Behind the Yellow Door Profile

A couple of weeks ago there was an impressive series on the impact of severe mental illness on a family.  Lora wrote up a nice summary of the article and we link to it here.  It dedicates a lot of Washington Post ink to a detailed look at a well adjusted husband's decent into madness. 

A man lives alone behind a yellow door in suburban Maryland. He shuns his wife, refers to his sons as ‘’suns’, ignores phone calls from his father, shuts all the blinds, and never accepts visitors inside. Certainly, one would expect an intervention from the family, friends, neighbors, etc. who have been reaching out to him, but nothing happens. The man has stayed behind the yellow door for two years now and shows no signs of coming out.

Despite his alarming behavior, the man behind the yellow door is relatively healthy and clean. He still tends to the lawn and keeps house. Despite the fact that he shows symptoms of schizoaffective disorder, he cannot be declared dangerous. As a result, he cannot be involuntarily confined to a hospital. He is not desperate or dangerous enough to meet the high standards for involuntary commitment to a mental hospital, and as a result, his family and friends are forced to simply stand by as his erratic behavior worsens. And worsen is exactly what they hope will happen. A psychiatrist recommends that his parents cut him off financially so that he will be forced into desperation, his sister hopes he becomes homeless, and his wife even admits that she hopes he will attempt suicide and fail. In a twisted way, they are only hoping for the best … because unless this man worsens, he may never get better.

Half a century ago, there existed a state of constant fear of psychological diagnoses and mental treatment. Rebellious children, loud-mannered women, immigrants, homeless people, and the like faced incarceration in a psychiatric ward where they were subject to ‘treatments’ of various inhumane natures. Then, a 1975 Supreme Court case changed the system. The ruling established a higher threshold for involuntary commitment to mental institutions and effectively safeguarded the sane from involuntary imprisonment. Now, forty years later, the tables have turned, and instead of worrying about wrongful confinement, people are finding it harder and harder to get into these hospitals in order to seek medical treatment.

That is to say, untreated mentally ill persons are left unaided, homeless, or, in the worst case scenario, left to deteriorate until they reach a breaking point. Today, we hear about large-scale acts of violence in which the perpetrator was reported to have shown signs of mental illness and in which family and friends failed to effectively seek treatment for the shooter. The signs of mental illness were all there, but due to subtle wording of federal legislation, treatment was kept out of reach and violence followed. We no longer fear the witch hunt atmosphere fueled by 20th century psychiatric standards, but instead, we fear for the people who desperately need treatment will be ignored when they could have been helped. We fear the violent psychological breakdowns and imminent suffering that could have been prevented.

Advocates are pressing for a bill to change Maryland involuntary commitment law. They wish to alter the wording of the law so that, to be eligible for involuntary commitment, a person does not have to ‘present’ a danger to himself or others but is only ‘reasonably expected, if not hospitalized, to present’ a danger. [Ohio has stepped forward to pass changes in the involuntary commitment--we will post the changes in a future post.]  Some oppose these changes, arguing that the new language would enable a roundup of the homeless, economically unstable, and the like. We would return to the ‘darker days’ of hospitalization. Would it be worth the risk? Is hospitalization the solution?

As the debate for these legal changes continues, the man behind the yellow door completely cuts off contact with his family. After two years of being a recluse, he leaves the house and is now somewhere on his own. His family loves him and would do anything to help, and for better or for worse, they let him go.

by Lora Zuo

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