The problem that just won’t go away

By Stephen Trimble

When I read the Salt Lake Tribune editorial on July 2, my heart sank. A Utah man with severe mental illness had died in a poorly regulated care home, with a mere $8,000 fine levied against the managers.

The editorial was fierce: “It doesn’t seem to matter how horrible the care … how many of these residents live in filth and squalor … the responsible authorities apparently make little to no effort to whip the homes into shape or, failing that, shut them down.”

In 1976, my disabled brother, Mike Trimble, died in just such a care home, in Denver. I’ve spent a decade researching his life and death for my book, “The Mike File,” and I know well the details and politics of his death.

Mike left home after turning 14 when his diagnosis — “paranoid schizophrenia, capable of violence” — shattered our family. A court committed him to the Colorado State Hospital in 1957. He never lived at home again.

When mental hospitals emptied their wards a decade later, Mike was mainstreamed back to Denver. Rejoining our family did not go well. Angry and resentful, Mike’s visits triggered emotional chaos. He soon cut off all contact.

In 1976, Mike died during a seizure, alone in his boarding home and undiscovered for three days. The Denver media used his solitary death to expose the “ratholes” that warehoused people with mental illness. Our mother found out about the loss of her 33-year-old son from the front page of the Denver Post.

The owner of Mike’s ironically named “Carefree Guest Home” described his death as a “slip up.” The staff member who should have checked on Mike was “snowed under.” Two other residents had died unnoticed in previous months.

In the days following Mike’s death, the director of the Colorado Commission on the Disabled demanded action. “I’m …thinking …of the other 85 residents there,” he said. “How many of them were not seen over the weekend but did not die?”

Officials issued “a severe reprimand.” Dr. Paul Kuhn, director of Denver’s Personal Health Service, said that Carefree had made “significant improvements,” but he mentioned only one: “Anyone not in the breakfast line is sought out and checked.”

Kuhn gave Carefree a break because of poor funding that left the guest home perpetually understaffed. “This is more than a Denver problem,” he said. “It’s a statewide problem. It’s a great societal problem.”

Reprimand issued, case closed, but hardly progress.

In 2002, The New York Times ran a Pulitzer Prize-winning series that included the story of Randolph Maddix, living in a private home for the mentally ill in Brooklyn. Maddix died during a seizure and wasn’t found for many hours. “His back, curled and stiff with rigor mortis, had to be broken to fit him into a body bag.”

In 2006, the Milwaukee Journal-Sentinel ran a series on the horrors of board-and-care homes, including the tale of a resident who died and wasn’t found for three days. These stories of outrageous neglect keep recurring, always about people overwhelmed by their mental disorders and neglected by their caregivers.

Why does Dr. Kuhn’s “great societal problem” persist?

As we steadily eliminated more than 500,000 beds in state psychiatric hospitals starting in the mid-1950s, according to a study by the American Psychiatric Association, the number of people with severe mental illness was growing with the U.S. population. Stigma and shame often silenced their families. Effective treatment disappeared into the fog of competing agencies, with no coordinated plan for people with chronic mental illness. Then add today’s epidemic of homelessness and prisons crammed with people who need psychiatric treatment more than incarceration.

While researching my book, I spoke with a Colorado psychologist who summed up our failure to care for our mothers and fathers, our brothers and sisters, our children and friends: “The mentally ill don’t have a strong lobby.”

The recent Tribune editorial proposes incentives for decently run care homes and appropriate punishments for neglect. But what we really need is a transformative system of care for the vulnerable and voiceless, and housing for those without homes. We know what to do. So far, we have chosen not to act.

This problem remains with us, just as it did in 1976 when I lost my brother. Please don’t let us read these same plaintive stories and unanswered calls for action when another 50 years have passed.

Utah writer Stephen Trimble is a contributor to Writers on the Range, writersontherange.org, an independent nonprofit dedicated to spurring lively conversation about the West. His latest book is “The Mike File: A Story of Grief and Hope.”

Ante Samarzija via Unsplash

This column was published in the following newspapers:

07/31/2023 Vail Daily Vail CO
08/01/2023 Grand Junction Daily Sentinel Grand Junction CO
08/01/2023 Forest Grove News Times Forest Grove OR
08/01/2023 Craig Daily Press Craig co
08/01/2023 Beaverton Valley Times Beaverton OR
08/01/2023 Hillsboro Times News Hillsboros OR
08/01/2023 Sherwood Gazette Portland OR
08/01/2023 Columbia County Spotlight Scappose OR
08/01/2023 Steamboat Pilot Steamboat Springs CO
08/01/2023 Denver Post Denver CO
08/04/2023 Pagosa Springs Sun Pagosa Springs CO
08/02/2023 Jackson Hole News & Guide Jackson Hole WY
08/03/2023 Rio Blanco Herald Times Meeker CO
08/03/2023 Boulder Daily Camera Boulder CO
08/03/2023 Montrose Daily Press Montrose CO
08/04/2023 Sierra Nevada Ally Carson City NV
08/04/2023 Wyoming Tribune Eagle Cheyenne WY
08/02/2023 Aspen Daily News Aspen CO
08/04/2023 Camus-Washougal Post Record Camus WA
08/04/2023 Taos News Taos NM
08/04/2023 Greeley Tribune Greeley CO
08/01/2023 Marinscope community newspapers Marin County CA
08/02/2023 Wenatchee World Wenatchee WA
07/31/2023 Rock Springs Rocket Miner Rock Springs WY
08/05/2023 Tucson Star Tucson AZ
08/05/2023 Carlsbad Current-Argus Carsbad NM
08/05/2023 Yahoo sunnyvale ca
08/05/2023 East Oregonian News Pendleton OR
08/06/2023 Glenwood Post Independent Glenwood Springs CO
08/08/2023 KVNF Radio Paonia CO
08/15/2023 Bandon Western World Bandon OR
08/29/2023 Sky-Hi News Granby CO
08/15/2023 The Insider Escalante UT
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Jim
10 months ago

A sad but real reality, we as a country spend money on so many nonessential things yet we don’t take care of those that can’t take care of themselves. I am aware of the struggles our health facilities have in this space but I am sure it is a much, much larger problem. Thanks for writing this and sharing your personal story. I am sorry for your loss and hope this helps others to see and acknowledge the issue with real action. P

Kathy Coates
10 months ago

I applaud Mr. Trimble for having the stamina to keep writing and talking about this problem. It is an exhausting, discouraging topic that well known people have tried to improve with very little success. I often wonder what it will take to change the fate of schizophrenics.

Cathy
10 months ago

Thank you for your honesty, I’m sorry for the loss of your brother. Can I ask, did he require round the clock support?

Stephen Trimble
10 months ago
Reply to  Cathy

Thanks for your warm words, Cathy. In the state hospital, Mike was probably heavily drugged. I’m not sure that counts as round-the-clock support! And in the care home, he was on his own. He was almost certainly misdiagnosed, and he would have a much better chance today at a full life. You can take a deeper dive into his life–and what an alternate outcome might have been like–in my book, “The Mike File.”

Marco Gonzales
10 months ago

You say we know what to do and don’t do it and also that the people like your bother and mine BTW, who died in a similar fashion, BTW, don’t have a good lobby. What is it (legislation) that can help? I’m a top tier lobbyist and have advocated for decades for the most needy. Our Governor might listen. Tell me what “we know what to do” is or means and I’ll work on it in NM.

Stephen Trimble
10 months ago
Reply to  Marco Gonzales

Marco– It largely boils down to money, as you well know. In the last few pages of my book, “The Mike File,” I imagine a best-case scenario that would have given Mike a different life and a much better one. A team of caregivers, connecting through agencies, a group home kept alert by regulators, a clubhouse down the street. The needed legislation would fund all of this, for all the vulnerable, in perpetuity!

johneyO
10 months ago

sorry but the last comment he should have this ” A team of caregivers, connecting through agencies, a group home kept alert by regulators, a clubhouse down the street. The needed legislation would fund all of this, for all the vulnerable, in perpetuity” Now who is to pay for this life of leisure? Us workers, so a disabled can live awesome while I toil away sometimes 7 days a week working? No, instead how about your family take on multiple jobs and pay for this care? I suspect your talking about $100,000/year in care in todays dollars. Maybe your family could pay for it? Or are you thinking tax payers should foot the bill? because your family passed the buck on taking care of him? Explain how its my responsibility to pay for your brothers club house and TEAM of care givers!

Stephen Trimble
9 months ago
Reply to  johneyO

Doing this right, efficiently–with less competition between bureaucracies and with far fewer mentally ill folks in prison–would actually save us money.

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