Michael’s story: Mentally ill man attacks his family after being deserted by Pa. health care — (PennLive)

SSRI Ed note: Young man smokes dope, diagnosed w. schizophrenia,on neuroleptics (cause rages, apathy), isolated, attacks grandma. Antidepressants make situation much worse.

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By Daniel Simmons-Ritchie | simmons-ritchie@pennlive.com

on October 08, 2015 at 7:00 AM, updated October 13, 2015 at 1:57 PM

On Jan. 23, 2012, Michael McDaniel awoke at 5 a.m. in his family’s poolroom and was overcome by misery on a scale that was unique even for him. He began to cry.
Michael was 30 years old and lived with his parents and grandmother in a sprawling, cedar-planked home on the wooded fringes of the Oley Valley, just east of Reading. That night, like many others in recent years, Michael had spent sitting on a worn recliner in the far corner of the family’s poolroom. The room had become something of a refuge for Michael since the onset of schizophrenia: he was now spending 16 hours a day there, writing furiously in his journal or, just as often, staring at the room’s white stucco wall and letting his mind draw shapes and people and angels and demons from its cracks and craters.
At 6 a.m., his tears drying against his dark beard, Michael’s misery gave way to an idea. It was an idea that Michael had long contemplated but, for a variety of logistical and moral reasons, he had repeatedly dismissed. Today felt different: Michael hoisted his 6-foot-1 frame from his chair, tightened a black hoodie around his head and lumbered through the greenhouse that connected the poolroom with the rest of the house.
Michael entered the family’s darkened lounge and found his mother sprawled on the couch, wrapped in a gold quilt, watching the morning news. Nina McDaniel’s presence wasn’t a surprise to Michael. As he had spent more and more time in the poolroom, Nina had taken to sleeping nearby to keep an eye on him.
Michael walked past her to the stairs and said “good morning” and she said “good morning” back. Nina, a 54-year-old with silver hair and wireframe glasses, felt uneasy; she had heard her son sleep little that night, which foreshadowed a day where he would scream and cry and laugh eerily to himself even more than usual. Still, at that moment, as he ascended the stairs of their split-level home, Nina assumed he was simply heading to the kitchen to grab a cup of coffee.
Once upstairs however, Michael didn’t linger in the kitchen. He walked down a carpeted hallway and toward the bedroom of his 74-year-old Ukrainian grandmother. Helen Badulak’s door was open, as it was every night because she, like her daughter Nina, suffered from claustrophobia.
Michael entered a spacious, hexagonal room: To his left, difficult to see in the dim light, were shelves of more than a thousand intricately painted eggs, a Ukrainian art form called Pysanky, of which Michael’s grandmother was a grandmaster. To his right, Badulak slept upright in a full-size hospital bed; Badulak’s health was poor, and it was because of chronic pain that she woke easily when she heard someone enter her room.
When she made out Michael’s form in the gloom, she smiled at him. The pair had always been close: Since he was old enough to talk, Michael, like his older sister Krissy, had known her as “Baba,” the Ukrainian word for grandmother.
But on this particular morning, Michael didn’t smile back. His face was flat and his eyes were stony and he began speaking in a deep voice in a bizarre language that confused his grandmother. Michael then stepped toward her bed, brandished one of her metal walking canes, and struck her in the head with it. Badulak cried out and tried to stand up but her legs failed and she toppled to the floor.
As she lay, Michael hit her again and again in the head, continuing to speak in his strange language. Badulak raised her hands to shield herself but Michael continued undeterred: he beat her until her fingers broke and her white bed, the white walls, the white vaulted ceiling and the pallets of white-shelled eggs that Badulak had yet to paint were splattered with blood. Between blows, still muttering, Michael would occasionally stare off into the corner of Badulak’s bedroom as if someone was standing there, spurring him on.
Eighty feet away, downstairs in the lounge, Nina heard nothing and, in the couple’s bedroom, neither did Michael’s father, Alan.
After several minutes, Michael stopped hitting his grandmother. Badulak, barely conscious, weakly asked Michael where his mother was. He told her she was dead. “They all are dead,” he added. He then walked out of her room and into the garage to look for a sledgehammer.

