Tony Mantor: Why Not Me the World

Jessica Ferguson : Brother in Crisis: A Family's Desperate Fight for Mental Health Support

• Tony Mantor

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Jessica Ferguson shares the deeply personal story of her brother's struggle with serious mental illness and how systemic failures led to his incarceration after being accused of a triple homicide when he should have been in psychiatric care.

• Her brother had been stable with his mental illness for a decade before showing concerning behavior changes in early 2023
• Despite three psychiatric hospitalizations within months, he was repeatedly discharged after 72-hour holds with no substantial care plan
• Family pleas for help were ignored as healthcare providers cited voluntary treatment requirements and HIPAA restrictions
• Only after being accused of a crime did he receive consistent psychiatric care
• The jail system provides minimal mental health support compared to psychiatric hospitals
• Families need healthcare proxy arrangements and better knowledge of resources before crises occur
• Massachusetts lacks Assisted Outpatient Treatment (AOT) options that could mandate treatment
• Mental health systems must partner with families who know their loved ones best

If you know someone with a story to tell, send them to TonyMantor.com. Tell everyone everywhere about Why Not Me, the World, the conversations we're having and the inspiration our guests give to everyone everywhere that you are not alone in this world.


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intro/outro music bed written by T. Wild
Why Not Me the World music published by Mantor Music (BMI)

Speaker 1:

Welcome to why Not Me? The World Podcast, hosted by Tony Mantor, broadcasting from Music City, usa, nashville, tennessee. Join us as our guests tell us their stories. Some will make you laugh, some will make you cry. Their stories Some will make you laugh, some will make you cry. Real life people who will inspire and show that you are not alone in this world. Hopefully, you gain more awareness, acceptance and a better understanding for autism Around the World. Hi, I'm Tony Mantor. Welcome to why Not Me? The World Humanity Over Handcuffs the Silent Crisis special event. Today we're joined by Jessica Ferguson, who will share the deeply personal story of her brother's struggle with mental illness. She'll take us through the challenges of supporting him, the events and circumstances that ultimately led to his incarceration, and the family's ongoing efforts to advocate for mental health awareness and reform. Thanks for coming on.

Speaker 2:

Yeah, no problem, no problem.

Speaker 1:

Can you give us a little background and what led your journey to supporting mental illness?

Speaker 2:

So I have a sibling who has severe mental illness and at the beginning of 2023, he's been very he'd been with his treatment for the last. He's had it for 20 years, but I mean so the last 10 years he's been stable and fine. In the beginning of 2023, we started to notice some changes going on. He was not quite himself and then just kind of navigating the system and, you know, trying to get him help, you know, the next three to four or five months or so, and just constantly being, you know, in voluntary hospitalizations for 72 hours and left back out without any kind of involvement of the family or any care plan put in place. Even though we're begging, please keep him. He's just not right.

Speaker 2:

And truthfully, you know, we were like, big question, massachusetts is always are they a harm to themselves or others? And of course, at the time, I'm like, of course I'm going to answer honestly, like no, I'm not afraid of him or anything. I mean, if anything, at that time I was probably more afraid something was going to happen to him, like he was going to get hit by a car or something like that, like he wouldn't be paying attention and he had odd behaviors. At that point he was no walking around barefoot. So like I was fearing, like is he going to step on a nail or something like that? I don't know, but anyways. So go through that whole process back and forth, back and forth, get slid out. 10 days after his third hospitalization, in three or four months, he's being accused of a triple homicide.

Speaker 1:

Wow. So what's happening now? Moving forward.

Speaker 2:

I couldn't tell you what happened that day, if he did it or not, or all I can say at this point is that he is accused of it. The silver lining is now they've given him help the past year. So maybe if they'd done all of that back, when we were screaming for them to do it, he wouldn't have even been in a position, meaning he would have been in a hospital to be accused of anything. So I think that it's like Massachusetts and again I can only speak for Massachusetts almost the only way to get them help is for them to get caught doing something or in trouble for doing something. Then they're finally like oh well, yes, he needs to be hospitalized. Well, yes, he actually needed that months ago, and when I told you that, he didn't want to listen. So that's kind of the short version of my story.

Speaker 1:

That's a very tough situation to be in with a sibling.

