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Long emergency room wait wears on N.H. mental health patient, family

  • Monique Miller speaks during an interview last week about navigating New Hampshire’s mental health system for her son, Tyler, who has schizophrenia. ​Elodie Reed / Monitor staff

  • Monique Miller speaks last week about navigating the state’s mental health system for her son, Tyler, who has schizophrenia. ​Elodie Reed / Monitor staff

  • Monique Miller speaks during an interview Thursday about navigating New Hampshire's mental health system for her son, Tyler, who has schizophrenia. ​Elodie Reed—Monitor staff

  • Monique Miller gets emotional as she speaks during an interview Thursday about navigating New Hampshire's mental health system for her son, Tyler, who has schizophrenia. Elodie Reed—Monitor staff

Monitor staff
Published: 2/27/2017 12:31:04 AM

Finally, the worst seemed over for Tyler Miller.

The 23-year-old had recently gotten his first job in the community, filling coffee orders at a local Dunkin’ Donuts and living in his transitional housing unit in Concord.

When his family saw Tyler in early December for a birthday celebration, they marveled at how well he was doing.

“He’s so happy and healthy-looking,” his mom, Monique Miller of Londonderry, remembered thinking.

But the voices in Tyler’s head – the ones telling him to take whatever sharp object he could find and slice into the flesh on his face, neck and arms – were back.

He was admitted to the Concord Hospital emergency room’s Yellow Pod in late January after the paranoia and delusions brought on by his schizophrenia had become too much to bear. There, Tyler waited for 18 days for a spot to open up in New Hampshire Hospital – the state psychiatric hospital, where he is still being treated.

Tyler is no stranger to the state hospital or the Yellow Pod. He’s been more than 30 times, his mother estimates.

His illness is so severe, he usually waits just a couple days before being transferred.

But this time was different. Two days turned into four, which turned into eight.

“I thought for sure, Monday, it’s got to be,” Monique Miller said. “And then Tuesday, and then Wednesday, and then Thursday. He was unrecognizable on the phone.”

On Day Eight in the Yellow Pod, Tyler couldn’t take it anymore and pleaded to be discharged.

His family and doctors agreed, but he was back in the emergency room less than 24 hours later, as the delusions persisted.

He stayed confined to a tiny room in the Yellow Pod, deteriorating rapidly, for another 10 days before a bed finally opened up at New Hampshire Hospital.

Monique Miller is quick to say she has no complaints about Concord Hospital’s staff, who treat her son with care and compassion. Compared to some of the other emergency room psychiatric units her family has been to, she says the Yellow Pod is like “the Ritz-Carlton.”

Still, the environment is difficult to endure, especially for long periods of time.

During his last stay, Tyler was agitated and paced frantically back and forth in the Yellow Pod, monitored by cameras. He was upset that the door to his room was marked with red tape, a sign for aggressive patients.

A small television in the corner of his room blocked off by a sheet of Plexiglass only made his condition worse.

“He can’t watch TV when he’s sick,” his mother said. “The TV’s telling him to do things.”

The noises of other patients yelling and banging on the walls increased his anxiety and set him off.

“That would be Tyler’s biggest complaint,” Monique said. “He can’t handle the noise, he can’t handle the banging, the screaming. And this has nothing to do with his mental illness, this is just directly related to being there.”

Monique said the sheer length of her son’s wait is something they’ve never before experienced; he’s usually out in a couple of days.

“Something is very, very wrong, and that scares me,” she said. “What are the other people, who I guarantee are not as bad as him, what are they going through?”

A painful life

When Tyler was a young child, he used to tell his parents that a black cat was following him everywhere, making him afraid to go play outside.

“We just thought, overactive imagination,” Monique said. “He was scared, he’d see devil’s faces on the wall. ... We just thought it was him just being a child and being on all these medications, off medications.”

Tyler was diagnosed as bipolar and ADHD as a child. He once told a doctor he could hear a radio in his head, but the doctor said he was too young to be diagnosed as schizophrenic.

Schizophrenia is a serious mental disorder that usually surfaces during teenage years and causes people to hear voices, see delusions and become paranoid that others are out to get them.

Tyler’s mental illness turned into something far more serious around the ages of 14 and 15.

The first sign something was terribly wrong was when his parents found him passed out on the floor, nearly dead, after drinking every bottle of liquor in the house.

The voices were getting worse, telling him to hurt his family. He didn’t want to do it, so he started hurting himself instead.

“That’s how he always is and how he always was,” Monique said. “We’ve never feared him, even to this day.”

At age 16, after a medication change, Tyler suddenly fled his parents’ Londonderry house in bare feet. Trying to run after him, Monique eventually gave up and went back into the house to call the police and get help.

Going up to his room, she found what she described as a “murder scene.”

Towels covered in blood lay all over his bed and the floor and a trail of red oozed between his bedroom and the bathroom.

“I found a little pair of nail nippers that he had broken in half,” Monique remembered through tears. “He had tried to cut his arm off to appease the voices and make them stop.”

The scars of Tyler’s mental illness are visible – scars all over his body and tattoos to cover them up. When he is in the throes of a schizophrenic episode, even the smallest tools like the metal end of a pencil or the metallic top of a small yogurt container can become lethal weapons he tries to use against himself.

“He’ll try to cut his eye out so he can’t see the delusions that are so scary,” Monique said. “He will cut his throat.”

He once came so close to cutting a major artery that a surgeon at Elliot Hospital had to come into his tiny concrete room in the hospital’s small psychiatric unit to repair his neck.

Tyler said, “I told you not to use black stitches,” and proceeded to rip them out, his mother remembered.

There are many sobering reminders of how serious Tyler’s schizophrenia can be. But her son is far from defined by his illness, Monique said. When Tyler’s medication is working, it helps. He has his diploma from Londonderry High School and was very proud to get a job at Dunkin’ Donuts.

“He’s just so unique; we still learn things about him to this day,” Monique said. “He’s an amazing kid.”

A few years ago, as her husband was visiting Tyler at New Hampshire Hospital, Tyler asked him if he wanted to hear a new song.

Despite having never played the piano growing up, he sat at an upright piano in the lobby and started playing his favorite song, “Broken,” by the band Seether. After playing a few more songs, he later explained that he can visualize the music as numbers on the piano.

“He hears it on the radio and sees it as numbers,” Monique said. “He knows where to go.”

‘So special’

Whenever she goes to visit him at New Hampshire Hospital, staff and security guards ask her, “Are you Tyler’s mom?”

“Tyler has touched people’s lives in person, to the point where everyone knows him,” she said. “They have such nice things to say about him; they just love him. That reminds me, he’s so special.”

Now that Tyler is recovering at New Hampshire Hospital, his family is hoping that continuing therapy and a new medication regimen will help him.

Monique prays that if there are more visits to the state hospital, they are not preceded by weeks in the Concord Hospital Emergency Room.

“I’m scared to death,” she said. “What if he’s in a paranoid state and someone’s just in the wrong place at the wrong time? And now you have another family that’s affected from a tragedy that was preventable?”

“What we went through should be the worst we ever have to go through again.”

(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)

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