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"I want to be able to tell my story": Family in mental health crisis is trying to stop a tragedy

Virginian-Pilot - 2/18/2017

Feb. 18--NORFOLK

Tony Martin paces the hallway of his mother's house, then goes up and down the stairs. He runs water in the bathroom. He says he needs a minute to focus.

"I want to be able to tell my story. It's going to be hard, being all fidgety. I'm not thinking clearly."

Tony is 28. He has a college degree. He drives a car. He lives on his own in a sparsely furnished apartment, but he sometimes calls his mother, Sherita Martin, dozens of times a day and often appears on her doorstep in the dead of night.

From the outside, he looks perfectly normal. But inside, something is going on. He feels anxious. Confused. Sometimes angry. He's 5-foot-11, 210 pounds, and speaks of shooting demons.

Sherita, who has had to call the police dozens of times when Tony has become aggressive, is constantly on edge. Tony has given her a black eye and bruises and has broken in her back door.

She harbors the fear of many parents with adult children who can live independently but who struggle with mental disorders: What if he winds up in a situation where he gets hurt, lashes out or ends up in jail?

She can imagine her son in recent high-profile stories: Jamycheal Mitchell, who died in the Hampton Roads Regional Jail in 2015 awaiting a state psychiatric bed. David Latham, a Norfolk man who was shot and killed by police in 2014 after his family called seeking psychiatric help. Gus Deeds, who stabbed his father, state Sen. Creigh Deeds, in 2013 before shooting himself.

Tony and hundreds like him are the ones you don't usually see, people who have not yet fallen through the cracks that Mitchell, Latham and Deeds did, but who live precariously near the edge. For them, life is a revolving door of mental health screenings, medication adjustments, psychiatric stays and short-term housing fixes.

Some of these people, if they're lucky, have family members waiting and worrying in the front row of their lives.

"My bedroom door is locked and there's mace under my pillow," said Sherita, 47. "My daughter and I both sleep with our doors locked. It's terrible to be afraid of your child. You love them, and you know they need help. I am trying to keep my son from being killed or hurt and keeping him from harming someone else."

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It's a situation familiar to many families, as more people with disabilities live in communities instead of institutions and as the network of state mental hospitals shrinks before supportive housing and services in their own neighborhoods are able to replace them.

Sherita wrote a letter to Deeds and tucked in a photo of her black eye. Someone in Deeds' office tried to assist, but the problem, as mental health experts will tell you, is hard to fix.

"Everyone is unique and needs different services. That's what makes it hard," said Sarah Paige Fuller, director of Norfolk's Community Services Board, which provides publicly funded mental health services. "There are 400 people in our mental health case management services. None of them need the same thing."

She cannot comment on Tony's case specifically because of patient confidentiality. But she touches on many common themes of his story: People struggling to maintain jobs with incomes that can jeopardize their disability payments. Medication that works for a while and then doesn't. Burning through the patience of friends and family, even health care providers.

There's a wide continuum of people -- some who have successfully cobbled together services, housing and supports; others who repeatedly call CSB.

"The demand always exceeds the capacity, there's no way around that," Fuller said. "When you see people in crisis, the conversation automatically starts to go toward more inpatient beds, but there's no reason we can't treat people in the community."

The General Assembly will consider proposals for more mental health funding this session, to bolster same-day access at CSBs. More money is also being proposed for supportive housing and expanding eligibility for the Governor's Access Program, which provides medical services for people with serious mental illness. And on Friday, Gov. Terry McAuliffe requested $4.2 million be put back into the state budget to create standardized screenings for mental health issues when inmates arrive at jails.

They are the latest round of mental health proposals -- like the ones that followed shootings at Virginia Tech and at Sandy Hook Elementary School in Connecticut, and Gus Deeds' attack and suicide. Still, Martin is hopeful and wants to know: Where can she go to lobby for change? Who can she tell her story to? Will it help?

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Tony lingers in the hallway, speaking in a low voice to his mother, before resuming his pacing through the hallway: "I need to think clearly. I have brain fog."

"Tony, we talked about this yesterday," Sherita says calmly, "that this is something that could help."

The tall, lumbering man with doleful eyes is Sherita's oldest child. The single mother also has another son, Duran, 24, and a daughter, Raven, 23.

Over the years, Tony has collected a long list of diagnoses: mood and anxiety disorders, schizo-effective psychosis, obsessive compulsive disorder.

It began with a subtle change that Sherita noticed when Tony was about 2. He stopped saying some of the words he had learned earlier.

"I knew something wasn't right," she said. "He lost eye contact. I thought it was a hearing problem."

She took him to the doctor -- his hearing was fine, but Tony was authorized for an early intervention program. He did well there and also when he entered regular school. He got As and Bs and had what's called an individualized education plan, required for public school students who qualify for special education.

Sherita marks a turning point when Tony was about 11 and was diagnosed with pervasive developmental disorder, a term that includes autism, which impairs the ability to interact with others. Some high-functioning people have normal intelligence but trouble reading social cues, making eye contact and showing emotion.

