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From
The Dallas Morning News:
Ken and Susan Koshar (pictured) struggled for months to find help for grandson Jeremy Andrew Brown, who has bipolar disorder, oppositional defiant disorder and an intellectual disability. But he's an adult – and out of control.
Jeremy Andrew Brown has threatened to burn down his grandparents' home. The teen has run away several times. He has lived on the streets, panhandling and using drugs. And he's landed in jail three times this year.
The Koshars struggled for months to find help for their grandson, who has bipolar disorder and oppositional defiant disorder in addition to his intellectual disability.
The Mesquite couple's ordeal illustrates the complications that can surface for families trying to care for a loved one with serious mental illnesses: There's not enough treatment available, the person with the illness often rejects help, and problems boil to a crisis point – often leading back to shelters or jail.
"The system to help these kids stinks to high heaven because there is none," Susan Koshar said.
Officials who work in the criminal justice system say they see people like Brown all the time. And there aren't enough services to help them, said Ron Stretcher, director of Dallas County's criminal justice department. Texas ranks 48th in the nation in per capita spending on mental health, according to a Mental Health America survey.
"In Texas, we just don't provide for this population," Stretcher said. "There's nothing out there."
Mental health agencies cannot force people with mental illnesses to accept the treatment that is available, officials said.
"You have the freedom to make mistakes," said Dr. James Baker, chief executive of Metrocare Services, a Dallas nonprofit. "That's one of the reasons there's such a large population with these disorders in jail."
Brown's behavior worsened as he bounced between jail and respite homes. Finally, a judge sent him to a locked state institution for the mentally disabled in Mexia, Texas.
Good times, at first
The Koshars took in their grandson in 2008 because his mother in Ohio could not handle him anymore. He was in and out of several psychiatric facilities in that state and possibly suffered abuse while growing up, according to an evaluation from Metrocare Services.
Ken Koshar, a disabled veteran, and Susan Koshar, who sells advertising for an employment newspaper, said the family had good times fishing, watching movies and having playful water fights. Brown loved fishing and playing video games and attended Mesquite schools. But the bad times became more common as their grandson's behavior grew worse.
"Mr. Brown has continued to have significant problems since moving to Texas with his grandparents, seeking housing from people who supply him with drugs," a March 16 evaluation by Metrocare Services stated. The report, which said Brown has an IQ of 52, also said that Brown has "threatened to harm himself, his grandparents and 'burn the house down.' "
A letter Brown wrote to his grandparents from jail, after a recent arrest for stealing two cellphones, includes a childlike drawing of a boy crying – offering another glimpse into his mindset:
Grampa, I love you very mach and I miss you very mach and I am sarey for poting you in all this. Plees forgiv me and I mis the fun times we have together can you forgive me love Jeremy Brown.
A lack of control
A judge agreed that Brown could not take care of himself and appointed the Koshars as his legal guardians when he turned 18. But guardianship, the grandparents found out, did not give them much control. They felt left out of decisions made by the courts, social workers and the Lew Sterrett Justice Center.
The Koshars were furious in January when they found out the Dallas County jail had released their grandson without notifying them. He had served 11 days after pleading guilty to stealing the cellphones from an electronics store.
"He's going to end up dead or back in jail," his grandfather said.
Susan Koshar drove downtown to the strip of liquor stores and bail bond businesses around the jail, trying to spot the teen with carrot-red hair that evening. No luck. Brown was missing and homeless for a week.
Ken Koshar said he had delivered paperwork to the jail stating that Brown had an intellectual disability and that he and his wife were the legal guardians. County officials say they never received the documents.
Parkland Health & Hospital System staff did not identify Brown as intellectually disabled during a screening process at the jail. Brown only told screeners that he had bipolar disorder, ADHD and used "illicit" drugs, said Sharon Phillips, senior vice president who oversees jail health for Parkland.