Speaker 2:

Just looking back on everything, I mean there's just so much leading up to it. Like, honestly, I didn't know. Like I'm the older sister, I mean some people, some family members, are like the parents and they've been in it forever. Like my relationship with my sibling was. I was his sibling. Seven years ago my mother passed away, so I'm the oldest sibling, so I guess I'm taking on that role and I was just learning, as I go First hospitalization I think I thought, oh, they let him out.

Speaker 2:

Doctors are the experts, so he must be fine, he's good. Of course they wouldn't let him out. He called me on a Wednesday in the middle of the day come pick me up. Oh, okay, they're just letting you out. I guess that's how it works, because that was my experience with hospitals at that point. I mean, I've gotten colonoscopies before and they won't let me drive myself home or let alone leave the office without someone physically coming up. You cannot take a taxi, you cannot take an Uber. They're letting my brother out. Okay, they know, the doctors are the experts, right? And that's when I started to realize you know, he gets home and my sister she's like, yeah, he's not okay.

Speaker 1:

So what's his age now?

Speaker 2:

He is. Let me do some math here 42 right now.

Speaker 1:

Okay, 42. So when did this all start?

Speaker 2:

This happened in 2023. So he was 41.

Speaker 1:

What were some of the events and developments that led you to believe that he needed help?

Speaker 2:

The word my sister and I would use to another. He's just off. And then the final catalyst for us to call our mobile crisis unit was she called me at like 7 am on a Saturday morning. It was like he's taken everything out of his room Many years ago. He's had other episodes, you know again this point had been about a decade ago. He kind of gone through this like purging of all of his things perfectly good things, there's nothing wrong with them and so he completely emptied out his entire bedroom and was, you know, taking mattresses outside and just desks everything out of his room. And when we asked him what he's doing he's on winter cleaning.

Speaker 2:

That point I said he was still at a point where he was agreeable. I said you know, why don't we call your care team and see, just have someone come out and talk to you. And he was fine with that. In Massachusetts you have the mobile crisis unit to come out. The patient has to agree to it. Everything in Massachusetts is very voluntary. Like they won't let you. There's not a whole lot of like involuntary, so you have to have their buy-in point. Sure they can come, like you know he's very agreeable at this point.

Speaker 2:

And the mobile crisis unit clinician came out. At that point it wasn't like take him away, or I wasn't saying take him away, I was like someone just evaluate him. So they were going to evaluate him. Well, when the clinician got there, he kind of was like I'm not ready to talk to them, took his time and then we kind of left him out, gave him some space, left him outside for about five minutes and once we went outside to go get him he was gone. And so then it turned into this like well, where is he? Where is he? When the clinician saw that behavior, the clinician made the determination that he needs to go to. Based on what I'm seeing, the little I've seen, he needs to go and be hospitalized. So the clinician is the person that pink slipped him. That's what started it.

Speaker 2:

And then, even after that first hospitalization, he was still at a point mentally where he was agreeable or at least playing the game. And you know, he allowed us to be part of the conversations with his clinician and his prescriber. We got on Zoom calls with him and his prescriber and he was, you know, willing for us to have this be part of the conversation. Meanwhile I'm also emailing the clinician because they're seeing him for 45 minutes on a Tuesday and I'm seeing him all week and so I'm emailing them and being like, just so you know, this is what we're seeing, we're still concerned, we don't think something's right. And they were kind of like OK, yeah, ok. And then it got to the point by March that he had determined my brother had said must have told the clinician, you can no longer speak to them. So then they were like we hear you, but unfortunately I am not able to speak to you about him any longer. So at that point he kind of cut us off. And that's when it was steady decline down.

Speaker 1:

So after that happened, when did you get involved again and trying to get some say on what needed to be done, moving forward?

Speaker 2:

you know, march. I kind of like backed off and my younger sister was saying you know, he's annoyed at you being pestering and you know meddling. So I kind of backed off. I was like, all right, I'm going to give him some space, like and again, I'm not a medical, mental health expert. I had no idea how to like handle this. I'm just trying to take my best guess at things. I'm calling we have a behavioral health fund. I'm calling them and they're telling me, oh, take him to this walk-in clinic, they can observe him. I'm like I don't think he's going to go for that At this point.

