Prelude to a Death; Those Who Watched Marie Elise West's Manic Spiral Saw a Collision Coming. But Under Existing California Law, There Was Little They Could Do to Stop It.


Copyright 2003  LA Times

 Al Bowman knew the answer, but he still had to ask. "Honey, why don't
you skip your shift tonight and check in at Harbor-UCLA? Maybe you could
use a little help." He phrased it as a gentle suggestion to his wife, but
her blazing blue eyes scorched him from across the room.

  "I'm not going to get strapped down and get a needle stuck in me," he remembers her saying. "I'm fine. I'm going to work."

  It was Aug. 31, 2000, the Thursday night before Labor Day, and Hermosa Beach was getting ready to do what it does best: paaaarrrtty. But the 41-year-old Bowman had no time for barbecues and block parties, no time for the skin-on-skates fashion show rolling down the Strand or the Fiesta de las Artes that turns the Pier Plaza into a sprawling, smoky street fair. His wife, 35-year-old Marie Elise West, was showing signs of another manic episode like the one she had experienced five months earlier, in March 2000, when she was arrested for trespassing at a Redondo Beach hotel called the Palos Verdes Inn.

  She had been hospitalized for 45 days after that arrest, her sixth arrest
and 19th hospitalization since 1990, when she was diagnosed with manic-depression,
also known as bipolar disorder. During the depression phase, she often
slept as many as 18 hours a day. But she had slept little during the previous
few days. At dinner with a friend the night before, Bowman says, she spoke
in the voices of three different personalities: an Army drill sergeant,
a college professor and a street-walking prostitute. Then she was involved
in a late-night car accident.

  Now she couldn't stop buzzing around the little Cape Cod-style bungalow
they shared with their three Chihuahuas five blocks from the beach. West's
manic episodes usually came in the spring or early fall, but clearly she
was close to the edge on that late summer day. Bowman says he paced the
floor in frustration after she rejected his plea to check in at a hospital.
Under the 33-year-old state law known as the Lanterman-Petris-Short Act,
mentally ill people in California can be held against their will only if
they are deemed a danger to themselves or others, or gravely disabled.
Typically, police are called during a violent episode and they "5150" the
patient to a hospital--a reference to a section of the LPS Act that allows
police to transport someone to a hospital, where they can be held for evaluation for 72 hours. Otherwise, people showing signs of a psychotic episode must sign themselves in voluntarily to receive emergency medical treatment.

  With West's mania and its surge of inflated self-confidence coming on,
Bowman knew there was no chance his wife would sign herself in that night.
A onetime law student, she knew all the angles of California's mental-health
laws. He had called the police under similar circumstances in March, to
no avail.

  The police officers who came to the house that March night determined
that West was not violent, and they made Bowman give her the car keys she
was demanding. Sgt. Paul Wolcott of the Hermosa Beach Police, who once
before had 5150'd West, says of the March episode: "She wasn't violent,
and the car was registered to her, so we had no choice. The law gives us
very narrow, very strict guidelines to work under. If she doesn't meet
the 5150 guidelines, there's not much we can do."

  Bowman had already called one of her psychiatrists, Dwight Bergquist,
and advised him of the situation a few days before. Bergquist had not seen
West in several weeks, but Bowman says the psychiatrist advised him to
adjust her medication, which he did, adding Haldol to the four medications--prescribed by different doctors--that she already was taking. Bergquist says he advised Bowman to take her to a hospital, but Bowman did not. What was the point, he says, if she wasn't going to sign herself in?

  The mental-health movement known as mainstreaming, designed to get mental patients out of hospitals and into the community, has had a number of unintended consequences, many of them positive, some of them deadly. One of every 20 homicides in this country is committed by untreated or under-treated mentally ill people, according to a 1994 report by the U.S. Justice Department.

 A recent study by the John D. and Catherine T. MacArthur Foundation, an
Illinois-based philanthropic group, estimates that mental patients released
into their communities commit nearly 1,000 homicides each year.

