Maxwell Chorak – Rest in Peace

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Sunday November 2, 2014

Today is All Soul’s Day, the Dia de Los Muertos. It is an especially painful day for our family this year.

On June 10th I was called out of an early evening meeting and told that my step-son, Maxwell, had committed suicide. He had jumped from a 5 story sky bridge at UC Irvine a few hours earlier that was known as a site for suicides. The parking structure had suicide prevention tiles with hot line numbers cemented into the walls from the third floor upwards.It was the culmination of every parent’s worst nightmare.

But it had been a long time coming. Susan, my wife, and I had been living in fear of “the call” for years. She thought that it might be drugs but had never thought of suicide. We are still deeply grieving. What we do know is that the system let him down badly.

Max - 6

How does one deal with the sudden, traumatic death of a child? There are no guidebooks. It is the worst sort of emotional blow. His sister and brother are distraught. We were all deeply concerned for him but the cold reality of such a violent death at a young age is searing. But somehow we must go on and help change a broken system.

Maxwell exhibited his first signs of mental illness at the age of ten. He would act out. He raged. He sometimes became violent. When the Sheriff’s deputies got to the house they did not know what to do. At the time, my wife as a single mother was on her own trying to chart new territory. There was no place in the county to which a ten year old child could be taken to be treated for mental illness. There still isn’t.

She eventually found a psychiatrist who tried to “get” him and he was treated for bipolar/schizophrenic disorder but not formally diagnosed. But Max was using street drugs to self-medicate and the doctors pulled back.

Maxwell entered high school but it didn’t last long. He was brilliant. He was bored. He was different. But he also had charisma. He was a handsome young man with a very gentle way most of the time. But by his sophomore year he was out. His erratic behavior, drug use, and inattention just were not going to get Max through a conventional education.

He was a wonderful young man. He would take his last dollar and spend it on a gift for his brother or take his 90 year old aunt out for a pedicure and manicure. He was kind. He wanted nothing more than to hang out with his family. He loved his brother and his sister devotedly. And then the voices would whisper in his ear and it would get scary.

He was too smart for his own good. He could argue the most absurd point until even a well educated person could be fooled. He could also listen to a guitar riff or even a whole song just once and play it back brilliantly. His guitar was his refuge. He could pick up a cello never before having touched one and play it better than his mother, who had studied for years.

Maxwell took the GED test without studying and passed with flying colors. He entered the local community college. He wanted to be a doctor. Shortly before he died he was discussing textbooks for the next semester.

Clonazepam is a drug used to control seizures. Usually an adolescent is given one pill and would sleep for 18 hours. They gave Maxwell five once and still had to restrain him. Marijuana has been well documented for its terrible effect on individuals with schizophrenia. The literature discusses adverse or paradoxical effects. You bet there are.

Maxwell would eventually learn to study the side effects of the various drugs prescribed for his treatment in order that he could tell the doctors that he was having them in order to avoid the drugs. The prescription drugs left him feeling lethargic and hemmed in. At least some of the illegal ones gave him a brown haze to find refuge in.

I call him Max because it was what my grandmother called me. She too suffered from mental illness. She had a nervous breakdown in the 1930’s after being thrown out on the Brooklyn streets one too many times with her 5 children after her husband had once again squandered his plumber’s salary on booze.

She ended up at a place called Creedmoor in Queens, NY for 40 years and it was only when Thomas Szasz and his accomplices in government closed the psychiatric hospitals in the 70’s that she came to live with us. Creedmoor had been her safe place. Now her life was disrupted. When she came to live with us it was a wonderful experience because of my mother’s love and compassion. She taught us to be kind and caring.

So I had a lot of empathy for Maxwell. He had no place to be safe. There was no safety net. We have since the 1970’s gutted out mental health care programs.

His condition was slowly deteriorating. It was only when he became 17 that the handbook of the American Psychiatric Association allowed him to be formally diagnosed as schizophrenic. By that point he had been in in-patient programs in Southern California and Idaho to help treat his condition.

Max - 25

By the age of 18 he had been in the local hospitals for six 5150’s, which refers to the section of the California Welfare & Institutions code which allows for an individual to be detained for up to 72 hours for psychiatric observation.

