Board and Care(less)
The strange man with the long hair and beard stood outside her home -- dirty, disheveled and in hospital scrubs on that Saturday morning in April. He seemed off, out of kilter with the world. Lee Ligon didn't know him. She was on her way to teach a college class and needed to get going.
Then he began speaking, and with equal parts horror, relief and resignation, Ligon realized that this bit of human flotsam was her first-born child.
"He'd been on the streets. I did not recognize him," she says.
His own clothes, except for a pair of underwear he was holding in one hand, were gone. His furniture, his '91 Mazda and his money were gone.
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Ligon had been looking for Darrell since he'd disappeared from his apartment in mid-January. But disappearances and disappointments had become a steady part of their relationship since the day, 15 years ago, when the then-22-year-old college student had wrecked his motorcycle and suffered a closed-head injury that had changed him, irrevocably it would seem.
So, in a move that perhaps only people who've been through years of taking care of relatives with severe mental problems can understand, she called a cab.
She told the driver to take Darrell to the Harris County Psychiatric Center. (Darrell always likes staying there, she says.) When the driver asked what to do there, she told him not to worry, that Darrell "knows the routine."
There was no fatted calf, no robes of fine raiment in which to adorn this prodigal son. The nice folks at HCPC could hose Darrell down, get the stink off him, clean him up. Darrell would get his medicine and his structure and would be safe till his mother could figure out what to do next. He couldn't stay there forever; there's a limit of about ten days, but a stop there had bought her some time.
All she had to do was get him to retrace his steps of the past several weeks. This from a man who hears voices that aren't always there and whose speech sometimes dissolves into incoherence as the electrical connections short-circuit in his head.
But as usual, he remembered his mama. He'd come home to her. And once again, she was going to do what she had to do to make this right, knowing all the while that things, of course, will never be right again.
What Ligon was to discover was that in the two and a half months her son had been missing, he'd spent time in a hospital, he'd been homeless. And he'd been packed in a room with three other men in what's called a board-and-care home, something that exists at a special unlicensed level lower than a personal care home.
And it was thanks to a newfound "friend" at this board-and-care home, a little white frame house on the industrial east side, that Lee Ligon believes her son Darrell had all his possessions stolen from him and was recruited for a monthlong medical experiment that dosed him with drugs for schizophrenics, not knowing about his head injury.
Darrell and others like him, you see, are mentally ill adults who have trouble living on their own but are too sane to meet the requirements for extended stays in any of Harris County's relatively few psychiatric facilities. They bounce from shelters to psychiatric facilities to halfway houses to the streets. Sometimes they end up in prison, their mental illness criminalized. Along the way they meet people who offer to help them manage their lives.
Proving once again that if there is a misery in the world, someone will see it and figure out a way to make a buck off it.
"In the early 1960s, John F. Kennedy instituted a policy allowing mental patients to go back into the community. Unfortunately, it was an unfunded mandate. So when I got out of the Austin state home, I got a pack of Camels, 25 cents for a phone call and a ride on the Greyhound. We called that 'Greyhound therapy,' " says Mike Harvey, a consumer and advocate of mental health services for more than 40 years.
Harvey, who is manic depressive, is well acquainted with the halfway house system: Clients hand over their disability checks and get money for cigarettes each week. For a long time, he says, the Texas Department of Mental Health and Mental Retardation okayed these places, till they got too bad and the licensed personal care home was born, which requires higher accountability.
But as state Representative Garnet Coleman observes, "You can put any rule and regulation in place and people will always find a way around it." The Houston Democrat is known for leading efforts in the Texas Legislature for more funding for mental illness needs. But Texas still continues to trail in this area, 43rd in per capita spending on mental illness nationally, and there aren't enough places and it isn't enough money.
If you give a mental patient a roof over his head, food and an opportunity to work, his chances of making it go up exponentially, Harvey says. But that roof is one of the greatest stumbling blocks in Harris County and one that divides health care professionals.
"Of all the shortages in the mental health system, housing is the greatest," according to Betsy Swartz, executive director of the Mental Health Association of Greater Houston, an advocacy group.
But she isn't certain that licensing of board-and-cares will help the situation. "If you were to register all of the board-and-care industry, many of them wouldn't be able to stay in business. So the people staying with them would potentially be homeless.
"Some need to be closed. Nobody should be there. But there are others that are okay."
