Steven Apilado’s Parents Shielded Their Mentally Ill Son From the Law — Until He Murdered One of Them — (The Dallas Observer)

SSRI Ed note: Sexually abused boy, 8, acts out, starts psych drugs, becomes "irritable, angry, violent", diagnosed bipolar, yrs of meds, worsens, permanent damage, kills dad.

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The Dallas Observer

Christian McPhate

November 7, 2017 | 4:00am

Steven Apilado says he dreamed of Mister Rogers when he shot and killed his father two days after Thanksgiving in 2015. The dream, Apilado later told detectives, was like a TV commercial in which someone had thrown a tomato at Mister Rogers’ face.

“I guess that was my dad getting shot,” he said.

The PBS children’s show Mister Rogers’ Neighborhood began with a routine, Fred Rogers singing “Won’t You Be My Neighbor?” as he changed his jacket for a sweater and slipped on a comfy pair of shoes. At 79, Vincent Apilado also was a man of routine: daily morning coffee at McDonald’s and a copy of The Wall Street Journal, meals served at the same time. The retired business professor from the University of Texas at Arlington often slept on the sofa in the living room because Steven, who was mentally ill and sometimes violent, couldn’t be left alone when he was unable to sleep. A family man and devout Catholic, Vincent was a skilled violinist who turned down a scholarship to The Juilliard School to pursue degrees in business and finance.

Steven’s father always took care of him, even as Vincent aged and got dementia, severe arthritis and Parkinson’s disease. “He had become a shell of a man who could not dress himself or shave himself, feed himself or bathe himself,” says his wife, Elsa Apilado.

Steven helped Elsa care for his father when his own illness didn’t prevent him. He would bathe his father, shave and dress him, and cut his food. He would take him for his morning coffee at McDonald’s. They were best friends and referred to each other as partners.

Then there was the other Steven, outlined in a trail of police reports spanning nearly a decade. Steven terrorized his family with uncontrolled violent outbursts. Years of therapy, medication and hospitalization failed to contain his anger and aggression.  The family moved from Arlington to El Paso, where Steven’s older brother lived, in January 2013 for a change of scenery that Vincent and Elsa hoped would help calm Steven, but his condition worsened.

“We were so desperate that we had a priest perform an exorcism,” Elsa says. “Everything that we tried failed. Maybe the devil took over.”

El Paso prosecutors painted a different picture at Steven’s December 2016 murder trial.

“So past is prologue,” prosecutor Ivan Martinez told jurors. “Are y’all familiar with Shakespeare and The Tempest? Right? What brought us to this point? Is it a mystery? No. Every single thing that we have ever done in our lives has brought us to this moment. And that’s what brought Steven Apilado to his moment to decide to kill his father.”

Maybe it was fate that led 37-year-old Steven Apilado to an 80-year sentence in a Texas prison, where researchers estimate that somewhere between 15 percent and 25 percent of inmates have severe mental illnesses. In a family with doting, aging parents sheltering a son with intractable mental illness in a state with scarce resources to deal with diseases that medical science struggles to define and treat, what else might have been done to avoid Vincent Apilado’s death at the hands of his son, best friend and partner?

When he was a child, Steven had a problem with hopping. He would hop all the time like a puppet from Mister Rogers’ Neighborhood starting at about 18 months old until he was 6 years old. He told a doctor he needed to hop in order to “imagine things.”

At 8 years old, he refused to go to school because he imagined he would get AIDS and frostbite, according to his medical records. He was also obsessed with sex. His mother took him to see a psychiatrist.

“I mentioned to him the constant talking about sex,” she wrote in a medical history timeline for her son’s Social Security disability application. “I felt he had been sexually abused and later found out he was [by a family friend]. But again the doctor did not take me seriously. He said that I must make him go to school or he would be hospitalized.”

Steven was an altar boy like his older brother. They attended Mass at Saint Vincent de Paul in Arlington where Elsa, a special education teacher, also taught Confraternity of Christian Doctrine classes.

Elsa says when 8-year-old Steven would get up in the morning, he would grab a knife and run out the door saying he was going to kill himself.

