Society must care for its most vulnerable

Lifetime, I have pledged four oaths. The first three I took willingly: fidelity to my wife; service to God (and those in need), and — along with my wife — to be a "forever parent" to two orphaned Korean siblings.

On Thursday I took an oath I hoped never to take: to be the legal guardian of our adult daughter, now 35.

The Inquirer, a day earlier, ran an article on Phil Schultz who died "sitting upright on a Rittenhouse Square bench." Despite regular visits by a nephew, and the caring staff and people of St. Mark's Episcopal Church, Schultz often refused shelter or medical help. It was said he suffered from mental illness.

Some might think Schultz an anomaly. He was not.

The National Coalition for the Homeless calculates that 20 to 25 percent of the homeless are severely mentally ill (compared with 6 percent of the general population). In 2008 the U.S. Conference of Mayors estimated that one third of their homeless single adults were mentally ill. Thirty-three percent the Cook County Jail inmates (which includes Chicago) are mentally ill, making the jail the largest mental-health service provider in Illinois. Fifteen percent of California's chronically mentally ill are homeless at least once a year. Patients with schizophrenia or bipolar disorder are particularly vulnerable.

My wife and I adopted our daughter when she was 5; her brother was 4. Both were bright, curious, and fun to be with. Our daughter had a wicked sense of humor, took to the flute like she was born to it, and excelled in art, math, and chess. She loved to read.

She changed dramatically at the onset of puberty. My wife and I had had long experience with junior high students so we understood what to expect. But our daughter was an outlier on the bell curve of pubescent behavior. While academically gifted, her affect was mercurial, caustic, and defiant/oppositional. We tried counseling; she berated the counselors. We worked with a Family Systems therapist (she refused to go) to change our family dynamics.

As a high school senior, our daughter had her first hospitalization. As a college freshman, she barricaded herself in her dorm room and had to be extracted by the police. The Menninger Clinic diagnosed her as suffering from schizo affective disorder (which combines bipolar disorder and schizophrenia).

Over the past 16 years, she has had numerous hospitalizations and lived in multiple nursing/group homes. In December 2003, she was struck by a truck as she ran through traffic during evening rush hour, giving her additional problems.

Eight months ago, she was evicted from a group home. She went to a homeless shelter; she stopped taking meds. She left the shelter and roamed rough city streets at night, oblivious to her safety.

Mental-health law states that the mentally ill can only be hospitalized involuntarily if they are "a danger to themselves or others." Since June, Lily has been hospitalized 14 times, brought in by the police or paramedics. This September, working with a psychiatrist and a licensed social worker, we were able to get our daughter declared incapable of taking care of herself.

Mental illness is complex, both as an illness and a cure, involving genetics, upbringing, medical expertise, and, sometimes, luck. Our daughter is mentally ill; her brother is not.

In probate court, as we waited for the judge to hear our petition to become our daughter's guardian, there were two other cases like ours — a young man whose drug habits had made him psychotic; an elderly man whose dementia makes him a danger to himself. In all three cases, guardianship was granted.

"Wards" like our daughter are fortunate for they have resilient (and sometimes relentless) families, friends who stick by them, and care providers tenacious enough to get them the help they need. Phil Schultz had people who cared surrounding him. Unfortunately, there is a large cohort of the mentally ill who are homeless, incarcerated or both, without people who care.

We live in an age where politicians get elected by promising to slash taxes — often by cutting programs targeting the voiceless (and voteless) like the mentally ill. People like our daughter are often ridiculed as takers; their parents are maligned as people unable to "control" their child. Mental illness remains a stigma.

But the mentally ill are someone's son or daughter, brother or sister. They do not deserve to be incarcerated like criminals or added to the throwaway homeless.

Phil Schultz had a community that cared about him despite his illness; our daughter remains our forever daughter.

An advanced society would step up to the plate to take care of its most vulnerable. It's what a caring adult — and an adult society — does.

George Koch Jr. is a writer in New Hampshire.  gkochjr@kochab.com