By Chris Lane
By Jeff Balke
By Aaron Reiss
By Angelica Leicht
By Dianna Wray
By Aaron Reiss
By Camilo Smith
By Craig Malisow
It is a routine his mother, Louise Abt, fears will be shattered by a move in Texas and across the country to put the mentally retarded -- no matter how severe their disabilities -- back living in the community. Because she does not see how Walt will make his way among dangers like the cars he has never learned to fear and the people he sometimes does.
And so she is afraid. She worries that some well-meaning people will push her son out, thinking that they are doing the best for him. She is afraid they've confused him with some of the mildly retarded people they've met or read about, people who are able to function well in the outside world with only a little extra training, a little extra help. She fears that some agencies that want more money for their own operations will succeed in convincing the Legislature to close all the state mental institutions. Mostly she is terrified that she won't live long enough to protect her son.
"I have to live 20 minutes longer than he does. I cannot die."
Richmond State School, where Walt Wingo lives now, has a long and varied history, and like most mental institutions, not all of it is pleasant. Opened in 1968 to offer treatment for the mentally retarded, the facility in Fort Bend County grew rapidly, housing adults and children. It now has about 600 residents, downsized from its heyday numbers of about twice that many. It has a therapeutic riding program, a swimming program, other recreational activities and church services.
It does a lot of good things, but there have been complaints over the years that not all is utopia there.
The late John Lelsz Sr. played a pivotal role in the treatment of mentally retarded residents of state institutions in Texas. In 1974 he filed a lawsuit alleging his son had been mistreated at the Austin State School. This action resulted in Texas's moving thousands of the mentally retarded from institutions to community homes. It also ultimately led to the closure of Travis State School and the Fort Worth State School in the mid-1990s.
In 1995 Lelsz filed a lawsuit against Richmond State School, alleging that John Jr. had been mistreated, that he had suffered a separated shoulder, a head gash requiring six stitches, a black eye and swollen face. An earlier investigation at Richmond had revealed that the school had used cattle prods to administer electric shock therapy on Lelsz (reportedly a very difficult patient) and two other clients.
In June of the following year, Richmond State School fired an employee accused of hitting a woman with a board, leaving marks on her back. This came in the midst of at least 21 reports of abuse or neglect, according to Houston Chronicle articles. Most cases were reported from two dorms occupied by residents who were unable to talk, the Fort Bend County Sheriff's office told the Chronicle.
Barbara Dawson became Richmond's superintendent a few months after these incidents. It was on her watch that findings of understaffing by the state threatened to close Richmond last year. The Texas Department of Human Services gave Richmond 23 days to fix the staffing problems, citing client neglect because of staff shortages.
Although Richmond met the state minimums for the number of caregivers per resident, Dawson says the closure threat occurred because the school was judged to fall short when the severity of some of the residents' needs was brought into the equation. As more mentally retarded people are moved out of state institutions, the ones left behind are the ones needing the most careful supervision. At the same time, pay levels for frontline workers at Richmond remain so low that a single mother with two children working full-time for the school can still qualify for food stamps, Dawson said.
So with these stories fresh in mind, why would any parents who cared about their children be fighting to keep them at Richmond?
"We're going to have abuse anywhere in a caretaking environment," Louise Abt says. The difference is, she says, "it can't go on too long here. There are too many people." In group homes, she feels, there are no such safeguards.
She doesn't forget the old days when people were told to institutionalize a child and forget about him and staffs were unresponsive to parents. But things have improved greatly since then, she says. Richmond's employees are good to her son, she says.
For years far too many people were kept in state mental institutions who had no reason to be there. But in the movement to push everyone into the community, some tragedies have occurred.
In Washington, D.C., a recent series by Washington Post staff writer Katherine Boo showed that with the closure of the notorious asylum Forest Haven, many of its former residents were preyed upon when they tried to live in group homes. The courts documented more than 350 incidents of abuse, neglect, molestation or stealing in group homes and day programs in the 1990s. According to the Washington Post articles, some of the retarded worked for the city for wages as low as 50 cents a week. Their day programs profited by this through private contracts for sending the residents to do the work. Some had no day treatment at all. For others the "treatment program" consisted of hours of shoveling horse manure at the program operator's stables.
In another forced ousting of residents, more than 2,000 mentally retarded people were to be removed from California state institutions in five years. The state hurried up and accomplished this two years early, says Tammy Hopp, executive director of Voice of the Retarded (VOR), a nonprofit advocacy group working for the mentally retarded. "The community-based provider network was not equipped to meet the higher needs," she says, and as a result, mortality rates shot up for these people.
In a 1997 report suppressed from the public until the next year, the California Department of Social Services reviewed 20 deaths and concluded that 16 were "preventable or questionable." Among the case studies was a retarded quadriplegic woman who was moved to a community care home supposedly because she wanted to be, according to her files. Her IQ was only six. Nine days after the move she died, the San Francisco Chronicle reported.
In a study by Robert Shavelie and David Strauss of the University of California at Riverside, printed in the American Journal on Mental Retardation, it was noted that of the 1,878 clients moved between April 1993 and December 1995: "There were 36 deaths, an 88-percent increase in risk-adjusted mortality over that expected in institutions."
Mike Bright, executive director of ARC of Texas, an advocacy group for the mentally retarded based in Austin, acknowledges the California and Washington, D.C., situations but speaks calmly and confidently when he says such things would not happen in Texas.
"I would just say that every state has a different kind of service system. In Texas we have a very strong set of rules and regulations in place," Bright says.
His group, numbering 3,700 members in Texas and 110,000 nationwide, advocates "that people should be served in their community so that everyone has the opportunity to live at home."
And that does mean everyone to ARC. "Even people with the most severe levels of retardation can live effectively in community-based environments," Bright says. And, "There is no one whose level of disability mandates they they live in a congregate or institutional environment." ARC has thousands of people still on waiting lists for placement in group homes, he says, and is asking the Legislature for more money to do that.
Opponents of ARC refer to these kinds of statements as "doctrinaire." They charge that ARC wants to remove their choice to decide what is best for their mentally retarded loved ones in favor of a one-size-fits-all package that simply does not exist.
Hopp says her group steers a more middle course than ARC and supports state institutions for certain people. Increasingly VOR's membership, which originally was composed of parents, now counts physicians and care providers, people concerned that some bad decisions are being made about the more severely mentally retarded.
Gladys Conner, an independent lobbyist on behalf of the mentally retarded, who is guardian of her daughter and two other residents at Richmond, sees rather clear-cut battle lines. "ARC and Advocacy Inc. want the state schools closed so they can have the money."
"We want choice," Conner says. Her "kids" include Jimmy, a thalidomide baby abandoned at birth in Houston, who is now 30. Larry was abandoned at 14. He has spina bifida. "He lives on a gurney with his face down.
"Jimmy had been in a group home in Beaumont. They couldn't keep him busy. Jimmy got tired of it. He started cursing everybody out."
As much as she loves her daughter, Conner says it doesn't work to have her at home. "Right now if I brought Linda home she would drag me from room to room. She's knocked me down twice. She's just dragged me all over the place. I can't handle her. She's 40. She's smaller but stronger than I am."
It was on her 24th birthday that Louise Abt took her four-year-old only child to Denton State School and walked away. It had gotten impossible at home. Walt kept pounding his head on the floor over and over and over. She couldn't get him to stop and didn't really know what to do with any baby, let alone this one, who had multiple physical handicaps and was mentally retarded to boot. Abt was supposed to have been a musician. She'd studied piano for years and had gone to college when she was only 16, but she'd married, dropped out, and now this had happened, and her husband couldn't deal with it. She had tried her best and was out of options. There weren't very many back then.
At the school, officials told her she couldn't see her little boy again for 30 days, and so she didn't. It took her ten years to recover from that terrible day. She still cries about it.
Her marriage did not survive. She went back to school, got her degree and eventually remarried. When she moved to Houston, she moved Walt to Richmond from Denton. That was more than 20 years ago.
She would have liked to have Walt live with her full-time but says that just doesn't work out. "My son has had severe behavior problems. Two and a half years ago his behavior went haywire. Last fall he broke a window out. It started with frustration about putting on a shoe."
"These are not just slow adults or childlike adults," Walt's mother cautions over and over. "These are people with real behavioral problems. They are mentally fragile."
Richmond superintendent Barbara Dawson, a former school teacher, argues, not surprisingly, that "choice" is the best option for Texas. Richmond, she says, provides services "for people whom the community is not ready to handle or cannot provide services for."
One of the key questions being debated by legislators is, of course, cost. Some say needs can be more cheaply provided for in a smaller group setting, particularly if the state mental institution left behind is nothing but an empty shell with few residents.
At Richmond, 250 people are in specially constructed wheelchairs, Dawson says, because they have so many physical and medical problems. "Probably we can provide more efficiently and economically for some of their needs because we have them grouped together. In a group home it is much more expensive to get specialists in to see them."
And this goes to other medical treatment as well. They have a consulting dentist on staff used to working with these patients and their special needs.
Charles Ferguson, who works with the Texas chapter of VOR, concurs. He has done his own cost study and believes the only way individuals and group homes can see service costs decrease over state school costs is if they don't provide services.
According to his research, it costs $46,687 a year to support someone in a state school. That same person's costs would rise to $69,947 in an eight-bed-or-fewer group home and to $78,787 a year in a group home of three or fewer beds. Texas Mental Health and Mental Retardation statistics show the average total cost of a state school resident at $71,868, but this is misleading, Ferguson says, because $25,181 of those costs are fixed (administration, maintenance and central office overhead) and unaffected by the addition of residents.
In the last half-year, Richmond State School has accepted 18 new residents, Dawson says. These are people believed incapable of being in the community. They have either significant medical and health problems or behavioral problems and mental illness.
Almost none are children anymore.
Walt Wingo has little capacity for abstract thought. Give him instructions, and they must be very concrete and specific. He cannot handle stairs. He cannot handle going to public restrooms because he doesn't know how to behave in them, so all of their outings have to be short, his mother says.
A few years ago Walt and his mother were walking together peacefully when they crossed paths with two young girls. Walt has an awkwardly rolling gait that gets him where he wants to go but isn't graceful. The moment is one that's hard for Louise to relate. She and her son just walking, doing something normal, enjoying the day. Two young girls passing the other way. Normal and pleasant.
As they crossed paths, one of the girls said something about "Frankenstein" to the other, making the common mistake of confusing the monster with his scientist maker's name. But the point was clear. It was a casual cruelty. And Walt heard it.
For the rest of the day, Louise says, Walt kept saying, "I'm not Frankenstein. I'm not Frankenstein."
For Louise the choice is made. "I really don't see the advantage of putting people in an urban setting where they're going to be ostracized and kept in all the time.
"I would prefer he be on that campus. He has more freedom. He's in a protected environment. He doesn't have to worry about predators or cars running over him."
Or being told he's a monster when he goes for a walk with his mama.
E-mail Margaret Downing at margaret_downing@ houstonpress.com.