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Some victims refuse help

Last modified: 9/28/2011 12:00:00 AM
In September 2006, Clyde Gauntt's family sent him to live at a Loudon campground, making him homeless. It was part of a plan: Gauntt, 54, had suffered from bipolar disorder and alcoholism for years, and his family had been trying to get him admitted to the state psychiatric hospital and managed by Riverbend Community Mental Health.

But they were told Gauntt didn't meet the criteria for treatment, partly because he needed to be sober. Taking the advice of a police officer, the family forced Gauntt from his elderly mother's house and got a no-trespass order, expecting he'd violate it. The officer had told them if Gauntt was homeless when he was arrested for trespassing, he'd have a better chance at emergency psychiatric care.

The plan went horribly awry a week later.

Gauntt appeared at his mother's East Concord home as predicted, and the police responded. But Gauntt was armed with a knife and lunged at a Concord officer, who shot him twice in the torso, killing him.

Five years later, the family still asks why it wasn't easier to get psychiatric help for Gauntt. This year, New Hampshire police officers have shot five people while defending themselves or others; four of them, like Gauntt, were in a mental health crisis at the time.

Those incidents have resonated with Gauntt's family.

"Why is this happening to people?" said Gauntt's sister, Kelley Nault of Concord. "Why are people not getting their meds? Why are the police being put in this position?"

Questions like those are not asked or answered in the state attorney general's reports of officer-involved shootings. Nor have this year's shootings generated a public discussion among the state's mental health community, despite their frequency. They have, though, illustrated significant obstacles to treatment and the limits to even the most intense care.

One shooting victim couldn't afford his schizophrenia medication. Another never sought treatment because he didn't recognize his own acute paranoia. A third victim was hospitalized twice but misused medication once she was released. Counselors were monitoring the fourth man almost daily.

No matter their experience with treatment, they had this in common: They put themselves in the line of police fire.

 'Like a zombie'

Wayne Martin Jr., 29, was under such close care that his Riverbend counselor had someone watch him take his medication six days a week. It was more supervision than Martin liked, and he responded by skipping a medication appointment on March 1.

Concerned, Riverbend staff asked the Concord police to go by Martin's Garvins Falls Road apartment the next day and return him to the state psychiatric hospital. After the police arrived and attempted for hours to convince Martin to come with them, he charged at them with a hatchet. Two officers fired and killed Martin.

Martin's sister, Grace Martin of Franklin, said she later found pills stashed under her brother's bed when the family cleaned out his apartment. She knew her brother hated taking the medication, and she understood why. "He'd be like a zombie, pretty much," she said. "Who wants to feel dead even though they're alive?"

For one of the others shot by the police this year, money stood between him and his life-saving medication.

Chris Seksinsky, 39, of Winchester, lost his job earlier this year and had stopped filling one prescription because he couldn't afford it, his brother, Tim Seksinsky of North Carolina, said.

On June 27, Seksinsky's landlord called the police after Seksinsky's wife told him her husband had a knife and was suicidal. When officers arrived and told Seksinsky to drop the knife, he instead stood up and walked toward them, the state attorney general's report said. Seksinsky didn't respond to police orders to drop the knife, or stop, even after three officers fired their Tasers at him. A fourth officer fired his handgun, killing Seksinsky.

Seksinsky's wife could not be reached for this story. His ex-wife, Arlene Seksinsky, said she had handled Seksinsky's prior suicidal episodes by calling his therapist instead of the police.

"He tended to cycle through his illness, meaning it wasn't a problem all the time, mostly in extreme stress," said Arlene Seksinsky, who had been married to Seksinsky for 13 years. "I would typically let him have his space, and I would call his therapist to talk him through it. There were times he just needed to be alone to process his thoughts."

Community mental health officials interviewed for this story fear cases like Seksinsky's are becoming more common with the worsening economy. If someone loses a job, he or she loses not only a paycheck, but often insurance benefits too that make medications affordable. Elaine de Mello, an educator with the state chapter of the National Alliance on Mental Illness, said the police and homeless shelters have increasingly become the first point of contact for people with mental illness and no money to get care.

There's a reason: The police and homeless shelters do not charge for their services. They're available 24 hours a day. And they don't turn people in crisis away.