Speaker 2:

He's like turned off by anything that I have to say, like I'm just a thorn in his side. I suggested to him as suspected no, a friend of his suggested to him no. So he kind of just I would say by April, may, we're like just kind of like standing by, being like somebody pick him up and take him to the hospital again, like I don't know what else to do, because it is hard to be like the one to pick up the phone and be like take my brother to the hospital. I mean, you don't want to be the bad guy or anything like that. And at that point, like also like I had no idea what a Rogers guardianship was or what kind of options there were other than this 800 behavioral health line that I've heard about and this mobile crisis unit that I had already called once before, and at this point they had told me that he needs to agree to it. So I'm like he's not going to agree to it, so why am I going to bother calling them again? So in May, the police ended up picking him up and taking him to the hospital on their own.

Speaker 2:

I don't know exactly what happened, but there was some incident. We were like, oh, thank God, and it was kind of near Memorial Day weekend or so he was there a little bit longer than just the three days I think it had to do with like weekends don't count, and then you had a holiday in there, I think something to that effect, and again, I'm not exactly sure. So I ended up being there a little bit longer. I didn't have any direct conversations with anyone at that hospital stay. Again, at that point I was kind of like I don't know what to do, like he's bothered by me.

Speaker 2:

His friend and my sister were probably more, a little bit more involved with that hospital stay, and by a little bit more. I mean, maybe there was like a phone call, but again they released him, sent him home in an Uber. My sister had talked to them, but they didn't tell her like, oh, this is the care plan. Oh, do you want to come pick him up? There was nothing. It was just like here's your voucher for an Uber ride to wherever you want. Bye.

Speaker 1:

So what happened at that point? Was there any change?

Speaker 2:

Again he comes home and we're all like yeah, he's not OK, like no, and at this point he's quit his job. He had a full-time job and then had also worked part-time. After his first hospitalization he quit his full-time job Sometime in the end of May, so probably after the second hospitalization he quit his part-time job. So he's not working. He has no money Because at this point, like any money he could get his hands on, it was spent within before it even hit his pocket. And so by June 11th I was driving by his house and his stuff is outside. Again he brought everything outside of his room. After the first time I went like, retrieved everything out from the garage and put it in wherever he put it around the house. I retrieved it all. He had taken his mattress back outside. Some of my belongings are outside and I'm like one, irritated that my stuff's outside and like what is he doing? And I was like that's it I'm calling, like this is ridiculous. I called 911 and told them like listen, please come, because again, that's what I thought you did. I didn't know it was either mobile crisis or the police, I don't know. So they came, he disappeared, they looked for him and they got him again and they brought him back to the same hospital. He went to the second time.

Speaker 2:

Again, there was very little communication with the family and then we hadn't heard anything. And so I called like hey, I'm just calling to see what's going on. I haven't heard anything and they're like, yeah, we're releasing him today. I'm like I'm sorry, what? Like yeah, we're releasing him. I was like, um, no, no, this is and I go into this whole spiel about this is the third time. You know, whatever months we've already done this 72 hour whole thing. He needs to stay longer. Like blah, blah, blah, blah.

Speaker 2:

And they're like, yeah, this is the third time in a hospital. Like I don't understand. And they're like, well, let me see what we can do. And I think you know, listen, I've worked at customer service. They're just trying to talk me off the ledge. So they got me off the phone for five minutes. Call me back. And they're like yeah, we talked to the doctor. There's, unfortunately, we can't, can't do anything. If you want to file with the courts, you can, but you have to get a lawyer. I don't know anything about this. You're telling me this at the final hour, that this is my option. Like, okay, thanks for nothing. I don't know. So I was like I don't even know what to do with it.

Speaker 1:

I don't even know what you're saying means. So, with all this happening, not knowing what to do, what were the next steps for you?

Speaker 2:

And so then my sister calls. My sister lives with him with her child, who's young, elementary school age, begging them. Please, like don't bring him home. Of course is he a danger to himself or others. And she's like I mean he's doing things that could be dangerous. You know he's bringing tiki torches into our house, he's leaving pots on our stove and just forgetting about them and you know they're burning, like so, yes, something could happen. They're like, yeah, no, that there's nothing we can do. We're so sorry.

