Justin’s story: when suicide is the only way out
A short story of my son’s suicide and how the system failed him. Short because it is only the last chapter. Maybe someday I will write the rest.
Ask any person with a mentally ill family member and they will tell you. The system is paralyzed. Danger to ones-self, danger to others, please don’t release him like this, he will only do it again, sorry m’aam there is nothing we can do. This is Justin’s story. The story of a good-hearted man.
When Tallahassee residents heard of the suicide jump at Hotel Duval, those affected by mental illness (#theaffected) knew exactly what had happened and instantly felt the pain, the torture, the frustration, the loss. Those who have been insulated from this painful life experience responded as we, #theaffected, are accustomed to. “Tallahassee is getting like Detroit.” “The homeless problem is getting out of hand.” We, #theaffected, know that the “homeless problem” is actually a “mental illness problem.” Mental illness has less political clout than the environment. It is not included in discussions of diversity. It does not have an @metoo movement. It is not “cost-effective” enough to include in the shiny new Hospital of hope. It is not taught in schools. It is, always and forever, swept under the rug. And so we sigh and say it is sad, and so our jailhouses are crammed, and so our ICUs recycle the indigents, and so we have a “homeless problem”. And so, I ask: is this “cost effective”?
Justin’s story is all too familiar to us, #theaffected. He struggled with schizophrenia. He had been medication compliant for at least 15 years but we all know that medications only lessen the severity and frequency of symptoms, they do not eliminate them. He attended TCC and was not satisfied unless he achieved the highest grade in the class on every exam. And he struggled. Some days he could not get out of bed to get to school. He did not have a car or a driver’s license, so getting to his doctor appointments, to school, or even to Publix was difficult. Justin knew enough about nearly every topic to hold his own in a conversation from history and politics to quantum mechanics but, his points of view often had a nuance of conspiracy and paranoia. His version of his own life was one spent continually saving the world from aliens and forces that we mortals could not see or understand. But if you ask his neighbors or his friends to give you one word to describe Justin, you will hear: “kind-hearted”, “generous”, “loving”, “non-judgmental”, “supportive”. Justin was always happy to see you, happy to meet you, happy to talk to you and happy to have the means to gift you something special that you always like.
So what happened? Many years ago, Justin was prescribed an atypical anti-psychotic called “Clozaril” or “Clozapine”. This was a miracle for us because it was the only medication that could control his symptoms. However, due to the severe side-effects of Clozaril, a blood test is required before each prescription refill. About two years ago, a new and experimental drug called Vraylar came on the market. His doctor at Apalachee recommended that he switch to it because, to paraphrase, “it works like Clozaril but the side-affects are not as severe and it does not require a blood test”. After his death, we have heard opinions that a patient should never be taken off Clozaril like that. But that was only part of the story. After a few weeks of this regimen, Justin complained that he had not slept in days. Clozaril promotes sleep but without it, Justin was insomniac. And so, he asked his doctor at Apalachee if he could return to Clozaril. As we, #theaffected, know all too well, an increase in dosage requires approval from the insurance company and the insurance company’s response is always to refuse, and Justin’s prescription was denied. The social workers at Apalachee fought this decision, as they must do, and eventually the insurance company FAXED approval for Justin’s Clozaril to the Walgreen’s at the corner of Monroe and John Knox. When Justin walked to Walgreen’s later that day, this time it was the Pharmacist who refused to fill his prescription. The pharmacist did not check for the insurance form that had been FAXED earlier that day, the pharmacist did not tell Justin to wait while he called Apalachee, but the pharmacist DID know the consequences of not giving a schizophrenic his medication. The social worker says that she spoke to that pharmacist and asked why he did this but, no answer was given. That evening, Justin took an entire bottle of Tylenol PM trying to sleep. He ended up in the ICU with liver and kidney failure for over a week. After stabilization, he finally got his medications but was never the same. About 6 months later he did it again. After another week in the ICU, he was stabilized and sent home. About 2 months ago he checked himself into the hospital for suicidal thoughts. He was held for 72 hours and released. While he was inside, we relayed a story to his social worker about how he had threatened a woman at a local bar the night before checking himself in; the story was relayed to us by a friend of the woman in an email. The social worker told us that he was not able to receive email so we needed to print the email and deliver it to him in person. I delivered that email and told him that if Justin was released without long-term observation to re-adjust his medications and truly stabilize him, that he would be either right back in the hospital, in Jail for danger to others, or dead from suicide. The social worker told me that he understood, but there was nothing he could do. He suggested that we take our son to court and take his rights away so that we could force long term care. This is an option that we, #theaffected, know and understand as unrealistic. A social worker told us recently of a defense attorney for the mentally ill in Tallahassee that was overheard saying: “I don’t care if they go out and kill themselves, I just want to win.” Within 3 weeks of his release, Justin took matters into his own hands and ended his life.
I could relay myriad stories like this from Justin’s life, beginning as a teenager. This was his last story. A series of all too familiar failures, from incompetence, to well-meaning individuals with their hands tied, to individuals with unconscionable behavior. It all adds up to a system that fails not just we, #theaffected, but all of us as taxpayers and as human beings.
Imagine. Justin was one of the lucky ones. He had parents who gave him a house and advocated for him all of his life. He had family and neighbors and friends that watched out for him. For those that are not so lucky, well, look around. Yes, we do have a problem.
After his death a friend was able to recover his files from his laptop. What I wanted to recover most was his poetry that he sometimes would read to me. I will leave you with this one:
What must be preserved, by Justin Dousa-Valdez
He buried his fear with a shovel and anger
He defeated his sadness with hope
And insight into his own iniquity
He wept for himself as he wrote poetry
Knowing that if he could help others cry
He could forgive himself
For some things must be said and even written
And release sometimes is death
And in the next realm is childhood and innocence
And this is what must be preserved
The Gilbert Laboratory 