Tony was prescribed Ritalin, often given to children with attention deficit disorder. Sherita believes the medication caused side effects, such as anxiety, obsessive-compulsive tendencies and aggression. Within a few years, he was on medications to treat those as well. Doctors who prescribed medicine -- sometimes seven at a time -- were often unavailable or unresponsive when problems with side effects arose.

Teasing out side effects from progression of mental disorders is always difficult, and there were also family disruptions. Sherita and her husband divorced when Tony was 8. The children stayed with their father until she regained custody.

Tony had become increasingly anxious and aggressive. Sherita would touch his shoulder and he'd jerk away. Once, when Tony was 16, she told him to clean his room. He didn't. She fussed at him.

"He got so upset with me. I told him to take out the trash. When he came back in, I could see in his eyes he was not himself. He came in the house and hit me in the face. I woke up on the floor."

When she came to, she saw her neighbor, whom her younger son had fetched. Sherita called the police, who arrived and called the CSB to do an an assessment. By the time they arrived, Tony was calm, so he didn't meet the legal criteria to be in the hospital without his consent.

It's been a common pattern: An aggressive outburst. A call to the police, who contact the CSB. An assessment. A determination that either leaves Tony at home or in a psychiatric unit. A change in medication. A return home. And Sherita left struggling over what to do next.

A constantly changing stream of medications presents a Catch-22. Side effects sometimes cause Tony to stop taking them, but then he suffers the consequences of being unmedicated. He'll go to the 7-Eleven for energy drinks to replace the focus the drugs gave him.

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Over the years, there have been services that helped. For instance, the state's rehabilitation department helped him attend Christopher Newport University, where he majored in ornamental landscaping.

The closer he came to graduating, the more anxious he seemed. Other symptoms cropped up, such as headaches and tingling in his fingertips and arms. Once, he took so much medication that he passed out, tearing a tendon while falling.

On commencement day, there was a protective order requiring Tony to keep his distance from Sherita and family members. Sherita struggled over what to do but decided to attend the ceremony.

"We worked 4 1/2 years for him to graduate," Sherita said. "I was not going to miss graduation. It was one of the happiest days of my life ... and one of the saddest."

Tony's robe was askew. He looked disheveled. He fidgeted throughout the ceremony.

"It broke my heart. He worked so hard for that. It tore me up. But ... he graduated."

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After graduation, Tony was able to get a job at Pride Industries, a company that employs people with disabilities. Then he received a letter saying the income would disqualify him from his Social Security disability, so he quit.

By this time, he was staying at a boarding house in Hampton where his medications were monitored under a publicly funded program. One day last year, he became anxious. He asked for his medication. The person in charge of giving it to him refused, and they argued.

He tried to choked her. Police arrived but didn't arrest him. He was admitted to a psychiatric unit -- one of seven he's been in -- and was asked to move out. He moved in with Sherita again and applied for a voucher for disabled people so he could afford his own apartment.

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Since Tony moved back to Norfolk, the cycle of agitation and lashing out has continued. He's become angry at doctors when the prescriptions caused problems or didn't lessen his anxiety. He's verbally threatened judges during temporary detention hearings, and his mother for having him involuntarily committed. A few months ago, he set a bush on fire outside her home.

"I am terrified he will get his hands on a gun," said Sherita, who suffered so much stress over her son's issues she took a leave of absence from work to find him help.

Tony was put on the waiting list for a Medicaid waiver in 2011, which would pay for support services in the community rather than state institutions. He was one of 11,000 people on a list that the U.S. Department of Justice has ordered Virginia to address with more community services, and he just found out last week that he's received a waiver.

Sherita hopes it will link him to services, but she's also been making videos of Tony's behavior to prove his need for more intensive help.

She plays a recent one:

Tony: "This insomnia crap is getting on my nerves. I'd shoot them right in the head."

Sherita: "Who?"

Tony: "The devil. I'd shoot the devil right in the head. I'd rebuke him. I'd shoot him in the head. I'd probably sleep then. I need to shove pills down my throat."

Sherita: "Tony, Tony, stop talking like that. You don't need to shove pills down your throat. Tomorrow we will talk to the doctor."

Tony: "If I have a gun and encounter the demon I will shoot them in the head. I will shoot the devil in the head."

She shuts off the video.

At the same time that Sherita fears her son, she also sees the kind side of him, "the real Tony."

One time, she was feeling so sick she couldn't concentrate on some work she was doing as a government contract specialist. She started crying.

"Tony put his arms around me and said, 'Mom, it's going to be OK. It's going to be OK.' I said, 'Tony, just pray for me.' And Tony prayed for me."

Tony sits on the sofa while his mother is interviewed, then puts his head in his arms to think about what he wants to say, how he wants to tell his story.

Finally: "I wish that the doctors would listen. Only God knows. It's unpredictable. It's uncertain. I'm waiting for God to reveal something. I don't know what tomorrow will bring. I am trying to take it one step at a time. I want to be like ... I want to feel comfortable. I want to concentrate and focus so I can function better. If I'm able to think clearly, get the brain fog out, I can do things."

Sherita: "What's on your mind right now? What are you thinking?"

Tony: "In my mind ... it's like I'm unalert. I'm not thinking straight. If I'm able to think clearly, I will tell my story."

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