  Proponents hailed the mainstreaming movement in the 1970s as part of
the civil-rights struggle. Critics warned the impact of the movement on
society could be dangerous, but they were brushed aside by an unlikely
alliance of politicians--including then-California Gov. Ronald Reagan,
who saw mainstreaming as a way to empty overcrowded treatment facilities
and cut state costs--and civil- rights leaders, who cited horror stories
of people held against their will after they were no longer a threat to
anyone.

  Thirty years later, the story of Marie Elise West highlights one of
the unintended consequences of that dramatic policy shift. It also raises
disturbing questions about whether California's mental- health laws are
outdated. Have the civil rights of the mentally ill taken priority over
public safety? Has the basic right to walk the streets safely been compromised by state government's unwillingness to legislate--and pay for--treatment of the mentally ill?

  "We've been aware that the pendulum had swung too far for quite a while
now," says Assemblywoman Helen Thomson, D-Davis, a leader in the movement to reform the state mental-health laws. "It's sad because 99% of the mentally ill are not involved in violent incidents, but the focus is on the 1% who do commit these violent acts because the headlines are so startling to
the community."

  The warning signs of problems with the new mainstreaming policy cropped
up early. Within the first five years after the LPS Act took effect Jan.
1, 1969, the number of mentally ill people who committed crimes and were
imprisoned in state or county jails  jumped 300%. Although the LPS Act
has been amended during the ensuing 30 years, it continues to guide California's approach to the tricky intersection of the criminal justice system, which is based on a culture of punishment, and the mental-health system, which is based on a culture of treatment.

  Thomson, who began working as a psychiatric nurse in 1963, asked for
a report on the criminalization of the mentally ill in 1997. That report
found that 20% of the state prison population and 11% of the county jail
population are severely mentally ill. In its final report, issued in 1999,
an LPS Reform Task Force--an ad hoc advocacy group made up mostly of mental-health professionals and affected families--concluded that the original law underestimated "the structure and support some people with mental illness would require to successfully participate in community life." Even with piecemeal amendments, it described the law as "one of the most adversarial, costly and difficult to administer involuntary treatment systems in the U.S."

  The report added to a growing call for reform, but major changes in
the LPS Act proved elusive until a spate of high-profile automobile homicides involving mentally ill people made the issue a legislative priority. In
1999, an Orange County man with a history of mental problems drove into
an Irvine schoolyard and killed two children. Last year four people died
during an Isla Vista street party when a UC Santa Barbara student with
a history of mental problems drove his car into a crowd. Several cases
involved affluent mentally ill people, reminding legislators that mental
illness is not just a problem among the homeless and disenfranchised.

  The basic issue--when and how someone should be involuntarily treated--remains the same. "It's not only morally and legally wrong to allow these people to go without care until they do something criminal, it's also financially wrong," says Carl A. "Tony" Capozzola, a defense attorney representing West in the case stemming from the tragic consequences of that late August night. "It costs taxpayers more in police, legal and incarceration costs than it ever would to treat them properly."

  West dressed for her shift as a server at the Hermosa Steakout restaurant in an outfit that showed off her blond hair and compact dancer's body. Barely 5 feet 6 in heels, she was a high-energy dancer who had worked as a Vegas showgirl in 1991 and 1992. For a moment Bowman remembered why he had stood by her, unlike two previous husbands who had bailed out when they realized this sexy, smack-talking beach babe was also mentally ill.

  After she left for work, Bowman called her parents, Roger and Geraldine
West of Seal Beach, at 7:30 p.m. He conferred with them, as he often had
since he met West in 1995 and married her in 1999. The relationship with
his in-laws had been rocky from the start. For five years, they were reluctant
caregivers, each blaming the other for her occasional flights into mania.
Bowman felt that any contact with her parents was stressful for her.

  Her parents felt that Bowman's lifestyle as producer of the Los Angeles
Music Awards--which Bowman says includes late-night clubbing, loud music
and 24/7 phone calls--was a catalyst for her manic episodes. But this night,
after nearly an hour of discussion, they agreed on a plan that ultimately
would be doomed by apparent miscommunication. Roger West and his son Allen, an attorney who had represented Marie Elise during many previous episodes, intended to come over to take her to the hospital, then to ask the hospital police to 5150 her.