Stretcher, the county's director of criminal justice, said intellectual disabilities can be difficult to detect because people often hide them.
"They don't want to be tagged for that," he said.
Brown eventually called his grandparents, saying he was happy living on the streets. Barely a week later, he landed back in jail, this time for indecent exposure. He allegedly exposed himself and masturbated in the shower in the women's area at the downtown YMCA, according to a police affidavit.
Susan Koshar said the teen may not have entered that area intentionally because he has trouble reading. In jail, Brown was under close watch part of the time because of suicidal behavior. He served several weeks in jail. The charge was later dismissed after he was sent to Mexia.
Request goes unmet
After Jeremy's jail time, the Koshars argued that he needed intensive treatment at a state-supported living center, formerly called state schools.
Instead, he was sent to a respite home, where a house manager watched over him and tried to make sure he took his medications. There, Metrocare staff tried to work with him on his behavior. They also took him to a mental health clinic for treatment, although it was not intensive.
Soon after Brown moved into the first home, he got kicked out after trying to sell furniture for drug money, Susan Koshar said.
Metrocare sent him to another home but he ran away several times. Staff there gave up trying to retrieve him from The Bridge, Dallas' homeless shelter.
Jeremy was missing again.
"He said he doesn't want to be at the respite home because he doesn't want staff telling him what to do," an e-mail from a Metrocare services worker to the Koshars read.
The Koshars filed a missing persons report on May 11. They discovered later that police had taken him to Parkland on May 15 before releasing him again. They finally located Jeremy on May 26 – back in jail for the third time this year.
Metrocare Services cannot force anyone to take medications or stay in a respite home, said Baker, who runs the agency.
"You have the right not to cooperate as long as you don't do something illegal," he said.
Baker said that an ideal solution would be for a judge to send offenders with mental illnesses to a residential facility that provides intensive treatment. Once the offenders meet certain goals, they could earn the right to leave, he said. But the state's mental health system does not fund places like that, he said.
One well-regarded private residential treatment center for adolescents, the Meridell Achievement Center in Liberty Hill, Texas, has contracts with several states but not Texas. The facility charges those states $480 a day. By comparison, Brown's respite house cost more than $1,300 a day – and Metrocare spent $63,000 on Brown's care between September and May, Baker said.
Transfer to state unit
Brown's arrest on May 26 for insufficient bond related to the indecent exposure charge finally gave the courts an opportunity to send the teen to a state-supported living center – the step the Koshars had been seeking after months of frustration.
Metrocare attorney Douglas Barnes asked a probate court judge on June 3 to send Brown to a locked unit in Mexia, 85 miles away. The center is one of 13 facilities, formerly called state schools, which have been plagued in recent years with complaints about abuse and neglect.
State officials signed a five-year, $112 million agreement last year after a four-year federal investigation into civil-rights violations. The settlement calls for hiring more than 1,000 new workers and drastically improving living conditions at the facilities.
The Koshars saw the facilities as their only solution, despite their past record.
Sitting next to his lawyer at the June hearing, Brown testified that he did not want to go.
"If you put me there, I'm going to end up suicidal," said Brown, who wore a blue and gray striped jail uniform. He said he liked living on the streets, where he had friends and a pit bull he said he adopted. He said he wanted the freedom to live his life and dress how he likes.
"If I want to look like a gangster, I look like a gangster," he said. "They can't run that part of me."
Brown said he made money by panhandling and used coke, methamphetamine, speed and marijuana on the streets with friends named "Shorty," "Crazy" and "Lil John."
"Please don't put me in a state school. I'm begging," he said.
Susan Koshar took the stand and said it was tough to send her grandson away – but that he needs help.
"We love that kid desperately," she said.
The judge ruled that Brown should be transferred to the Mexia facility on June 8.
Brown bowed his head on the table before being led back to jail. After the hearing, Ken Koshar hugged Susan, as tears ran down her cheeks.
From The Dallas Morning News:
