By Chris Lane
By Jeff Balke
By Aaron Reiss
By Angelica Leicht
By Dianna Wray
By Aaron Reiss
By Camilo Smith
By Craig Malisow
Steve Chesser waited until after his children had gone to school that September 1 morning. Then he beat his wife, Maria, very carefully -- he knew how to do it so that nothing would show -- tied her up with duct tape, held a gun to her head and said he would kill her if she didn't agree to stay with him.
Then Steve put the gun in Maria's hands and told her to shoot him. "He said, "Shoot me. Kill me. I can't be in this misery anymore,' " says Betty Chesser, Steve's mother. She sits in the front room of her modest home in Pasadena, recounting the last days in the life of her troubled son who was determined to hold on to a failing 14-year marriage.
Maria refused to pull the trigger, and the anger of the moment subsided. She fled the home and eventually moved into a women's shelter with her three daughters. Steve told his mother what he had done and realized he needed urgent help, Betty says.
She called the Mental Health Mental Retardation Authority of Harris County and was told to take Steve to the NeuroPsychiatric Center, MHMRA's crisis center at the old Ben Taub Hospital. According to his mother, Steve spent five hours at NPC on September 3. But while he apparently made no secret of his dangerous state of mind, Steve was released after his heart rate and blood pressure were checked. He was given no medication, no treatment plan.
"He told them what he had done," Betty says. "The psychiatrist -- I don't know her name, she was an Indian woman -- told him this was normal behavior after 14 years of marriage and that he just needed counseling."
Six days later, as Maria arrived for work at Delta Airlines, Steve confronted her in the employee parking lot, shooting her twice. Then he put the barrel of the gun in his mouth and pulled the trigger. Maria was able to drag herself 40 yards, where two Southwest Airlines employees came to her aid. She survived. Her 34-year-old husband was dead.
MHMRA will neither confirm nor deny that Chesser sought treatment at the facility. But Dr. Steven Schnee, the authority's executive director, says it's unlikely NPC's staff would ignore such an obvious cry for help. "If somebody comes in and says, "I'm going to kill myself, kill my wife,' don't you think the psychiatrist would do as thorough a job as possible evaluating that person?"
Few people who suffer a severe mental breakdown pose a violent threat. But the tragedy of Steve and Maria Chesser underscores a grim reality in Harris County: Receiving treatment for mental illness is often a hit-or-miss proposition, particularly if you are poor or uninsured.
Access to most public mental health services in Harris County is controlled by MHMRA, which receives roughly $80 million a year in state and county funds to treat adults with "severe and persistent mental illness." As patients and mental health advocates point out repeatedly, that's not nearly enough to care for people suffering from a chronic and, in many cases, life-long affliction. Texas spends just $14.61 per resident on the mentally ill, compared to a national average of about $27. And at a paltry $11.65 per capita, Harris County -- one of the largest and fastest-growing regions in the nation -- simply cannot meet the demands for medication, psychotherapy, housing and employment assistance or, for those in crisis, a few quiet days in the hospital.
On August 31 MHMRA ended its budget year more than $2.7 million in the red, a deficit that prompted the agency to start rationing care to adult patients who can't pay. Last month MHMRA cut services to the poor and uninsured by laying off 29 caseworkers and reducing the size of its clinical teams. Most of the agency's resources were shifted from indigent patients to those with private insurance or Medicaid benefits. This budget year MHMRA's contract with the state requires it to treat 8,800 poor and uninsured adult patients each month. Only 980 will receive a full range of services. The rest will have to make do with medication and an occasional appointment with a physician.
Melvin Corsey, a patient and consumer adviser at Northeast Community Service Center, says the cutbacks will have a significant impact on those seeking MHMRA's services for the first time. "Once you have [patients] to refer, where are you going to refer them to?" Corsey wonders. "There is no safety net for the incoming consumer."
Some blame state lawmakers and the Texas Department of Mental Health and Mental Retardation, which funds nearly all public mental health services in the state. Two years ago the department reported a $30 million shortfall. Shelly Hayes, a private psychiatrist and member of the county's Adult Mental Health Planning Advisory Council, believes the department is trying to balance its budget by forcing local agencies like MHMRA to generate more of their own revenues.
"Basically they have told a public agency, "You are to go into business,' " Hayes says. "So we have this totally stratified system based on whether you have money or you don't. I find that offensive."