Every week, I saw him standing, sentry-like, in the same place. A medium-sized figure, he had worn-out black sneakers, faded blue jeans, and a well-washed T-shirt. Gangly pale arms hung listlessly. Baby-blue eyes in a mask-like face surveyed the traffic — nurse aides, licensed practical nurses, social workers, deliverymen, sometimes a doctor, and an occasional visitor.
Every week for years, I said, "Hi, Danny," as I passed down the hallway where he stood. Was there a flash of acknowledgment, or did I just imagine that?
He, like my sister, had once been an in-patient at Fort Logan Mental Health Center.
In the 1970s, Denver, a leader in the community mental health movement, dismantled institutional care for the seriously mentally ill. With psychotropic medications, housing in boarding homes, and supervision by case managers, the mentally ill would function well within an integrated community. Everyone, the well and the ill, would benefit, both in health and in money saved. Such was the mantra, the theory, and the goal.
In 1986, my sister, having spent more than a decade bouncing between boarding homes and acute- care hospitals — where medical professionals would try to stabilize her schizoaffective disorder — entered a nursing home. She, like Danny and other gravely disabled, chronically mentally ill, were quietly re-institutionalized, with no public fanfare, no theory or explanation as to why they did not function under community mental health care. To this day, the mentally ill cared for in nursing homes remain a mostly unheard-of non-entity to the public.
Every week for years, on the way to visit my sister, I passed Danny. His brown, thick hair turned thin and dull. Sometimes, sparse gray stubble resembled a beard.
One day before I could say, "Hi, Danny," he looked directly into my eyes and stepped forward. "I want to show this to you. Nobody ever visits me. So I want to show this to you."
He reached into his jeans, pulled out a worn wallet, slipped a white paper from the bill slot, placed the wallet back into his pocket, then unfolded the lined note paper to reveal an expert pencil sketch of his own face.
Smiling at me, he said, "I was once a really good artist."
"Why thank you, Danny," I said. "What a wonderful drawing! Yes, indeed, you are an artist."
While I gushed, he carefully folded the paper, reversed his steps, and resumed his sentry position.
Never again did he approach me.
Sometime during the next decade, he added portable oxygen and a nasal cannula to his garb. Sometime during the third decade, he left his post. I don't know how old he was, what he died from, or if he ever had a visitor.
Isolation is a given for someone with severe mental illness. The disease itself robs them of their cognitive, artistic and emotive abilities, painful losses that they strive to hide from themselves and others.
Medications, even the newer psychotropics, may eliminate hallucinations and delusions, but often leave the person apathetic, with a blunted personality.
Certainly Danny, during his long illness, spent time in seclusion rooms, with padded floors and walls, a single light bulb on a high ceiling, and a heavy, securely locked door with a small high window. How many days might Danny have spent in such a room — just himself and his disease?
Mental illnesses are often long but not fatal diseases. Patients outlive their parents and often their siblings. They live homeless on our streets, in shelters, in jails and prisons, and in nursing homes. There's no easy way to ascertain exact numbers — I've tried.
Perhaps our society is more comfortable not knowing, not acknowledging how many citizens, like Danny, live decades being treated for major mental illness in our nursing homes.
May is National Mental Health Month. Among 10 recommendations from the advocacy group Mental Health America is for people with mental illness to "connect with others." The rest of us should do our part, get connected, acknowledge the mentally ill, and reach out to help them.
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