I wrote a letter to the Governor of Colorado.
I hope my sister approves and I will send it along. If I cannot save my mother's life, maybe I can help change things so that someone else's life can be saved.
Love to all, Margo.
....
Dear Governor Hickenlooper,
My
name is Dr. (Margo Sloan), an audiologist currently living in California, and I
am writing you today to address the dire need of legislative change in regards
to mental health care in Colorado. I am
a Colorado native, as are the other members of my family: my father, (name retracted); my sister, (name retracted); and my mother, Kathy (retracted), who recently
committed suicide.
In
light of this, I found it imperative to alert you to the situation surrounding
my mother’s passing, in the hopes that it can influence positive change in how
Colorado views and regulates mental health care, so that other families can
avoid the same fate and despair that my family has.
In
November of 2014, my mother started to act very strange. While she had a long history of mental
illness, and self-regulated her troubles through Prozac and recreational
marijuana, her family and friends noticed a drastic change in her
behavior. She became obsessed with the
notion that my father, by then her ex-husband, was a dangerous criminal that
was stalking her. Despite all the
evidence to the contrary, she could not be persuaded. It would be difficult to describe her
condition as anything other than a personality change: a common symptom of
dementia or Alzheimer’s disease.
I
had recently moved to California to pursue a career in Audiology, as such
opportunities for employment were less available in my home state. When I first moved, I spoke on the phone with
my mother nearly every day. But in
November, when her condition began to deteriorate, I stopped receiving phone
calls and started receiving emails. They
increased in number until I was seeing over 100 messages daily; many if not all
of which were speckled with nasty comments, accusations towards my father and
her sister, and even name calling. It
was highly unlike my mother to use this type of language, and especially out of
character for her to be so irrational as to write such a high volume of
messages to all sorts of people on her contact list. She claimed to be looking for help, but I
must be specific in saying that she was never obviously suicidal or threatening
to either herself or someone else; Kathy was merely attacking all of us she was
sending messages to.
By
the following March, she had started emailing the local police department in
Englewood, a fact I only learned by seeing a lone email address amongst a long
list of CC’s in one of my mother’s messages.
Officer Mike Fast was very helpful at assisting me in my quest to get my
mother help; he claimed to believe something was very wrong with her, that she
seemed manic and obsessed with the idea that my father was dangerous, even
going so far as to continue repeating a claim that she had been told he was a
suspect in a murder case by an officer in Adams county. I remember laughing at his complaint that he
was getting a whole 15 emails daily; I responded that 15 would have been
considered a “very light day” on my end of the spectrum. Less than a week after I spoke with Officer
Fast, my mother was taken to Porter Adventist Hospital, after he ordered a
welfare check in response to an email that seemed vaguely suicidal.
When
I called Porter Adventist Hospital to find out where my mother was, they
refused to give me any information other than confirm that she was in their
confidential wing; a side effect of HIPAA regulations that I am very familiar
with as I work in the medical field.
However, I was the point of contact for the physicians working with her,
and was contacted by her “evaluator” a few hours after her admission. They asked me about her prescription drug
use, of which I knew little, and I repeated the same concerns to them that I
did to the officer earlier that week: I believed my mother to be very ill, that
she was suffering from delusions, and needed help. The evaluator agreed that she was manic and
possibly bi-polar, a diagnosis I did not agree with but decided it was better
to trust the assessment to the physician at her end, and my mother was admitted
for 72 hours. What happened during that
time, I will likely never know, as I heard nothing until she was released three
days later, back to her home in Englewood where she lived alone.
As
the months went by, I received some messages that suggested the physicians at
Porter had diagnosed my mother with psychosis and prescribed medication
specifically for that condition, but she refused to take that medication. She then accused me of altering her medical
record – another delusion. All the
while, she occasionally claimed to have a counselor that corroborated that I
was a terrible person, and that I had abandoned my mother on purpose, and was
abusing her from a distance. At this
point, I was seeking help from all avenues, from family and friends, to
colleagues, to counselors, even contacting the police department to see if they
had received any more emails from her. I
was desperate to find her help, as I couldn’t do much of anything from my
location in California, and she lived alone.
The
answer was clear: Colorado law stated that I could not get my mother admitted
to a hospital for mental health care involuntarily unless she was an immediate
threat to herself or someone else. I
couldn’t say she was a threat to herself because she never openly threatened suicide,
and I couldn’t say she was a threat to someone else because she lived alone. I could get her institutionalized by court
order only if she had more than one 72 hour admittance to a hospital within a
three year time frame (Colorado
Revised Statute, Article 10, Title 27: Care and Treatment of Mentally Ill, 102.8.5,
Gravely Disabled, Header B).
