Mental Help

I can still see him after all these 25 years, the former stockbroker whose life had been shattered by his tormenting mental illness. I can still hear his shaky voice, I still wince at his trembling hands, and I still want to cry when I think about what he told me.

I met him in a fleabag apartment in Central Phoenix, where he lived now and then: a tiny room with one chair and one twin-sized bed and a drape stretched against one wall for a makeshift closet. Certainly not the type of place you’d find a guy who once made a six-figure income, drove a sports car and had a hefty bank balance. But that was before the schizophrenia stole everything away. Now, this was all he had.

The man who was then the public fiduciary for the mentally ill of Maricopa County, Charles Arnold, took me to meet him. Arnold’s name will forever be remembered because he eventually sued the state of Arizona for its inaction and neglect of our citizens who have broken minds – a suit that forced the state to act and is still being “monitored” by the courts.

But on that day a quarter-century ago, Charles Arnold hadn’t yet sued. He was still in the trenches, just beginning to focus a spotlight on the problems, and I know I wasn’t the only reporter he took in hand to see the issue through the tortured lives of real people. Like this man, a guy who established a criminal record just so he could get the medications that kept him from killing himself.

I remember the man was so very polite – he offered me the only chair while he sat on the bed and Arnold leaned against the wall. He haltingly told me how he’d lost everything to the disease that had invaded his mind. He’d been confined for several years in the state’s mental hospital at 24th Street and Van Buren, but had been discharged because the new vogue in mental health was to release patients into “community” facilities.

It was a good theory – better to integrate than segregate – but the problem was, there were no community mental health facilities. And so, like this frightened man, they ended up in flop houses, or homeless on the streets, or caged in jail, forced to make it on their own, bewildered by a society that neither understood nor wanted them.

In his illness, he had actually developed an amazing survival technique. He used it whenever he ran out of medication and the money to buy more – when his only hope was to get himself committed again to the state hospital.

This man would eventually rob what was then First Interstate Bank on Washington Street. He’d hold his hand in his pocket as though he had a gun, would demand money, and then would walk out of the bank with the few dollars the clerk handed over. The police would arrest him at the corner, where he always stopped to obey the traffic light.

He told me he’d done this three or four times, and it had always worked – the courts always sent him back to the state hospital for “observation,” where there was hot food and the medication he so desperately needed. But then he’d be released again, and eventually his meds would run out. This man might not be able to see the obvious danger of the “solution” he’d crafted, but Arnold certainly could; anyone with a functioning mind could.

I used that man’s pitiful tale to tell a story on the problems of the mentally ill in Maricopa County and how Charles Arnold was desperately trying to get them help.

I hadn’t thought of that sick man in years, but his face and his trembling hands and his sad story were with me the morning I walked into Toby House.

This is where it all began, and it still stands as the citadel of caring. But few remember how far we have come, or what it took to take those first steps, and those are stories we should never forget. Not now. Not ever.

Toby House was Arizona’s very first residential treatment center for citizens with mental illness. When it opened its doors 34 years ago, it was one of the first facilities in the entire nation.

It’s apropos that Toby House is a home, because home is where mental illness strikes the hardest. We’re into the second decade of seriously trying to deal with the treatment and cost of mental illness in Arizona, but it’s not in the statehouse that the real pinch is felt – it’s in homes with mothers and fathers, brothers and sisters, grandparents, and all the rest.

Having a mentally ill family member is often like having a house on fire – nothing else much matters while the flames burn. Your entire resources – time, money, love, attention – are focused on the sick person, often to the detriment of everyone else. It’s not only emotionally exhausting, but also financially devastating. No one can be surprised that many families fall apart under that stress.

And until Toby House came along, these families were totally on their own – there wasn’t a firefighter to help fight the blaze.

The story of how Toby House came to be is a testament to the “power of one.” Not that Toby Citron did it all by herself, but she was the “one” who led the others to make it happen.

Toby was a hometown girl – her father owned the Goodman’s Corners department store in Downtown Phoenix in the 1930s – who married and raised her family under the theory that life’s rewards come from help-
ing others. She was active in many civic affairs, and in the 1960s served on the Phoenix Board of Adjustment. That’s where she first learned about the plight of the mentally ill from the new “de-institution movement.” She was appalled at the squalor of the boarding houses that were their only options besides the streets; she was upset at how poor these fragile people were and how food and medications were always in short supply. She was disturbed by how the community had tried to ignore this problem.

She joined the Maricopa Mental Health Association, and in 1969 was its Volunteer Woman of the Year. Soon after, she became president of the association.

Just as Charles Arnold took me by the hand to understand, Toby did the same with newspaper writers of the early 1970s, including Phoenix Gazette columnist Gladys Bagley and Arizona Republic medical writer Julian DeVries. Their stories clearly laid out the plight of the mentally ill and promoted what came to be known as Toby’s Dream: a residential facility where the mentally ill could not only be safe, but could build a new life.

As a history of the facility notes, Toby “began to preach her dream – she made speeches to groups, to individuals, to corporations, to clubs, to churches, to any organization that would listen.”

