In 2005, the city I lived in at the time was rocked to its core when a man with a mental illness lost control; lost his ability to communicate effectively with his family, with his mental health providers, and with hospital workers.
Within 18 hours, six people’s lives were changed forever, as were those of the family members of the six, as well as an entire community and, perhaps, a nation. It started early on a warm summer morning, when the first victim, a 54-year-old grandfather, who worked for the State Department of Transportation, arrived at work for his 6 a.m.
shift. He was shot to death, in the back, at close range. After this early morning shooting, the accused killer walked in to the local hospital where he had been treated for years. He was clearly upset—asking for help, making threats to hospital workers, and demanding an appointment. When turned away, he phoned a number to a state agency that manages health care programs. He made an appointment to meet with his caseworkers later that afternoon. Within less than an hour, the accused killer called the state agency again. He was angry, he was agitated, he wanted help. He left a threatening voice message stating that he had a list of people he wanted to kill. He never arrived for his appointment with his caseworkers. Later that day, just before 5 p.m. closing time, the same man went to a motorcycle shop and killed two more people, both employees of the motorcycle shop: a 17-year- old high school student with a bright future and a 26-year-old newlywed and father of a newborn son. The recorded 911 call from the 17-year-old is chilling. After more phone calls by the accused killer to doctors, therapists, and a local hospital, police were dispatched after 9 p.m. that evening to do a “routine” pickup of and hospital transport for a man with mental illness. The connection between the daytime murders and the standard pickup/ transport had not been made at this point. A belt recording of one of the officers lasted for 23 minutes. Seven minutes later, one of the officers made a frantic call: “Shots fired! Officer down!” Both veteran police offers, who recently rejoined the police force after retirement, were shot dead—one in the head and the other under the armpit of his bulletproof vest, straight through to his heart. The accused was apprehended just minutes after midnight. He continues to stay incarcerated, deemed unfit to stand trial. “It was one of the worst days in the history of the city, without a doubt” (Wilham, as cited in Stafford, 2007, para. 230).Within any 1-year period, mental health disorders directly affect about 20% to 26% of adults in the United States (Kessler, Chiu, Demler, & Walters, 2005; Substance Abuse and Mental Health Services Administration [SAMHSA], 2012). The impacts of these disorders also have far-reaching effects on family members, friends, and communities. Although the true story above has extremes, it also has events that are very typical in the lives of people who live with mental illness; family members who do not know what to do to help, individuals with mental illness who are not able to communicate the extent of their isolation, fears, and needs; and the sometimes inexplicable behavior of people who live with mental illness, which often leads to conflict within families and other interpersonal relationships. After providing some margins to this chapter, which include definitions and descriptions of mental disorders, and specific categories of mental disorders referenced within this writing, this chapter explores the role of race and ethnicity on mental health, the relationship between mental health disorders and family conflict, as well as practical suggestions for providers and families. Throughout the chapter, the opening story and another family’s story are referenced in an effort to illustrate how the research findings and definitions are manifested in specific cases.