When Carla Clark's cellphone rang, she assumed the news was bad. The phone number displayed on the caller ID belonged to the probation officer for her daughter, Melissa.
It was the last Tuesday of December, the day Melissa was scheduled to be taken from Cook County Jail to a treatment program for people battling mental illness and substance abuse.
Less than an hour after she arrived at the facility, Melissa took off, the probation officer said. No one knew where she was, and a warrant was to be issued for her arrest.
"I felt like I had been kicked in the stomach," Carla Clark said.
Melissa's flight from treatment was the latest in a long string of heartbreaks for Clark as she tries to help her only daughter, whose bipolar disease and schizophrenia have turned her into her own worst enemy.
The family's struggles were chronicled in the Tribune last year as a criminal court judge was deciding what to do with Melissa, who spent about 16 months in jail awaiting trial after being charged with robbery at a Whole Foods store.
Three weeks ago, she pleaded guilty in a plea bargain and was ordered to participate in a residential substance abuse program at Haymarket Center on the South Side for people who are mentally ill.
But as her case illustrates, solutions often don't come easily for people who battle serious mental illness. Ten hours after running away from the court-ordered treatment, a disheveled and disoriented Melissa landed at her mother's downtown condo, putting Carla Clark in the gut-wrenching position of having to turn her in.
Melissa is now back in Cook County Jail, where she awaits a hearing Friday.
Jesus Reyes, acting chief probation officer of Cook County Circuit Court's Adult Probation Department, said his department does not keep statistics on how many probationers flee court-ordered treatment. But he said it's rare.
"These are not confined places," Reyes said. "They are not set up to be that way."
Reyes, who declined to talk about the Clark case, said probationers are not always motivated at first to participate in a treatment program.
"They're all (in court-mandated treatment) because they were ordered to (be)," Reyes said. "Our goal is to get them to the point where they see the actual need for it."
Dan Lustig, vice president of clinical services at Haymarket Center, where Melissa was taken, said it's a challenge for chronically mentally ill people to participate in treatment before they are stabilized on medication.
"That window (of time) poses the greatest challenge," said Lustig, who declined to talk about Melissa Clark's situation because he did not have her consent. "They will commit crimes if not stabilized and will do inappropriate things until we can get them stabilized."
Haymarket has seen a rise in people referred by the courts who are struggling with mental illness and substance abuse, referred to as a dual diagnosis. Since July 1, the agency has had a 25 percent increase in such patients, which Lustig attributed to funding cutbacks and the inability of seriously mentally ill people to navigate an increasingly complex health care funding and delivery system.
Mental health advocates worry about deepening cuts in funding for community-based programs and say limited treatment options result in mentally ill people cycling in and out of jails and prisons.
In the past, Melissa Clark, 22, has refused to take medication and has been difficult to manage. She has wandered the streets, committed petty crimes, overdosed on heroin and been assaulted by drug dealers. After being arrested in the Whole Foods in September 2010, she joined the sizable mentally ill population in Cook County Jail.
With about 20 percent of its 9,000 or so detainees diagnosed with mental illness, the detention center has become the state's largest psychiatric facility.
"In Illinois we have a wandering legion of people with complicated diagnostic histories of mental illnesses and substance abuse disorders, many of whom have burned out their family support networks and fallen between the cracks of a woefully inadequate mental health system," said Ron Davidson, director of the mental health policy program in the psychiatry department at the University of Illinois at Chicago.
It's not uncommon for people with mental illnesses to self-medicate with street drugs.
Substance abuse is known to exacerbate psychiatric illnesses, especially anxiety or mood disorders but also schizophrenia, and treatment in such cases requires an effective community-based program that can maintain patients after discharge from a hospital, Davidson said.
A systemic problem arises when psychiatric hospitals fail to identify mental illness in a drug abuser and vice versa, or to link patients to community programs qualified to treat people with such complicated diagnostic issues, he said.
"Sadly, Illinois has historically opted to continue its ineffective revolving-door system instead of funding evidence-based and far more cost-effective solutions that can help people recover their lives," Davidson said.
Carla Clark, meanwhile, is hoping her daughter will be ordered into a locked facility and forced to take psychiatric medications.
Said Clark: "That's the only way her mind is going to be clear enough to make good decisions."
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