One supporter was Louise Stewart, who once owned the Camelback Inn. She invited friends to her home in 1972 so Toby could explain her dream. Afterward, one of the women asked Toby if she’d go to lunch so they could continue the conversation. Toby didn’t know the woman, so her good graces chose an inexpensive restaurant in case the woman couldn’t afford more. That’s how the legendary meeting between Toby and Future McDonald – perhaps the wealthiest woman in Phoenix at the time – came about at a Guggy’s restaurant.

By the end of lunch, Future had pledged $125,000 to make Toby’s dream a reality. That money purchased a large Tudor-style home on Willetta Avenue in Downtown Phoenix. Toby wanted to name it the “House of the Future” in honor of Future McDonald, but Future insisted it be named for the person whose dedication and persistence had brought it into being. So it became Toby House, and to this day, Toby Citron is active on its board of directors.

The first five residents moved in on January 8, 1973. There was no paid staff at first, because there was no extra money. Toby and Bob Huffman, who’d serve as the first executive director, did everything – he slept there on a cot each night, they both cooked and cleaned, and they also did anything else that was needed.

That obviously couldn’t go on forever, and true to her nature, Toby found a solution – she formed a women’s guild that became the bedrock for fundraising, and it’s still helping to this day.

Today, Toby House is not just the Tudor, but a network of 12 residential facilities across the Valley, as well as seven federally financed apartment buildings for independent living. They also have an outpatient day treatment facility and a vocational rehab program that offers a client-run lawn and cleaning crew and retail training in the Toby House Thrift Shop.

In 2004, Toby House served about 400 clients and had a budget of $4.6 million. Its programs are licensed by the state and financially supported by Value Options, the Regional Behavioral Health Authority, the Volunteer Nonprofit Service Association (whose annual book sale is a major help) and by grants and contributions.

All that started with one woman who couldn’t turn her back on the most vulnerable people in our community.

“Mental illness represents our shadow – people don’t get into this unless they have to,” says Raymond Grey, executive director of Toby House since 1984. “They’re always seen as a burden without much reward.”

He wants the public to start seeing not the burden but the person who is struggling with an illness.

Grey doesn’t wear any blinders when it comes to dealing with the politics of mental illness, and he admits it gets mean sometimes – “we’ve been treated like a bunch of dogs in the yard” – but he says the fight is worth it.

“There is a constant struggle on how much money to put into this,” he says. “Typically, most governments say none. Our history of caring has always been poor.”

And that history is so poor that it took Charles Arnold’s lawsuit – filed in 1981 but not decided on until 1989 – to force the state to care for the mentally ill. By then, the Arizona Supreme Court had found that this state was last in the nation in providing services to the chronically mentally ill.

Things have improved significantly since then, which isn’t to say they’re fine – The Arizona Republic reports that 85 percent of the mentally ill in Maricopa County still don’t get the services they need – but at least they aren’t swept under the rug anymore. Arizona has seen some truly dedicated public servants and elected officials who have stood up to this responsibility – don’t we wish everyone were so enlightened – but any attempt to slack off is met with fierce opposition by the Center for Law in the Public Interest, which is a tireless advocate for the mentally ill.

Grey says that kind of advocacy is needed, because he fears that without it, the Legislature would shut down the mental health programs “in a heartbeat.”

“I’d like to see our state government make a genuine commitment,” Grey adds. “The government made a commitment to get us out of a lawsuit – I’d like to see a commitment to get the job done right, not just to get by.”

And he can tell you all the numbers:

• One-fourth of the inmates in Arizona prisons are on some kind of psychotropic medication or have been diagnosed with a serious mental illness, mostly for crimes they committed because they were not being treated for their illness.
• On any given day, about 4,200 severely mentally ill residents in the state of Arizona are homeless – more than 1,500 in Maricopa County alone.
  Mental illnesses are more common than cancer, diabetes or heart disease – they are not, he stresses, the result of personal weakness and cannot be overcome through “willpower.”
• One in five families is affected by mental illness.

If he could, Grey would repeat that last point again and again. Because here is the bottom line: “These are our sons and daughters, our mothers and fathers.”

It would be easy to throw up your hands and say an issue as big as mental illness is too much to deal with. But that isn’t true. Toby Citron certainly did not believe that. Neither do I. So here are seven things on the Toby House wish list that give you an idea of how you can help:

• Move-in makeover donations: Donate pots, pans, dishes, utensils, linens, towels and toiletries.
• Welcome baskets: Give hospitality gifts including any non-perishable food baskets, supermarket and salon certificates, plants, and magazine or newspaper subscriptions.
• Adopt a Toby House: Upgrade an existing facility with paint, carpeting, new furniture and artwork, or help furnish a new facility.
• Day treatment Picassos: Replenish the art supplies at a Toby House.
• Start fresh: Provide build-outs for new offices, or donate fitness equipment, TVs, videos and games.
• Brighten our smiles: Donate dental services for clients – a constant need.
• Volunteer: Everything from joining the board of directors to helping in the thrift shop to supervising client outings.

There’s something everyone can do.

For more information on Toby House, call 602-234-3338 or visit tobyhouse.com.