Sunday, April 22, 2012
Youngstown
Before the Mahoning Valley knew William Bednar as the man accused of strangling and hog-tying two German shepherd puppies, he was known as a meticulous gardener.
He weeded and tilled the narrow patch of land behind the Windhaven House on the West Side, spreading seeds for peppers and constructing a trellis from which to hang cucumbers. From fall to summer, for 31/2 years, he lived at the home for those learning to cope with mental illness. The garden was his project, said the owner of Windhaven, Mark Zidian.
Gardening, Zidian said, was his life.
While staying at the 90-year-old home in 2004, Bednar controlled his mental illness, Zidian said.
Twice a day, nurses supervised Bednar taking his medication, as they do with each of the 46 clients living there today.
In the summer of 2007, Bednar told Zidian he was well enough to live on his own and left for the Phoenix House, an independent-living facility in Austintown.
There he was solely responsible for taking his medication and had periodic visits from case managers.
Less than five years later, the homeless, 55-year-old Bednar was appearing in a video arraignment in Youngstown Municipal Court, accused of killing the two pups.
Police said they found Bednar on the city’s West Side pushing a shopping cart filled with a dead squirrel, a mangled bird and syringes.
“I was shocked,” said Zidian after reading about the charges.
Bednar, his hair slicked back and speech sporadic, had difficulty answering questions from municipal Judge Elizabeth Kobly, and at the arraignment’s end, she ordered him to undergo a mental evaluation to determine if he was competent to face trial.
If found guilty, it will be the third charge against him involving abuse to dogs, and the second since January.
It is the fourth criminal charge against him in the span of four months, which includes public indecency and possession of drug instruments.
Bednar had agreed to an interview with The Vindicator but was ordered to Heartland Behavioral Center earlier in April after being found not competent to face trial, and thus, was unable to be part of this story.
Bednar’s last eight years of life are told through his letters to various Vindicator staff members, court records and professionals who knew him.
His life is not the exception. Instead, mental-health advocates said he is a microcosm of the mental-health system in Ohio.
Ohio’s mental-health system creates a revolving door between hospitalization, prison and the city streets and encourages independent living for those who actually need 24-hour supervision, advocates say.
It is a system that reacts to mental illness in most cases only after someone commits a crime, said mental-health professionals in the penal system.
The National Alliance on Mental Illness Ohio estimates that 40 percent of all homeless people in Ohio suffer from mental illness and about 100,000 who need acute supervision do not receive it.
Living unsupervised leaves the severely ill six times more likely to be victims of crime, said Terry Russell, executive director of NAMI Ohio.
In contrast, Russell said the mentally ill commit 50 percent of the “horrendous crimes” in Ohio, such as 26-year-old schizophrenia patient John Mallet, who is accused of stabbing four people at random in downtown Columbus on March 14, according to the Columbus Dispatch.
“We’ve ignored that population since they closed the state hospitals,” Russell said. “Shame on us; shame on our society.”
FUNDING CUTS
In 1988, then-Gov. Richard Celeste signed the Mental Health Act. It shifted funding and treatment from state-run hospitals to county-level health boards, such as the Mahoning County Mental Health Board.
Local boards use the funding to pay for hospital stays for those in their respective communities. But hospitalization is expensive. Currently it costs a local board $700 a day per bed at a state hospital, Russell said. Instead, boards send money to locally operated facilities, such as Turning Point’s Crisis Center in Youngstown, that provide temporary inpatient treatment but rely mostly on outpatient community care with periodically visiting case managers to check on their condition.
With shrinking budgets, state hospitals began closing, including Youngstown’s own Woodside Receiving Hospital in 1996. This left many of the mentally ill with nowhere to go but the city streets, Russell said.
Today, only six state hospitals remain and are used mostly to rehabilitate those found incompetent to face trial or not guilty for reasons of insanity before releasing them into the community.
“They can’t get better without a roof over their heads, food in their stomachs and someone who knows their name in the morning,” Russell said.
Since the recession began, budget deficits in Ohio have wreaked havoc on mental-health treatment.
Ohio lawmakers have not increased the maximum amount of Residential State Supplement, a program that subsidizes rent costs for the mentally ill, from $877 each month since 2008, according to the state Department of Mental Health.
