On Jan. 23, 2012, Michael McDaniel awoke at 5 a.m. in his family’s poolroom and was overcome by misery on a scale that was unique even for him. He began to cry.
Michael was 30 years old and lived with his parents and grandmother in a sprawling, cedar-planked home on the wooded fringes of the Oley Valley, just east of Reading [PA]. That night, like many others in recent years, Michael had spent sitting on a worn recliner in the far corner of the family’s poolroom.
The room had become something of a refuge for Michael since the onset of schizophrenia: Michael was now spending 16 hours there each day, writing furiously in his journal or, just as often, staring at the room’s white stucco wall and letting his mind draw shapes and people and angels and demons from its cracks and craters.
At 6 a.m., his tears drying against his dark beard, Michael’s misery gave way to an idea. It was an idea that Michael had long contemplated but, for a variety of logistical and moral reasons, he had repeatedly dismissed. Today felt different: Michael hoisted his 6-foot-1 frame from his chair, tightened a black hoodie around his head and lumbered through the greenhouse that connected the poolroom with the family’s main house.
Michael entered the family’s darkened lounge and found his mother sprawled on the couch, wrapped in a gold quilt, watching the morning news. Nina McDaniel’s presence wasn’t a surprise to Michael. As he had spent more and more time in the poolroom, Nina had taken to sleeping nearby to keep an eye on him.
Michael walked past her to the stairs and said “good morning” and she said “good morning” back. Nina, a 54-year-old with silver hair and wireframe glasses, felt uneasy; she had heard her son sleep little that night, which foreshadowed a day where he would scream and cry and laugh eerily to himself even more than usual. Still, at that moment, as he ascended the stairs of their split-level home, Nina assumed he was simply heading to the kitchen to grab a cup of coffee.
Once upstairs however, Michael didn’t linger in the kitchen. He walked down a carpeted hallway and toward the bedroom of his 74-year-old Ukrainian grandmother. Helen Badulak’s door was open, as it was every night because she, like her daughter Nina, suffered from claustrophobia.
When [Helen Badulak] made out Michael’s form in the gloom, she smiled at him. The pair had always been close: Since he was old enough to talk, Michael, like his older sister Krissy, had known her as “Baba,” the Ukrainian word for grandmother.
However, on this particular morning, Michael didn’t smile back. His face was flat and his eyes were stony and he began speaking in a deep voice in a bizarre language that confused his grandmother. Michael then stepped toward her bed, brandished one of her metal walking canes, and struck her in the head with it.
Badulak raised her hands to shield herself but Michael continued undeterred: He beat her until her fingers broke and the white bed, the white walls, the white vaulted ceiling and the pallets of white-shelled eggs that Badulak had yet to paint were splattered with blood. Between blows, still muttering, Michael would occasionally stare off into the corner of Badulak’s bedroom as if someone was standing there, spurring him on.
Eighty feet away, downstairs in the lounge, Nina heard nothing and, in the couple’s bedroom, neither did Michael’s father, Alan.
After several minutes, Michael stopped hitting his grandmother. Badulak, barely conscious, weakly asked Michael where his mother was. He told her she was dead. “They all are dead,” he added.
He then walked out of her room and into the garage to look for a sledgehammer.
Michael’s family would ultimately survive the events of Jan. 23, 2012, but it would leave them deeply traumatized and even more disillusioned with Pennsylvania’s mental health care system.
Multiple System Failures
The McDaniel family believes that what happened on that day could have been avoided if Michael had received the help he needed when he needed it. While the failures of the system were multiple, the most glaring, perhaps, were those that occurred when Michael was in the depths of psychosis over the preceding five years.
On three different occasions, Michael’s family had involuntarily committed him to a psychiatric ward but, each time, Michael was released a few days later, or a few weeks later, still deeply delusional and with poor follow-up care. On many more occasions, Michael exhibited behavior that equally scared or disturbed his family but they were told repeatedly that he didn’t meet Pennsylvania’s commitment criteria.
Michael McDaniel’s story lies at the heart of one of the most contentious debates in the mental health care field.
The McDaniel family, along with a subset of police officers, mental health care advocates, and correctional officers across the country, believe that states need to either rewrite their commitment laws – or be more willing to implement their existing laws – to make it easier to mandate that mentally ill people get treatment.
National scrutiny over the criteria for involuntary commitment has intensified in recent years in the wake of several high-profile mass-killings.
James Holmes, the 27-year old schizophrenic who shot and killed a dozen people in a movie theater in Colorado in 2012, made comments that disturbed his psychiatrist but she didn’t believe met the state’s standard for involuntary commitment.
Jared Loughner, the schizophrenic man who shot U.S. Rep. Gabbie Giffords and killed six people in Arizona in 2011, was perceived to be mentally ill and possibly dangerous by officials at his college but they also never petitioned for an evaluation for involuntary commitment.
