Editor’s Note: This is the first story in a three part series. The names of family members in this story have been changed to protect the identity of the subject and the family.
June Smith’s son, Sam, grew up healthy and happy. He was the easiest of all five children she raised.
A go-with-the flow kind of children, he often left his outspoken siblings have their way.
“He was a leader in high school very outgoing….loved the lord,” she said.
Then at 21, someone close to Sam died, and that started him down a path that would eventually lead to his arrest on several counts of aggravated assault with a deadly weapon – family violence in March of 2020.
In April of 2021, an order of criminal commitment was entered in the cause due to incompetency. Sam has been in the Grayson County Jail for almost two years.
Sam Smith is now on a list to get a bed at a state hospital.
In the Texas Health and Human Services’s 2020-2021 semi-annual report for mental health services which was presented in April of 2021, in the first two quarters of 2020 there were more than 840 people waiting for beds in non-maximum security forensic state hospitals. And the average wait time was more than 120 days.
During the same time period, there were more than 550 people waiting for beds in maximum security forensic state hospitals, and the average wait time was more than 340 days.
But, the Smith’s introduction to mental health services started before 2021 and the need for placement in a state facility.
June Smith said the family didn’t know it at the time, but during her son’s first semester back at college after the death of a friend, he struggled with depression.
“He was told by a peer that marijuana would help with the depression,” she said.
Sam tried it.
Looking back, the Smith family now wonders if that triggered the bipolar disorder he has now been diagnosed with. June Smith’s father lived with mental illness, so she wasn’t exactly unfamiliar with it.
As defined by the National Institute for Mental Health, bipolar disorder is a mental disorder that can cause shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. The disorder was formerly known as manic-depressive illness or manic depression.
“I always believed in my heart that nurture won over nature …. that a loving home, a godly home, stressing integrity and character and doing the right thing, loving all of that would win out,” she said. “I always believed that.
“When I would hear about things that would happen in other homes, I would wonder what those parents were like. That is awful to say, but before this happened to us. I always wondered. But, boy when it happened to us, you see that the mental illness is very very real. It is genetic.”
The Smith family didn’t even really realize what was going on when her son had his first episodes. But then, the episodes got more frequent.
She said he would have a couple of episodes a year and they could last for months.
During that time her son who was able to earn a master’s degree in communication, but then he become so unstable he couldn’t keep a job. She said episodes brought on periods of euphoria and mania where thought he could do anything, but they also brought about bouts of aggression where he was easily triggered.
At times, he threatened his parents and others.
According to NIH, mood episodes can last from days to years in some individuals. Without proper treatment, a hypomania can lead to severe mania or depression.
Looking for a treatment
He wanted help sometimes, she said.
“He got a book on how to treat mental illness naturally and the book recommended (mushrooms),” June Smith said. “That’s when he went off the deep end.”
The family had Sam placed in treatment facilities three times.
The 2020-21 General Appropriations Act, H.B. 1 appropriated $59,055,770 to address waiting lists and increase outpatient mental health treatment capacity at Local Mental Heath Authorities and Local Behavioral Heath Authorities including North Texas Behavioral Health Authority which serves Dallas-area counties and Texoma Community Center which serves Grayson, Cooke and Fannin counties.
June Smith said one time Same had his bags packed and was ready to go, but the facility turned him away.
“Because when he is manic, he can fool people,” she said.
She added that on the same day they turned him down for that facility, he threatened to kill himself.
Other times, the family had him in a facility, but it wasn’t a good fit. He later went back to the same facility, and things were better. But, it was very expensive and short term.
“It is a very difficult fine tuning game,” she said about finding the right doctor prescribed medications, dosages and willingness to take medications that have their own side effects.
On medication, Sam was flat and emotionless.
While in jail, Sam stopped eating and speaking. He withdrew into himself and wouldn’t take visitors. Jail staff have offered him medical intervention, June Smith said. But in his current state, he refuses it, and jail staff don’t have the legal authority to make him take medication.
Sam has not signed paper work that would give his parents the rights to make decisions for him.
Additionally, rules meant to safeguard his privacy, like HIPPA, mean his family isn’t even entitled to regular reports on his condition.
“Basically for a long time, we had zero information about him and his well being,” June Smith said. “And that’s not right. But I would say that due to the Lord himself, we have come across some individuals who have been able to share a little with us. It is our belief that he is being cared for and protected so that he is not harmed by the other population…He is in isolation.”
And there he is likely to stay until he can get a bed in a state hospital.