The National Alliance on Mental Illness, which relies on volunteers to take calls, is also hearing from more people in need as state budget cuts have forced the state's 10 community mental health centers to lay off paid counselors. The volunteers receive training, but they are often not licensed clinicians.

"We are getting more and more calls, and more of them are crisis (situations)," de Mello said. "When we thought it was bad 10 years ago, it's far worse now."

 'Doctor shopping'

Access to medication is not always the obstacle.

Shelly Naroian, 47, of Hillsboro was filling more prescriptions than was good for her, according to her family.

Naroian was shot and killed in May by a Hillsboro police officer responding to a call for help from her husband, who reported that his wife was armed and threatening to kill herself. When the officer stepped through the front door, he came face to face with Naroian, who was sitting on a couch with a gun aimed at him, according to a state report. She refused repeated orders to put down the gun and was shot once in the neck.

Like Seksinsky, Naroian had a history of mental illness, in her case bipolar disorder and depression. She had admitted herself to private hospitals for psychiatric care twice, most recently last winter. She stayed for 11 days both times because her insurance wouldn't pay for additional days, according to her husband, Jim Naroian. He believes both stays were too short and thinks the hospitals and insurance company share responsibility for her death.

Naroian, though, had little difficulty obtaining medications, according to her family. They said she was "doctor shopping" and getting multiple prescriptions from doctors unaware of her scheme. Naroian's family also suspects she was taking medication prescribed to others, including her mother.

Many mentally ill people drift through life without contact with psychiatrists or counselors. And some have no family members to look after them.

Larry Minassian, 51, of Salem, suffers from such acute paranoia that he risked his own life with a call to the police on Jan. 6. He believed a former roommate was setting him up on drug charges, and that the Salem police were ignoring his proclamations of innocence.

Determined to get their attention, Minassian called the police and threatened suicide, according to the state's report. He then met officers outside, with a 12-inch sword in one hand and a Bible in the other. When he advanced toward the police with the sword, he was shot six times.

Minassian lived but lost his left leg. He now faces criminal charges for the incident, and his lawyer is hoping psychiatric care will be part of the case's resolution. But even if it is, the deaths of Naroian, Seksinsky and Martin show there will be obstacles to getting well.

 A question of rights

Minassian had exhibited symptoms of mental illness before but had never seriously pursued treatment. Had someone else recognized Minassian's illness and tried to have him hospitalized against his will, there is a good chance that person would have failed.

With the intention of protecting the rights of people with mental illness, state law has made it very difficult for families or the police to have someone involuntarily admitted to the state hospital. The person must be a danger to themselves or someone else.

"It's a huge challenge," said Louis Josephson, chief executive officer of Riverbend. "I'm very empathetic with families. . . . People, even with serious mental illness, have rights. If somebody's ill, but they're not an absolute danger to themselves or others, we can't always hospitalize them."

There is a similar threshold for getting even outpatient psychiatric care from a community mental health center.

"The state imposes what are called eligibility criteria on us," Josephson said. "If somebody is impaired by their mental illness enough, we have to serve them regardless of their ability to pay. If they're not impaired enough, they don't have access to that for free."

The Gauntt family believes that if Clyde Gauntt had health insurance, he would have qualified for treatment from Riverbend. When his mother, Louise Jobin, was told he didn't meet the criteria for case management, she said she asked the Riverbend worker: "How do you spell that? M-o-n-e-y?"

"He said, 'You got it,' " Jobin said.

Her daughter, Kelley Nault, remembered being told that her brother had a dual diagnosis - bipolar disorder and alcoholism. And if counselors can't prove that patients' erratic behavior is the result of mental illness and not alcohol or drugs, those patients don't qualify to be treated with the federal money received by the mental health center.

If Gauntt had qualified, his family believes his life wouldn't have ended so abruptly.

But looking back on his death, Nault doesn't know what more her family could have done to avoid his tragic ending.

"I've asked myself, over and over again, what could I have done differently?" she said. "I honestly can't tell you what I would have done."

(Annmarie Timmins can be reached at 369-3323 or atimmins@comonitor.com. Maddie Hanna can be reached at 369-3321 or at mhanna@cmonitor.com.)


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