And through all of this, Max’s friends and family became isolated from him. His mom and his family visited him when he was in treatment, but the loss of human contact was deeply upsetting. We loved him, but one of the things one encounters with the mentally ill and addicted is that it is difficult to love them in a normal manner. It is sometimes impossible to be close and to be there for them. You often don’t know what to expect and a lot of what you do expect is bad.

He was arrested for petty crimes and began the cycle of being in jail and on the street. 40% of America’s jail and prison population have mental health issues. Experts here in Orange County have told me that it is more like 70% -80% in our local jail. It is a cycle that we somehow have to break.

Maxwell was homeless at times. His interactions with law enforcement bordered on the absurd. While he was in jail he was sentenced for a “failure to appear”. He spent several months at a local mental health facility which is outsourced by the county. And then he would end up back in jail for another petty offense. He began to hear voices, holding conversations with them and laughing to himself. He would end up in the psychiatric unit.

The drugs, especially those that were self prescribed, left him in a haze that was better than the suffering, but psychoactive drugs do not affect the mentally ill the way they do others.

For most of his last 18 months Max was either at one of the very few facilities for the mentally ill in California, a drab forbidding site in Riverside, or in jail. Maxwell was a prime candidate for long term care. But there is almost none available. There are 5,900 acute mental health care beds in a state of 34,000,000 people. There are almost no long term facilities. And there are an estimated 1.5 million Californians with serious mental illness.

When he was released from the facility (you really can’t call it a hospital) in Riverside he stayed with his father. He saw his brother and mom and things were looking up. He had a great day with an old friend just hanging out. He left his father’s house one night and didn’t come home.

He was found the next day in a catatonic state in a local park and taken to the emergency room. He was then transferred to UCI Medical Center, the regional acute mental health unit, where he stayed for 9 days.

When we were informed of his admission to UCI his mother immediately contacted the doctors and nurses regarding his care. Maxwell did very poorly on Haldol, the drug of choice for the zombification (aka control) of the symptoms of schizophrenia in state run facilities. We knew this from years of experience. Haldol can cause severe depression.
We knew that Risperdal was more effective for Max and told his doctors so. The nurse responsible for him told my wife “It doesn’t make any difference since they don’t stay on their meds when they leave here anyway.” They put him on a maximum dose of Haldol.

She had requested that she and Maxwell’s dad be notified before he was released. This did not happen. Max was released at @ 1:30PM on the day of his death with the clothes on his back and a bus pass given to him by the hospital. He took the bus directly to the main campus of UCI several miles away and jumped almost immediately. After his mother found out and after collapsing, she called the hospital to ask why he had been released. There was silence at the other end of the line.

To this day we don’t know if Maxwell jumped because he was disoriented on Haldol or because of other factors. We will never know. That hurts.

The system is broken. Many of the professionals are callous and uncaring. There are petty jealousies and a lack of communication. The system as designed and implemented is malevolent. Our brothers and sisters with mental health issues are warehoused in our jails and in a very limited number of beds. We read daily of misdiagnoses and maldiagnoses and even misconduct in psychiatric care.

Treating mental illness is a matter of the physical, the mental, and the spiritual. It is perhaps the most difficult of illnesses. With the mentally ill there are often no good answers. As a society, we don’t want to know. We don’t want to deal with them on a concrete level. The mentally ill are often stigmatized. And at the most basic family level it can be heart wrenching.

But Max is gone. He will be a statistic to most but he will have left a massive hole in the hearts of his family and friends. There is little understanding left except that he was deeply, fatally mentally ill in a world that does not treat those who suffer from this very well. He is at peace now.

We can honor him by doing better, as individuals and as a society.

“Let us touch the dying, the poor, the lonely and the unwanted according to the graces we have received and let us not be ashamed or slow to do the humble work.”

Mother Teresa

© Matthew Holzmann 2014

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8th Grader dies of overdose – Media silent

b6fc9d2c155111e3931722000a1fc67c_6The other day, an 8th grader at Niguel Hills Middle School in Laguna Niguel, CA died of a drug overdose. The cause of Branden Stock’s death was Vicodin, one of the most commonly prescribed drugs.

