Chapter 15: Abnormal Psychology and the Law? Now that you have learned about psychology and the law, including the ways in which the law serves to protect both the Mentally Ill a

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Behind the yellow door, a man’s mental illness worsens

June 28, 2014

Everyone is worried about the man in the house.

His ex-wife, his mother, his father, his neighbors, the psychiatrists he has seen and no

longer sees, they are all concerned because he has been alone in the house in suburban

Maryland for two years.

No one knows what he is doing. No one knows what he is thinking, what he is eating or how

he is surviving. In two years, since his frightened wife took their three young boys and left

him there alone, he has not spoken to anyone for more than a few minutes. He has not let

anyone beyond the front door, which he has fortified with a new lock, a piece of plastic

bolted over the window, and a piece of plywood bolted below that, all of which he has

painted a bright shade of yellow. He keeps the living room curtains shut.

The man in the house, a 42-year-old who once earned six figures working on Capitol Hill

and was a devoted husband and father, tells his family that he is not sick, even though a

psychological evaluation found he had “a schizoaffective disorder, depressive type with

persecutory delusions.”

As far as they know, he has stopped taking the psychiatric medication prescribed after he

told police that God was speaking through his 3-year-old son. He has quit his job and

stopped paying bills. His family doesn’t know what to do.

His mother leaves bags of groceries on the porch. His ex-wife sends text messages, and his

responses are increasingly worrying, such as when he refers to his sons as his “suns.” His

father is always leaving a version of the same phone message — “Hey, this is dad. Let me

know if you want to come out and talk. We love you. We care about you.” — which his son

never answers.

Once, the man’s family might have handled the situation by having him involuntarily

committed to a psychiatric institution. For decades, it was a routine and simple procedure:

If a doctor agreed that the patient had a mental illness, he could be institutionalized even

against his will.

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The problem was that it was a process with few safeguards, and during much of the 20th

century, all kinds of people who didn’t belong — from free-thinking women to gay people,

minorities and rebellious children — wound up locked in hospitals where abuse was

common and conditions were often bleak.

So the system changed, with one catalyst being a 1975 Supreme Court ruling that effectively

restricted involuntary commitment to instances when a person becomes a “danger to self or

others,” a phrase that now appears in one form or another in state laws across the country.

But 40 years after that standard was established, some people are asking whether society’s

concern for the constitutional rights of people with mental illness has led to their

abandonment. At a moment when about one-quarter of the homeless population suffers

from severe mental illness, when the number of mentally ill prison inmates is higher than

ever and when mass shootings are often followed by stories that the shooter had heard

voices, the people asking questions include the family of the man in the house. Their

concern is growing every day.

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Because he does not think he is sick, voluntary treatment is not an option.

Unless he threatens to harm himself or someone else, or is so sick he cannot keep himself

alive, he cannot be deemed dangerous, particularly in Maryland, where commitment laws

are among the most stringent in the nation.

And although there are days when he wears bright yellow from head to toe, or all white

including sandals he sprayed with white paint, he appears well-groomed and healthy, so he

is unlikely to meet even the most lenient legal definition of dangerous.

On day 730 of being alone in the house, he still tends his lawn. The few times he has opened

the bright yellow door to get groceries or money from his worried mother, what she could

see of the living room appeared clean, if bare — the family photos removed from the walls.

The ex-wife

The ex-wife of the man in the house — who for privacy reasons is being identified only by

her first name, Jennifer — remembers the last time she was in the house before she left.

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The furniture was neatly arranged. The stereos, TVs and computers were working. The

boys’ rooms were set up with bunk beds, and the kitchen was full of food for a family of five.

That was the day she decided her husband’s behavior had become so alarming that she had

to take their sons and leave, and now, 755 days later, Jennifer is in the New England town

where she lives, watching from a distance as the boys Skype with their father.

He sits in a chair she does not recognize, saying “my sons, my sons” as the boys play in

front of the computer screen. His head is tilted to the side, a half-smile on his face. He looks

thinner, she thinks.

On another day, he sends her a text message.

“skyp sun,” he writes. He sends a yellow dot symbol.

What she wishes is that her ex-husband, whom she still loves, could be involuntarily

committed to a psychiatric hospital for however long it takes doctors to figure out what’s

wrong, for medications to work, and for him to once again be the person she married.

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But because she can’t have him committed, she is doing the only thing she can think of to

do. In accordance with the divorce decree, she is selling the house, which she is hoping will

force her ex-husband into a situation desperate enough that he might meet the standard for

involuntary commitment. For him to get better, she realizes, she and his family have to let

him get worse.

“He’ll be homeless . . . ” she says. “And we just have to let it happen.”

She has been watching him deteriorate for three years now, a process she traces to the night

he didn’t want to share a glass of wine, which had been their evening ritual since they

bought the house and started building their life together.

