In this case, a clear causal link is presumed between mental disorder and violence. The purpose of this assignment is to provide a critical -and complementary- view of this man’s dangerousness. Using concepts and theories learned in class so far, discuss the following points: 1) limitations of the concept of mental disorder as a predictor or risk factor for violence and 2) factors or concepts that may contribute to explain the link between mental disorder and violence, in this particular case (e.g., theoretical formulations, mediators).
Mother’s pleas to help schizophrenic son ignored
Standing 6-10, Kelvin Johnston is an intimidating young man.
That he is, says his mother, Cindy Johnston, but it is the thoughts inside his head that make him a really scary fellow. She thinks he is ready to explode.
If Kelvin doesn’t get the help he needs soon €” and she thinks it has to be in a psychiatric hospital so he can be treated for his schizophrenia and substance abuse €” Johnston says she is certain Kelvin, 22, will either kill someone or end up dead himself. Johnston says Kelvin has attempted suicide several times and hears voices, including those from demons who have said things that were too bad to tell his mother.
Recently, says Johnston,he’s talked of throwing himself in front of a bus.
Kelvin was diagnosed with paranoid schizophrenia when he was 18. But he suffers from a number of other mental-health disorders, some going back to age 4, when he came increasingly aggressive with fellow students at a Montessori school. Johnston was forced to pull him out.
He was first diagnosed as having anxiety distress disorder, then obsessive compulsive disorder, and by age 12, it was determined he was bipolar as well. Johnston says when he was placed into a program at age 5 to deal with his aggression and anxiety, he was, at that time, the youngest patient ever to receive treatment at the Royal Ottawa Hospital €” now the Royal Ottawa Mental Health Centre.
Johnston says Kelvin’s condition is so bad that he, too, now realizes he needs hospital care. She says he recently tried on four separate occasions to have himself admitted through emergency to the psychiatric wing of the Civic campus of The Ottawa Hospital. While she keeps fighting to get her son back into the Royal Ottawa, she’s hoping that in the meantime, he can begin rehabilitation for his substance abuse. But that doesn’t seem likely. He hedges back and forth on entering a program. And he isn’t abstaining from drugs and alcohol. Abstinence is a typical requirement for people seeking treatment, according to a case manager at the Ottawa Mission, where Kelvin sometimes stays and could get help.
Not long before he was diagnosed with schizophrenia, Johnston says Kelvin’s aggressiveness and anger got to the point where she had to move him into his own apartment on Lorry Greenberg Drive. He was 17. She says she feared his constant mood swings endangered the rest of her family, including his older brother, younger half-brother and adoptive father. There had been assaults on family members and numerous occasions when he damaged the house and furniture. Often, police had to be called to the house. It is horrifying when Kelvin flies into a rage, his mother says. Family occasions were very strained when he lived at home, but they can also be pretty nerve-racking when he’s alone with his mother.
Last fall, Kelvin became so incensed while Johnston was driving him to the Montfort Hospital that he put this fist through the front passenger window of her car. About five years ago, he suddenly lunged for the steering wheel as Johnston was driving and forced the car into a farmer’s field.
Kelvin had a driver’s licence for a very short period. It was permanently revoked when he was 18 by a review board at the Royal Ottawa following a number of incidents involving road rage and careless driving. In what his mother believes was one of his suicide attempts, Kelvin was involved in a high-speed single-car crash. His vehicle flipped three times, front end to back end. He suffered permanent injuries to his back.
Johnston says her son often doesn’t take his medication and further aggravates his condition with alcohol and drugs, including crack cocaine. His substance abuse goes back years. When he does take his medication these days, his mother says he crushes it into a powder and snorts it as it apparently gives him a quick high.
Kelvin now spends his time shuffling between shelters for the homeless in Lowertown. He moves about because his behaviour €” threats, fights, putting his fists through walls €” gets him into trouble. He’s usually told to take a time out and go to another shelter. It was the same behaviour that got him kicked out of three group homes in the last year and eventually landed him on the street. His mother says drug dealers use him as an enforcer or protector whenever there is a problem with buyers.
When I saw him this week, one day at the Salvation Army men’s shelter on George Street and the next day outside the Ottawa Mission on Waller, he was anxious and tired. Kelvin doesn’t want his story in the paper. He says everything is fine and he’s doing OK. He says he doesn’t want people to know my s€“t. He says he would return to hospital if he could.
