LD 12 (Sen. Epstein, Rep. Contreras, Rep. Travers)
Taylor was a beautiful and happy child. An honor student in high school and an athlete, he ran cross country and half marathons and loved basketball. He was a loving mentor to his younger brother. Taylor earned a full academic scholarship to college and dreamed of becoming a Doctor of Physical Therapy. But after three college semesters, Taylor was forced to drop out. He developed Bipolar 1 with severe mania and psychosis and was designated seriously mentally ill, or SMI.
For 10 years Taylor’s parents have battled Arizona’s complex behavioral health system. Eventually, Taylor was court-ordered to treatment, and placed in a behavioral health residential facility or BHRF. But the BHRF system of care was inadequate. Many facilities threatened to discharge Taylor because of his severe mania and disruptive behavior. Because Taylor does not understand he is ill, he repeatedly engaged in hiding and avoiding his medications.
Despite these repeated problems with adhering to treatment, the minute Taylor was declared “stable” and “compliant” he was “dropped down” to a lower level of care. AHCCCS refused to give Taylor an Assertive Community Treatment team, also called an ACT Team, to monitor him and ensure medication compliance. Predictably, as soon as the court order for treatment expired, he stopped his medications.
Within months Taylor’s psychosis worsened, and he deteriorated significantly. Both his doctor and his parents believed he was a danger to himself and others. Taylor was petitioned for involuntary treatment FOUR TIMES – and ALL FOUR TIMES Community Bridges’ Screening Center released him with no treatment at all. Despite his SMI designation. Despite running frantically through his housing complex wearing only underwear and yelling that he needed to “destroy Satan’s spirits.” The main excuse given by Community Bridges was that he would not verbalize that he was suicidal. He refused to say the magic words, “I am suicidal.” Sometimes there were no secure beds available. It seemed no one would listen to Taylor’s parents, or even his doctor.
Just one day after his fourth release from Community Bridges, police found Taylor catatonic, unable to move, speak or respond. Taylor has never fully recovered from this psychotic event. The interruption in treatment took a permanent toll. This is a well-known problem: repeated periods of untreated psychosis can leave permanent brain damage. When Taylor was finally court-ordered into treatment again it was too late. The previous medications no longer worked, and finding an effective medication was an even greater challenge than ever before.
Taylor has cycled in and out of hospitals 13 times. He has spent half of the last 3 years in inpatient facilities. Between hospitals, Taylor has been at five different BHRFs, the only non-hospital facility that AHCCCS offers. But BHRFs do not have nurses or doctors. They have “behavioral health technicians,” who are generally high school graduates, not licensed or certified by the state of Arizona. The facilities are not secured, so patients can walk away at any time, even if they are in active psychosis and refusing medication.
Clearly, Taylor needs long-term treatment, but no such facilities exist in Arizona. So, the cycle continues. Time passes and Taylor further deteriorates. Taylor is nearly 30 years old. If he does not get long-term treatment, he may end up in jail or prison from his bizarre behaviors during psychotic periods. He may hurt himself or, God forbid, someone else. Worst of all, it is highly unlikely that Taylor can ever again live independently. The lack of adequate, consistent treatment for his psychosis all these years has seriously hampered Taylor’s recovery.
Taylor’s parents spend countless hours advocating and caring for him. If Taylor had an equally debilitating condition like Alzheimer’s or autism, his family would be eligible for added support like caregiver reimbursement and respite services. But sadly, there is significant discrimination against psychiatric disabilities within our current system of care.
