They are our loved ones!
by Catherine J Rippee-Hanson
My twin sister, Linda hugging our brother, James Mark Rippee, who was dumped repeatedly back on the streets of Vacaville even though he had a traumatic brain injury, schizophrenia, anosognosia and was physically disabled. He was not deemed "gravely disabled" under the law in California. (2022)
In homes like mine and across social media, warriors are preparing. We are marching and clamoring for change in unison as our voices grow louder in the distance. We are showing up at Sacramento's state capitol in meetings and hearings and rallying in parks and on sidewalks. You will hear us. Our ranks are growing. We are family members of those with severe mental illnesses. We are mothers, fathers, sisters, brothers, sons, and daughters whose loved ones are dying on the streets of our cities and towns. We are here to fight for them and to fight for the resources they need. We will not back down until they are safe and have access to the treatment, care and housing that they deserve. We are determined to make a change.
We know that mental illness is a medical condition, not a character defect. We have seen our loved one's struggle with a lack of access to appropriate care and services. We are here to make sure that our voices are heard and that our loved ones receive the care and support they need to lead healthy, productive lives. The misplaced concerns of those who promote civil rights and liberty above all else - including life - often adversely affect our loved ones who are severely ill. It is our loved ones are who are in the most need of safe, effective, and accessible treatments. Instead of focusing on civil rights, we should prioritize finding treatments that can help those in need. We should put the greatest emphasis on saving our loved ones' lives. We should be working towards finding ways to ensure that everyone has access to the treatments they need, regardless of their ability to pay. We should be prioritizing funding for research into treatments for these brain diseases, as well as providing resources for those with severe illness. This will ensure that everyone has access to the care they need, and that those in most need get the treatments they require. They've been waiting too long. We've been waiting too long for our loved ones' lives to matter.
It's not in our loved ones' best interests to have idealistic strangers fight for their right to die on the streets with their rights intact. We can still fight for civil rights, but only after we have addressed the immediate needs of those who are suffering. We must put their health and safety first, and only then can we look to the future and strive for a better world. Our loved ones need our help and protection, not the protection of strangers who are far removed from the situation. We must act to ensure that the rights of our loved ones are respected, but also that their safety, security, and well-being come first. In the context of severe mental illness, autonomy is already stripped away by virtue of the disease process - particularly when the individual lacks insight.
In these cases, it is often necessary for a conservator or guardian to have the legal authority to make decisions on behalf of the ill person. This is not an infringement on civil rights or autonomy. Instead, it is a recognition that the person is not in a position to make decisions about their own needs and interests. Furthermore, guardianship should be tailored to respect the individual's rights as much as possible while also providing the necessary level of care. We do not, in general, withhold treatment for any other disease. Especially one that can end in untimely or premature death.
We need to understand that the person suffering from the illness is not capable of making informed decisions about their well-being, and therefore needs to be provided with the care and protection they need until they are capable. Furthermore, guardianship is meant to provide long-term care and support, and should not be used to limit an individual's freedom or autonomy. That motivation is extremely rare in families like ours. Rather we view it as a way to protect our loved ones from harm or exploitation. It should be implemented in a way that is respectful of individuals' rights. On that we agree.
Guardians should be chosen with the individual’s safety and interests in mind and should be held accountable for their decisions. When used carefully, involuntary treatment can protect the most vulnerable members of our society based on common sense, compassion, and competent clinical care. Although involuntary treatment may seem unsavory from a moral and legal perspective, it is by far better than homelessness, imprisonment, or death. The mantra "Give me liberty or give me death" does not apply to people with serious mental illnesses. Death is not necessary and there is no freedom from the disease. Involuntary treatment is a necessary tool to help people with severe mental illness who are unable to seek help on their own due to their condition. It is a last resort, but it can be a crucial bridge to recovery. It is a humane and compassionate approach to severe mental illness.
Changing the narrow definition of the Gravely Disabled legal term in California and the CARE Act may improve the homelessness crisis by helping the most severely psychotic individuals into treatment and care. But saving our loved ones' lives is our top priority. It's too late for my brother, James Mark Rippee - who lived and died homeless in Vacaville, California, due to schizophrenia, a TBI, blind and physically disabled. His journey in this life ended on November 29th, 2022, just three and a half months ago. This was after he had been found on the streets in the middle of the night gasping for air. He was dropped off at the local hospital by a stranger with a 50% oxygen level and a raging untreated UTI infection. He died soon after from pneumonia and total organ failure due to sepsis. His death was a tragic example of how a lack of access to medical care and mental health services can be devastating for those living on the streets. This tragedy highlights the need for better access to resources for the homeless and mentally ill, so that the same fate does not befall others.
In the obituary, I told the truth about his death. He died from severe mental illness that wasn't treated. He barely survived 16 years on the streets after getting hit by cars and falling and breaking his hip. We jumped in fear and anxiety every time the phone rang. Our family suffered along with my brother and his untreated mental illness for three and a half decades. Our laws didn't allow us to protect him or make decisions for him. Under the law, we couldn't do anything or even get answers to our questions about his needs or possible resources. We had no rights. Even after being hospitalized for almost a year and hospitalized again and again - he was put back out on the streets every time.
If our family members had Alzheimer's, dementia, or other neurological brain diseases, this wouldn't happen. When someone has a heart attack, we intervene and help them... Why do we just walk over, around, and see through those who are the most vulnerable? Especially those with anosognosia - without the ability to choose - rotting on a sidewalk? We need to do better. We need to create a system that supports those who are most vulnerable and ensures they have access to the care they deserve. We owe it to put people first and ensure they are not forgotten or ignored. We must take action to provide resources and support for those who are homeless and suffering from mental illness. We must remember that everyone deserves to be treated with respect and dignity, and no one should be left behind. We must do our part to ensure that our loved ones who are most vulnerable are given the help they require and deserve.
To ensure their rights are protected, how many dead bodies of our loved ones should we ignore and step over? In order to ensure that everyone is treated with respect, we must actively work to create an environment that is free from discrimination and inequality. We must also make sure that everyone has access to basic necessities like food, water, shelter, and healthcare. This includes advocating for policies that guarantee that everyone’s rights are respected, and providing support, treatment and resources to those who are most in need.
When legal restrictions are placed on us, our families' lived experiences should be taken into account. It's time to make changes to the laws that have bound our families to tragedy time and time again. It’s like cutting off someone’s oxygen supply and expecting them to breathe - the laws are inhumane and oppressive and need to be adapted to accommodate our families’ needs and experiences. We must remember that the laws that have bound our families to tragedy cannot remain static. Only by taking a stand and speaking up can we ensure our collective voice is heard and progress is made. It is our duty to act now and push for laws that protect our families, rather than laws that perpetuate the cycles of tragedy. Through our collective voices, we can advocate for a better future and bring about true change. In the civil rights movement, activists and advocates who value autonomy over life need to sit down and be quiet for a moment... so the truth of this issue can be heard.
Our loved ones have been at the back of the line for much too long. No more.