The only media report of his death was on Channel 5 News. His school and the district said nothing at all beyond their confines. He died at home alone. Imagine finding your child or your best friend cold and lifeless and there’s nothing you can do. His friends held a memorial service at Salt Creek Beach, where I spent many days in the water surfing like Branden was said to have loved to.

The death of a child is the most painful thing a parent goes through. No one should have to endure this burden. And yet his parents will carry this sadness for their entire lives. His friends will remember for a while and then more rarely and maybe a few will remember to pray for his soul sometimes over the course of their lives.

That the death barely made the news is indicative of the problem. Drug abuse begins in 6th-8th grade now. Kids are experimenting and going through new emotions and have left the cocoon of grade school. And the availability has never been greater. The taboos are gone. “Everyone is doing it.” I heard the same thing when I was a kid. And here we are 40 years later and we’re still getting it wrong.

And it’s not just public schools. It’s everywhere. Catholic schools, prep schools. If you go to the parking lot of Gelson’s in Newport Beach you can usually score within minutes. The Port Streets in Newport are considered one of the last bastions of the Ozzie & Harriet lifestyle and the drugs and alcohol usage by kids is pervasive. Laguna Niguel and every town in Orange County are the same.

Prescription drugs are the new battlefield. Vicodin, Codeine, Oxycontin, Zanax, Opana, Percocet, and Valium are all being abused at record levels. Between dirty doctors, pill shopping, and stealing from mom & dad’s medicine cabinet it is an epidemic. That people can even obtain some of these drugs like Opana, which is prescribed for very limited applications, indicates how awry the system is. And it is hitting 12 & 13 year olds, those who haven’t got a clue, the worst.

And after they can’t find the prescription drugs or can’t afford them, heroin lurks in the background ready to offer a brown haze from which there is little chance of escape. $80 for an Oxycontin or $6 for a bindle of Afghan white or black tar? This is the reality on the street here in the OC.

The Orange County Register did an article a few weeks back on heroin abuse in our high schools. The number of OC kids trying heroin has doubled since 2006. And once heroin has you it is a monkey on your back that is very difficult to remove.

And a lot of people just don’t want to know. Two girls were caught recently smoking heroin in a bathroom at Laguna Beach High School. “The girls caught smoking was an “isolated incident,” Laguna Beach High Principal Joanne Culverhouse said.”

30 years ago when I lived in Dana Point, Laguna Beach High School had one of the worst drug problems in the county. Nothing changes much, it seems. Denial isn’t just a river in Egypt.

In San Clemente, the community has bonded together through CURE, which links the church, counselors, schools, parents, other stakeholders and the kids. We need such programs in every city. Every loss of a child is one too many.

Education is vital and we need to get to the heart of the matter and educate parents and children about the consequences of bad choices. We have the resources. But first we must recognize the problem honestly and without blinkers.

Drug abuse and self medication are the scourges of our times. Between addiction and mental health issues we have responded in a woeful manner. We must open our eyes and our hearts to this plague.

 

 

A Great Disturbance in the Force – The Gathering on Mental Health and the Church

An incredible thing happened the other day and I am still digesting it. The Roman Catholic Diocese of Orange and Saddleback Church held “The Gathering on Mental Health and the Church“. This is a first certainly for California and perhaps for the world. From all over Southern California and the country, 3,500 people gathered at Saddleback Church and thousands more participated on-line in a frank discussion of how faith-based organizations can contribute more to ameliorate a problem that is growing out of control.

We live in an increasingly secular world today that is overwhelming us both emotionally and physically. New technology is bringing us closer together than ever before and yet isolating us even further. Old boundaries are crumbling and as a culture we are becoming ever more dysfunctional. The effects of our physical and psychological world are taking a toll on our souls that is sometimes unbearable. The widespread availability of drugs both legal and illegal has turned us into a self medicating nation.

According to the experts at the Gathering, 26% of adult Americans will be diagnosed with some form of mental illness this year. 7-8% of our population suffers from addiction. from depression to bipolar disorder to schizophrenia to personality disorders were are facing a crisis.

