A warning I heard at home from my parents was, “Don’t volunteer for anything.” Like that would stop me! I was in college studying political science in the late 1970s. I wanted to volunteer to serve on a committee of relatives of people seeking to improve their loved one’s lives at the Rhode Island State Mental Hospital where my sister Ann lived. Then in her late 20s, Ann had a life-long course of schizophrenia, a serious mental disorder.

I told my mother of my plans to help my sister as an advocate. She was horrified. A very private person, she was afraid our neighbors would see me on TV at an event related to patient welfare. She always told our neighbors and friends that my sister was in a fancy private facility for people with mental disorders. If people saw me at a rally, her secret would be revealed. So I did not volunteer. (It wouldn’t surprise me if other mothers told the same “white” lie.)

Here in Alabama, Gov. Kay Ivey and Commissioner Kimberly Boswell of the Alabama Department of Mental Health recently announced the awardee of a fourth crisis center, an essential addition to the Alabama Crisis System of Care. The center will serve individuals with mental illness and substance use disorders. 

“The Ivey Administration is fully committed to addressing the very real challenges in the area of mental health care,” the governor said. “This is critical and should not be overlooked, which is why it remains of high importance in my agenda. These centers will go a long way in improving mental health care in Alabama.” (Montgomery Area Mental Health Authority serves several counties, including Lee. The Crisis Center phone number is (334) 279-7830.)

The Alabama Crisis System of Care does such things as expands access to care; reduces the number of arrests; includes someone to talk to, someone to come to assist you and someplace to go; assists individuals in crisis to achieve stability; and provides connections and referrals to agencies and organizations.

 My sister was diagnosed in the late 1960s after her grades went down and she missed three chances at passing the sixth grade. In earlier grammar school classes, her grades were very good. She was eventually diagnosed with schizophrenia, in which people interpret reality abnormally. People with schizophrenia require lifelong treatment.

According to the Mayo Clinic, “schizophrenia may result in some combination of hallucinations, delusions and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling.” This began for Ann when she was in sixth grade, and it affected us all. It was difficult for me when I was ages 11 through 14 because of my sister’s outbursts. I didn’t complain much, though.

At age 19, Ann moved to what would become a series of mental health facilities. A nurse when my sister moved in told my mother: “She probably stayed with your family too long; if this continued, you too might need mental health treatment.” Ann moved thru the system for 50 years, staying with us on holidays and spending weekend days with me after I got my driver’s license. Medicaid helped Ann’s situation tremendously.

Today, the Crisis Centers sprouting up in Alabama are designated places for community members, law enforcement and first responders to take someone who is in a mental health crisis. With a short-term admission, the individuals can receive medication management and case management. They offer walk-in access and the ability to transfer individuals from the Center.

In the early 1970s, my sister Ann settled into a good life under government care. She welcomed the exit of the old buildings with white walls and nurses in white uniforms. But she had to tolerate people like an elderly man who told everyone he hoped to die as he was born: “Toothless, naked and bald.” Ann enjoyed breakthroughs such as cozy group homes and attendants in colorful garb.

My sister, though, had two challenging medical crises. In 2005, she was diagnosed with leukemia and initially did not want to undergo chemotherapy. Even people under government mental health monitoring have “agency”; so Ann had to be persuaded the treatment was preferable to death. My Aunt Helen gradually convinced her to fight the good fight. Ann’s cancer went into remission.

But, 14 years after Ann’s “self-agency” approved the chemo, came another serious problem: She suddenly refused to eat. As she was under Medicaid, she stayed in
her group home even into the end-of-life stage. I visited three times from Alabama for a week each time, but she decided this time, to give up. When I offered her some local Del’s Lemonade she used to love, she still refused to eat. It was then that I knew she was determined to leave us.

My sister died in 2019. She would have been 71 last Sunday (Oct. 10). She would be delighted to hear of the growth of mental health crisis continuum of care centers. Even my publicity-shy mother would applaud the work of Ivey, Boswell, House Majority Leader Nathaniel Ledbetter and many others. But Mom would still suggest that we avoid the spotlight, even when her youngest son is a journalist.

Greg Markley first moved to Lee County in 1996. He has Masters’ in education and history. He taught politics as an adjunct in Georgia and Alabama. An award-winning writer in the Army and civilian life, he has contributed to the Observer for 12 years.