Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, March 31, 1991 TAG: 9104020061
SECTION: VIRGINIA PAGE: A/1 EDITION: METRO
SOURCE: CHARLES HITE MEDICAL WRITER
DATELINE: LENGTH: Long
Free of the hallucinations of spaceships hovering menacingly over her apartment. Free of the paranoia that all her food was poisoned. Free of the anger that made her curse and spit at those who tried to help. Free of the fire burning in her brain.
She is free of the mental hospitals that have been her home more times than she can remember over the past 30 years. For the first time in her life, she feels free to laugh.
Catawba Hospital, she says, made her free. It was there she learned how to laugh.
"I had a good time at Catawba," Wesselhoft, 54, says. "It was the first time in my life I ever laughed."
For nearly three months last year, Wesselhoft was a patient on Catawba's second floor, a floor where the patients are noticeably different. While the typical patient on the geriatric floors is 77 years old, patients on the second floor are much younger, usually in their 20s, 30s or 40s.
The patients on the second floor don't stay nearly as long as their elderly counter parts. The average stay there is 40 days, compared with nearly two years for the other floors.
The 35-bed adult acute-admissions floor is a short-term unit for people 18 to 65. These are people in crisis: Their mental disorders have led to behavior that threatens themselves or others. More than half have had schizophrenic or other psychotic episodes. More than a third have a history of drug abuse. Nearly all have no money or insurance to pay for psychiatric care.
Ideally, they will return to their communities and their own homes and live much like anyone else. Like Josie Wesselhoft, they will have their illnesses under control. They will have some self-respect. For the first time, they may have a reason to laugh. They will be free.
Josie Wesselhoft and her husband and her three children - two daughters and a son - moved to Southwest Virginia in the early 1970s. By that time she had been in and out of state mental hospitals in New York 10 times.
Her diagnosis was schizophrenia.
During the seven years she lived in Hillsville, Wesselhoft was treated at Western State Hospital once and Southwestern State Hospital seven times. In 1979, with her children grown and her marriage failing, she moved to Roanoke.
She lived in apartments and boarding homes on small Social Security disability checks. Her schizophrenia got worse. A couple of times she was admitted to the psychiatric unit at Roanoke Memorial hospital. The doctors tinkered with her medications. Wesselhoft didn't like them. She gained weight. She felt like a zombie. She stopped taking her medications. She smoked marijuana. "I had the habit bad," she says.
Wesselhoft grew more paranoid. She refused to see the outreach workers from the local mental health community services board.
A couple of years ago, Wesselhoft decided to let her son live with her. She realizes now that was a big mistake.
Mark Wesselhoft began abusing drugs when he was 9. He sniffed glue and drank alcohol, then went on to marijuana, cocaine and amphetamines. He was first treated at a psychiatric hospital at 15. When he came to live with his mother in Roanoke he was nearly 30. The previous six years he had spent at Southwestern State Hospital. The longest time he had spent outside a psychiatric hospital since he was 17 was five months.
Mark Wesselhoft has what is called "schizo-affective disorder." Like schizophrenics, he has delusions and disjointed thoughts and confused and often paranoid behavior. But he also has mood swings, alternating between an excitable and energetic period and a subdued, withdrawn stage.
Josie Wesselhoft complained that, after her son moved in, he just sat around and did nothing. Mark Wesselhoft grew irritated with her griping. There were angry shouting matches. Once, he punched her in the face.
Josie Wesselhoft's paranoia reached such an extreme that she refused to eat or drink. In her mind, only water would not poison her body. She drank it in massive quantities. One day Mark Wesselhoft found his mother passed out. She was suffering from "polydipsia," an excessive intake of water that can damage the kidneys and upset the body's chemical balance. It leads to hemorrhaging and uncontrolled diarrhea and seizures.
Josie Wesselhoft spent several days in intensive care at Community Hospital. Then she went to the second floor of Catawba Hospital.
"I let loose at Catawba," Josie Wesselhoft says. "I screamed my head off. I got rid of all the things bothering me for years and years."
It was the staff's willingness to let her scream and to listen to her that started her on the road to recovery, Wesselhoft says. "They put their arms around me. They told me to take it easy."