Elsa says when 8-year-old Steven would get up in the morning, he would grab a knife and run out the door saying he was going to kill himself. She would calm him down enough to get him in the car, but a counselor and principal would meet her and her husband at the school door.

“It took four people to carry him in kicking and screaming,” she says. “I can remember overhearing a mother say, ‘What kind of parents would allow this to happen to a child?’”

Steven began taking psychiatric medication when he was 8.  After three weeks, his symptoms eased, but by seventh grade, he began having problems sleeping and claimed to see demons whenever he was alone in his room at night. He began reading extensively, delved into religion and said he was planning “to save the Jews.” He was also more irritable, angry and violent.

“A totally new Steven emerged,” Elsa says.

The high price of treatment

Steven was 15 when he became a patient at Children’s Medical Center in Dallas. He was paranoid, withdrawn, aggressive and agitated. It was the ’90s, and an enormous change in the mental health system was underway. New legislation and policies were intended to promote access to mental health services, and insurance coverage for mental illness expanded, according to a 2005 study titled “Prevalence and Treatment of Mental Disorders, 1990 to 2003,” published in the New England Journal of Medicine.

The study found that the number of annual visits to mental health specialists had increased 50 percent, the number of people receiving treatment for depression tripled and the number of people with serious mental illnesses receiving treatment by specialists increased 20 percent by the end of the ’90s.

Steven had been treated at Millwood Hospital in Arlington and diagnosed with bipolar disorder. He was given Tegretol for seizures and pain and lithium to help control manic episodes, but he said the drug combination made him more agitated.

At Children’s Medical Center, Steven began taking clozapine. The drug, introduced commercially in the U.S. in 1990, is considered one of the best for treatment-resistant schizophrenia. It helped to control his anxiety, agitation and paranoia. Nevertheless, a year later, Steven returned to the medical center. He wasn’t sleeping and was dealing with “pressured speech, hyper-religiosity, impaired judgment and increased paranoia,” according to medical records. He received the same diagnosis of bipolar disorder, but a seizure disorder, “possibly due to the clozapine,” was added.

When Steven was released, Elsa decided to home-school him and take him on walks to Lake Arlington to help calm his mind, but his illness worsened. He began taking more medication, some of which put him in a zombielike state, and experiencing side effects such as restless legs, weight gain and insomnia.

Elsa says she and her husband tried to get Steven into a long-term treatment facility whenever a manic episode hit, but their insurance would cover only 10 days. The fiance of the couple’s daughter Maya eventually loaned the family $30,000 to send Steven to a private long-term facility in Florida, but Maya says he was sent home a few days later because “they said they couldn’t help him.”

Admission into one of Texas’ 10 state mental hospitals requires a referral by a mental health authority from the hospital’s service area, but they are often full, with nearly 400 people on waiting lists, according to a May 2016 Texas Tribune report. “The number of beds the state pays for in private facilities has not kept up with the state’s rapid population growth,” the Tribune reported.

John Dornheim, special projects manager for the National Alliance on Mental Illness in Dallas, says some boarding houses in Dallas will work with aging parents of adult children with severe mental illnesses who receive Social Security or disability checks. Some are still unregulated, but “a majority of the decent ones” are accredited by the city.

The violence grows …

The first record of Steven’s domestic abuse appeared not in police reports but in a July 14, 2009, letter Maya sent to Roger Robinson, a Fort Worth psychiatrist who specializes in Asperger’s syndrome. Steven, then in his late 20s, had received several new diagnoses, including obsessive-compulsive disorder, attention deficit hyperactivity disorder and Asperger’s syndrome, a milder form of autism.

Maya wrote that her brother’s violent behavior had escalated.

“Many times he made our family and others feel extremely uncomfortable and in danger,” she wrote. “He is very verbally and physically abusive with my parents, our family and others who are close with him. My parents, probably because they are scared, do not give him any consequences for his actions.”

Maya described Steven’s attack on their father, who was 72 at the time, saying Steven struck him in the head 15 times and spat on him in April 2009. Adult Protective Services was called several times over the years, “but every time they tried to get in contact with my dad, he could not talk because Stevie was around,” she wrote.