  At the restaurant, West was so exuberant she started inviting people
in off the street and urging them to order dinner and put it on her credit
card. At 9 p.m., two hours before her usual quitting time, her supervisor
ordered her to go home. When she arrived, Bowman was convinced a manic
phase was beginning, and that it likely would lead to an incident that
would keep her hospitalized anywhere from two days to four weeks.

  At 10:30 p.m., West began to fear for someone else's safety, another
signal that she was spiraling into a manic phase. In 1993 she had driven
her car into the Huntington Beach Pier because she thought Nazis were gassing Jews underneath it, and in 1995 she had attacked a teacher at an elementary school after she walked on the school grounds, announced she was the Messiah and warned students they would be sold into sexual slavery. Now she began to obsess that Michael Maglieri, son of Mario Maglieri, owner of the Sunset Strip clubs The Whisky, The Roxy and the Rainbow Bar & Grill, would be killed by gang members.

  Bowman hid West's car keys when she went into the bedroom to change
into black jeans and a black shirt, but he was no match for her guile as
the mania took over. A minute later she came flying out with a "secret"
set of keys to her 1989 green Volvo 240DL and said she was going to rescue Maglieri. She began screaming and ran outside, drawing the attention of neighbors. Once before, Bowman had been issued a domestic-abuse warning when he says he was merely trying to get assistance for her. He feared another such police misunderstanding, so he stood and watched as she drove away at 11:30 p.m.

  Bowman called her parents again and swore that he would take her to
the hospital himself--against her will--as soon as she returned and ask
the hospital police to 5150 her. Then he called Hermosa police and warned
them she was loose. They promised to look for her.

  At 1 a.m., West called from the Rainbow Bar & Grill. Bowman begged her
to come home but she ranted about land mines on the 405 Freeway and hung up. He walked the floor all night and called police twice more. Nothing.

  At 3:45 a.m., as Bowman was still pacing in  Hermosa Beach, Jesus Plascencia pulled his old, cranberry-red Buick into the parking lot of the Western Bagel Shop in Van Nuys. It was the same routine the 65-year-old Mexican immigrant had performed six days a week for the last 12 years: pick up several dozen bagels and bring them to nearby Weiler's Deli, where he worked as a busboy. A frail, gentle man at 5 feet 9 and 140 pounds, Plascencia spoke little and communicated mostly through his hands. As he walked into the bagel store, he passed a green Volvo parked in a no-parking zone with a blond woman fidgeting behind the wheel.

  When Plascencia came out with his bagels and approached his car, police
say West suddenly put her car in reverse, backed up and hit him. The blow
knocked him to his knees as dozens of bagels and his black baseball cap
scattered onto the oil-stained parking lot. His shirt caught on the undercarriage and he was dragged 30 yards onto Sepulveda Boulevard, where he rolled free.  Although no one knows if she did so deliberately, police say West stopped the car, turned around, and ran over him again, once more snagging his shirt and dragging him farther down the road until he rolled free again.  She left him dead in the street, police say. She drove back into the parking lot, went in the bagel shop and asked employee Hector Quintero for a cup of water.

  When Quintero confronted West about Plascencia, she replied: "Oh, him?
He's roadkill." Quintero called 911. West grabbed the cup of water and
stormed out to the parking lot, where she wandered aimlessly for a few
minutes. One witness said West looked like a "stripper" in her black blouse
and tight black pants. Then she picked up a few of the fallen bagels and
put them in the trunk of her car before being confronted by a firefighter.

  "You're not a police officer," she said. "I don't have to answer your
questions." As other firefighters surrounded her, West got in her car,
locked the doors, rolled up the windows, turned up the volume and put on
a favorite CD.

  Firefighters from L.A. Station 90 in Van Nuys were on the scene within
five minutes of the dispatcher's report of a car-pedestrian accident at
Western Bagel. After several firefighters surrounded the Volvo, West rolled
down her front passenger window.