Speaker 1:

Wow, so this is the third time that he's been in this type of situation. What were some of the next steps that you took to try and help him?

Speaker 2:

I think I was just kind of calling this behavioral helpline. All they were telling me was to go to these clinics. I was like, well, that's not an option and I think that I just was at a loss. I didn't know what to do at this point. Hadn't really been connected. I tried calling at some point NAMI. I heard they had a family to family class, but I had missed the start of it because I didn't get started in March. So I didn't get any information that way and I really didn't hadn't dug into NAMI and all the different resources that they do have.

Speaker 2:

Again, I'm learning this like mid crisis, in the midst of everything. I'm working full time. I have my own life, like I don't know. So was I doing anything profound at that point? Probably not. But again, I didn't necessarily think that. Like I wasn't afraid that he was going to hurt himself. Like I said, more of a had odd behavior. You know, like again walking around barefoot or, you know, going to open houses for million dollar homes. He doesn't have a penny to his name, like that. But telling me. But then telling me, jess, I think I found the one. This is the house, this is going to be the house, and I'm like, just you know, obviously not in reality.

Speaker 1:

So when he got out and ultimately he was accused, mm-hmm. So what happened then? Now you're dealing with the legal system. That's a completely different system than dealing with the hospitals psychiatric hospital.

Speaker 2:

When he was accused, police took him to the hospital because they were like, oh, he needs to be hospitalized. And from the hospital he was not there for 72 hours. They took him to jail. Then, from jail he was acting psychotic and they're like we can't do this. This is not us.

Speaker 2:

Within 24 to 40 hours of being in jail he's sent to the state psychiatric hospital, which, for men, is run by the Department of Corrections. It's not run by our Department of Mental Health. The Department of Corrections hires a contractor to handle the medical needs. So he was sent there and he was there for 11, almost 12 months. He was found not competent to stand trial for the first 11 or so months. So he was receiving care. I mean he was medical compliant. Like he was, you know, not competent to stand trial. It doesn't really mean like are you acting crazy, it's just can you aid in your defense? He was found not competent but at this point we're able to visit with him, we'll have meals with him. Like visitation Over time got much more closer to his baseline, much more recognizable as who we know.

Speaker 1:

That sounds a little better. So how did that work out and what was the journey like from that point?

Speaker 2:

He was then found confident to stand trial, which then means oh, back to jail for you, while they claim there's mental health care there. The mental health care for him consisted of, once a week a clinician stopped by his cell for 10 to 15 minutes and that was it, and he got his medication. Every day he came in. There's an intake unit that you go into the intake unit for 72 hours so they can observe you, especially when you're coming from a psychiatric hospital. So he was in a cell by himself for the first 72 hours.

Speaker 2:

It was very difficult to understand. Like the prison, the actual jail operates completely different than the psychiatric hospital. The psychiatric hospital, again, is overseen by the Department of Corrections. The jail is overseen by the county sheriff department. So, figuring out this whole new system, how things work, all these things, the clinician talks to him and says you know, here are your options of where to go from this intake unit, we have a mental health unit that you can go to. The mental health unit is dorm style one big room, 40, some odd beds, everyone living in the same space.

Speaker 1:

So how did that work out from there?

Speaker 2:

Depending on your personality, that sounds wonderful or that sounds awful. For his personality that sounds awful he's like no, our personalities are very different and that sounds awful to me. So it was either that or stay where he's at in this room by himself. So he was like I'm all set, I'm going to stay by myself, which meant he was very isolated, very like, not healthy for anybody, any human being Like. He didn't have interactions with anyone. He was in a cell by himself essentially 24 hours a day, whereas before at the psychiatric hospital he could walk around. There was TV he could. He had a TV in his room. This place he wasn't allowed to have a TV in his room. He had a little tablet that he could get movies on, but for some reason his tablet never worked for movies. He ate all of his meals in his cell by himself. He didn't even get to go to the cafeteria. It was just awful, awful, awful in my eyes. The alternative also sounds awful to me. So I don't know. Pick the lesser of the evils.

