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Sorting through nightmares and realities of the Arkansas mental health care system
By Alex Gladden
Photos by Chase Reavis // Infographic by Katelynn Santiago // Illustration by Raleigh Anderson
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My first memory at The Bridgeway, the mental hospital I stayed at my senior year of high school, was screaming on a hard, black couch in the lobby. I thought I was in hell. The lights were harsh, and I could see a spiral staircase. I wailed until the strangers let me call my mother. She sang to me on the phone until my screams subsided to sobs.
I arrived at the hospital after a series of medical mistakes scrambled my mind. When we arrived at Bridgeway, Dad immediately noticed the bars on the windows and that the place was dirty. I was separated from my family. Mom, Dad and Gregory, my brother, came to visit me on the second day. Families could visit two days a week. I sat at a table with them in a stoned haze.
The doctors wouldn’t listen to Mom at first. They kept sedating me, which kept me calm and obedient. The doctors kept me in this state for about three days, wiping my memory along with making me agreeable. What I didn’t remember, the other patients filled in. They said the doctors kept shooting me up with Haldol any time I became too difficult, like when I took off my top and threw it at the scariest Bridgeway nurse, a man who used intimidation to scare the patients into behaving. Or when I was allowed outside to attend group therapy and broke away, climbing to the top of the jungle gym. Mom called the hospital continuously, trying to get someone to listen to her. The nurses eventually tired of her constant calls and connected her to my psychiatrists. They obliged my mother’s wishes and took me off all medications except for Abilify, the new medication the doctors were hoping would straighten out my brain.
After the doctors took me off my birth control, I had a period – an expected event for someone stripped of birth control. I was hardly capable of handling a period and bled through my clothes often. One of the nurses took pity on me and broke the rigid shower schedule. She allowed me a night shower. The next night, there was a different nurse on duty. He didn’t care that one nurse let me bend the rules. He refused to let me take a shower and made me marinate in my blood until the morning when the proper shower schedule resumed.
I met with my psychiatrist, who had not read my medical file, and told him I have struggled with depression since an emergency surgery removed one of my ovaries. The doctor acted in disbelief at my odd tale but later verified the statement with my mother.
While I was a hindrance for my doctors, I became a beloved pet among the other patients. My peers enjoyed my antics and became protective of me, as I was the craziest patient on our floor. Mostly, the other patients were in the hospital for drug-related problems – overdosing or dependency on hard drugs. We had some cutters and some kids who tried to kill themselves. We had teenage alcoholics and kids with anger management problems. But the difference between me and the other patients was that they were lucid, and I was not. Basically, I took the heat off the other kids on my floor. KJ, short for King James, always made sure to look out for me. He had dark skin and eyes and a close-shaven head. KJ left before I did and was shipped off to another hospital. He was a foster kid who had proven to be difficult. His punishment was to be cycled through Arkansas mental hospitals until he turned 18.
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Arkansas’ History with Mental Health Care
Although Arkansas lawmakers created 13 Community Mental Health Care Centers to supplement the state’s one 222-bed mental hospital in 1989, Arkansas remains a state with one of the worst mental health care reputations. Mental Health America ranks the states according to the prevalence of mentally ill people and their rates of care. The organization named Arkansas the 41st worst state in the U.S. During the 2015 to 2016 fiscal year, Arkansas got about $7 million for mental health care from the federal government. In comparison, the federal government gave Arkansas about $16 million for substance abuse programs during the same year, according to the Substance Abuse and Mental Health Services Administration.
Besides the state-run facilities, there are also private hospitals and centers, like Bridgeway, where Arkansans can seek mental health care. Some of these places allow patients to use Medicaid or Medicare to pay for their stay. Shara Saucier, a counselor who worked with me before and after I stayed in Bridgeway, said that there is not enough money reserved for mental health in Arkansas. “It angers me at how little we help the people who are mentally ill,” Shara said. She described a system where the workers are overwhelmed and have few resources to give people the help they need. But earlier this year, Gov. Asa Hutchinson devoted about $6.4 million to establishing four mental health crisis stabilization units in Arkansas. Crisis stabilization units are places that law enforcement officials and others can take people who are having a mental health crisis. The idea is to try to divert people with mental health problems from jails and prisons. In Arkansas, if you have a mental health crisis, you are 3.3 times more likely to be incarcerated than taken to a hospital. Hopefully, these crisis stabilization units will help alleviate this problem. Unfortunately, officials have lagged on creating the units. The original startup date for the units was Nov. 15, and none of the four counties have made significant moves to launch the units.
