2nd STAFFER: You know, he's really well managed right now on three times a day medication dosing, which is difficult to expect of anybody, even without, you know, mental illness. But that seems to be the magic bullet for him. So you know, therein lies the problem.
NARRATOR: This state hospital once housed 5,000 mentally ill patients, but today there are only 110. With so few beds, even the seriously mentally ill are now held only for short-term crisis care.
NURSE: Good Morning, Keith.
KEITH WILLIAMS: Good morning.
NURSE: Do you want juice or water?
KEITH WILLIAMS: Juice, please.
MICHELLE ISTLER-PERRY, R.N., Northcoast Behavioral Healthcare: The good news is that Keith is getting better and he is more stable. And in a sense, the bad news, as well, is that because of this, he'll be sent back into the community in Toledo. And he'll back within three months - three to six, probably - probably very psychotic, and hopefully, not having hurt somebody out in the community. But that's always a possibility.
NARRATOR: Once he's released, Williams will once again be responsible for taking his own medications.
INTERVIEWER: And how will you know when to take them and which to take?
KEITH WILLIAMS: I would know when to take them because if I feel like- if I- if I feel just normal, I know when to take them. But if I- if I feel like- like kaboo-ka-kaboojaning, or- or like grou-foamy- I mean, groovy or something, or kaberjering or something, maybe- you know what I'm saying? That's when I know I took them already. So yeah. That'd be it, too. Uh-huh.
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REFUGE OF HOPE PRAYER LEADER: Today's devotion is "I am that I am." Moses wanted to know not only who he was but also who God was. Most people don't know who God is. God says that I am. That means he is whatever you lack in your life. If you lack health, God is your healer. If you lack salvation, God is your savior. If you lack finances, God is your source of supply. What do you need today?
SCOTT SCHNYDERS, Program Director, Refuge of Hope: Lynn Moore has been in here two months. It's almost a little over two months since he first arrived at the Refuge of Hope. At the beginning, he came around for meals and I would see him, you know, on a fairly regular basis. I knew that he was following up on meetings. He was taking his medication when he was in here.
He thought he was going to get housing right away, and then that kind of fell through. And then it looked like that kind of like, swung his mood, like he was pretty depressed about the situation and didn't feel like there was much hope. And then he failed the breathalyzer on September 5th, and so he was dismissed from our facility for 30 days. And so that's the last I know about his whereabouts.
911 OPERATOR: 911, what's your emergency?
CALLER: Well, there was a guy out here busted a window out of my trailer today, and they arrested him. I don't know how he's out, but he's back here again. He's back here throwing rocks again.
911 OPERATOR: What's his name?
CALLER: I think the report says it's Lynn Moore. [to person in background] I know it's the same guy! I'm on the phone again. Well, I'm on the phone with them. I don't know what the hell's going on with that guy!
911 OPERATOR: What was your name?
CALLER: My name is Ron Whitmore.
NARRATOR: Lynn Moore was arrested again. He was taken to the county jail and charged with criminal damage. It had been three months to the day since he was released from prison.
INTERVIEWER: Lynn, just tell me- tell me how you are. What's happened this week?
LYNN MOORE: I don't know, the devil, antichrist, bin Laden, Satan, Saddam. First class, 300 Prospect. I don't know. Just cigarettes, you know? You work to perfection and you try to work to perfection.
INTERVIEWER: When you went to the camper last week and to the house, what were you hoping to do?
LYNN MOORE: Like I said, it was bin Laden, Saddam, Antichrist, the devil, Ronald Whitmore. I hope I didn't miss none. But that place is for real.
INTERVIEWER: Do you think this could all be part of your illness, though, and your delusion?
LYNN MOORE: [long pause] Part of my delusion. No, I don't think it's no delusion. It's no delusion. The spirits are going which way they're going, and that's- that's delusions because it's like pinpointing right exactly where he's at.
NARRATOR: After spending 30 days in jail, Lynn Moore would be released. One week later, he would be arrested again.