Speaker 2:

So after four months there I don't really know how it happened he must have raised his hand and said I want to be re-evaluated for competency. And again this also this time like I'm advocating more and like talking to his lawyer and saying I begged them not to move him from a psychiatric hospital. I begged them. I said it's not right. This is where he's gotten well. He's about to go through a very stressful time. He needs support. Those supports are not going to be in the jails. You know, I was on the phone with the director of clinical services. I was on the phone with the state hospital. I was just talking to anyone I could talk to, because I know that some people have been able to stay in the psychiatric hospital, but I don't know what the magic button is. No one is telling me what the magic button is.

Speaker 2:

I know he was unhappy when he got to the jail. He asked me please just don't meddle too much, because this is jail and I don't want to be like retaliated against because you're being, you know, poke, poke, poke, poke, poke, poke, poke. I respected his wishes and I really like laid off. The family engagement person at the jail just kind of irked me. Within the first week. Anyways, when I emailed her asking her questions, she flat out told me please don't email me this much, I am only one person, just call me. And I was, like, can you say that? Like, don't email you. So I talked to the director of medical services at the jail once. She was very nice but didn't really get anywhere with it.

Speaker 2:

So he must have raised his hand and got reevaluated, which meant that he was sent back to Bridgewater in September. They took about, I think, 40 days to evaluate him and then he was deemed not competent again. So he is committed to Bridgewater again for up to six months. So he's there now. I guess he's better, I guess. But it's hard to stay like hopeful in these situations. I mean, his life has been on hold for over a year and a half and it's like you know you don't have any end in sight. The possibilities of what could happen are terrifying. So is he in a good place mentally? Hopefully not. Who would be?

Speaker 1:

What's the legal end? Look for you now. What type of lawyer do you have? Is it a specialty lawyer, public defender? What kind of lawyer is helping you through this?

Speaker 2:

Just a public defender. I'm not sold on him, but I don't really know what other choice we have. I mean, obviously he has gone through whatever hoops he needs to go through because he's a private lawyer that I guess you know. Massachusetts contracts out their public defenders, I guess. So he's gone through whatever hoops he has to go through to have cases of this caliber.

Speaker 2:

So it's not that I don't think that he's not knowledgeable in law. I'm just not convinced he's truly, truly knowledgeable in what mental health means and serious mental illness means. I think that you know, when we asked him, he's like well, every homicide case basically involves mental health. And I'm like okay, sure, you're probably right, but I don't get the impression he's going to bat for him like 150%, like why is he not fighting to keep him at Bridgewater and raise his hand and explain why? And I think he just doesn't truly get it. He will just re. When I bring it up to him, he just regurgitates the law to me and I was like you're not understanding me, like the supports are not there. And he's just like well, the jail has been deemed acceptable. And I'm like okay, I hear you, I hear you. So I've had some conversations with him.

Speaker 2:

I feel like I'm in an odd place, like I try not to meddle too much and I'm trying to still get my brother's buy-in because I can be part of the conversations with him and the lawyer.

Speaker 2:

I think my brother, at this point, hasn't wanted me to be and I think don't know if it's because there are things that he doesn't want me to see or hear or whatever. And I'm not saying I need to be part of, like the what happened conversations, but like, maybe some of the strategy conversations I could be part of, or like, even if he's deemed competent, can a request be made into the judge for him to remain where he's at while he's awaiting trial? I think that I'm I'm more outspoken than my brother, but while he's awaiting trial, I think that I'm more outspoken than my brother, but he also doesn't know anything. I mean, he's been all this happened, he's been thrown in this hole, he doesn't have access to Google, he doesn't know, like, what his options are. He's just knows what he knows and which isn't a whole lot, because this isn't our world. So I'm still trying to convince him that, like I, at least should be part of those conversations.

Speaker 1:

Sure, that makes perfect sense. It's always good to have an advocate on the outside. Now, what about your sister? Is she part of the conversations as well?

Speaker 2:

She is to an extent, but I mean she has a kid and I feel like I just have a little bit more time on my hands to deal with this and so I think she plays the younger sibling role very well. Like somebody else will take care of that. I'm just so farther down the road than she is. You know, if she wants to know something she'll ask, otherwise she just kind of stays out of it. Of course she keeps in touch with him and talks on the phone and writes letters and that sort of thing, but like in terms of the advocacy and figuring it out and all of that, that's not really her. But like in terms of the advocacy and figuring it out and all of that, that's not really hard.