He wanted to be on the computer instead. He began reading conspiracy theory Web sites.

He started saying he was going to jail and taking batteries out of cellphones. Jennifer told

herself it was stress and tried to get him to see a counselor, but he wouldn’t.

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Then one day a package arrived, and he told her to take the kids outside, and she watched

as he put on a biohazard mask and used long-armed tools to open the box, which contained

a crank radio he ordered.

He built an eight-foot-high cross and nailed it to a tree in the front yard. He started wearing

all yellow or all white. When they visited a relative who had a gun with five bullets mounted

on a wall, he said the bullets were a sign that their family of five was going to be killed.

Jennifer kept trying to persuade him to see a counselor, but there was nothing else she

could do to get him treatment until the day he disappeared with the boys.

On that day, Jennifer called the police, who tracked him to Atlanta, where he reportedly

told them that he and his children were going to be killed and that a flock of birds had

signaled for him to take the boys south.

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She and her father-in-law arranged for a mobile crisis team — mental health workers and

police trained for such situations — to meet them back in Maryland, and when he still

refused to see a doctor, police were able to invoke the “danger to self or others” standard

because of the erratic trip, his delusions about being killed and a small knife found in his

possession.

It was the one time he met the threshold of involuntary commitment. He was taken to the

emergency room in handcuffs, at which point an array of regulations aimed at protecting

his civil liberties kicked in.

Within six hours, a doctor had to certify that he was dangerous. Within 30 hours, the ER

had to locate a bed in a psychiatric hospital or release him.

Once he was admitted, he was appointed an attorney and a hearing was scheduled before a

judge who would review whether he was still dangerous enough to stay hospitalized. And

even then, he still had to consent to taking medication.

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After a while, doctors thought he was improving. He acknowledged making “errors in

judgment,” according to his medical records, and agreed that his thoughts about the family

being killed were “not based in reality.”

After 24 days, doctors found that he was “no longer suicidal or homicidal.” He no longer

met the criteria for involuntary commitment, and so he was discharged.

Back home, he went off his medication. He became angry and withdrawn, cursing his wife

and family for putting him in the hospital. Then he sent Jennifer an e-mail referring to her

in the third person — “She’s hell bent on lying,” it began — which a counselor told her

exhibited the kind of dissociative thinking that precedes a potentially violent psychotic

break, and she left.

He followed her. He banged on her parents’ door in the middle of the night. She called the

police, who saw that he was violating a protective order she had obtained, and took him to

jail, which as Jennifer now sees it was his last chance for help.

She said that during his court appearance she begged the judge to order mental health

treatment, but a psychiatric evaluation found that he was only delusional, not dangerous,

which limited what the judge could do. He was released after four days.

He went back to the house and painted the door yellow.

Jennifer filed for divorce in the New England town, where the judge in the case ordered her

husband to have another psychiatric evaluation after he attempted to represent himself.

That one found “the presence of schizoaffective disorder,” which led the judge to declare

him incompetent and appoint him two legal guardians.

Jennifer thought the ruling could help force another involuntary commitment, but a friend

of hers who is a judge in Maryland told her it wouldn’t be enough.

“Everyone says he could become dangerous,” she says. “But not that he is dangerous.”

It wasn’t enough, she realized, that the divorce judge found “by clear and convincing

evidence” that her husband “suffers from a profound mental illness which renders him

incapable of caring for the children or exercising parenting time with them except in a

supervised setting.”

It wasn’t enough that she has notified her kids’ school to call the police if he shows up.

Or that she dreams he kills her, which she shakes off because he has never been violent, but

which remains a visceral enough fear that when she sees a black SUV, as she does one day,

pulling into a gas station across from her office, she is startled.

“It’s just like his,” she says, squinting at the car.

When she sees a homeless man walking by her office, she thinks that could be her ex-

husband, too, and sometimes the sight of him makes her cry.

But none of that was enough, so she is waiting for him to become sicker, so he might

become dangerous, so he might get some help. She imagines how it might happen.

“Maybe if he stopped eating and passed out — that’d be an ideal situation,” she says.

“Maybe if he steals food and gets caught, and if he’s in a state of confusion so police officers

could see,” she says.

“You hope he tries to kill himself and fails,” she says.

“My goodness,” she says, realizing how horrible that must sound.

The mother

On day 768, the mother of the man in the house, Kay, drives over to see her only son.

She keeps in contact with a psychiatrist who once evaluated him and gives her advice about

what to do, and one thing he has been telling her lately is to stop going over there alone. But

she is going.

She, too, wishes her son could be committed to a psychiatric facility of some kind, but

because that is not possible she texts him that she is bringing groceries.

“Ino.I” he texts back.

