Prison Suicide

Tuesday I read articles in both the Helena Independent Record and the Great Falls Tribune about the tragic suicide of the 28 year old inmate who suffered from schizophrenia who hanged himself on Monday. Please forgive me if I offend anybody, but please allow me to vent.

I do not pretend to know any of the circumstances related to this young man's incarceration related to the fact he was convicted of killing his mother in 2006. I have heard his mother also suffered from schizophrenia, but I do not know that for sure. This story is all too familiar to NAMI families. As I said, I do not know the actual circumstances of this tragedy, but let me guess how these events has transpired over the years.

Brandon John Orr probably developed schizophrenia in either his late teens or early twenties. From the story it would appear that he did not receive adequate treatment or did not receive any treatment at all. I do not know if his mother tried to access treatment for him, but in most cases she would have tried. Then one night while she was sleeping his command hallucinations instructed him to kill his mother. He may have done this because he hated her or wanted to save her from a worse fate. He then hit her in the head with a hammer while she was sleeping and then slit her throat.

He pleaded guilty to the crime and was hospitalized in the Montana State Hospital. There was probably no chance he would ever be released back into public life. He was receiving treatment at the Montana State Hospital until July when he was transferred to the Montana State Prison. He probably received better treatment at the hospital, but since he would probably never be released and the hospital is overcrowded, he was transferred to the prison. He probably received some treatment at the prison, but it was not as effective as the state hospital. The prison's responsibility is to incarcerate dangerous felons and protect the public and they are effective in doing that. He was very cordial when the staff brought him his food. :"He was kind and the staff did not see any problems." Then he hanged himself in a one person cell on Monday.

Who is to blame and who will take the responsibility? We can say "the system" failed and everybody is off the hook. We know that mental illness cannot be prevented, but disability can be prevented. Early intervention and appropriate treatment can prevent disability. We now know that early treatment to avoid psychosis, mania and depression can prevent damage to the brain and reduce cognitive deficits and an individual can lead a rewarding life and recover. But the law implies that a criteria of "imminent danger" is required to mandate treatment. By the time Brandon Orr was an "imminent danger" his mother was dead.

Now Brandon Orr is dead and two lives have been tragically lost to mental illness. If the pattern continues another Montanan will lose their life to mental illness in the near future or maybe even take the life of another individual. But, we do not have to accept the blame or responsibility. We can continue to blame "the system" and that relieves our guilt. There is an old saying, "The more things change, the more they stay the same." There have been significant changes in the mental illness treatment system in Montana, but people still die because they cannot access early intervention and appropriate treatment.

Every person suffering from a severe mental illness has, or had a mother and a father. They may have had a brother and a sister. The may have even had children. In most cases they had, or have someone who cares!

Dr. Gary Mihelish