  "What do you want? All I did was stop and try to get some water because
my radiator is overheating," she said. She rolled up the window again,
turned the volume all the way up and ignored them. Finally, Capt. Corey
Rose took a ball-peen hammer and broke the Volvo's left rear window. West kicked and cursed as she was dragged out of the car.

  "You people don't run this country, you're just servants," she said.
"Wait till my ex-husband hears of this. He's a big man, and, yes, he is
black."

  Police took West to the Van Nuys division of the Los Angeles Police
Department. As she was brought in for booking, Det. Al Aldaz says, West
made anti-Latino slurs and kicked at the officers escorting her. The first
TV reporters arrived at Western Bagel minutes after police took West away.
Within hours, Aldaz made the first of several public statements suggesting
the homicide was a hate crime. He told the media: "She said something about
people of Hispanic descent should go back to their country, after the intentional hitting of the vehicle toward the victim." He also told reporters that
West said "she hated people of Hispanic descent."

  At 5 p.m. Friday, a reporter for WABC/7 news delivered a report that
was typical of the early TV coverage: "This was no accident here this morning," he began. "Police have arrested 35-year-old Marie West of Redondo Beach [sic] and charged her with murder, and they do say it was a hate crime. They say she intentionally ran down a Hispanic man simply because he was Hispanic."

  After showing footage of the crime scene, the reporter concluded: "L.A.
police say they see no indication that Marie Elise West is crazy. They
say the first thing she did when she got to the police station was ask
for a lawyer."

  The hate-crime angle continued to build in the media echo chamber over
the weekend as details emerged. Plascencia had never married, but he had
worked at the deli for more than 20 years and he lived with a family that
took him in as their honorary grandfather. He was known and beloved by
his friends and co-workers as a humble, hard- working man. They gathered
2,000 signatures on a petition demanding that West be charged with a hate-crime
murder.

  To convict West of a hate-crime murder, the state would have to prove
that she intentionally killed Plascencia because of his ethnicity. Such
a charge also would make her eligible for the death penalty or life imprisonment without the possibility of parole, depending on how the district attorney decided to pursue it.

  On the morning of Sept. 5, four days after the homicide, Gil Garcetti,
then the L.A. County district attorney, charged West with a hate-crime
murder, alleging that she killed Plascencia in a premeditated act because
he was Latino. Capozzola, West's attorney, says he asked Jacquelyn Lacey,
head of the D.A.'s hate-crime unit, to hold off on the charge until West's
mental state could be evaluated. He says he was told the decision had already been made and that the complaint could be amended later if it turned out a hate-crime charge was not warranted.

  "I told her it was premature and not consistent with a careful evaluation
of the facts," says Capozzola, a former deputy district attorney. "Why
was there such a rush to judgment?"

  West's parents suspect that Garcetti--who declined several interview
requests for this story--was trying to curry favor with the Valley's Latino
voters as part of his losing bid for reelection two months later. Bowman
tried to fight back on local newscasts, arguing that West was out of her
mind on a toxic cocktail of medications at the time of the homicide and,
in her right mind, would never harbor any racist thoughts. Three weeks
after Plascencia's death, a judge in Van Nuys Superior Court referred West's case to a mental-health court, which determined that West was not competent and should be held for treatment and evaluation until she is competent to stand trial.

  Chuck Jones, Western Bagel's human resources director, was at the scene
the morning Plascencia was killed . He says he is surprised that D.A. Steve
Cooley--who defeated Garcetti--still has not dismissed the hate-crime charge. 

  He said all the employees he talked to that morning understood instinctively
that West was mentally ill. "Several of the workers said she was crazy.
It's unfortunate the police turned it into a hate crime so quickly," Jones
says. "It had nothing to do with [Plascencia] being Latino--unless there's
something we don't know about in her background."

