Published in The Post-Star (A1) and poststar.com
12/5/05
Editor's note: This is the second in a two-part series on services for the mentally ill. Sunday's edition looked at the difficulties the mentally ill face when they get in trouble with the law.
The last time Brian Donovan's name appeared in this paper, it was connected to ugly words like "criminal," "guilty" and "addictions."
"Without a doubt, going to prison saved my life, because that's how I finally got treatment," he said.
Donovan, 25, spent 3-1/2 years in state prison after admitting involvement in a 2001 burglary spree in Glens Falls and Queensbury. At the time of his sentencing, he told the judge that he stole in order to fuel his drug habit. But the prosecutor suggested he seemed more motivated by "thrills."
Both were true, as it turns out.
Donovan was struggling with what are clinically termed "co-occurring disorders" -- substance abuse and mental illness.
"Looking back, it was definitely a manic period for me. The burglaries were a way of getting outside myself and having control," he reflected. "Something about it made me feel well. In a sick way, it made me feel human."
Drugs numbed his racing mind and gave him an emotional high when he felt so low that he "just wanted to die," he said. At the time of the burglaries, he told police he was spending $75 to $100 a day on the drug ecstasy.
His alternating episodes of mania and depression were a symptom of bipolar disorder, but he didn't know it at the time.
"I didn't think I had a mental health issue; I just thought that I was a bad person -- and I ended up being one," he said.
Since the age of 16, Donovan had cycled in and out of various substance abuse treatment programs, but it wasn't until he received counseling and medication for his mental illness that his life got back on track.
"I don't want mental health issues to be an excuse for my actions. What I did was very wrong," said Donovan. "I can't take it back, but I don't hold it against myself, either. I've held a lot against myself for so many years."
A common story
Forty percent to 50 percent of substance abusers suffer from at least one serious mental illness, according to the National Mental Health Association. Until recently, however treatment approaches have been completely separate.
In 1999, the state decided to take a chance on a new approach, by funding "dual recovery" programs. The Warren-Washington Association for Mental Health received one of the first grants to create such a program and now handles a caseload of about 40 people with co-occurring disorders.
Cliff Green, coordinator of the Warren-Washington dual recovery program, said substance abuse and mental health are often linked because people with mental illness are seeking a way to become "normal." Drinking or doing drugs with their peers can seem like a way to fit in.
It can also become a form of self-medication.
"With bipolar, for example, research shows that many people survive for years without medication, by using alcohol and drugs to regulate their mania and depression," said Green.
Brad Morrow, a dual recovery case manager, has personal experience with this subject.
"For years, I had used drug and alcohol to mask things. I was trying to stop feeling something, and the scary thing is -- it works," Morrow said. "I knew on some level that what I was doing wasn't sustainable. I knew I was right on the edge of a cliff."
One day, he said, "the addiction just took over." He lost his job as a cook and ended up in rehabilitation.
Even when Morrow emerged from rehabilitation, he knew something wasn't right. He finally went to see a psychologist and was diagnosed with bipolar disorder.
"It blew me out of the water; it really made me question who I was," he said. "I thought my life was over."
Then Morrow stopped into a dual recovery self-help meeting at the East Side Center in Glens Falls and was blown away again.
"I realized, wow! I'm hearing my story coming from other people's mouths," he said. "I felt like, 'Oh, crap, I have a real problem.' But I also felt a sense of relief: 'So this is what it is.' "
Now, he works as a case manager for the dual recovery program and helps run self-help meetings each weekday evening. Attendance at the meetings is growing, he said, because "the status quo isn't working for people with co-occurring disorders.
"The neatest thing is to watch new people coming in, and they get that look in their eyes, like, 'Now I know,' " Morrow said.
Green nodded. "It doesn't mean it's perfect. But it's different for them from then on."
Integrated solutions
In many cases, treatment is not the first step towards helping people with co-occurring disorders, said Green.
"They've been cycled through dozens of other programs and had different labels put on them," he said. "If you can't sit down with a person and decipher what their most immediate need is -- if you can't help them with what they think they need, not necessarily what you think they need -- you may never see them again."
Many of these individuals have just come from jail, a rehabilitation program or the streets.
"How can you talk about treatment when they don't even have a place to sleep?" he asked.
"There's a tremendous housing crisis in this area, and it's very difficult to place people."
In the future, Green said, he hopes the dual recovery program will be part of a "wraparound" solution.
"There will never be enough dual recovery case managers. ... I would rather see all the community providers having the basic knowledge and skills to do what we do," he said. "Co-occurring disorders are not going to go away."
A new life
Like Morrow, Donovan now uses his own experience as a foundation to support other people affected by mental illness and substance abuse. He is taking classes toward a degree in human services and works full time as a peer advocate for Voices of the Heart, a state-funded mental health agency in Hudson Falls. He also volunteers at the dual recovery program.
"Being able to give back helps me stay balanced," Donovan explained. "The odds were against me, and I'm sure they still are. But I refuse to give up. I still have hard times, but they're not like they used to be."
He insists on talking about mental health, rather than mental illness.
"I hate that word, 'illness.' It's debilitating and self-perpetuating," he said. "Ex-con, drug addict, mentally ill -- these are all labels of behaviors. They're not me."
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