We once believed, with deinstitutionalization, that the mentally ill would have the same rights and freedoms as the rest of us. But for the seriously mentally ill, real freedom can be hard to define.
JAMES RODIO, M.D., Psychiatrist: There is this notion of focusing on freedom, which is an important idea, of course, in our country, but what's maybe not appreciated is how free one isn't when you're being affected by schizophrenia. Maybe there was a hope, when many people were in the hospitals, that we could do things better in the community and that people would have more freedom. But we also see the negative side of that freedom.
JONATHAN LEE, Executive Director, Bridgeview Manor: Was it a good policy change to deinstitutionalize? Absolutely. But I think that it went a little bit too far and that we do have people that are out there that really do need some level of supervision on a regular and consistent and constant basis. They're chronically mentally ill.
NARRATOR: There are now over a million mentally ill inmates in prisons across the county, and within 18 months of their release, the vast majority will wind up back behind bars.
REGGIE WILKINSON, Fmr. Director, Ohio Dept. of Corrections: I don't promote the bringing back of state-run facilities, by any stretch of the imagination. But we need to understand better how to divert persons who are mentally ill who have committed a crime to something other than a state prison or jail. State prison and correctional facilities is not the answer.
NARRATOR: It's been seven months since William Stokes moved into Bridgeview Manor, and he continues to do well.
Michael Grissett was hoping to complete his parole, but on January 16th, 2009, he was shot to death during a robbery in his group home.
Two weeks before his court review, Bennie Anthony stopped taking his medication, packed up his belongings from Gibbs House and disappeared. He is now back in the Allegheny County jail.
And four days after he was discharged from the state psychiatric hospital, Keith Williams assaulted a police officer. He is now facing 10 years in prison.
WRITTEN, PRODUCED & DIRECTED BY
Miri Navasky & Karen O'Connor
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SERIES MANAGER SENIOR PRODUCER EXECUTIVE EDITOR EXECUTIVE PRODUCER EXECUTIVE PRODUCER A FRONTLINE Co-Production with Mead Street Films © 2009 WGBH Educational Foundation FRONTLINE is a production of WGBH Boston, which is solely responsible for its content. ANNOUNCER: Explore more of this story on our Web site, where you can watch the full program again on line, see more video and photos of life inside Next time on FRONTLINE: These women have been torn from their lives, taken from their families and sold into slavery. They are victims of a multi-billion-dollar international business that traffics an estimated 500,000 women a year. FRONTLINE goes undercover to tell the tragic story of the sex trade. ["Sex Slaves"] FRONTLINE's The Released is available on DVD. To order, visit Shoppbs.org or call 1-800-PLAY-PBS. [$24.99 & s/h] FRONTLINE is made possible by contributions to your PBS station from viewers like you. Thank you. With major funding from the John D. and Catherine T. MacArthur Foundation, committed to building a more just, verdant and peaceful world. And additional funding from the Park Foundation.
A FRONTLINE Co-Production with Mead Street Films
© 2009 WGBH Educational Foundation
FRONTLINE is a production of WGBH Boston, which is solely responsible for its content.
ANNOUNCER: Explore more of this story on our Web site, where you can watch the full program again on line, see more video and photos of life inside Next time on FRONTLINE: These women have been torn from their lives, taken from their families and sold into slavery. They are victims of a multi-billion-dollar international business that traffics an estimated 500,000 women a year. FRONTLINE goes undercover to tell the tragic story of the sex trade. ["Sex Slaves"] FRONTLINE's The Released is available on DVD. To order, visit Shoppbs.org or call 1-800-PLAY-PBS. [$24.99 & s/h] FRONTLINE is made possible by contributions to your PBS station from viewers like you. Thank you. With major funding from the John D. and Catherine T. MacArthur Foundation, committed to building a more just, verdant and peaceful world. And additional funding from the Park Foundation.
FRONTLINE is made possible by contributions to your PBS station from viewers like you. Thank you.