Melinda Henneberger
Melinda Henneberger is a RealClearPolitics columnist based in Kansas City. She won the 2022 Pulitzer Prize for commentary and was a Pulitzer finalist for commentary in 2021, for editorial writing in 2020 and for commentary in 2019
First, is it true that “No One Cares About Crazy People” – the title of both Gail Freedman’s important new documentary and the bestselling book by Ron Powers that inspired it?
You may remember that last year on Fox & Friends, Brian Kilmeade suggested this simple solution to the problem of homeless people who refuse treatment for a serious mental illness: “Involuntary lethal injection, or something. Just kill them.” That it took him four days to apologize suggests that not everyone felt he needed to.
Or how about the situation of our active duty military suffering a mental health crisis? Surely we care about them, right? If we did, we’d demand accountability for the conditions that led to that sailor jumping off the USS Lincoln – driven to despair, his wife said, while serving the United States of America during a record number of days without a port stop. When that man told superiors he was struggling, she said, they repeatedly blew him off.
After both the Navy Times and Stars and Stripes wrote about suicidal sailors and food and water shortages on the aircraft carrier, Secretary of War Pete Hegseth said those accounts “completely misrepresented” reality. Let them eat testosterone, I guess. With no defined mission and no way to resupply, they should have brought the Lincoln home. Yet the commander in chief called the sailors’ record time at sea “not nearly long enough.”
We can be counted on to care, at least in a ghoulish way, in the rare instances when “crazy people” turn to violence. So the public is highly engaged in the murder trial of former Massachusetts labor and delivery nurse Lindsay Clancy, whose defense team says she was suffering from postpartum psychosis when she strangled her three children and then jumped out a window.
And everybody has an opinion about Nick Reiner, accused of “lying in wait” before killing his famous parents, Rob Reiner and Michele Singer Reiner, in their Brentwood home. When I see friends on social media declaring that tricky Nick can’t have been that sick because he was well enough to plan the killings and then get himself across town, I think once again that in general, we care exactly enough to blame the ill for their illness, and blame everyone around them, too: Why didn’t somebody do something?
That’s the question Freedman’s movie answers. Watch it – streaming on Apple TV and Prime Video – and, to be blunt, you will stop saying crazy things about crazy people.
You will never again assume that the family of that person you see sleeping under a bush yelling at the sky just didn’t care. Because you will have watched families over five years’ time, doing everything possible, and sometimes the impossible – there is a lot of love in this movie. You will have seen up close what serious mental illness looks like – what it requires and costs.
You will see the overwhelming desire in Mark Rippee just to live a normal life in his hometown of Vacaville, California. Mark was a handsome, happy 24-year-old riding his motorcycle home from a Father’s Day barbecue in 1987 when a car swerved into his lane on a country road and he landed in an abandoned grain harvester.
That accident blinded him, caused a serious brain injury, and in the years that followed, robbed him of his sanity as he developed schizophrenia. His family cared for him for the first 20 years after his accident. When that finally became impossible, because his voices had him starting fires and tearing down walls where he thought his tormentors were hiding, his sisters lobbied and looked everywhere for a way to get him the treatment even they couldn’t force on him.
I wrote about Mark several times for the Sacramento Bee, and when I first met him in 2022, he told me that the voices he heard were being broadcast from a military submarine using “mind warfare.” I saw how hard his twin sisters, Linda Privatte and Catherine Rippee-Hanson, tried to save him – and to change laws.
That had to happen, because as someone whose initial diagnosis was a traumatic brain injury, Mark supposedly didn’t qualify for help for his severe mental illness on a medical basis. And in Solano County, he didn’t qualify for a conservatorship based on his mental illness, either.
Though he regularly wandered into traffic, had been hit by a car twice and was often beaten and robbed on the street, he was not considered sufficiently “gravely disabled” for a conservatorship since he could still make decisions, such as they were, for instance about where to sleep.
Each California county was at that time free to interpret that term gravely disabled as meaning that anyone still able to feed himself and seek shelter – behind a building, maybe – was mentally stable enough to make decisions about his own care. Thanks in no small part to some of the advocates in this documentary, that’s no longer the case.