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The Road to Crazy
Before Bridgeway and before I got sick, I had Disney movie nights with my friends. I made straight As. I was filling out scholarship applications for out-of-state colleges.
I entered the chaotic world of hospitals and prescriptions and hallucinations March 1, 2014, when I checked into the ER after developing a kidney stone. Although the doctors listed off possible negative outcomes, they made it clear that they were not concerned and sent me home with a prescription for OxyContin and a pill to help me pass the stone.
And for a few days I was OK. But then I started running a fever, a symptom that my mother now thinks was my body reacting to the medicine. She raced me back to the ER, where the doctors labeled my fever the result of a urinary tract infection. They gave me an antibiotic and sent me on my way. Unfortunately, the antibiotic only served to make me nauseous, so I switched to a different antibiotic.
On Saturday, a week after I had first gotten the kidney stone, I quit sleeping. In the wee hours of the night, I came to the realization that I was high on painkillers. It was an odd feeling, one I had never experienced before. After my third sleepless night, my parents began to worry. Eventually, they decided to take me back to the hospital, specifically Washington Regional, as the doctors already had my paperwork.
While we were at the hospital, the medical staff threw out suggestions like a drunk throws darts at a board in a bar. My nurse, a large woman with glasses and a bleach-blonde bob, became convinced I had a sexually transmitted disease. She sat my parents down and explained that “We don’t know what young kids explore,” dad told me. But the doctors decided I had a spinal infection that had reached my brain. They doped me up in preparation for a spinal tap. A doctor inserted a 5-inch needle into my back, but the test did not yield results. When the doctors failed to decipher what was wrong with me, they sent me to a doctor who specialized in kidneys. The group reasoned that as long as my kidney stone was removed, I should bounce back to normal.
The new doctor decided I needed surgery to remove the stone, thinking my actions were caused by pain. At the unfamiliar wing of the hospital, my mom had stepped out of the room, leaving me alone. I looked up at the IV chaining me to the bed and decided to bite through the plastic to free myself. Blood spurted from the jagged opening. I held the IV above my head and wadded paper towels over the top to keep from losing too much blood as I walked down the hallway. I hadn’t made it far when Mom found me and returned me to my room. I then decided I was not going to have any surgery. In protest, I tore up my glasses and threw them across the room. My underwear quickly followed suit. Alarmed, the doctor refused to perform surgery on me.
When we got back home, my mom said they couldn’t leave me alone. She was worried that in my erratic behavior I would hurt myself. I fell into a pattern. I usually only slept two to three hours in the evening. After I awoke, I was hyper. But my euphoria would turn to terror as the night wore on and my brain continued to malfunction on the lack of sleep and the cocktail of drugs floating in my system. By the time the morning came around, I was manic. My dad, who worked from home to keep an eye on me, said I created elaborate stories that melded my life and history and fictional fantasies. I had lengthy conversations with people who weren’t there. I created bizarre outfits that paired skirts and pajama bottoms.
After a flurry of doctors’ appointments, my parents scheduled a visit to Valley Behavioral Health, a mental hospital near Fort Smith. When we got to the hospital, the doctors tried to separate me from my parents, and they immediately demanded that my family admit me for an extended stay there. My parents hurriedly left the hospital and decided to drive to Arkansas Children’s Hospital in Little Rock. Before we could leave town, my dad got a call from the Department of Human Services. The doctors from Valley had reported my parents for medical neglect because they refused to leave me alone at their hospital.
My parents checked me into Children’s, and I was complacent until the doctors began to run tests on me. They couldn’t give me any drugs to calm me down until I had my blood work done. My dad remembers a heavy nurse pinned me down with her body. Following the tests, they finally said they would admit me. The Children’s doctors gave my parents an answer. They said my mind was pushed over the edge by all the different medicines, and it would take more medicine to reverse it. It was a matter of trial and error until it seemed like the new medicine, Risperdol, worked. I had more time when I was coherent – time when my eyes didn’t roll back in my head, and I didn’t just stare at the ceiling. I eventually seemed somewhat normal again, and the doctors let me go home.
At home, I gradually quit sleeping again. My mom said it was like the medicine just quit working. I added Sertaline, an antidepressant I was on before I got the kidney stone, back to my regimen April 7, 2014. The doctors wanted to see if the antidepressant would spur Risperdol back to working. I went to my first class, English. I flipped to the last page of the book we were reading and frantically decided the book couldn’t end that way. I ran from the classroom and down to the office. I knew I needed to call Ashley Crain, a family friend who was supposed to pick me up if I needed to go home.
