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A Death In The Family

In one short year, severe mental illness stalked all three sons in the Breitbarth family. When the parents sought help, they found a revolving-door system that was hopelessly ill-equipped. Then one of the sons got a gun.
By Skip Hollandsworth |

EVEN AS HER OLDEST SON. ERIK, WAS DYING IN HER arms, the two bullets in his stomach choking off his breath, Mary Lou Breitbarth, a sixty-year-old Dallas elementary school teacher, worried about what she would tell the police. She always had needed to pro- tect her children; this night would be no different.

“Erik was starting to slump over,” she recalls. “He had been trying to say something to me, but he couldn’t get the words out. I felt his heart getting weaker. And I looked at him, as he lay there. I have always wondered what he wanted to tell me.”

It was February 13, 1986, when Erik, age thirty-two, died on the couch of his mother’s North Dallas condominium. When the police arrived, Mary Lou said she did not know who killed him. She said Erik had stumbled into her condo, already shot. Erik was a good boy, she explained, but he had sometimes been a little, well, mentally different.

It seemed unlikely that the gentle, deeply pained woman had anything to hide. But she did. Mary Lou Breitbarth was the mother of two grown sons and the stepmother of another. All were chronically mentally ill. Now, the events of that evening would bring into sharp focus the lonely battle she had been waging-a battle she never knew how to fight, that she long ago sensed could not be won.

As boys and men, the three had been shuttled through hospitals, halfway houses, and outpatient clinics where little was done for them. Mary Lou Breitbarth had learned that our mental health “system” is simply a loose collection of dedicated but poorly equipped people who face numbing odds. While an estimated 17,500 Dallas residents suffer from long-term, severe mental illness, some reports indicate that only 10 percent of them ever get any sort of treatment; for most of them, the system is a revolving door. They are filled with drugs at clinics or hospitals, then sent back to the community which has scant services to provide them.

Like the thousands of others who have watched as mysterious mental disease suddenly throws a loved one’s life into a black hole of despair and madness, Mary Lou saw her sons lose the desire to prosper and sometimes even the will to live. No matter what was done for them, they ended up back home in Mary Lou’s two-bedroom condominium, doing nothing, getting sicker. After fifteen years of living with their disease. Mary Lou didn’t know what else to do except hang on and hope that the worst would not happen. When it did, on that cold winter evening, Mary Lou told the police that Erik had been shot somewhere else by an unknown assailant. She was lying.

For the police, the death in the family would turn into a perplexing murder investigation involving an argument between two brothers. But for the Breitbarths, the tragedy was just beginning. Within a year of Erik’s death, they would find themselves plunged into yet another episode of terror-and this time, it would rip the Breitbarth family in half.

WHEN MARY LOU BREITBARTH MARRIED HER FIRST HUSBAND and began having children in the mid-Fifties (Erik was born in 1954: Karl in 1955), the country was still pursuing a policy whereby the “lunatics” were put in asylums and quietly forgotten. But in the early Sixties, stirred by the publicity given to the wretched conditions in most state hospitals, authorities embarked on a program to phase out the hospitals and move the mentally disabled into community treatment centers. The movement was humane, ambitious, and effective. Nationally, mental hospital rolls went from a high of 550,000 patients in” 1955 to about 140,000 today; Texas had a parallel decline, from 16,000 patients to 4,200.

Yet, in this rush to compassion, the government did not provide enough housing, transitional care, and job training to integrate patients into society. And nowhere was that failure more obvious, and distressing, than in Texas. By the early Seventies, patients were being given antipsychotic drugs and then dumped on the streets. In 1972, when the first of Mary Lou”s sons was diagnosed with severe mental illness, Texas had just begun funding its community centers. Dallas County created a Mental Health and Mental Retardation (MHMR) Center, which could do little more than provide band-aid care because it never had any money. By 1984. MHMR directors were begging for almost six times the county’s funding of $550,000 per year to deal with mental patients.

