Personally Speaking: My Daughter Needed Help, Not Handcuffs

By Martha Stringer

No one should ever have to call a news reporter to ask them to cover their child’s mental health crisis in a desperate bid to get them help. Yet, that is exactly what our broken mental health care system forced me to do two years ago.

In June of 2019, I emailed Brett Sholtis, a reporter with WITF in Harrisburg who was doing a series called “Through the Cracks” about the mental health system in Pennsylvania. Would going public with our family’s story allow me to get help for my 28-year-old daughter? I asked him. She lives with a bipolar disorder and has anosognosia, or “lack of insight,” a symptom of her illness that impairs her ability to understand and perceive her illness.

A few months earlier, I had heard Brett’s radio story about Act 106, a new law passed in Pennsylvania to lessen the requirements for mandatory outpatient services. Involuntary commitment laws in Pennsylvania, and many places around the country, require an individual be an imminent threat to themselves or someone else – in short, in crisis.

At that time, my daughter was in a downward spiral, wandering the streets all hours, pushing a shopping cart of trash, eating out of dumpsters, not taking care of activities of daily living and yet, amazingly, not considered in enough of a crisis to qualify for involuntary commitment.

When I heard the law passed, I was hopeful. That is, until I realized that it passed with no additional funding, and it was optional for counties to participate.

Not one county opted in.

I was desperate not only to get my daughter help but also to shed light on how the system was tying my hands. My interview with Brett was published in a story headlined “Praying for involuntary commitment: One family struggles to help their bipolar daughter.”

Coincidentally, the evening before the story aired on radio and was published in print, I called the police when my daughter showed up to our house unannounced, highly psychotic and covered in open sores and started an altercation.

I begged the police to take her to the hospital and file a “302,” Pennsylvania’s procedure for involuntary commitment, allowing a hospital to keep an individual in a mental health crisis for up to 72 hours.

As a result, my daughter was admitted to the behavioral health unit for five weeks. I credit Sholtis’ story with helping to facilitate her commitment, by providing crucial insight to our struggles and the extent to which she had deteriorated.

In late August, she was discharged on a 90-day outpatient commitment. Providentially, she had a court hearing scheduled a week after discharge for criminal charges she had received earlier that year.

Although she was better and accepting a monthly injection, the judge found she would benefit from long-term oversight. She was sentenced to supervised probation and ordered to continue medication and therapy as prescribed. I was grateful to have more eyes on her than ever before and hopeful this was the beginning of meaningful recovery.

Until it wasn’t.

Lack of insight also means she does not recognize medication as beneficial. By October when she determined no one was able to hold her accountable for the monthly injection, she stopped taking it.

The next six months were like watching a slow-motion train wreck. Disordered thinking set in, and she began to deteriorate. We emailed her therapist and probation officer to no avail. Neighbors called police to report bizarre behavior. Then, on April 13, 2020, she was arrested on charges of assault and terroristic threats. She was taken to the county correctional facility and held on $50,000 bail.

Immediately, I called our county’s forensic liaison who knew our story and struggles. We were advised not to pay the bail but rather wait until a bed could be secured at the local behavioral health hospital. Sadly, we listened to that advice.

One Friday evening, Brett Sholtis called me. I fell to my knees in horror as he recounted for me how another jail inmate, Courtney, assigned to my daughter as her babysitter (protocol when one has been placed on suicide watch), was desperate to find me. She witnessed my daughter lying naked in urine and feces with only a soiled suicide smock, being pepper sprayed and confined to a restraint chair for not responding to verbal commands.

When I learned what was happening, I reached out to anyone who would listen – my state senators, local representatives, county commissioners and lawyers. And Brett got busy writing, filing another story, “She’s breaking down’: Inmates at Bucks County jail decry treatment of suicidal woman with severe mental illness” on June 15. I pushed it hard on my personal social media channels and in just two days, my daughter was moved from the jail to Norristown State Hospital in what was described to me as a catatonic state.

The way my daughter was treated in jail caused me to take a hard look at the criminalization of the mentally ill, the lack of available psychiatric beds and the impossibly high standard to get loved ones help when they don’t recognize they need it.

As our story continued to unfold, my anger turned to advocacy with hope that what happened could shed a bright light on how the incarceration of people with mental health challenges worsens an already bad situation. I promised myself I would continue to fight for change in my community for people like my daughter.

Working with the staff of the Treatment Advocacy Center, I invited Bucks County officials to become educated on the effectiveness of assisted outpatient treatment for people who are chronically resistant to treatment. I am hopeful that Bucks County will implement an AOT program, having recently learned that the county has reached out to the implementation team at Treatment Advocacy Center for assistance.

After nine months at the state hospital, in March of 2021, my daughter was transferred to a step-down program as part of an involuntary commitment. A caring psychiatrist worked to find a medication she tolerates well and presently agrees to take. She is now in a Community Residential Rehabilitation (CRR) program with an Assertive Community Treatment (ACT) team who comes to her to work on activities of daily living, employment coaching, therapy and medicine management. She is still on probation.

Her anosognosia means there is real possibility of a setback, but with meaningful support we are hopeful she continues on this path of recovery.

I hold out the same hope, a mother’s hope, for other families. Last March, I accepted a new position with the PA and Family Parent Alliance as a family support partner. Using my lived experience, I help other families in Pennsylvania navigate the mental health and criminal justice system as well as advocate for support services for their loved ones.

My first priority will always be my daughter, but no one’s family member should ever be criminalized for experiencing mental illness. I’ll never stop fighting to bring about change.

Martha Stringer is a Pennsylvania-based mental illness advocate and family support partner. She is married to Paul and a mother of three children.