It was once easy – arguably far too easy – to involuntarily commit a person in America. In the first half of the 20th century, the standard for involuntary commitment was simply that a person be mentally ill and needed treatment – a threshold that was so low that there are stories of families who committed unwanted relatives.
That ease of commitment, and general concerns about poor conditions within state hospitals, came under intense scrutiny in the 1960s. As the Kennedy administration began a nationwide push to close state hospitals and treat people in the community with caseworkers and psychotropic drugs, states also began to reassess their eligibility criteria for involuntary commitment.
In 1964, Washington, D.C., was the first to change its laws so that a mentally ill person could only be committed if they were “gravely disabled” or posed an imminent threat to the safety of themselves or others. One by one, states adopted similar standards, largely based around a threshold of “dangerousness.”
Among the states, however, Pennsylvania’s new standard, established in 1976, remains one of the strictest in the nation. In order for a mentally ill person to be committed, according to the law, it must be reasonably probable that a mentally ill person’s “death, serious bodily injury or serious physical debilitation will ensue within 30 days without treatment.”
Many civil liberty groups and mental health advocates are content with that standard: They believe that forcing a person into a psychiatric ward is typically the most traumatic moment in their life and should only be done under extreme circumstances.
But critics, like the McDaniel family, say that while they empathetically support more caseworkers and more mental health housing, they believe one of the fundamental problems with Pennsylvania’s mental health care system is that it can’t treat seriously mentally ill people who don’t want help.
According to researchers, about half of schizophrenics and 40 percent of people with bipolar disorder don’t believe they are mentally ill, a condition known as “anosognosia” in the field.
Those individuals, like Michael in the prelude to 2012, have the right to refuse therapy and medication. A family’s only recourse then, under the law, is to wait for their loved one to deteriorate to a point where they’re either suicidal or dangerous so they can be hospitalized.
Desperate Search for Help
Michael’s family desperately tried to get help for Michael but, beyond pleading with him, there was no way to compel him to take his medication or see a doctor unless he chose to – and Michael had no interest in either. Eventually, as before, Michael stopped eating. He told a crisis intervention worker that he wanted to “die in the name of love” because his former coworker had spurned him. “I’m dead without her,” he added.
On Aug 28, barely a month after his last hospitalization, Nina McDaniel filed a new petition for involuntary commitment and argued, as Krissy had, that Michael’s starvation was a danger to himself.
Once admitted to the hospital, the degree of Michael’s deterioration was on full display. He told medical staff that he thought he was god and, while watching television that afternoon in a waiting area, claimed responsibility for a series of car crashes that appeared on the screen. Michael got a new diagnosis: major depressive disorder with recurrent, severe psychotic features. He was released five days later.
On Dec. 15, 2008, around 6 a.m., as Nina and her husband slept in their bedroom, she bolted awake when she heard a whimpering cry from Michael’s bedroom.
Nina grabbed her glasses and ran to his door where, through a crack between the doorframe, she could see her son sobbing on his bed. Nina asked Michael what was wrong and he screamed back, “Leave me alone or I will kill you and dad.”
Nina was chilled. Despite all the times she had been rebuffed or abused by Michael, it was the first that her son had threatened to harm her and Alan. Nina’s nerves had already been rattled by an incident a few days earlier: Michael had woken her at 2 a.m. and asked where the family’s guns were because, he told her at the time, “God wants to know where they are.”
Nina called the crisis intervention team and Michael was taken to Reading Hospital that morning and involuntarily committed for the third time in his life. Nina cried in the waiting area. The accumulation of a year’s worth of anguish and stress was now compounded by a new realization for her: She no longer felt safe living with her own son.
Inside the hospital, Michael initially downplayed his symptoms to medical staff. As a nurse asked him questions, Michael stared back at her through his black aviators and told her he didn’t have visual or auditory hallucinations. He added that he had never said he wanted to harm his mother. On the contrary, he told the nurse, he believed his mother wanted to harm him.
While Michael was hospitalized, Nina tried to arrange for Michael to be transferred to county-funded housing for mentally ill people.
The program offered 24/7 supervision. But staff at Reading Hospital didn’t believe that a residential treatment program was appropriate for Michael. They wanted instead for Michael to return to his family’s home and partake in a program called Assertive Community Treatment, or ACT, which would mean he would be visited each week by a social worker and psychiatrist.
The hospital staff also told Nina that Michael’s preference was to return home rather than go to a residential treatment program.
The hospital and the McDaniel family were at loggerheads, but as the days wore on, Nina and Alan were forced to relent. It became clear to the couple that the hospital would release Michael to a local homeless shelter if they didn’t take him. So, on Jan 9, 2009, after 20 days of hospitalization, Michael’s family reluctantly welcomed him back to their Oley Valley home.