After a couple of weeks, doctors began tinkering with her medication. They tried a combination of Prolixin and Prozac, an antipsychotic and an antidepressant. Wesselhoft says the combination worked. She didn't feel as paranoid. She enjoyed talking to people again. She was able to come out of her shell. "I felt sensitive," she says. "I could cry again."
Wesselhoft began participating in some of the many support groups and activities on the unit. She made friends in a therapy group - where patients discussed their goals for treatment - and a substance abuse group. She felt she had something to offer. People actually listened to her.
"I was so happy," Wesselhoft says of her time in the groups. "Sometimes we were just laughing and laughing. I don't even remember smiling in all my life."
Wesselhoft took more interest in her appearance. She got new clothes. "I was really spiffing up. I looked like the doll I used to be."
Aside from putting her in touch with her feelings once more, Wesselhoft says her stay at Catawba allowed her to set some goals: to get an apartment, buy food and clothing, repay some old bills, get some new furniture, and live like everyone else.
"I'm just going from day to day," she says. "I found out I really don't want material things. I want to be happy."
Other patients say the adult acute care unit has helped them, too.
Mark Wesselhoft came to the unit three months after his mother was discharged. He, too, felt people were poisoning him. He believed at age 7 a Vietnam veteran stole parts of his brain and took them to war. He was fascinated by kung fu, judo and other martial arts and wore tight-fitting clothes and head garb to make himself look like a warrior.
"The best thing here is the substance abuse class," Mark Wesselhoft said shortly before his discharge in February. "I'm out of all that drug stuff now. No way you can live like that."
Wesselhoft, 31, now lives at a home for adults in Botetourt County.
Charles MacKenzie Jones, 36, was committed to Catawba after he threatened to kill marchers at a Ku Klux Klan rally in Blacksburg.
"I'm very anti-Klan," said Jones, who was diagnosed with a manic-depressive illness six years ago. "Catawba has helped me deal with my feelings about the Klan and put things in perspective. When I'm in a manic phase, I do things to the extreme." He says he threatened to kill Ronald Reagan twice and that the Secret Service has been following him since he took part in a civil rights rally in Washington, D.C.
Jones said he's been hospitalized 15 times in the past six years for his illness in institutions from Massachusetts, his home state, to California. He ended up in Roanoke last year when he came to visit a brother.
In his manic state, Jones said, he doesn't sleep. "You pace. You have extraordinary energy and strength. You can hallucinate. You can get in a delusional state. The TV seems to be playing for you. You're on center stage."
The medications at Catawba allow him to sleep and to control his manic feelings better, Jones said. "I'll probably be discharged in a week or so," he said in an interview in February. "I won't stay in Roanoke. Anyone who goes around with a chip on his shoulder about the Ku Klux Klan should not be in the South."
"The best thing that really happened to me is Donna, Donna Clark," Josie Wesselhoft says. "When I need her, I can call her."
Clark is one of 13 counselors or "case managers" for the Community Resource and Counseling Center on Elm Avenue, an outreach program of Mental Health Services of the Roanoke Valley.
Clark and other case managers work with nearly 700 chronically mentally ill adults in Roanoke and Roanoke County who, like Wesselhoft, live in the community.
"Josie is a good example of someone who needs a case manager calling on her at least once a week to see how she's doing," Clark says.
Life on disability income is tough enough for someone without a mental illness, Clark says. Dealing with the paperwork of various social service agencies that her clients must deal with can be mind-boggling, she adds.
Wesselhoft is lucky. Because she lives only a block from the resource center's new offices, Clark can easily slip over to see how she's coping. "I help her control the influx of bureaucratic garbage," Clark says. She helps Wesselhoft fill out forms, pay her bills and plan a budget. She makes sure she's eating the right food and comes to the center to get her medications.
When Wesselhoft decided she wanted to buy a dinette set, Clark went along to the store to help make credit arrangements. "She's paying for it each month," Clark says. "She knows how to do it."
Unfortunately, Clark says, her caseload of about 60 clients makes it impossible to give everyone the attention she's able to give Wesselhoft. Ideally, she says, her caseload should be less than 30.
Still, Wesselhoft is proof that the chronically mentally ill can make it in the real world with close supervision and support.
"Josie's doing it," Clark says. "And that's the bottom line. They're supposed to live like us. They just need more help."
by CNB