Today, despite a variety of new programs designed to fix the system, life has gotten worse for the mentally ill. There is now, astonishingly, an even greater push to get people out of the hospitals, even though every local expert admits there is nothing for them to come home to {see “Mental Health Care in Dallas.” page 41). In Dallas, more and more of the mentally handicapped suffer alone in rooming houses or in the back bedrooms of their parents’ homes, or even worse, on the streets. One study has found that 40 percent of Dallas’s 12.000 homeless are beset with mental illness. The simple truth is that someone afflicted with mental illness in this city is very likely to get a lot worse before he gets a chance to get better. “I must get eight phone calls a day,” says Maura McNiel, president of the Dallas Alliance for the Mentally III, “from people who do not know where to turn. I wish there was something I could tell them.”

BEFORE 1970, MARY LOU BREITBARTH KNEW LITTLE OF MENTAL illness. She remembers a distant cousin of her first husband who had “some crazy spells,” but she couldn’t imagine that anything like that would happen to her or her family. Even when Karl’s second-grade teacher called and said that he kept whistling in the classroom, unaware that he was making a sound, the mother did not worry. It was a phase, she said. The little boy would grow out of it.

They were almost total opposites, her two sons. Erik was the outgoing older brother, popular with the girls, funny and talkative around other friends. He fixed cars in his free time. He played in a neighborhood rock band in high school. Mary Lou worshiped him: in Erik, she saw everything she had not been. Because of a childhood heart condition, she sat on the steps with her teacher at recess while her classmates played. She once asked eleven boys to a school banquet, and none would go with her.

Karl was different. As an infant, he didn’t like to be held. Erik would tell his mother that he loved her. Karl rarely did. Mary Lou, however, tried to stay close to Karl: volunteering as his Cub Scout den mother, buying him a drum set. Around 1967. when he began making poor grades in school. Mary Lou figured it was because of the strain at home, where her marriage was deteriorating. She had also begun to teach school to add to the family’s income. After six years of teaching elementary school, she was asked to teach, of all places, in a special education classroom. For the next fourteen years, she spent her days with a class full of disturbed kids, only to come home to the same unyielding problems.

In 1970. about the time Mary Lou and her first husband divorced, Karl, then fifteen, went through a rebellious period. He started smoking marijuana and distanced himself even farther from school. He had run-ins with the police. He wouldn’t talk much at home. “I kept thinking.” Mary Lou says now, “that Karl was going through a phase. God, that’s what parents always think, isn’t it? That their kids are going through a ’phase.’”

Later in 1971, Mary Lou met her second husband. Hans Breit-barth. It was far from a typical romance. Hans, who was born in Germany, had just been hospitalized after suffering from emotional problems (“a plain old nervous breakdown is what it was,” says Hans), and he was trying to rebuild his life. Like Mary Lou, he had recently endured a difficult divorce. Though he sold light bulbs on commission. Hans looked like a scholarly professor and spoke with an accent that she adored. While they were dating, he had to return to the hospital for another ten-day stay, and when he got out, Mary Lou, deeply in love, said she wanted to marry him. They married in February of 1972.

Mary Lou also wanted Hans’s thirteen-year-old son, Willi, to move in with them. Since the age of seven, Willi, a sweet, soft-spoken boy. had been in one mental institution after another. In the first grade, he would wander out of the room and walk across the street, apparently unaware of the traffic rushing by. At the time, Hans thought his son “lived in his own land of his imagination.” But after a stay at Children’s Hospital in Dallas, Hans says, Willi was diagnosed with schizophrenia.

Hans tried many things to help his son; Willi even spent time in a special school where the staff tried to re teach the children everything, beginning with crawling, in the hope that this time, their brains might work correctly. Nothing seemed to help. Willi would be standing there, seemingly attentive, and then suddenly he’d go silent. His mind would wander for hours, lost in its own unrevealed world. For six years he was in the Austin State Hospital, followed by two years at the Buckner Baptist Children’s Home in Dallas.

Mary Lou loved Willi. Smiling and good-natured, he never got in anyone’s way, and he was eager to learn. Mary Lou thought her years of teaching disturbed children would be an advantage in bringing him along. “I remember thinking back then,” she says, “what a tragic waste it all seemed.”