Unknown to Nina or Alan however, their concerns may have had more validity than even they realized. In a psychological evaluation conducted by Dr. Anna Czipri, a psychology intern, and reviewed by Dr. Michael Magdalinski, a licensed psychologist, Czipri noted Michael’s potential for dangerousness.
The report concluded: “Mr. McDaniel currently experiences distressing hallucinations and delusions but has increased amounts of resistant to treatment. He also exhibits homicidal ideation towards his parents. He has extremely poor insight and minimizes both his homicidally and psychotic symptoms.”
Recognizing the 'Risk of Dangerousness'
The report continued that the results of his psychological test “indicate a risk of dangerousness to others given his impaired ability to tolerate stress, difficulty modulating emotions, impaired reality testing and mistrust towards others.” But that report, like all of Michael’s federally protected medical records, was not shared with the McDaniel family.
On more than 20 other occasions, by Nina’s count, the family were told by crisis intervention staff that either it wasn’t worth pushing for a commitment or that Michael didn’t meet the criteria.
On Oct. 3, however, Michael exhibited behavior that even Nina and Alan, as jaded as they were, felt certain would meet the threshold for involuntary commitment.
That morning, Nina sat down to her computer to check her email account and found Michael had left his own account open. Her eyes were drawn to one of Michael’s emails: “Bud’s Gun Shop.” Nina opened it.
The email read: “We welcome you to BudsGunShop.com. You can now take part in the various services we have to offer you.” Nina checked the browser’s history and found that Michael had also been looking at a website for another gun shop.
Because Michael had been involuntarily committed he would have failed a background check to purchase a firearm, but still, that he was trying to get one was alarming in itself.
The couple asked Michael about the email from Bud’s Gun Shop and he explained that he needed a gun for protection because he believed someone was going to shoot him in the head. Alan and Nina told Michael that he didn’t need a gun and that they could protect him – but Michael became enraged. He said that they didn’t understand what was going on and that if they stood in his way he would “blow their heads off.”
Nina called the county’s crisis intervention team. Two police officers and a crisis intervention worker arrived. The police officers told the couple that they could file charges against Michael for terroristic threats – but Nina said they didn’t want their son jailed. They wanted him treated.
Nina filled out an involuntary commitment petition and the police officers took Michael to St Joseph Medical Center at 11 a.m. Two hours later, to their disbelief, Nina and Alan received a call from Michael. The hospital had determined that their son didn’t meet the commitment criteria and Michael asked for a ride home. His voice was casual, as if nothing had happened that day. Frustrated, and again frightened of their own son, Nina and Alan brought Michael home.
It would be two months later, a chilly winter morning, when the police would next receive a call from the McDaniel household.
On a gray September afternoon in the suburbs of Reading, Michael McDaniel opened the door to his red brick home and welcomed me inside. “I’m going to put these on if it’s all right with you,” Michael told me as attached a pair of clip-on sunglasses over his spectacles.
“Might be able to communicate better.”
Michael wore black Nike sneakers and an oversized black T-shirt. He was now 35 years old and he had gained considerable weight since he first appeared on TV, nearly four years ago, in handcuffs and a white jumpsuit.
The weight gain was a side effect of Michael’s antipsychotic medication, which boosted his hunger. As of September, he had been taking the medication for the longest continuous period in his life: beginning in prison, over the two years he spent in Wernersville State Hospital, and since his discharge in April back into the community.
The extra weight frustrated Michael – he was walking two miles a day to try and fight it off – but he had no intention of stopping his medication. He remains deeply remorseful about the attack on his grandmother and he still struggles to understand why he did what he did. His memories of that morning are blurry.
Michael now lives in a house with two other people with mental health issues – the same kind of housing that Michael’s parents desperately wanted for their son in 2008. He’s stabler and happier he has been in eight years. He proudly shows me his white-walled bedroom, immaculately clean, and a composition book full of his religious writings – a slightly more coherent continuation of his former poolroom ruminations on God, the soul, space, and Satan.
But while the McDaniel family is proud of the progress that Michael has made they still struggle to understand why it took a tragedy to get the help he needed.
“Why do those with a brain disorder have to commit a crime in order to get help and treatment?” Nina asked me.
Daniel Simmons-Ritchie, a writer for PennLive, is a 2014-2015 John Jay/Langeloth Justice and Health Reporting Fellow. This is a highly abridged version of the latest installment, published October 8, in the “From Patients to Prisoners” series in Harrisburg Patriot-News/Penn Live as part of his fellowship project. The series examines the treatment of the mentally ill in Pennsylvania. For the full version and other stories in the series, please click HERE. Daniel welcomes comments from readers.