These are issues that hide in the back of our collective closets. Individuals feel stigmatized and marginalized and our societal bias against the mentally ill and addicted is deep and pervading. Families are tortured and damaged and the mentally ill are reduced to hopelessness by a system that is deeply fractured and nonresponsive.

There is a War on Drugs that costs over $50 Billion/year. Mental health treatment costs our nation over $170 Billion/year. Incarceration costs our country over $40 Billion/year. And there are significant overlaps. And what is ever more clear is that we are doing it wrong.

Government is the large hammer. Our medical system is designed to prescribe medicine and perform surgery. Even psychiatry has been increasingly defined as the adjustment and prescription of medications.

The etymology of the words psychology and psychiatry is the Greek word ψυχή, or soul. And yet in our modern, rationalist, scientistic world the soul is the last thing that is considered in the treatment of mental illness. Holistic treatment of mental illness is secondary to biochemical investigation and treatment. And this is where faith based organizations are increasingly seeing the need and the gap.

Pastor Rick Warren and Bishop Kevin Vann assembled a stellar array of health care professionals, psychiatrists, neurologists, and mental health experts from a wide range of specialties in order to examine and propose how faith based organizations can deliver effective care to those with mental health problems.

Saddleback Church has taken mental health on as one of their core ministries. Church is one of the first stops for many people with mental health issues and their families. Faith helps individuals and families cope and hope.

But there is a wall between faith and the rest of the world today that must be broken down if we are serve our brothers and sisters effectively. I am not neutral in this. I have skin in the game. We lose two young people per week to overdoses just in Orange County and mental health issues have affected my own family.

In studying what works in addiction treatment, 12 step programs stand out as the most effective tool. What is even more evident is that compassionate faith based recovery and treatment increase the likelihood of a successful outcome. Almost every study confirms these results. Compassion and empathy are critical.

Working with those with addictions and mental illness is among the most challenging of callings. Addicts are often not nice people. Certain mental illnesses can be especially difficult to cope with on a daily basis. I know.

But it is often that engagement that is at the heart of the matter. Depression may not be logical but to know that someone cares and is listening can be a lifeline.Borderline Personality Disorder is a license for drama and conflict but can be managed. Dual diagnoses such as Bipolar Disorder/Schizophrenia or Bipolar Disorder/Addiction require fortitude and compassion as well.

And yet our society is doing its best to remove faith from our national dialog. We warehouse the addicted and mentally ill in our prisons and an emaciated psychiatric treatment system. The VA is very good at dispensing pills but is not so good at counseling and longer term treatment of problems such as PTSD. Government is the large hammer and a scalpel is often required in mental health treatment.

Modern humanism has become a cult of its own using deconstruction, revisionism, and disproven cultural models such as Marxism to support an ever growing disassociation from reality. Perhaps this may contribute to the psychological dissonance of the mentally ill and addicted. They are adrift in a culture that makes little logical sense.

Faith is the ultimate expression of reason. It is only through logic and metaphysics that we can make sense of the world around us. It is imperative that we as a society use all of the available tools at our disposal to re-think mental health care and treatment.

Stigmatization has done terrible damage to the mentally ill and everyone around them. The first step is to remove this stigmatization. The Church is one of the most effective tools for doing so.

The Church, as was made obvious time and again during the Gathering on Mental Health, can also take a lead position in working with specialists in providing a support network and counseling of the mentally ill and their families. As Pastor Rick Warren and Bishop Vann said time and again, the Church can also take a lead role in counseling and providing resources to those with mental health issues. The Church is one of the first stops, regardless.

Mental health issues are some of the most delicate and complex to face those involved in them. Proper training, empathy, and the right personalities are critical to successful outcomes. It is not for the faint of heart. Compassion and competence must go hand in hand. It is not just a job. It is a calling.

Who better to make this critical contribution but the Church? We have been on the front lines of health care, both physical and mental, since the beginning. The Byzantine Church was the first to set up hospitals in the form quite recognizable now. Today we are being called to re-think and to commit to a new ministry, the healing of minds and souls.

The Gathering was a call to arms for Christians. To open our hearts and our eyes and our minds to the treatment of mental illness. Movements, like chemical reactions start with catalysts. I believe this was one of them.  The Force has been disturbed in a great and wondrous way.