She had no idea how much waste she would see. One year after Willi moved in with the family, Erik, then nineteen, began changing in ways that terrified Mary Lou and filled her with pity. He was diagnosed as schizophrenic, like Witli. And then they learned that something was very wrong with Karl as well, that behind his wall of silence was another tormented young man whose sanity was seeping away. Mary Lou and Hans were shattered, baffled. How, they wondered, could fate twist so cruelly through the life of one family?

There are few diseases as feared and misunderstood as schizophrenia: as a result, it is mostly ignored, even by those families who find themselves the victims of it. Schizophrenia is not, as often thought, a disorder producing “split” personalities who may be unaware of each other; nor is it a “neurosis” that can be corrected through therapy with a psychologist. It is a disease, a biological impairment that causes the personality to disintegrate. Typically, it strikes men in their late teens and early twenties, and women perhaps five years later. One in every one hundred Americans suffers from schizophrenia, with 100,000 new cases diagnosed a year. But almost everything about its treatment is fraught with uncertainty. At any time schizophrenia can cause such varied mental disorders as paranoid hallucinations and fragmented thinking. Some victims of the disease hear voices, others completely withdraw. There is some evidence that schizophrenics can get better over time, and many psychotic outbreaks can be controlled with neuroleptic drugs. But there is no cure.

Erik was never the one Mary Lou worried about. It was Karl. He had always been very slow in school, and a psychologist who examined him last year had determined that Karl’s intellectual abilities were at the junior high level, and his emotional maturity was severely retarded. He developed into a heavyset young man with a childishly round face and shoulders that sagged forward. The psychologist said that Karl, despite his 180-pound size, “sees himself as a child, facing a dangerous world, and he perceives situations as a young child would. He doesn’t think of himself as aggressive; he sees himself as a victim of mean people.”

Hans thought Karl was a “bully,” and it never surprised Mary Lou when Karl would occasionally get frustrated at work and walk off some low-skilled job as a dishwasher or laborer. Patiently, she’d help him look for another job, But when Erik came home one day, saying he too had quit his job and that he was hearing voices. Mary Lou began to panic.

Erik was seeing imaginary trees and hearing imaginary birds. Mary Lou took him to Parkland Hospital, where a doctor said he showed possible traces of schizophrenia. Mary Lou. horrified, threw away the report. She couldn’t believe it. Then, in November 1974, Erik’s hallucinations grew even more vivid. He said he could see the moon sitting in the tree in the front yard. He paced endlessly around the condominium. Mary Lou took him to Parkland’s psychiatric emergency room where he stayed for ten days. There was no denying it now. Because something had twisted somewhere inside his brain, the son that she thought she knew was disappearing before her eyes.

And so, for the next decade. Erik wandered through a mental health system that, tor all practical purposes, is nothing but a chemical crap shoot. Erik would check into the Terrell State Hospital, get pumped full of antipsychotic drugs until his mood was controlled, and then be sent back to Dallas, where his mother tried in vain to find some place for him to be treated. There were some boarding houses, but they only offered Erik a room and a hot meal, no treatment. There were the Dallas County MHMR outpatient clinics, but they only had time to prescribe more medication for Erik. There were the private hospitals like Timberlawn, but Mary Lou couldn’t even begin to pay their prices; moreover, even the best insurance available will only cover a small part of the cost for mental health care. This was not a new story-thousands go through the process every year.

For brief periods, Mary Lou found Erik a place through the Independence House program, the only publicly funded halfway house and day treatment center for former mental patients in Dallas. She was lucky; such programs can only reacn a small fraction of the mentally ill. But whenever Erik would stop taking his medication (the effects of the drugs were horrible for him, distorting his facial features and causing him to shake), or when he’d succumb to another psychotic breakdown, he’d disappear for weeks at a time. Sometimes he’d show up at home, his clothes completely disheveled, where he would rant incoherently, then pace about the house. A staff director from one of the programs recalls Erik as “a passive schizophrenic, never violent, but if discouraged, he’d just take off.” More than once. Mary Lou wished for the days when it was easier to keep someone in a state hospital where the supervision was greater and where a patient could stay in one place long enough to get help.