  West had grown up assuming she was white, but in 1978 she learned that
her mother was officially "racially mixed" because of her Creole background.
That was when the West family first learned that her mother, Geraldine
Porche, had ancestors in Louisiana that included black slaves who had borne
the children of white French settlers.

  In the summer of 1990, West completed an internship at the Bet Tzedek
Legal Services firm, where she told everyone she was headed to Berkeley's
Boalt Hall law school. In her exit review, dated Aug. 13, 1990, her supervisor described the 25-year-old West as a "legal assistant extraordinaire."

  The flattering description was supported by detailed insights: "Marie
Elise is an extremely intelligent woman. She has excellent oral and written
communication skills. . . . She is highly organized." On her application
to Boalt Hall, West checked off "racially mixed," a factor that could have
helped her gain admission after graduating from UCLA in 1988 with a bachelor's degree in history and a 3.2 grade-point average. She delayed starting law school for two years.

  By the time she arrived at Boalt Hall, West had begun to wonder if she
had been admitted because of affirmative action policies. She decided she
would leave law school if she had. "She felt she would have been depriving
someone who had suffered true discrimination of the extra help they were
entitled to," Bowman says.

  West checked with the admissions director, who told her, informally,
that affirmative action had not been a factor. Two days later West tried
to join the Black Student Union. Her lead attorney, Capozzola, did not
allow her to be interviewed for this article. But according to Bowman,
West claims she was ridiculed by some of the black students, who may have
felt the blond-haired, blue-eyed West was mocking them.

  On Sept. 9, 1990, two weeks after she arrived at law school, West told
her roommate that CIA spies were following her. Someone called police after seeing her behave erratically at a mass-transit station, and police took
her to the Herrick campus of Alta Bates Medical Center, where she was first
diagnosed with the onset of bipolar syndrome. She stayed for more than
a week, then she checked out and resumed classes. But after two more weeks of classes, West voluntarily returned to Alta Bates. She checked out in mid-October and came home to Seal Beach. Four days later, a very troubled West was admitted to College Hospital in Cerritos.

  Her "chief complaint" on her admission form, as quoted by the attending
physician, Charles Clegg: "There is too much--too much-- the pressure
of law school is too much." It became clear to West's College Hospital
doctors that there were other problems--family and racial issues--that
may have played as much a part in her initial breakdown as those first
weeks of law school. She said she was hearing voices that frightened her,
and ascribed racial overtones to her emerging mental problems.

  According to Clegg's notes of Nov. 3, 1990: "She stated the voices told
her they knew she was mentally ill. She stated she thought these voices
were people from the black student union she had joined at Berkeley. She
stated she was extremely fearful of these voices. She stated she was a
Creole and that had made her black. In fact the patient is Caucasian. .
. . Her initial mental status examination showed her to be totally overwhelmed. Flight of ideas and tangentiality were obvious. . . . She was clearly hypomanic and did not appear to realize that she was mentally ill."

  Clegg had identified a critical problem for West and many mental patients:
the inability to realize they are ill and need medication. Her parents,
Geraldine and Roger West, have joined several organizations for families
of the mentally ill. They say they have seen and heard about the denial
syndrome many times.

  During an interview at their Seal Beach duplex, Roger, a retired computer
salesman, reaches into his shirt pocket and pulls out a 3- by-5-inch notecard.
In capital letters, he carefully prints the word "ANOSOGNOSIA"--defined
as a patient's inability to recognize his or her own disorder or illness.

  "It's the key to understanding all this," he says as he hands the card
over. Even though they don't get along, Bowman agrees with his father-in-law
on this point. "It's the Catch-22 that the authors of the LPS Act didn't
take into account," he says. "Medication works, but only if the patient
is conscientious about taking [it]. When the mania comes on, they start
to feel so good that the idea there might be something wrong with them
is absurd. So they no longer feel the need for medication, and that's when
the public is endangered."

  J. Raymond DePaulo, a specialist in manic-depression at Johns Hopkins
University in Baltimore, says it is crucial for a patient to establish
a stable, long-term relationship with a hospital and a therapist. Ideally,
outpatient care of medication and therapy is  supplemented with brief hospitalizations when necessary. More than 75% of America's 3 million manic-depressive patients manage to live fairly stable lives, he says, even though most are not correctly diagnosed until 10 years after the onset.