“You can’t even find a hotel room for $28 a day,” said Zidian, who pays professionals to supervise his tenants and feeds them three times a day.
According to NAMI, Ohio lawmakers have cut $26 million, or 5 percent, from the Department of Mental Health since 2009.
Nationally, states have pulled $1.9 billion from their respective mental-health programs. That means Ohio’s decrease in funding makes up more than 13 percent of all cuts nationwide.
What that’s translated to is more strain on family members, who are now forced to provide the majority of caregiving for the mentally ill, Russell said.
FAMILY STRESSES
As the organizer for Tea and Tears, a support group in Columbus for family members acting as caregivers for the mentally ill, Rachelle Martin has heard it all: a bipolar son filled with rage pressing his mother against the wall; a husband frustrated and in tears over dealing with a schizophrenic wife; and a schizophrenic son addicted to drugs who has been beaten, stabbed and shot on separate occasions.
“Their families, they just don’t know what to do,” said Martin, who also is an executive director for NAMI Ohio in Franklin County. “They are overwhelmed.”
The support group offers tips on how to get family members into the mental-health system, where the mentally ill can be assigned a case manager, a social worker and in some cases, a psychiatrist.
She said there is a waiting list that on average takes three months to clear before treatment begins.
But before it gets to treatment, there often are hurdles in persuading family members to attend classes.
“More often than not, they’ll call and ask me about classes,” Martin said. “Yet they don’t have the courage to come.”
Some family members don’t like the stigma associated with having someone suffering from mental illness in their family. Others are so overwhelmed emotionally with taking care of the family member that they cannot get themselves to come to the meetings.
But often the biggest hurdle in the way of treatment are the mentally ill themselves, living in denial that anything is wrong.
Although Martin agrees with community-based treatment over institutionalizing against someone’s will, she thinks there was never enough money put forward to make the treatment effective.
Today, a probate judge can force someone to get mental-health treatment if proved they are a threat to themselves or someone else.
But that is a point hard to prove, sources said.
When the bipolar son released his grip on the mother in Martin’s support group, the mother called police requesting her son be taken away. But the son was calm by the time police arrived, and without proof, there was nothing police could do, Martin said.
Fed up with violence, the mother left the home.
Family members, Martin believes, should have more weight when it comes to enforcing treatment for the mentally ill, but not all the weight.
“We have to respect the rights of the mentally ill,” Martin said. “But we also need to think about the family.”
Etta Almon, a retired nurse living in Columbus who attends the support-group meetings, agrees with Martin.
Getting her 45-year-old son Leroy Almon, now diagnosed with schizophrenia and post-traumatic stress disorder, into the mental-health system was particularly difficult because he hasn’t spoken a word in 12 years.
She said when the symptoms first showed up in the late 1990s, it was difficult to get Leroy into the mental-health system.
“By that time, he had stopped talking,” Etta said. “They kept telling me he has to call, and I said he doesn’t call because he doesn’t talk.”
On four occasions she called to have a doctor come to the home and have her son diagnosed so she could receive Medicaid for his condition. Etta said she paid $275 per visit, and finally the fourth doctor wrote Leroy a prescription. Medicaid now pays for a psychiatrist and a case manager who checks in on Leroy periodically.
But when it comes to daily activities, Etta is the one that cares for Leroy.
“That was the worst thing that has happened to me,” she said of seeing her son slip into schizophrenia. “You deal with it on a day-to-day basis. You have to let go of the person he used to be and accept the person he is now.”
A Reactive System
After Bednar left Windhaven in 2007, it would be another four years until Zidian would see him again.
Zidian received a call from Bednar’s case manager, asking if he’d be willing to speak with Bednar at St. Elizabeth Health Center’s Behavioral Health ward on the sixth floor.
Upon arrival, Zidian realized Bednar “was not the same man” who made everyone laugh at Windhaven.
His hair slicked back and shirt buttoned low, Bednar spoke with vulgarity. But there was one old characteristic that still shined: Bednar’s cordiality.
He helped wheelchair-bound patients to tables so they could eat. That, Zidian said, was the William Bednar that he remembered from Windhaven.