Mary I ou was like most parents of schizophrenic children: if the man-child showed up at home, she’d sympathetically take him back, hoping this time he might remain stable enough for them to live normally. She would keep him at home rather than abandon him to the streets. She would try not to think about the time when she and her husband would be dead and the children would be on their own.

Mary Lou’s plight was not unusual. Linda Donelson, one of the most respected mental health consultants in Dallas, says that of the estimated 17,500 seriously mentally ill here, 10 percent get treatment, 40 percent try to get treatment and don’t receive it, and 50 percent don’t even attempt to find help. From 1983 on, Erik spent most of his time at home. When Karl began to split further from reality, Mary Lou never pushed him to get into some kind of community treatment. Willi never received any more treatment, either, once he was moved out of the hospitals as a child. He didn’t seem that sick, compared to Erik.

“Okay,” Hans says, “if we had the money and could put them in an institution where they could get medicine, then yes, that might have been a better alternative. But we didn’t have the money, and the state wasn’t spending any money. And so all we could do was live from incident to incident.”

That existence came to a shattering climax in February 1986, when Karl, then thirty-one, pulled a pistol from under his bed and decided to use it.

Until then, there had been no signs that Karl was growing more violent, In fact, Erik was showing the more aggressive tendencies as his illness got worse. Once when Mary Lou wouldn’t give Erik money to buy a soft drink, he went outside and beat on her car. He began to play the radio loudly in his room. He frightened Mary Lou by talking about a girl who had been raped and an incident (probably fictitious) in which he had been stabbed. “Erik was becoming thoroughly miserable,” recalls Hans. “The disease was destroying him, There was nothing for him to live for.”

The night of his death, when Mary Lou walked in from school, Erik was strung out on medication and vodka. “He was all keyed up, talking about getting a new job at the Dairy Queen,” she recalls. “He talked to me nonstop for two hours.” Mary Lou. exhausted as usual from her school day with the special education kids, walked into her room and shut the door.

Erik came right in after her. “He was going from Dr. Jekyll to Mr. Hyde. He’d yell at me, and then he’d be nice. I have never seen him that way, I told him I was tired and wanted to be left alone-and all of a sudden he took his belt off and said, ’Maybe you need to have your face rearranged.’” Mary Lou was shocked. He had never threatened her before.

Erik’s actions may have triggered something in the normally docile and silent Karl. Soon, Mary Lou heard Karl arguing with his older brother in the kitchen. Then she heard , Karl say. “I’ll find something to shut you up.” Karl got his pistol, which he had bought the year before at a sporting goods shop, and shot Erik twice in the stomach.

Mary Lou told Karl to leave. When the police came, she said she had no idea who killed her eldest child, but it didn’t take them long to catch on. A neighbor told officers that she had heard gunshots from inside the condominium. The police saw twenty-eight-year-old Wilii, who seemed oblivious to what was taking place, and they spoke to Hans. They then went looking for Karl.

He hadn’t gone far. He was found that night down the street in the parking lot of a gas station. The gun that killed Erik was in his car.

A few days later, the mortician showed Mary Lou a photograph of Erik taken before the autopsy. He looked so old and gaunt that she broke into tears. Mary Lou asked that he be cremated. After a plea bargain with the prosecutor and judge, Karl was given a ten-year probation on a voluntary manslaughter charge. Karl’s court-appointed defense attorney told the judge that Karl was obviously mentally ill, was only trying to protect his mother against a deeply disturbed brother. Karl didn’t need prison so much as he did good psychiatric care, the attorney said. And that was precisely what he would not get.

WILLI BREITBARTH WAS THE KIND OF PER-son who made mental health professionals realize why they liked their jobs. He wanted to get better; he appreciated those who tried to help him. He went to high school in the special education program, and he would smile and tell me how much he wanted to go to college.

“I have this ’space’ problem,” Willi said to me one time. “My mind doesn’t pay attention to what’s going on all the time. It just has thoughts that are different. It’s hard to keep my mind from drifting off.” And then, just like that, his mind drifted off.