Michael’s family would ultimately survive the events of Jan. 23, 2012, but it would leave them deeply traumatized and even more disillusioned with Pennsylvania’s mental health care system.
The McDaniel family believes that what happened on that day could have been avoided if Michael had received the help he needed when he needed it. While the failures of the system were multiple, the most glaring, perhaps, were those that occurred when Michael was in the depths of psychosis over the preceding five years.
On three different occasions, Michael’s family had involuntarily committed him to a psychiatric ward but, each time, Michael was released a few days later, or a few weeks later, still deeply delusional and with poor follow-up care. On many more occasions, Michael exhibited behavior that equally scared or disturbed his family but they were told repeatedly that he didn’t meet Pennsylvania’s commitment criteria.
Michael McDaniel’s story lies at the heart of one of the most contentious debates in the mental health care field. The McDaniel family, along with a subset of police officers, mental health care advocates, and correctional officers across the country, believe that states need to either rewrite their commitment laws – or be more willing to implement their existing laws – to make it easier to mandate that mentally ill people get treatment.
National scrutiny over the criteria for involuntary commitment has intensified in recent years in the wake of several high-profile mass-killings.
James Holmes, the 27-year old schizophrenic [actually his mental state was casued by Zoloft – Ed] who shot and killed a dozen people in a movie theater in Colorado in 2012, made comments that disturbed his psychiatrist but she didn’t believe met the state’s standard for involuntary commitment. Jared Loughner, the schizophrenic man [he had a long history of illegal drug use combined with alcohol abuse – Ed] who shot U.S. Rep. Gabbie Giffords and killed six people in Arizona in 2011, was perceived to be mentally ill and possibly dangerous by officials at his college but they also never petitioned for an evaluation for involuntary commitment…

On July 14, 2007 at about 4 p.m., Michael called his parents with news that was difficult for them to understand.
Up until that month, Michael’s life, while rough in patches, had seemingly found its groove. At 25 years of age, Michael lived in a farmhouse-turned-apartment owned by his grandmother at the top of the Oley Valley, just 10 minutes north of his family.
Here, he had fallen into a comfortable routine: From Monday to Sunday, at 3 a.m., Michael would roll his 200-pound body out of bed, jump into his white Honda Prelude, pack a glass pipe with marijuana, and then drive 10 minutes north to the Kutztown Tavern in downtown Kutztown. For eight hours, before the first barflies arrived at noon, Michael swept and scrubbed and wiped the grease off the bar’s wooden stools. He made $1,850 a month and largely worked alone – just how he liked it.
But Michael’s routine was disrupted that July. One day, while cleaning the tavern’s basement dance floor, a co-worker – a relatively new employee in his 50s – noticed the peculiar way that Michael’s head swayed from side to side as he worked. The movement was an impulsive habit that Michael had developed when he was just 5 months old and, through his school years, had proved the target of merciless teasing. Michael’s co-worker continued in this tradition.
At school, either in his tiny hometown of Quakertown or his teenage years in the Oley Valley, Michael’s defense – as his mother had always taught him – was to ignore the teasing and walk away.
But at the Kutztown Tavern, while Michael still walked away, his co-worker’s words were less easy to ignore. Since graduation and the years he spent working largely alone on a pheasant farm, Michael found relief from the abuse. His co-workers never drew attention to his head bobbing and his friends – the handful of younger boys that he drank and smoked pot with – didn’t either. So, on that morning, to hear his co-worker ridicule him, unleashed a torrent of painful memories.
When Michael got home to his apartment that night he fell into an obsessive depression. Over the next few days, he called his mother and repeatedly asked her why she didn’t do more to seek medical help for his head bobbing.
Nina tried to explain that she did seek help; that a neurologist studied Michael when he was 6 years old and concluded there was nothing wrong with him and that he would likely outgrow the habit, just as a child might with thumb sucking. But the explanation only angered Michael. He accused her of giving him brain damage.
The calls continued for two weeks until July 14 when Nina and Alan received a call from Michael that even they didn’t expect. Michael told them he wanted to kill himself.