Before leaving the hospital, Zidian asked Bednar if he’d be willing to come back to Windhaven.
“I told him, ‘You’re going to end up in jail or dead,’” Zidian recalled.
He said Bednar declined.
“I like my freedom now,” Zidian recalled Bednar saying.
“We have a reactive system rather than a proactive system,” said Linda Blum, a forensic monitor at Turning Point Crisis Center. “The only way to get [the mentally ill] to do what we want them to do is if they commit a crime.”
NAMI Ohio estimates that 18 percent of incarcerated people in Ohio are severely mentally ill.
As a forensic monitor, Blum oversees the most violent of the mentally ill in Mahoning County, those who have been charged with high-level felonies such as murder or rape, found not guilty by reasons of insanity and conditionally released into the community.
If one of her case managers feels the client has stopped taking medication, “I can make a phone call and have them arrested within an hour,” she said.
But those found not guilty by reasons of insanity make up less than 1 percent of convictions or acquittals.
There are other programs for the mentally ill who commit lower-level felonies, but for the mentally ill outside the penal system or on probation, Ohio has cut case-manager visits to 52 hours every six months for all clients, said Joe Sylvester, the executive director at Turning Points.
“That forces us to take care of the people that need us the most,” Sylvester said.
But between visits, sources said, clients not under 24-hour supervision often stop taking medication for many reasons, whether due to adverse side effects, stigmas surrounding mental illness or because the client thinks they are cured.
“It’s just like us,” Blum said. “When the cold goes away, we stop taking the medicine.”
And for managers of independent-living units, by the time they recognize a tenant has stopped taking their medication it is often too late to notify the case manager.
Homelessness
It is unclear when Bednar became homeless.
Zidian said Bednar already was homeless when he visited him in St. Elizabeth’s Behavioral Health ward in the summer of 2011.
But court records reveal he was officially evicted from his last known address at the Phoenix House in Austintown on Nov. 23, 2011.
Greg Moore, the manager of Phoenix House, would not comment specifically on Bednar or what triggered the eviction, citing Department of Housing and Urban Development rules on tenant privacy.
But the paperwork to begin eviction was filed Nov. 3, one day after authorities said Bednar stole a dog from a nearby Austintown home and chained it to a tree in the woods behind Phoenix House.
Five days later, Austintown police found Bednar lying on a bench in front of Phoenix House with his genitals hanging out of his pants, according to a Vindicator article from that time. He was charged with public indecency and animal abuse.
“If you house the disabled, which includes the mentally disabled, you’ve got to have proper support,” Moore said.
Right now, he said the support in housing the mentally ill does not exist.
“You don’t know the last time they took their medication or the last time they met with their case manager,” Moore said. “When you do find out, a lot of times it’s too late.”
In early January 2012, Bednar was convicted of both public indecency and animal cruelty after refusing to cooperate during his mental evaluation, according to court records.
He was released, and days later, authorities said he strangled a pair of German shepherd puppies, hog-tied them and left the carcasses in the grassy boulevard in front of the Western Reserve Transit Authority terminal in downtown Youngstown.
Authorities said due to his past, he was a person of interest almost immediately. But to those who knew him at Windhaven, it seemed unbelievable.
Hope
Gov. John Kasich did place some focus on housing the mentally ill in his midbiennial budget released in March.
In it, the only department slated to receive a funding increase was the Department of Mental Health, pegged at $3 million. The governor also earmarked $10 million of his $1.74 billion capital-improvements budget toward housing the mentally ill.
“I see a light at the end of the tunnel,” Russell said. “I think we are starting to see more attention put toward people like William Bednar.”
Bednar agreed by letter to an interview with The Vindicator but at an April 5 hearing was deemed not competent to face trial and was ordered to Heartland Behavorial Center for rehabilitation.
“I am kind of depressed when I read some articles in The Vindicator ...,” said Bednar in a series of letters to Vindicator staff members.
His love for music and for the city are made clear from those letters.
“ ... I have lived in Youngstown 55 years and proud to say I did not pull up roots even though many things have been said about me!!!” he wrote.
As for the Windhaven House garden, which has sat untouched since Bednar left in 2007, residents there plan to start it again this summer, Zidian said.