During the year after Erik’s death, Willi seemed to be getting worse. He was kicked off a DART bus on his way to his job making tennis rackets at the Texas Rehabilitation Commission, because he kept staring wildly at other passengers. Soon, he lost that job as well. Willi was also arrested for suspicion of driving while intoxicated. When the police gave him a blood test, they found he hadn’t been drinking at all. It was just his odd manner. At home, he’d take his shirt off and stare at himself in the dining room mirror, occasionally gesturing to himself.

“Willi is getting very frustrated,” Hans told me after Erik’s death. “He wants a normal life so badly. I think he’s finally realizing nothing will change.”

When I asked why they hadn’t tried again to have him hospitalized, there was a small catch of breath as Hans tried to frame his answer. “For his entire youth,” Hans said, “he went through programs. He went through hospitals. Nothing helped. I suppose I got to the point of not even knowing what to wish for anymore.”

Meanwhile, Karl seemed to return to his placid ways, showing neither hostility nor happiness. He couldn’t hold a job-he tried working at a car wash and at a restaurant before just walking off-but that wasn’t unusual for him. One time, when his mother wouldn’t give him some extra spending money, he suddenly yelled, “You’ll be sorry. I’ll get you.” But no one paid much attention. He picked on Willi as he always had: he charged Willi $10 a week to share his room, and Willi, without telling anyone, dutifully gave him the money.

“What is it,” I once asked Karl, “about Willi that bothers you?”

“Willi, I’m not real fond of,” Karl said slowly. He spoke, as he often did. with a finger in his mouth, making him difficult to understand. “Willi will sort of tease you. He acts weird in the house and junk. Like. 1 was in the kitchen, and I knew he was messing with my mind.”

“How did you know?”

“Willi, he doesn’t know how to comprehend with life. It makes me kind of mad and all. You know, that kind of junk.”

How strongly he meant that, it was hard to say. Karl, his face round as a coin, his large body already settled into a middle-aged softness, seemed genuinely befuddled by much that surrounded him, his emotions expressed at the simplest level. When I asked him how he felt about Erik’s death, he said, “I didn’t think the gun would kill, you know. It made me kind of mad. It got me in a lot of trouble and all that. I won’t do something like that anymore.”

But this past January, Karl started to change again-and it quickly got ugly. While he was riding his motorcycle one afternoon, a car cut in front of him, sending Karl into such a rage that he jumped off his bike, grabbed two rocks, and threw them through the window of the nearest parked car. When the police arrested him for criminal mischief, Mary Lou paid the $500 bail to get him released from custody. A couple of nights later, Karl began to beat on the doors and kitchen cabinets. “He’s troubled,” his mother said at the time, the panic rising in her voice. “I can’t get to him. It’s like he’s tormented by something he sees.”

Finally, on a Sunday night, Karl went on a rampage. Willi was standing in the kitchen, smiling, acting out some vision of himself, when Karl came after him without warning. Karl began beating him with his fists, then got him in a headlock, trying to choke him. Willi squirmed away. Hans had warned him. after Erik’s death, to run if Karl ever turned violent again. Now he broke for the frontdoor. Mary Lou, rushing out of the bedroom, tried to grab Karl, but he threw her to the floor. Then he grabbed a wrench and went after Willi. As Willi jumped into his own car, Karl smashed the windshield with the wrench, then beat against the car door as Willi squealed away.

Mary Lou, bruised and trembling, tried to calm Karl, but he stayed up most of the night, wound tight as a golf ball. Late that evening, when I talked to Mary Lou, she was sobbing. She said Hans had told her that someone would have to go. “My husband told me I would either have to decide between him and Willi or my very own son.” she said. “All I’ve ever wanted was a family. And now we’re being torn apart.”

IN DESPERATION. THE DAY AFTER WILLI was attacked, the Breitbarths tried to get Karl committed on a seventy-two-hour emergency Order of Protective Custody to the Mental Diagnostic Center (MDC), the local holding and evaluation unit for the mentally ill who are considered dangerous to themselves or others. But to get someone committed to MDC, an examining doctor must certify that the person is mentally ill and a threat.