Michael’s parents rushed to their son’s apartment and on to Reading Hospital. He was seen be a social worker who prescribed him an antidepressant and then discharged him. But over the following days, Michael’s condition didn’t improve. He stopped going to work. He stopped leaving his apartment at all.
On July 22, Michael’s sister, Krissy, and her husband, Billy Schaeffer, tried Michael’s cellphone six times before he finally picked up. “I don’t know what’s wrong with me,” he told her. As they talked, Michael mentioned that he hadn’t eaten in five days. Krissy asked why and Michael explained that he planned to “wither away to nothing.”
Krissy called Berks County’s Crisis Intervention Team, a special response team that most counties in Pennsylvania have to handle emergency situations involving mentally ill people. The team helped her file a petition for involuntary commitment; Krissy argued that her brother’s starvation posed a danger to himself.
A day later, on a gray morning, two police officers knocked at Michael’s door, identified themselves, and led Michael to a waiting ambulance.
Watching from a distance, Krissy, Billy, and Nina found Michael’s appearance barely recognizable: His black hair was wild, his face was grey, and his body looked sunken – as if someone had jabbed him with a giant syringe and sucked out 20 pounds. Tears streamed down Nina’s face as they followed behind Michael’s ambulance, its siren whining and its lights flashing.
Michael was committed to a psychiatric ward in Ephrata Community Hospital, about 20 miles southwest of Reading. The doctors attributed Michael’s psychosis to his daily marijuana smoking – a habit he’d developed in his early 20s. On July 26, three days later, Michael was discharged to his parents.
Under Pennsylvania’s involuntary commitment law, a hospital must release a person when they are no longer considered a danger to themselves or others and medical staff judge that person can be placed in the “the least restrictive” setting to achieve treatment…

One day, after hearing a song play on a local radio station, Michael interpreted it as a message from God to head to town and find her. The woman soon filed a restraining order against him and Michael was fired from the Kutztown Tavern.
Michael’s family desperately tried to get help for Michael but, beyond pleading with him, there was no way to compel him to take his medication or see a doctor unless he chose to – and Michael had no interest in either. Eventually, as before, Michael stopped eating. He told a crisis intervention worker that he wanted to “die in the name of love” because his former coworker had spurned him. “I’m dead without her,” he added.
On Aug 28, barely a month after his last hospitalization, Nina McDaniel filed a new petition for involuntary commitment and argued, as Krissy had, that Michael’s starvation was a danger to himself.
Once admitted to the hospital, the degree of Michael’s deterioration was on full display. He told medical staff that he thought he was god and, while watching television that afternoon in a waiting area, claimed responsibility for a series of car crashes that appeared on the screen. Michael got a new diagnosis: major depressive disorder with recurrent, severe psychotic features. He was released five days later.

By 2008, Michael McDaniel’s mind was undergoing changes that neither he nor his family truly understood.
James Robinson, PennLive.com

Shortly after he was released from the hospital, Michael asked his parents if he could move in with them at his grandmother’s cedar-planked home. Nina and Alan agreed, hoping that a change of scenery might make life easier for their son.
But Michael’s mind was undergoing changes that couldn’t be easily halted.
It was a bright summer day in 2008 when Michael’s world took on new dimensions. Michael was cutting the 20-acre lawn at his former apartment, which was owned by his grandmother, as a favor to her.
It was then, sitting atop a John Deere mower, that he heard something just beneath the mower’s diesel roar. Michael stopped and listened. It was the voice of one of his former neighbors – a heavyset, blond woman who used to talk openly to Michael about her depression.
Over the weeks that followed, the voice of Michael’s former neighbor grew louder and was joined by other voices. He heard his mother, his father, and his sister; sometimes offering warnings, sometimes offering instructions, sometimes saying little more than “Mike” or “Michael.”
Soon, sitting in his bedroom or his family’s living room in the middle of the night, Michael heard wholly new voices: God, Satan and a succubus that Michael would come to call “Mohinee.” The voices fascinated him. Michael secluded himself in his family’s poolroom to listen to them more closely.
The voices were eventually joined by visual hallucinations. Michael started seeing orbs – red ones and blue ones and black ones – floating in hallways and tucked in corners of rooms.
They made him chuckle.
Meanwhile, he discovered that if he took his glasses off and stared at the white stucco wall in the poolroom, he could see translucent spiders – bigger than tarantulas – crawling across its surface. Other hallucinations came in time and Michael took all of them as affirmation that God and Satan were communicating with him.
His reverence for his hallucinations was such that, in November, upon the advice of the voices, Michael swallowed a random assortment of antidepressants and painkillers in Krissy’s bathroom and he was rushed to the emergency room.
Michael’s family were struggling to adjust to Michael’s increasingly bizarre behavior. Michael was often awake at all hours of the night and constantly wore a pair of dark aviators, even when he slept.
His mood was often unpredictable and he would grow angry quickly. Michael’s grandmother, who grew up in Ukraine in the midst of World War II, knew little about mental illness and had particular difficulty understanding what was happening to her grandson.
Handcuffed, clad in a white jumpsuit, Michael was shown being led by a police officer into the Berks County Courthouse in Reading. As he walked, his head lolled from side-to-side and his eyes were listless – as if he were in a trance. Barely looking at the camera, Michael raised his middle finger in its direction.
Michael was charged with attempted homicide, attempted first-degree murder, aggravated assault, simple assault and harassment. Two days after the attack, Nina gave a teary-eyed interview to WFMZ. Her voice contorted in anguish, Nina told the reporter: “I’m being tortured right now because I love my mom and I love my son. I have to make the hardest decision of my life and that is my son will never be able to come back to our house.”…