The other thing the psychiatrist tells Kay is that she needs to stop bringing food, stop

paying for his car and take him off her credit card. He says that she is enabling her son’s

delusional behavior and that any support should be conditional on him seeing a doctor.

Otherwise, the psychiatrist says, she should cut him off and let him get worse.

Another text: “I no I” he types.

She decides not to go to the house. Instead, she calls her daughter, who is the sister of the

man in the house, and a few days later they are talking about what to do.

“Everything has to stop, isn’t that what the doctor said?” the daughter is saying gently.

“Yeah,” the mother says.

She looks pale. She has been getting thinner.

“His thought is it doesn’t give him any incentive to talk to us as long as he knows he’s going

to be supported,” the daughter says.

“And my fear is we’re going to push him into a corner, and he’s going to feel desperate,” the

mother says. Then she remembers what the doctor said about that. “He said, ‘You don’t

know that because you haven’t tried it.’ ”

She is 66 and has put off her retirement indefinitely because she doesn’t know how long she

may have to support her son.

“My feeling is we use it to barter with,” the daughter says. “We say that our help is going to

be based on him seeing a doctor.”

“I guess,” the mother says.

She is fidgeting with her earring; she is kneading her cheek.

“I think it’d be easier if we saw him,” the daughter says.

The last time her mother saw him was several weeks before, when she was bringing food

and he came outside. It was evening, and he would not let her inside, so they sat on the

porch. She tried to talk to him, but he took almost every word as having a double meaning.

When she said “hi,” he said, “I’m not high.” When she said she didn’t mean it like that, he

said, “Do you think I’m stupid?”

He told her that she and his father — they divorced when he was a teenager — were bad

parents. He would seem angry, then lost, and then, she thought, close to a realization. He

looked at the sky and said, “Don’t you just wish we could go back to when we were a family

again?” He talked about being “free.” He said the family was trying to kill him.

The psychiatrist has told her not to take such talk personally, that it’s the illness.

But she always believes there is truth in what her son is saying, however jumbled it might

seem, and one thing he has said is that he’s never going back to a hospital. She thinks he’d

die rather than go.

During his one involuntary commitment, she had visited him nearly every one of those 24

days. She still regrets how it happened, the handcuffs in the middle of the street. She

regrets that he was in a locked ward with patients who she guessed were homeless and an

elderly man who walked around naked one day, which she is sure embarrassed her son. She

worried that he felt demeaned. She promised him then she’d never do anything to put him

back there again.

Only now, almost three years later, she knows he needs help, and she knows that cutting off

his financial support might be the only means to that end.

“Me personally, if I saw how bad off he was, it would be easier to be firm that we’re doing it

for his own good,” her daughter is saying. “I feel if he’s near the final stages, and we’re only

going to make him suffer a short period, it’s easier. If he’s not near the end, and we’re going

to make him suffer longer, it’s going to be worse.”

“When you say ‘near the end,’ you mean the point, where — ?” his mother asks.

“Where he’s near his low point,” is all the daughter says, trying not to upset her mother.

“We just cut to the chase and force him to that point quicker.”

They go on talking, the mother fidgeting, the daughter gently prodding, and resolve that

they will tell him that there will be no money without cooperation.

A few days later, the mother tells him. Then she leaves him $100 for his birthday, and $200

for Christmas, and more groceries on the porch, until her son says if she comes back he will

get a restraining order.

A few days later, he sends her a text.

“IIIIIIII” it reads.

The father

By Stephanie McCrummen

(Alex Nabaum/For The Washington Post)

ADVERTISING

Jennifer now lives in New England. Although she loves her ex-husband, his behavior became too alarming and she decided to take their sons and leave. (Michele McDonald/for The Washington Post)

Kay has had a long and painful ordeal coping with the mental illness of her son. She put off her retirement indefinitely because she didn’t know how long she would have to support her son. (Michael S. Williamson/The Washington Post)

Charles has tried to get help for his mentally ill son from anyone he thinks might be able to help, but no one can. It leaves him wondering: If his son can’t get help, how will things end? (Andre Chung/for The Washington Post)

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Nine days later, day 802, his 69-year-old father, Charles, is going over to the house.

He is worried like everyone else, and as he pulls into his son’s neighborhood at noon on a

Thursday, he is surprised to see him out of the house and in his car, parked by the

neighborhood entrance. He seems to be adjusting a GPS device.

Charles honks his horn, parks and walks over. He taps on the window, and as it rolls down,

he sees his son for the first time in so many months of trying, months of sitting outside the

house, waiting for him to come outside, leaving messages — “Hi, it’s Dad. I’m out here.”

He looks thin, his father thinks, but neat and clean. There are piles of blankets in the back

seat and, on top of the car, a wooden cargo box.

Charles asks his son how he is doing, and his son just stares. Charles says they need to talk

about a new living arrangement because the house is being sold and tells his son about his

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