She's echoed by Evelyn Johnson, with the Alliance for the Mentally Ill in Houston, who says: "The No. 1 problem is that there is very, very, very insufficient housing for people with mental illness. For several years we've advocated for more and better housing but if we attempt to close those places down, those folks may have to go under the bridge."
Readily admitting that some of the places in Harris County are "dirty and filthy," Johnson says they are better than nothing.
In a best-world scenario, Swartz says, mental patients who need the help would be in places like Safe Havens, a well-supervised group home run by the Mental Health Mental Retardation Authority of Harris County. And a visit to Safe Havens shows a clean, attractive facility in Midtown, a set of one-bedroom apartments with microwaves and small refrigerators in each room to encourage those staying there to take care of themselves. But it is transitional living, not a permanent stop and, like most of the best places in Harris County, small -- only 25 rooms. It has funding to operate for only one more year.
Dr. Steve Schnee is the executive director of MHMRA and the man with the numbers, which he employs in appeals for funding: "The state of Texas will spend an average of $14.61 per capita for the mentally ill in the year 2000. In Harris County the average is $11.65. For Harris County to even get to the average, we're short $9.8 million a year." The national average is $26.98. For Harris County to reach the national average would take close to $51 million a year.
At one community meeting, Schnee asked recipients of his agency's services how they might better serve them. One man told Schnee, "I need a lock." Schnee didn't understand. The man went on to say that his room at a group home had been broken into several times, his possessions stolen. He couldn't sleep at night because he was so worried, so scared, and that what he really needed was a lock for his door. "How can this man be stable?" Schnee asks rhetorically.
David Clark, another mental health consumer and advocate, is one of the lucky ones and knows it. He lives in Tomball Pines, a 21-unit complex that provides the means for him to manage his manic depressive illness and work part-time. It took him two years on a waiting list to get in, and he says there's no way he'll ever leave.
He dismisses board-and-cares, saying, "Most are neither board nor care." In most cases, he says, you have an absentee owner who insulates himself from what's going on by having an employee take care of boarders.
"In most so-called board-and-care homes they turn you out and they won't let you stay there during the daytime. So where do you go? You don't have a place to bathe; you're wearing ugly, dirty clothes," Clark says. Most stores invite such people to leave; about the only place that leaves them alone, Clark says, is a library.
"We enable our housing problem to continue. The bad news is that most of this property is dangerous, ill kempt and dehumanizing. The good news is that we have plenty of it."
Lee Ligon, and her second husband, Gordon, spend a lot of time with Darrell, but living with him doesn't work. He'd been an employee in Spring in his dad's underground-sprinkler business, but the two of them couldn't get along. So Ligon and her husband moved Darrell to the Southern Oaks Apartments, 6353 Skyline, on January 1. When they checked on him in mid-January, someone else was staying in his apartment and Darrell was gone.
Piecing together Darrell's whereabouts is a bit like trying to sort out his brain. From a hospital bill she received months later, Ligon found out Darrell was admitted to the Bayou City Medical Center, 6700 Bellaire, on January 15 and was released on January 26. His records said he was psychotic, unable to function. He had been transferred there from Ben Taub's short-term crisis psychiatric center, which said Darrell was responding to internal stimuli and had outbursts of negative behavior after he had checked himself in there. The good news was there were no drugs or alcohol in his system. The bad news, by Ligon's accounting, is that Darrell was misdiagnosed as a bipolar or manic depressive personality.
Bayou City personnel told Darrell he needed to be somewhere that would monitor his medication, his mother says. That's why she can't understand why he ended up at the Horizons Group (previously known as Texas Community Care) at 4930 East Old Spanish Trail, a board-and-care that is neither licensed nor monitored by the state, and is not supposed to be giving out medication to anyone. Bayou City did not return telephone calls from the Houston Press.
When Ligon went out to the four-bedroom home, she found five adults "floating around the house" and a manager named Diane. Diane told her boarders stayed two to a room, got three meals a day as well as snacks and that their medications were monitored. Diane called owner Genevieve Walker, who in turn called Ligon. Walker denied that medication was given out and said Diane only did the cooking and the laundry.
Darrell said he was in a room with three other men and that Diane did give out medication. Ligon says Walker told her at one point that Darrell's "friend," a J.D. Blackwell, had brought all of Darrell's possessions from the apartment to him at the board-and-care. Later she said she didn't know where the property was.
The helpful Blackwell had taken Darrell to the Louis Fabre Clinic on Crawford. Darrell went voluntarily. They were going to pay him $500 to participate in a study of psychotic drugs, and Darrell needed the money. Places like the Fabre Clinic do these kinds of research studies, trying out drug companies' new products on patients. Ligon feels this is completely unethical. It was during this time, she says, that Darrell's apartment was stripped.
Dr. John Rodriguez of the Fabre Clinic told Ligon that Darrell had refused to tell them much of anything and nothing about any relatives. The Fabre Clinic declined to return a Press call.
Ligon says her son remained at the clinic for about six weeks. The clinic kept very detailed records, she says, and she commended it for its cleanliness. But as its own reports indicated, she says, Darrell was quiet and cooperative at the beginning of the drug trial and agitated at the end. He decided to leave, collected his check for $500, took another $400 out of his bank account, into which his latest social security check had been deposited, and stayed in hotels till he ran out of money. Then he lived on the streets before finally showing up at her house in the Idlewood subdivision.
Genevieve Walker has several businesses across the city and does not like to be questioned. In addition to owning the home on East OST, she also runs Silveridge Community Mental Health Center in the FM 1960 area. When Darrell and his parents visited the Horizons Group home in late June to look for his property, Diane put Walker on the phone with Darrell's stepfather, and a sometimes heated discussion ensued.
The next day, contacted by the Press, Walker reluctantly answered some questions.
"As far as we're concerned, nothing happened to Darrell Jones. As usual, we're always the scapegoat." She insisted repeatedly that her home was fine, that anything bad that happened to Darrell was on account of the people who transported him. Check out J.D. Blackwell, she said, but she didn't offer any way to contact him. She denied he ever worked for her.
Norma Ezema was the driver who regularly transported clients to the Horizons house. She denied working for Walker or knowing anything about what happened to Darrell. "I picked him up. I didn't do any of the feeding or the medication. Whoever's in charge there, they do that.
"I know she's got a lot of clients there. They seem to be okay. I didn't spend much time there." Later Ezema said she had worked for Walker's "partial hospital" rehabilitation program, another business Walker operates in the 1960 area.
Walker's speech was a contradiction of concern and denial. On the one hand, she said: "The state doesn't have to monitor me to get me to treat a person right." Then she insisted this was just a boarding house, like an apartment house, and they had nothing to do with the personal lives of the people who stayed there. She denied they were giving out medication. She said she had only three or four people staying there. When it was pointed out to her that there were six in the yard the night Darrell's parents visited, she started screaming, "Liar, liar! You are lying."
She said she wanted to meet in person, to get to the truth and would call back later that day to set up a tour of the house. She wouldn't leave a telephone number, and she never called back.
Meeting Darrell Burt Jones is a surprise. The man who presents himself is handsome, engaging, casually dressed and able to clearly explain what happened to him. It is easy to envision the National Merit Scholar he'd been in high school pulling down A's and B's, the college student.
This is Darrell in one of his good, lucid moments, his mother says. There are, of course, others less delightful, less hopeful, more violent.
Now his best hope for a life is at Liberty Island, where he is watched over and encouraged to learn and handle as much as he can in a supportive environment. He has now, finally, been medically diagnosed as suffering from a closed-head injury, which allows him to stay there, where he hands over his disability check each month. He's hoping to go to work for a local grocery store.
Ligon just wishes she had found this place sooner. It would have spared Darrell and her whole family a lot of grief. "We've got to change something so these people aren't exploited like this anymore," she says.
A doctor releases a mental patient from treatment and says it's up to the social worker at the hospital to place the patient. The patient should have his medicine monitored but is sent to a place that is not allowed by law to give out medication. The patient has all his possessions stolen, ends up in a drug treatment study for a condition he doesn't have, then out on the streets alone again in charge of $900, which he wastes.
The experts acknowledge that some of the board-and-cares are dismal but say they are better than nothing. The mentally ill don't seem to agree. No one likes the options. There are caretakers who may mean well but don't do well. There are others who don't care for anything but the money. Most of us console ourselves by not seeing these people, letting them operate without interruption, rationalizing what they do.
It is a deal with the devil. We are saving our money and turning away from people who need protection. It is all a deal with the devil.
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