I became familiar with these laws in
December of 2015 after my mother called a welfare check on her sister, who
lives in Chicago, in the hopes that she would be accosted by police officers in
her area and taken to a hospital as a result.
However, as my aunt is not a threat to herself or someone else by any means,
that did not occur. She was visited by
police, was asked a few questions, and they left. My mother was now using law enforcement to
harass her family members. At this time
my aunt called the Englewood police department to report the problem and seek
help. Nothing came of it, despite my
mother’s history with them, and Officer Fast’s history of setting up a case
file with Arapahoe County Mental Health services. Because she posed no physical threat, nothing
could be done based on Colorado law, despite the growing evidence to her
illness.
In February of 2016, I received a
message from my mother that crossed many lines in terms of her abusive words,
and I again sought to get her help. I
contacted Arapahoe County Mental Health Services and requested a case worker be
sent out to evaluate her on the basis that she might be a victim of “elder
self-neglect;” an assertion I felt had validity since several of her messages
claimed that she was emaciated and losing weight. My mother, a master typist and organized
businesswoman, was sending emails that were heavily misspelled and
disorganized, as if she had been banging on the keyboard in rage. Their response was that I could call the
police department for a welfare check if I felt she was a danger to herself,
and that they would decide based on my complaints if she warranted an
evaluation. I never heard back from
them.
By March, I hadn’t been able to have
a conversation with my mother in almost 18 months. She frequently hung up on my calls, left
bizarre voicemails on my phone, and the emails got progressively stranger. My mother claimed that my father was behind a
robbery at a downtown pizza parlor and obsessed over the online video of the
crime, despite the fact that the obviously very young, mustached man looked
nothing like my 60-year-old mutton-chopped dad.
When confronted with recent pictures, she would claim it was “not the
face, but the body” that identified him.
It was becoming increasingly clear that her condition, whatever it was,
was deteriorating.
But in late March/early April,
something even more strange happened: she got better. She spoke with me on the phone for a whole 45
minutes before I said the wrong thing and she hung up on me. We talked more regularly, and the mean emails
tapered, then stopped. She was selling
her home and moving to the Springs. She
wanted to know when I wanted her to come out and visit the baby; I was due on
April 20th. But she didn’t
understand why I had not previously invited her out; it was as if she was completely
unaware of the things she had said in rage-full typed words for months on end. Until, one day, she apologized for what she
typed. She said she was, “horrified by
her behavior,” but didn’t say what prompted the apology. I decided to see it as a blessing; maybe she
was really getting better.
On April 30th, ten days
after my labor due date, my daughter was born.
My mother was the first person I called; I was happy that I had not “cut
her off” as so many people had suggested I do when her words became painful to
read and to hear. I was glad I did not
give up on her, that somewhere in her poisoned mind my mother still
existed. She was teary, but not from
happiness; it was evident that she had been up all night crying. She wouldn’t tell me why. When I brought my baby home on Sunday, May 1st,
my mother called and told me she thought she needed to be
institutionalized. She wasn’t sure she
could be trusted to make decisions, and wanted to give me power of
attorney. On Monday, May 2nd,
my mother called me less than two miles from her home, crying and helpless
because her car broke down. After I
called a tow truck, she then claimed she needed an ambulance; an assertion she
dropped when the tow truck arrived and she got home. Tuesday, May 3rd, she initially
called me several times looking for a way to re-home her pets, only to call
back and say she was feeling better. I
kept asking her to give me more time to organize the people I knew in Colorado
to help her; I begged her to not worry, that we would get her the help she
needed.
It was then that she started
sounding vaguely suicidal, something that I had never heard from my mother
before. She was not specific enough to
warrant a welfare check; in fact, she said she had a doctor’s appointment that
coming Thursday, and would discuss any concerns she had over her mental status
at that appointment. I trusted that she
would do so, convinced that she was not capable of harming herself, and
certainly not when she was on the phone with me, hearing my newborn coo in the
background. On Wednesday, May 4th,
she called and asked me if I thought she had Borderline Personality Disorder;
something I had asserted many years prior in response to a number of nasty
exchanges we had. I assured her that
even if that was the case, that she was worth helping. She regurgitated a few things she had read on
the internet about people with the condition, said it was not curable, and
reiterated something she had said a few days prior: she thought that people who
had incurable mental diseases had a duty to their families not to be a
burden. I said again, “You are not a
burden to me, Mom, and we don’t even know if you have something like that,”
ever hopeful that she did not really have the Alzheimer’s that I suspected and
that instead she was suffering from a hormonal imbalance that we could fix
medically.