Michael was so psychotic when he arrived in Berks County Prison that he was held in an isolation cell for 24 hours a day in his first few weeks. Like many seriously mentally ill people who are imprisoned in the nation’s jails, isolation only further aggravated his psychosis. Michael spent most of those weeks crying, often slouched on his bed, his head bobbing back and forth so frequently that he would later earn the nickname “bobblehead” from other inmates.
He was prescribed psychiatric medication but refused to take it – his right as a prisoner – because, as he told Nina on her first visit, his walnut-brown eyes staring at her through the glass screen, “the voices in my head are souls and I will not hurt them with medication.”
Michael spent most of Nina’s visits to the prison yelling at her through that screen, his voice muffled through the vent beneath it. He repeatedly told his mother that he shouldn’t be in prison, that his incarceration was a conspiracy, and that he didn’t understand why the family was afraid of him.
After multiple visits, Nina worked up the courage to ask Michael why he attacked his grandmother. But his answer made little sense to her. Michael explained that when he woke up that morning, he was overcome with sadness and decided to kill himself by getting a gun from the family’s safe – despite the fact that the family, as he should have been aware, had removed guns from the house a long time ago.
Michael continued: “As I went down the hallway to the safe, I thought that I will break everyone’s necks and that would be a peaceful way of dying. Don’t you think so, mom?” Michael stared at Nina and she felt frightened. The use of “mom” was particularly unnerving – it was the first time that Michael had called her “mom” instead of “Nina” in a year.
Uneasily, Nina answered her son. “I guess it would be peaceful if a person is asleep,” she said. “But why would you need to kill us if your intention was to kill yourself?” Michael’s eyes grew wide. “I told you,” he yelled. “I wanted to kill myself and die. All of you would have stopped me. I cannot go through the rest of my life like this.”

Michael was found incompetent to stand trial and, after 52 days in Berks County Prison, was transferred to Torrance State Hospital near Pittsburgh for what’s known, in legal parlance, as “competency restoration.” Michael spent two months at Torrance State Hospital, which marked the longest hospitalization of his life and his first in a state hospital rather than a psychiatric ward. When he returned to prison, Michael was significantly more stable; for the first time in more than a year he took his medication voluntarily.
Meanwhile, outside of prison, after five days in the hospital and several months of healing, Helen Badulak had regained her strength. Berks County’s District Attorney’s office urged her to testify against Michael but Badulak refused.
The office was particularly interested in the possibility that Michael tried to kill his grandmother so he could inherit her property. Badulak found the claim ridiculous and insulting after everything the family had been through. “Michael didn’t do this to me,” she recalled telling the attorneys. “The mental illness did.”
Michael’s trial was held on Aug 10, 2012, in the Berks County Courthouse in Reading. Michael’s public defender, Richard Joyce, argued that Michael was legally insane at the time of the incident.
Dr. Larry Rotenberg, a forensic psychiatrist who had interviewed Michael shortly after the attack, testified in support. “He may have understood the nature of the quality of what he was doing but certainly did not understand what he was doing was wrong,” he told the court.
Rotenberg submitted a report that went into greater detail. After reviewing his screeds of writing that McDaniel had written in the poolroom, Rotenberg wrote, “One can see the workings of a mind that is almost totally free of any sanity.”
That afternoon, Judge Stephen Lieberman acquitted Michael on all charges and he was committed to Wernersville State Hospital. In his closing comments, Lieberman called the case a “tragedy.”
He criticized the closure of state hospitals in Pennsylvania and other states since the 1970s and the underinvestment in community mental health services that were supposed to replace them. “It is an idea that seems to be working out a lot like communism,” he said. “Looks great on paper but in practice it’s leaving families of people that suffer from mental illness, and leaves the person themselves that suffer from mental illness, with virtually no resources and no help.”
Due to a lack of free beds in Wernersville State Hospital, Michael waited a month longer in Berks County Prison before he could be transferred.