Speaker 1:

Now, how is he compared to when he first went into the hospitals and the jail system? Is he better, worse? How is his mindset now?

Speaker 2:

Yes, yes, yes, yes, yes, I think that they have helped him. However, I will say at the state hospital he's at, one issue I will say we're seeing is that you know, he's had this illness for 20 plus years. So he's been through lots of therapy and lots of whatever. So I kind of liken it to a school system. Like he done kindergarten level work, he's done first grade level work and I feel like the state hospital really only goes up to like grade three and he's more like a seventh, eighth grade level.

Speaker 2:

So in terms of the therapy there he's quite frankly bored. It's hard for him to engage with it because and I guess they, you know, they play to the lowest common denominator and so some of the denominators are pretty low. To a certain extent they aren't able to service him at the level that I think he probably needs to be serviced at at this point. But it's far better than what he would get in jail, which would be nothing needs to be serviced at at this point, but it's far better than what he would get in jail, which would be nothing.

Speaker 1:

Well, at least that's a good thing. Now, what would you like to tell our listeners that you think is very important? That they need to know about the situations you're going through, so if anyone else is going through the same situation, it could help them a little.

Speaker 2:

Well, I mean, I think in hindsight, I wish that I kind of knew all this before you're in the middle of the crisis. So learn everything you can before there's a crisis happening, because it's really hard to learn on the go. In Massachusetts, specifically, we're missing a key tool in our toolbox, which is AOT the assisted outpatient therapy, to allow for more involuntary and the courts to be involved in more treatment plans that are followed by the courts, because having these people go to these hospitals, whether even if it's for three days, two weeks or whatever I mean I think he got released with a 30-day supply of medication and was like told good luck I mean that's not going to help anybody. There needs to be a better systematic care plan in place. So I guess to other family members I would say you know, just educate yourself as much as you can, because you never know when you're going to might need that need to know what to do.

Speaker 2:

Like those behavioral helplines. While they are certainly a tool in the toolbox when you're dealing with someone who's in psychosis and well past understanding that they're sick, you know our senators and lawyers need to realize that those helplines fit a certain segment. There's another segment afterward that still needs help, and they need help, just like somebody with Alzheimer's. You know, you find your grandma walking outside in her pajamas and no slippers on. You're going to do something. You're going to tell them you cannot be outside. You're going to involuntarily take them inside. The same should be true of someone that's in psychosis. They're human beings, you know, and their brains are flexing, and not flexing correctly, and they just need some support and not to be left like. Good luck, you know. Hope it works out for you.

Speaker 1:

Yes, absolutely. And when you get thrown into it, sometimes it can seem like it just happened overnight when it didn't. But it can be the big unknown and you just don't know what to do. It can be so overwhelming to the families and the loved ones that's trying to help them.

Speaker 2:

Yes, agreed, very overwhelming, Very very overwhelming.

Speaker 2:

I don't know if he would have agreed but maybe before all this had happened just having myself or my sister be healthcare proxy, because most doctors and hospitals protect themselves by HIPAA Sorry, hipaa, I can't do it and they hide behind the HIPAA curtain.

Speaker 2:

So HIPAA needs to be rewritten, and I've heard that it has been. I guess we're going to probably need to educate everyone that has been rewritten or rewarded a little bit to better help people in situations like my own. So if someone's in psychosis or not mentally, well, then yes, you can talk to a family member or the appropriate person regarding their care. Then really the families are the ones on the front lines. These doctors need to partner with us and realize that, like we know our loved ones best, we're not just saying these things to be, you know, annoying, like we know them better than anyone. So just partner with us and helping them, because together we can like get this person on the right path. People with serious mental illness are able to live normal lives. They just need help getting up when they fall, that's all.

Speaker 1:

Yeah, absolutely. Well, this has been great Good conversation, good information. Thanks for coming on.

Speaker 2:

Yeah, no problem, I appreciate you talking to me and thanks for getting the word out.

Speaker 1:

Absolutely. It's been a pleasure. Thanks again, thanks again. Tell us their story, send them to TonyMantorcom contact, then they can give us their information so one day they may be a guest on our show. One more thing we ask tell everyone everywhere about why Not Me, the world, the conversations we're having and the inspiration our guests give to everyone everywhere that you are not alone in this world.