Ashley arrived, and I walked down to her car. I climbed in the backseat with her 13-month-old daughter Adeline. She began to cry, scaring me, so I ran back up into the high school. The school nurse and counselors tried to calm me down, but they just made me more hysterical. I crouched in the office and screamed until my throat was raw. Ashley decided to call my mom. She also enlisted her husband Mike to help.
Before Mom got there, I abandoned the office, sprinting away from the school officials who were trying to catch me. It was still first hour, but I decided I had to move on to second hour. I went into the class and sat at an empty desk. A girl I had known since elementary school looked over at me wide-eyed. “Alex, are you OK? What are you doing in here?” I hurriedly left the class and went on to third hour. I made it to my sixth hour before three assistant principals and the school resource officer caught me in the upstairs hall way. They wrestled me to the ground and wrenched my arms behind me to slap handcuffs on my wrists. I kicked and snapped my teeth at them.
I was confined to the theater makeup room, where light bulbs surrounded the mirrors. I leapt on to the counter and anxiously paced. There was no escape for me now. My only option was defiance. I cursed at my captors, who in my mind were agents of some vast and terrible organization. They had come to capture and torture me. Plots to novels and movies threaded together with historical events and poured out of my mouth.
My mom got to the school and tried to talk me down. But I soared above my captors on that counter – besotted with the drugs that ran through my veins and the way they made me fly. They pulled me down when I started ramming my shoulder into the light bulbs, making them pop off with a dramatic crash. So I pissed myself – a last resort of a failed rebellion. The torrential expulsion of urine rained down along with my fiery anger.
When the ambulance finally arrived, the crowd could breathe again. My mother hurried alongside me, still determined to keep me from leaving in the ambulance with these strangers. I was supposed to ride with Mom. She was going to drive me to the hospital. I walked with her, and the rest of the crowd I had accumulated hovered around us. But as she led me out, I sealed my own fate. I screeched, “Just blow me up!” The fine medical professionals took this as admission of a grand plan of suicide. It took the control out of my mother’s hands. The EMTs wrestled me onto the gurney and lashed my arms tight to the railing. I screamed and thrashed as they held me down, making the gurney jump with me. The EMTs loaded me into the ambulance, and I stared at the ceiling. I closed my eyes and muttered, “It’s not real. It’s not real.” But I couldn’t keep lying to myself. I opened my eyes and screamed in terror. I was horrified to find myself still in the ambulance, the restraints still digging into my flesh.
The ambulance ferried me to Mercy Hospital in Fort Smith, and my mother argued with doctors and explained my convoluted medical history. But there was no way around it – the doctors agreed I needed to be in a mental hospital, a place with 24-hour care that specializes in mental illnesses. When my dad eventually arrived, my parents, left with few options, decided to put me in Bridgeway. My dad rode with me in the ambulance all the way there. The EMTs kept me restrained for the entire three-hour drive.
I stayed in Bridgeway for eight days and eventually became lucid enough that the doctors sent me home April 15, Gregory’s 15th birthday – I always make sure I’m the center of attention. The doctors diagnosed me with bipolar disorder. They recommended that I take Abilify for at least six months and that I continue using the medicine even after that. But I quit Abilify after mere weeks following my hospital stay. The medicine gave me nightmares and made me too antsy to sit still in class. My mom helped wean me off the medicine, taking smaller and smaller doses until I didn’t need to keep taking Abilify. I have not hallucinated or had any other symptoms of bipolar disorder since I quit taking it over three years ago.
I was in and out of hospitals for about six weeks. By the time I graduated that year, I had missed about two months of school. Despite that, I graduated with high honors and straight As. I passed one of the three Advanced Placement tests I took at the end of the year, giving me college credit for – and don’t think the irony has escaped me – psychology. For weeks after I got out of Bridgeway, I was angry. I felt a white-hot anger at my doctors, the school, my parents. I had trouble reading. I couldn’t memorize lines well enough to assume the lead role in the high school play “Lost in Yonkers.”
When the anger faded, I felt like a shell of my former self. I was depressed. I felt like I wasn’t as funny or as smart as I used to be. I was scared to go to college. But in August, I moved to Fayetteville to attend the University of Arkansas. I lived in the honors dorm. I made good grades, swinging a 4.0 that first semester. I began reporting for the school newspaper, The Arkansas Traveler. I started working two other jobs on top of reporting to pay for a study abroad trip to Rome.
On a cool November evening, I had a night off work, and I went out to grab pizza with some friends from the dorm. We sat around the table laughing. I don’t remember the joke I made, but we laughed until we cried. I felt so happy. I remember feeling like me. It was an odd feeling, feeling like myself again. It was like jumping into a pool in January. I hadn’t realized I hadn’t felt alive until I did. And I did feel alive again.
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