We talked about whether or not it
was wise for her to move to Colorado Springs, and if she should take her house
off the market. I talked with her about
how my new baby had the prettiest eyes and looked just like her. I told her I loved her. She said her realtor was on the other line,
that she would call me back later. On
Thursday, May 5th, I received a package in the mail that my mom had
sent a few days prior – it was filled with my old baby things, some photo
albums, and rather inexplicably, some of my mother’s clothing. I called, and got no answer; I was not
terribly concerned, as she said she had her doctor’s appointment that day, and
my sister was in town visiting. Since
I’d spoken with her every day that week, I comforted myself with the thought
that she would call.
Little did I know, my mother let her
dogs out in the front yard alone, and left her door propped open. Her car, still in the shop from the tow truck
on Monday, could not take her to the doctor’s appointment she had assured me
she was going to. On Friday, May 6th,
her neighbor discovered her in the basement of her home, after checking to see
why the dogs were still outside. I was
notified by my local police, and I cried on my sister’s shoulder, who was just
as thankful as I was that we were together.
My mother had committed suicide less than a week after my baby was born,
18 months into the saga of her deteriorating mental illness that I had tried
desperately to get her help for, and was constantly told that her indirect
threats were not enough to get her the help I knew she needed.
Do
you know when you call organizations for a welfare check on a family member
that they ask you if the person in question has a method of which to hurt
themselves? Are you aware that Colorado
treats mental illness as something that can only be taken seriously when
suicide is directly threatened, and not when the conditions that often precede
suicidal ideation or behavior present themselves? If you look up psychosis online, the symptoms
are fairly specific: difficulty concentrating, depressed mood, sleeping too
much or not enough, anxiety, suspiciousness, withdrawal from family and
friends, delusions, disorganized speech, depression, and suicidal thoughts or
actions. My mother obviously exhibited
all of these symptoms except for the very last one. Should it not have been evident to any
medical care team that it was an inevitable symptom that they may not have been
seeing?
My
mother was not a violent person. She was
not a gun owner. She was not a heavy
drug user; her vice was cigarettes and marijuana. Yet in the last few weeks of her life, she
spent time on the internet researching ways to commit suicide at home, how to
overdose on Prozac and household chemicals.
When one of her methods was unsuccessful, she went back to the search
bar and typed in, “now what?” before settling on her fate. No one, not her friends nor her family,
simply did not believe my mother was capable of such a thing; as my sister
says, that is why they call it “the unthinkable.” She was determined to end her life; she left
no breadcrumbs to be found, none but the obvious signs that she had quickly and
frighteningly gone from zero to sixty in less than a week. But, was it really just a week, if I had been
asking people to help her for almost two years?
Through
all of this, I had been limited by the blind spots that were present because of
my distance. Since she passed, I have
learned even more information: that my mother was under the care of several
doctors, who echoed my concern. She saw
a counselor relatively regularly, who noticed that she was manic and erratic,
but couldn’t put her in an institution because she didn’t come in with evident
marks, scars, or self-inflicted wounds.
They wanted her to take anti-psychotic medication, but she refused, and
often threatened to leave if doctors challenged her reality. These people knew she lived alone, and yet
they continued to let her leave. They
watched her lose weight but believed her when she said she was eating. They saw my requests for help; how could they
not? Myself, my sister, her sister, the
police department; her name was raised in several places due to the complaints
we raised, and yet, my mother deteriorated.
So
my quandary is this: if I could not help her because I was far away, and my
only evidence were the words typed out in front of me, that would be an
understandable reason why she could get worse.
But after being committed for a 72 hour hold at the hospital, why was
there no follow up directly aimed at the possibility of suicide? If she had a case worker through Arapahoe
County, what happened in terms of the follow up for the appointment she missed
on the day she took her own life? If her
counselor could see that she was not well, and needed to continue returning for
treatment, why do we insist on not
allowing the caretakers of folks like this – family, friends, and medical
personnel alike – to make the call that they need help despite their lack of
outright suicidal ideation?
In
mental health care in Colorado, why is only evident and imminent suicide deemed
the only worthy cause for care?
Governor
Hickenlooper, I implore you to examine the history of why Colorado law is the
way it is, and understand that mental illness takes many forms. Long before my mother committed suicide, she
exhibited several obvious and dangerous symptoms that could have warranted her
institutionalization in other states.
Colorado’s “Imminent Threat” laws prevent people like my mother from
receiving help because it prevents family members, friends, and caregivers like
me from seeking help for their loved ones.
Remember the old adage, “crazy people don’t know they’re crazy?” It is absolutely true; the ones who most
desperately need help often do not recognize it until it is too late. My mother never acknowledged that she was ill
until less than a week before she took her own life. I will be racked with guilt and nightmares of
her death for the rest of my life, and all I have to show for my actions are
thousands of emails and a log of phone calls, peppered with my cries for help
that went unanswered.
Thank you for your time.