  West's medical records, provided by Bowman, are littered with references
to her resistance to medication. She complained constantly that the medications were fueling her descent into mental illness. Within two months of her initial episode, the pattern for the next decade was set: West--often convinced that she was not sick- -began a modern odyssey of 19 hospitalizations that would lead her to eight hospitals, seven therapists and an ever-growing list of medications, including the mood-stabilizing drug lithium and the powerful psychotropics Haldol and Seroquel.

  "That happens all too often," DePaulo says. "Her case is not unique.
The cohesive support network often just isn't there."

  Money for medication, therapy and hospitalization quickly became an
issue. West's parents went through more than $125,000 helping her during
the first few years after diagnosis, until a monthly bill of $951 for medication
finally forced them to look for help from Medi- Cal. West was granted Social Security disability payments in December 1995, but that did not cover all the medical costs. Money was always a stress point for her.

  West's parents say California's outdated, inadequate laws force families--even relatively affluent families determined to stay involved with their mentally ill children--to watch helplessly as their loved ones try to live independently until their next episode, when they again can be hospitalized against their will. That leads to fragmented treatment, they say.

  "The reality is that when someone is 5150'd, the police take him or
her to the nearest institution equipped to handle them. That's how she
started at Alta Bates and Harbor-UCLA," says Geraldine West, a retired
paralegal. She noted, too, that her daughter was 5150'd eight times before
she ran down Jesus Plascencia.

  During the decade that passed between Sept. 9, 1990, the day of West's
first psychotic episode, and Sept. 1, 2000, the day she killed Plascencia,
West had struggled to live as a "normal" person, to prove to everyone how
smart and involved she was. She tried law school three more times, and
three more times she quickly had psychotic episodes and dropped out. She
also worked as a legal assistant, as a Las Vegas showgirl and as a cosmetics
saleswoman.

  She joined health clubs and the Sierra Club, volunteered for the ACLU
and wrote songs. She tried to start a bumper sticker business with her
own heartfelt messages ("Immigrants Are People Too," and "Why Do We Kill People to Show Them That Killing People Is Wrong?") and wrote hundreds of letters offering advice to politicians such as former President Bill
Clinton and U.S. Sen. Dianne Feinstein. She took up the causes of everyone
from inmate Mumia Abu-Jamal to publisher Larry Flynt.

  She married three times, once to a black man and the third time to Bowman, who is half-Latino. Bowman did not realize she was mentally ill until several months after they began dating, when he woke up to find her burning his Beatles albums and screaming, "These are not the Beatles. They're impostors from the CIA." Bowman called her parents in the morning and learned he was in love with a mentally ill woman.

  "Up till then I just thought she was a beautiful, kind, idealistic girl
who had a really outgoing personality," he says. "By the time of the first
episode, I was in love, and I couldn't leave her."

  Typical of West's efforts during the five years Bowman lived with her
was a letter she wrote to film director Steven Spielberg on June 7, 1997.
"I recently saw your latest movie, 'The Lost World.' I was shocked and
delighted to see a young girl of color play a role in your film that would
have normally gone to a Caucasian. . . . I am very sensitive to race issues
for reasons unknown to myself."

  The letter shows why the hate-crime charge is so absurd, Bowman says,
and so painful for West's friends and family. "She celebrated her own ethnicity," he says. "This had nothing to do with hate. She couldn't control the illness. It controlled her. Because the law wouldn't let us hold her against her
will when the illness took over, Mr. Plascencia is dead and my wife is
facing the death penalty."

  West's case has been stalled for the past 20 months as she goes through
her prison-style daily routine of evaluation and treatment. Currently taking
five different medications, she remains at Patton State Hospital, waiting
to be declared competent to stand trial. She was found incompetent again
last month, and her next hearing is scheduled for Oct. 8. If West is found
competent, both sides agree a trial could follow soon after--unless a deal
is struck. The fundamental questions posed by the hate-crime charge remain:
Did West kill Plascencia deliberately? Did she kill him because he was
Latino, or because she was out of her mind and would have backed into whoever
was there?