His mother wants her son’s story told in the hope that someone in authority at the Royal Ottawa reacts positively to her son’s situation. She understands there is a bed shortage at the Royal Ottawa, but says one has to be found for Kelvin so he can be stabilized.
Johnston says her son’s doctors don’t see Kelvin in any immediate danger and think he can manage with the support they are giving him. She says his Royal Ottawa psychiatrist has more or less dismissed her as an overbearing parent.
That psychiatrist refused a request to be interviewed. The psychiatrist heading the Assertive Community Treatment Team (ACTT) €” which provides rehabilitation support to Kelvin and others in the community with severe mental illnesses €” did not answer any of my requests for an interview.
But Mary Alberti, chief executive of the Schizophrenia Society of Ontario, says it sounds as if the mother in this case needs to calm down and let her son’s doctors and support team do their work.
Being connected with an ACTT team, this individual has a lot more support than many other people have in terms of being in the system, in being connected.
Alberti suggests that parents with schizophrenic children turn to support groups to help them cope and come to a better understanding of the mental-health system. As well, says Alberti, it is important for parents to continue letting the care team and psychiatrist know what the family viewpoint is, what they are seeing, what they are experiencing and what their concerns are.
Johnston says she often updates Kelvin’s doctors and support team about what is happening to her son. But all she sees is Kelvin sinking deeper into his psychosis and drug abuse.
It was an assault on a neighbour at the Lorry Greenberg apartment building in 2008 that led doctors to finally determine he had schizophrenia. He was charged by police, but following his diagnosis, he was deemed not criminally responsible for the assault and spent the next 13 months at the Royal Ottawa. Though his psychiatrist decided after three months that Kelvin was ready to leave the hospital, Johnston took the matter to the Royal Ottawa’s review board and convinced members that her son should not be released.
Once he was allowed to leave in June 2009 €” against his mother’s wishes €” Johnston placed Kelvin in a Rothwell Heights residence, which primarily accommodates seniors. He was there a year before doctors determined he was ready to live on his own
Johnston found an apartment for Kelvin on Walkley Road in June 2010. His mother would visit to help him with groceries, cleaning and laundry. But the visits became less frequent as he made it clear he wasn’t keen having her in his apartment. His mother says her son fell in with a bad crowd. In June 2011, he was attacked in his unit by three men €” Johnston believes it was over drugs €” and his head was bashed with a beer bottle. He suffered a severe cut to an ear and nerve damage to an eye and his mouth.
He was released from the Civic the day after the attack. Johnston picked him up. But on his way back to the apartment, Johnston says her son talked about revenge and that he planned to catch his attackers and eat their faces. Alarmed, Johnston called police after she dropped him off. Police took him back to the Civic and had him admitted to the psychiatric ward.
Johnston says an ACTT worker got in touch to tell her the team would be recommending that Kelvin be readmitted to the Royal Ottawa.
Buoyed, Johnston says she got Kelvin out of what was left on his lease, but not before she spent $600 having the apartment professionally cleaned. She says what she found in the unit was shocking. Besides blood-stained walls, floors and mattress as a result of the attack, Johnston found filth everywhere. The stench in the unit made her gag. His fridge and cupboards were bare. There were beer bottles and drug paraphernalia that indicated he was drinking and doing drugs, and as such, contravening the rules of the community treatment order he was under. That alone could have been enough to force his return to the Royal Ottawa, says Johnston. How could the ACTT members have missed so much stuff during their visits, she asks.
When Kelvin phoned her to say he was being released from the Civic and going home, she was caught off guard because she thought he was being readmitted to the Royal Ottawa. There was no apartment to return to, she told her son, who reacted by putting his fist through a plate-glass door. He was kept at the Civic for another couple of days before his psychiatrist from the Royal Ottawa determined he was OK to leave.
His release had Johnston scrambling to find a place for him to stay. The Rothwell Heights’ residence agreed to take him, but he was kicked out after a few months because of bad behaviour. He ended up in a group home in Limoges last November, but was forced to leave in April, again because of his behaviour. That’s when he ended up homeless for the first time and started staying at the Ottawa Mission. He moved to a group home in Vanier in June, but, by the end of July, he was kicked out of there, too. He has been staying at the Lowertown shelters since then.
Says Ottawa Mission spokeswoman Shirley Roy: I saw someone quoted recently about how our jails are becoming the new mental-health institutions. I would argue that shelters are starting to equal that, too €¦ we’re seeing a lot of people who are in crisis.