Mary Lou and Hans put Karl in the car and drove to the MDC building at the Parkland Hospital campus, where they left him to be committed. They were shocked when they saw Karl walk through the door of their home the very afternoon they dropped him off. He had taken a bus home. Apparently he had calmed down; the examining doctor couldn’t find enough problems with Karl to warrant admission.

But to the Breitbarths, Karl didn’t look any better. He seemed paranoid, fearful of what people might do to him. Hans would later say that he thought Karl would try to get another gun. The couple was frantic. They had no idea where to turn next. They could not believe the mental health system had so casually released their son; they were sure it would only be a matter of time before he’d become violent again.

Then came a miraculous stroke of luck. Karl’s criminal mischief charge had been assigned to Judge F. Harold Entz’s court, where Keith Clements, a young district attorney’s investigator, was astonished to learn that Karl would not be committed. When Clements got one look at Karl, huddled on a bench, utterly withdrawn, he decided that he had to do something.

Clements went to a prosecutor assigned to Entz’s court, who quickly went to Entz. “When I heard what these guys were telling me,” Entz says, “that there was a guy in my court already on a murder probation and threatening to kill again, I felt that we had a cannonball rolling across the deck of a ship, ready to explode.”

And so. one criminal court decided to find a way to get treatment for one mentally ill young man. Entz immediately set the bond for Karl’s petty criminal mischief charge at a whopping $5,000. A sheriffs deputy arrested him and took him to jail, where Entz at least knew he would not harm anyone. Then the judge ordered well-known Dallas psychiatrist Dr. Clay Griffith to examine Karl and determine his condition. After a long interview, Griffith reported that Karl was hearing voices and probably was a paranoid schizophrenic.

A jury ruled that Karl was incompetent to stand trial and ordered him to the criminally insane unit of the Rusk State Hospital in East Texas for a period of at least sixty days. He could be kept up to eighteen months. For the first time in his life, Karl was going to gel treatment for his mental problems.

THIS PAST APRIL I WENT TO SEE KARL AT the Rusk hospital. Back in Dallas, his mother and stepfather were still unsure what to do when he was released from Rusk. Mary Lou wanted to find Karl a halfway house, but as she had already figured, no halfway house in Dallas wanted him; his record of violence was too threatening.

Deep down, Mary Lou couldn’t imagine telling Karl that he was not welcome back home. “I know what kind of help he needs. I know what it will do to my family if he comes back,” she told me after the trial that had sent Karl to Rusk. “But am I also supposed to forget that I am a mother?”

Hans was sympathetic, but he, too, had his own loyalties. He wasn’t certain whether they would all live together again. “Mary Lou is a good woman. I love her, and she loves me,” Hans said softly one afternoon. “But her obligation to her child is greater than her obligation to me-and (hat’s how she’ll choose.”

“And you?” I asked.

Hans didn’t say anything for a moment. Then: “If he comes home, then we’ll wait until he hurts someone else. And then it will start all over again.”

The criminal unit of Rusk is a deceptively beautiful place-the buildings are spread over the top of a hill, overlooking a rolling forest of pines. Little gusts of wind sweep over the hill, past the dorms, then down through one twelve-foot wire-link fence with V-shaped barbed wire on top, and through another eight-foot fence topped with coils of barbed wire.

At Rusk, Karl was in one of five dorms for the 250 patients who have been ruled incompetent to stand trial. In the main room of the dorm was a television, a ping-pong table, and couches. On one wall was a large painting of a nature scene. Everyone seemed very calm. One man coughed into his coffee cup, another man slept sitting up in his chair. Several stared vacantly at a television.

I was allowed to speak to Karl in the visitors’ area. A wire screen divided the patients from their guests. While a couple of security guards watched a fishing show on television, Karl pressed his face close to the screen and said, “I guess I need to keep people away from me. I’m afraid to get close. I don’t know what I might do. Maybe they’ll give me some medicine.”

“Are you getting better?” I asked.

“Nobody is really crazy here,” he said. “We’re just all going through life and stuff.”

If the Rusk staff decides Karl is competent to stand trial, he will be sent back to Entz’s court. If they rule he is not getting any better, then he will be sent back to court with the demand that he be turned over to another state hospital for treatment.