  Bowman says his wife should be charged only with involuntary vehicular
manslaughter. "This was a terrible accident by a woman having a psychotic
episode, a woman who tried desperately to stay on the right mix of medication. Mr. Garcetti tried to pump it up into a hate crime for his own political purposes," he says. "It was a politically motivated rush to judgment."
While Deputy D.A. Scott Millington, who took over the case and now is head of the D.A.'s hate-crime unit, and Det. Aldaz say they still believe this
was a hate crime, Plascencia's nephew, Sal Hernandez, says he is not sure.
"I don't know why she did it," he says. "The reason will probably never
be known."

  Hernandez, who works as a mechanical engineer in Los Angeles, says he
does not want to see West on death row. "But she deserves to be put away
from society, so she will not commit a similar act," he says. "She was
responsible for maintaining her medication. This is what society demands
of all of us."

  home alone at night with his three dogs, estranged now from West's family,
notorious in the town he was raised in as the husband of the crazy woman
who ran down a kindly old immigrant, Bowman says he relates to the plight
of Rusty Yates, husband of the Texas woman convicted of drowning her five
children in the family tub. "Sometimes I feel like the only man in America
who can relate to what he has had to endure, when you love someone who
turns out to be mentally ill," Bowman says.

  He says he is haunted by memories and second-guesses. Suspecting the
approach of another manic episode, he says he talked things over with a
still-rational West a week before Plascencia's death. He says she told
him she wanted to be treated at Alta Bates Medical Center in Berkeley,
where she was brought after her first episode back in 1990. "She always
felt they did the best job with her," Bowman says. He also says she wanted
to go alone, insisting, "I don't need a babysitter."

  So he bought her a plane ticket for San Francisco, arranged for her
to stay with friends and took her to the airport on Aug. 27. That same
day workers began a long-planned refurbishing of their house.

  When West arrived at Alta Bates the next day, she told the admitting
doctor she was having gynecological problems, not mental problems. "I think
that, like many mental patients, she just chickened out from admitting
herself to the psych ward. No one likes to get strapped down or get a needle
stuck in them," Bowman says.

  The doctor prescribed an anti-bleeding medication and released West
without any mental evaluation. She flew home Aug. 29, took a taxi from
the airport and showed up at the house unannounced. She found the carpet
pulled up and the furniture removed, and Bowman says his wife began crying
hysterically.

  "Any kind of stress like that, any change in her environment, could
set her off," he says. "I knew she was on the edge, but I felt helpless.
There was nothing I could do. Not until she was violent. Not until it was
too late."

What is not likely to change, said Mikula of DMH, are the state and federal laws that grant young people the right to refuse treatment and medication at the age of 18.

For some parents, those laws remain the central problem, giving their children veto rights just at the time in their lives when they most resist authority. If her daughter had been forced to move into a supervised group home, Louisiagnau said, the 11 emergency hospitalizations would not have taken place. "It doesn't make any difference right now how many programs we have," she said. "The law has got to change."

Even for parents who would not alter the laws, the transition can be jarring, even frightening. One night last fall, a case manager from the Department of Mental Health came to John and Carol Willett's home carrying a sheaf of release forms for their son, Michael, who had turned 18 a week before. Michael had been treated by a psychiatrist since he was 14, when his obsessive hand-washing became a problem, and was eventually diagnosed with schizoaffective disorder. As Michael's parents stood by, the case manager informed him that unless he signed the forms he no longer needed to inform them of any of his treatment decisions.

"I didn't know what to make of it all," said Michael Willett, who immediately signed the release forms because, he said, "I want my parents to be informed." But since then, it has gradually dawned on his parents how completely they could be shut out of their son's medical treatment.

"Right now, if he goes psychotic I can't do anything," said his mother. "That scares me silly."
 

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