They never gave up
Mark Rippee never gave up on life; his sisters never gave up on him or on the possibility of change, and yet he died a few months later, of pneumonia and an untreated urinary tract infection that led to sepsis and organ failure.
I met state Sen. Susan Eggman, who wrote the legislation that expanded the definition of “gravely disabled,” at Mark’s memorial service. It only took effect this year, and should help families like the Rippees get conservatorships in the future. I met Gail Freedman, who made “No One Cares,” at his service as well, and could not be more impressed with what she has accomplished with her film.
The documentary also shows Carmelo Burgos, who has severe bipolar disorder, dancing with his young daughter, being good at his work fabricating countertops and then losing that job and their family home in Connecticut. He is not on disability because he wants to work. But at times, he’s so low he can’t get out of bed, and we see that, too, which was such an act of bravery on his part.
If you see this movie, you will be changed by it.
In “No One Cares,” you’ll also meet the Pulitzer Prize-winning writer Ron Powers, his wife Honoree Fleming, and the younger of their two musically gifted boys, both of whom were diagnosed with schizophrenia. Their older son, Kevin, who was a prodigy, hanged himself at age 20. Their younger son Dean struggles still. The horrible coda to their story, which the movie does not show, is that Honoree was murdered three years ago – shot in the head on her favorite walk on the D&H Rail Trail near their home in Vermont. Her killer has never been caught, but Ron suspects it was a random act by someone in a psychotic state. “It’s like this disease has stalked me my entire life,” he said after her death.
Yet for all of this, the film is hopeful, showing Mark’s family and others in California demanding change and getting at least some of what they wanted.
Because “No One Cares” also shows – and this part may challenge some viewers – California Gov Gavin Newsom working harder than others in public life to improve the lives of seriously mentally ill Californians and their families.
“Deinstitutionalization started 60–70 years ago,” said Dan Morain, whose book on the history of deinstitutionalization and mental health treatment in California will be published next year by the University of California Press. “It’s taken us 60 years to get here, and you can’t reverse six decades of mistakes in one or two or three years, or two gubernatorial terms in office.”
“You can agree with Newsom or disagree,” he told me, “view him as the most slick, glib politician ever to exist – but you can’t deny he’s put more effort, time and money into this than any other governor.”
He’s added $1.1 billion and 3,000 positions to the California Department of State Hospitals, “and no governor would do that,” Morain said. “He could have spent that in 100 ways that would’ve gotten more attention.”
The changes in the law Newsom has pushed for have been meaningful, too, though they’ve been watered down at every turn on their way to passage – that’s how the process works.
First was the establishment of CARE Courts, which, after referrals from a family member, first responder, or anyone, really, can order an evaluation and treatment for up to two years. These courts have no enforcement mechanism, though, and in the end did not include the option for the temporary involuntary treatment that families, as Mark Rippee’s hoped for. That’s been a keen disappointment for many families, and every effort to address that has been thwarted, as recently as last week. No one is proposing a return to warehousing, but a better care that was supposed to follow deinstitutionalization.
At a discussion after a screening of the documentary in San Francisco, Susan Eggman, a former social worker now retired from the legislature, responded to a member of the audience who said she’d been let down by CARE Court. Basically, the woman wanted to know how it had its teeth pulled.
“There was too much negotiation and too many concessions made,” Eggman responded. “The bridge wasn’t there” to involuntary treatment. But her bill making it easier to get a conservatorship “just went into effect now,” she said, and that’s going to help a lot. “Counties have to implement it, so it’s going to be long, but…we added the ability to provide for your medical care and to provide for your personal safety to the definition of ‘gravely disabled.’ So that should catch a lot of those folks who were being left untreated before.”
“And with the improvement coming to CARE Court, if you fail, you could be referred to a conservatorship,” she added.
No, that fix did not pass last week, though it was expected to, which again shows what those pushing for change are up against. Which is the ACLU and disability rights groups, convinced that involuntary treatment is in all cases wrong.