Still, the mystery of mental illness is such that no one can predict the outcome of even the best treatment. After I talked to Karl, I went to see Dr. James Hunter, the director of Rusk’s clinical services in maximum security, who has worked with the disturbed patients of the criminal unit for nineteen years.

Hunter stuffed some tobacco in his pipe. “All you can do in this business,” he said, “is make the best of several bad choices.”

We talked about whether people get worse, if they get more violent, if they ever fully recover. As the day wore on, the glow of the setting sun began to fill the room. From outside came the sound of birds, and then the far-off noise of a horn blowing, clear and thin. Through Hunter’s window I could see several patients milling around outside. Suddenly there was Karl, standing alone, wearing a Dallas Cowboys cap, a big soft drink cup in his hands.

“I don’t know,” Hunter said, a twisted rope of pipe smoke hanging above his head. “1 think there’s always some sort of hope for these people. You have to believe that somebody is going to get better.”

It looked like Karl was saying something,but there was no one near him to listen. Hetugged on his hat. Then, a dim little smileplayed momentarily across his face, and.quite slowly, he turned and looked off intothe distance, toward the hills.

Mental Health Care in Dallas:

A Shameful Problem Is Getting Worse

How poorly does Dallas treat its mentally ill? “It’s abysmal,” says Linda Donelson, one of the stale’s most influential mental health consultants. “But it’s not because people aren’t trying. It’s because (he mental health system doesn’t have a penny to do any work.” The numbers show that she does not exaggerate:

●In 1986, 1,304 patients were discharged from the area’sslate hospital in Terrell back to Dallas, yet there were only 310 local residential beds in clinics or other mental healthprograms for the menially ill. The county mental healthdepartment’s outpatient clinics are swollen: as many as 450people are assigned to one psychiatrist, and it sometimestakes three weeks to get an appointment.

●The state Legislature has recently passed all sorts oflaws affecting local mental health centers. New statutesrequire the creation of emergency screening and crisisstabilization programs for the mentally ill. The law now requires local mental health authorities to provide enoughresidential programs to achieve a ratio of sixty residentialbeds per 100,000 population. But the Legislature didn’t provide one cent for local agencies to develop these programs.Instead, because of political pressure. 80 percent of thestate’s mental health budget continues to go to the mentalhospitals-despite the fact that the state hospital populationhas dropped by two-thirds.

●The mental health system is being squeezed by anothersource-U.S. District Judge Barefoot Sanders. Sanders hasordered the state’s mental health department to reduce itspatient-staff ratio in the state’s eight mental hospitals to onestaff member for every five patients during the day. Theresult? A near-panic. The state, lacking funding for additional staff, simply decided to release even more patientsfrom hospitals. Also, as an incentive to keep the mentallyill from going to the hospitals in the first place, the state offered a local mental health authority $35.50 a day for eachperson it kept out of a hospital and treated in its own community facility. Local authorities, furious, claimed theS35.50 didn’t even begin to pay the final cost, yet they hadlittle choice but to accept the additional patients.

●In 1986, the Dallas County Department of MentalHealth and Mental Retardation spent $13.8 million on mental health services to treat approximately 8.700 mentally illpeople. Because of the influx of new patients coming toDallas, local mental health officials project they will needto serve 2,000 additional severely ill people in 1987. Yet the1987 budget increase for the entire agency is only $400,000over last year’s budget, and the money must be split between departments in both mental health and mental retardation.

●To meet the Legislature’s demand for increased residential services for the mentally ill, Dallas County needs anadditional 740 beds, which would cost more than $8 milliona year. Says one local mental health official about thelikelihood of getting that money: “Fat goddamn chance.”In fact, the only local public center that provided care forpeople undergoing an acute crisis or major psychoticbreakdown, a fifteen-bed residence, had to be shut downthis past year because of a lack of funds.

“Obviously.” says Dr. John Gill, acute services director for Dallas county’s MHMR program, “we don’t have the services to meet the need. The best we can hope for is only that we can take care of those who are the sickest.” -S. H.