George's psychiatrist used to tell his family members to lie to the doctors.
“You have to lie and say he's harmful to you,” the psychiatrist would tell them.
Because when George was in the midst of a psychotic break, he could still fake sanity. Even if he thought he was Jesus Christ, he knew not to tell anyone that.
“Especially when you're grandiose, you have the ability to really pull some thoughts together,” George said.
George and his family knew what would happen: If George wasn't suicidal, he was going home. If he wasn't going to hurt someone else, he was going home. Believing he was a savior didn't merit a bed at a psychiatric unit.
The laws are specific: If an adult isn't a danger to himself or others, he cannot be held against his will. And oftentimes, that's how it's decided who will get treatment, because turning away those who are dangerous has potentially lethal consequences. Meanwhile, George and a lot of other people can't get help until they're so unstable they might break.
Oklahoma ranks No. 2 in the nation for its rates of mental illness but No. 46 in the amount of state money budgeted per capita for mental illness.
Over the past three years, Gov. Mary Fallin and the state Legislature have allocated millions more to address the problems Oklahoma faces, including allocating money for suicide prevention.
“But they are trying to overcome decades of underfunding, and you can't do all that in just three years,” said Terri White, Oklahoma's mental health commissioner. “The biggest problem we have right now is lack of resources.”
A bright future fades
Before college, George was a straight-A student and a leader on his high school football team. Once he got to college, his desire to excel ended quickly, though. He started making C's, and he was redshirted on the football team.
George, 66, was diagnosed with bipolar disorder in 1970, shortly after he graduated from Stanford University in California.
“I've been hospitalized 35 to 40 times in my 43 years,” he said. “I've changed jobs about 15 times because the bipolar issues and the anxiety issues make it very difficult to hold down a job. I have been functioning fairly well ... for the last seven and a half years.”
Last October, two police officers approached George's home. They told him they had an emergency order of detention for him, and they were going to take him to a hospital in Norman.
Earlier that week, George's psychologist had told George he didn't think he was stable. George has always been diligent in taking his medicine. But sometimes, his medicine can't keep his brain from falling into a psychotic break.
That day, George looked out into his driveway. The officers had blocked off the street. He decided to go with them without any problems. The rest of the story is foggy.
“Maybe I'm maturing, maybe I'm finally accepting responsibility for my illness and know because of my illness, I have to go endure things that seem barbaric at times.”
A place to calm down
Hundreds of Oklahomans in crisis walk through the doors of the Oklahoma County Crisis Intervention Center.
On a Friday night in March, staff members stood in a mostly quiet room, noting that it's a calm night so far. The night before, they had treated about 10 people in 11 hours.
A young woman, probably in her 20s, is in the hallway in a white tank top and animal print shorts. She's effortlessly placing each arm in the air and walking gently forward. From the outside, it appears she's on a balance beam. Or maybe she's a ballet dancer.
Regardless, she's coming down from anger and confusion.
Moments earlier, she was headed to the bathroom with a security guard when she used a few lines of expletive-laced sentences. “Don't f--- with me!” she said.
But for now, she's calm.
“See, she's not hurting anybody,” said Chris Flanagan, the center's interim director. “She's not a danger.”
If she weren't at the crisis center, the woman could be misunderstood as dangerous. While at the center, she requested an antipsychotic medicine to calm her, and she'll probably leave in a few hours.
The crisis center is broken into two areas — the urgent care unit and the residential unit. People are allowed to stay on the urgent care side for 23 hours and 59 minutes. After that, law requires they have a bed somewhere or be released.
The urgent care unit at the crisis center is a new concept, started in the past few years. It's an effort to give people a place to sit and calm down. If they're able to calm down, then maybe they won't need a bed somewhere. And then maybe that bed can go to someone else.
“There are a lot of people who look pretty bad but in 18 hours can look very different,” Flanagan said. “It is really hard to tell.”
‘Not ill enough'
On a recent Monday afternoon at the state Capitol, Terri White stood in the fourth-floor rotunda with a microphone, screaming.
She was joined by about 80 people. They all wanted — and screamed — the same thing.
“My mind matters,” they screamed. “Fund mental health.” Every corner of the building likely heard the echoes of their demand.
As the state mental health commissioner, White is not subtle in addressing what Oklahoma needs. Essentially, the state needs more of everything: crisis centers, hospital beds and especially outpatient services.
About 620,000 adults in Oklahoma have a mental illness. Meanwhile, about 65,000 people received mental health treatment through an Oklahoma Department of Mental Health and Substance Abuse Services facility.
White knows that people are regularly turned away because they're not “ill enough.” And providers have to serve the sickest people first — the people who might hurt themselves or others.
“We turn people away every day who need help because they aren't ill enough, and we just don't have enough money to pay our contractors to hire enough therapists and provide enough medication to reach people,” White said. “So then they get sicker, and finally, they do meet the criteria.”