A stake in the ground
In the panel discussion, Eggman also talked about the passage of Prop 1, which authorized $6.4 billion in bonds to fund treatment beds, supportive housing and other community treatment programs. “The first money that went out is landing – every county that applied got millions of dollars to go into upfront investment for residential treatment, so construction is going on, things are being built, and counties are reorganizing how they deliver care, with a lot of changes in the last five years.”
Again, none of this adds up to the involuntary treatment that some people do need, “and that’s very disheartening for a lot of advocates,” said Mark Rippee’s sister Catherine Rippee-Hanson. Those hardest to help are still “not being helped.”
Still, “it’s huge what they did,” said Teresa Pasquini, an advocate who is also in the documentary, with her son Danny. “I was surprised that those three things passed to begin with,” she said of CARE Court, reform of conservatorships and Prop 1.
“Some people are not going to be helped with voluntary-only care – they’re just not,” said Pasquini. “The counties are claiming that they don’t have any money to do anything extra and CARE Court is too expensive – too bad, so sad. The state allowed the counties to do whatever they wanted for the last 20 years. So even though yes, they do have money, they don’t want to spend it on involuntary care.”
The fight isn’t over, she said, vowing: “We won’t be deterred.”
Yet she’s worried about what comes after Newsom, “the only governor we ever had that put a stake in the ground on this.”
“We’ve had this amazing investment in infrastructure and that’s because of Gavin Newsom and the legislature –now there’s hope,” she said. “I’m really nervous about what’s going to happen with Gavin leaving.”
I wound up spending a year at the Sacramento Bee writing mainly about people living on the street or by the river, and was not immediately won over by the governor. What changed my mind was his willingness to take on even some traditional allies on behalf of those who are seriously mentally ill.
This does not describe all homeless people, or anything close, though I would say that the chronically homeless people I met were almost always there because of some addiction or trauma beyond the loss of housing. That’s what makes bringing them back inside so hard.
‘I was in a trance’
Just think for a minute what taking on this issue was ever going to get Newsom politically: nothing. On the contrary, his efforts cost him. It really comes down to whether you see those pushing grocery carts around in circles talking to themselves as exercising their right to freedom or as people whose illness has long since stripped them of any real choice.
That question was answered for me 40 years ago. For my first newspaper project, for the Dallas Morning News, I spent three months reporting on a lovely man with schizophrenia, starting on the day he was released from Terrell State Hospital with no housing, a prescription for medicine he never took and the name of a mobile social worker he already knew well and completely ignored.
That’s not how “community mental health” was ever supposed to work after deinstitutionalization. Or in his case, during endless shuttling between the state hospital and as soon as he got better, back to sleeping under bridges and in the cemetery next to City Hall in Dallas. There was nothing in between for him, and that’s because, as in most places, money for community mental health that was supposed to be there when we stopped warehousing people for long stretches was spent elsewhere.
Maxwell Maxey was lucid and funny at first, but as he stopped taking his medication, he became convinced that we were being followed by Jews in long coats intent on killing him. This gentle person would never have willingly hurt anyone, but his voices kept telling him to get himself killed, and they almost succeeded.
I was not with him the night he pulled a knife on a cop. But when I visited him back at Terrell later, he said he’d gone after that officer at the suggestion of a voice “telling me how sorry I am and things like that. I pulled it out and told him to kill me. But I want to live as much as the next person. I was in a trance.”
So too are we if we choose to believe that those with a serious mental illness are sleeping on a square of cardboard because they choose to. In leaving them alone, or simply sweeping them from one spot to another “FAR from the Capital,” as Donald Trump ordered in Washington, DC a year ago, though all he really did was tell them to move along, then we are in effect leaving them to die – just as callously if not as quickly as Brian Kilmeade suggested.
Gail Freedman, who made this fine movie, said the experience of doing so changed her mind: “Five years ago, if someone would have asked me should anybody ever be treated involuntarily, I would have said no – I’m an old lefty – but we’re leaving people free to destroy their lives.”
Problem solved, no. But problem met head-on, yes. As Dan Morain says, we’ll know more in five years. And though I don’t underestimate the California governor’s ambition, I don’t connect this to his presidential hopes, either. Because No One Cares About Crazy People.
This article was originally published by RealClearPolitics and made available via RealClearWire.
