THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Sunday, February 11, 1996 TAG: 9602090206
SECTION: VIRGINIA BEACH BEACON PAGE: 14 EDITION: FINAL
TYPE: Cover Story
SERIES: SPECIAL REPORT: MENTAL ILLNESS
SOURCE: BY NANCY LEWIS, CORRESPONDENT
LENGTH: Long : 167 lines
Jacob Smith opens his miniature car case and takes out handful after handful of brightly colored vehicles.
He pushes back a lock of wavy red hair, yanks a black Carolina Panthers sweatshirt off over his head and gets down to business, smoothing out a big square of plastic marked with roads.
With the familiar little-boy sound of revved up motors coming from his pursed lips, he begins maneuvering the little trucks and cars around corners and down straightaways.
To watch the 8-year-old at play, you'd never know that sometimes the warm look in his blue eyes turns cold as steel, his dimples vanish and he lashes out at those around him. Sometimes, he even hurts the people he loves most.
Jacob has a ``Jekyll and Hyde'' personality, says Vickie Feight, the aunt who has cared for him since he was 2. Jacob calls her ``Mom,'' and she and her husband, Victor, count him among their five children.
Jacob is a victim of childhood mental illness. During the past five years, he's been hospitalized twice and has been on and off so many medications it's hard to name them all. Just now, he's pretty well stabilized on lithium and two other prescription drugs, but his bright demeanor could change without warning if the balance is upset, Feight says.
And when that dark cloud comes over Jacob, he is liable to kick and hit brothers, sisters and parents - even doors, walls.
If it were not for the help she gets from the city's Comprehensive Mental Health department, Feight would be hard pressed to know what to do sometimes. She knows that as Jacob grows older, things could become even more trying, but she relies on the knowledge that there are many state and city services available for children of all ages.
``When you're the parent of a child with lots of problems, life can be very stressful,'' she says, watching the youngster play. ``It keeps you hopping.''
Feight has become pro-active in trying to help her nephew and others like him. She is a member of the national Federation of Families for Children's Mental Health and helps run a Beach support group for parents of children and adolescents with emotional and mental disorders.
``I like to keep up on everything,'' she says, opening a thick, three-ring notebook. ``I'm not a parent that sits back. I stay on top. If you don't learn about it and do your utmost,'' you're to blame as a parent. ``You have to do it.''
Recently, Feight addressed a letter to Gov. George Allen urging him not to allow cutbacks in state funding to adversely affect programs for children receiving mental health services.
``These children are our future,'' she says emphatically.
Feight readily admits that raising Jacob is a tough job, but it's one she does willingly even though the boy is her sister's child. Feight prefers that the circumstances behind her custody remain undisclosed.
Jacob's problems became evident at about age 3 when he began having severe tantrums and experiencing hyperactivity and aggressiveness.
``I knew he had problems that needed dealing with,'' Feight says. ``It's not that you're looking for someone to say something's wrong, but if you don't admit it, you can't do anything about it. The earlier the better.''
So she took Jacob to see a private therapist. His behavior improved after several months of treatment, and tests showed that Jacob had Attention Deficit Disorder as well as an IQ that marked him as gifted.
Ritalin, a drug used to treat children with ADD, was tried after Jacob began having recurrent episodes of uncontrollable behavior, but he is among a small percentage of children for whom ritalin has the opposite of its desired effect, and Jacob became ``psychotic.''
``He heard voices, was seeing things,'' Feight remembers.
Jacob climbs up on the couch Feight is sitting on and puts his arms around her. He snuggles up against her arm and yawns, then sits back up and yanks a ``No Fear'' baseball cap down on his thick head of hair.
Other medications tried during the next year had similar undesirable side effects.
``He's not done real well with medication,'' Feight says.
By the time he was 5, it became necessary to admit Jacob to a psychiatric hospital. He stayed about a month and seemed much improved for a time after his release. But then things fell apart again.
It was at about this point that Jacob's private psychiatrist recommended that the Feights connect with Comprehensive Mental Health Services because of the plethora of services offered by the department.
``They have a lot of programs,'' Feight says, citing her experience during a recent difficult night with Jacob.
``Things got really bad - tantrums, cursing, hitting, kicking, punching people, things,'' she recalls with a deep sigh. ``I felt like I'd had it. I called emergency services because I needed someone to talk to. The reassurance I got - that things would get better. It was nice to feel that there's someone to talk to who understood.''
And, even more recently, Feight called on emergency service counselors to help with the decision to hospitalize Jacob a second time.
``The night he was hospitalized, the decision was devastating. The worker asked questions, then told me, `You need to do this.' It took the burden off me. Someone else was telling me. But it didn't take away the trauma of doing it. As a parent, there's no right or wrong. It's what's best for the child. But it's devastating no matter how old they are. They're your children.''
Jacob's memories of his most recent stint in the hospital are ones of loneliness.
``I missed my family, people holding me tight at nighttime,'' he says quietly, sinking into Feight's encircling arm.
At home, Jacob listens to a tape of relaxing sounds - the ocean, birds - at bedtime, and Feight sits with him to calm him down.
Under Comprehensive Mental Health Services, Jacob has been able to continue to see the same psychiatrist he saw previously, and it's this kind of continuity that is so crucial for children with mental illness, Feight says.
Because of his disability, Jacob qualifies for Medicaid and Supplemental Security Income benefits, and it's the recent change to HMOs that mandated a new doctor for the boy. He has to have frequent blood tests to measure the level of lithium in his body.
At the doctor's office Jacob was accustomed to, ``they knew him by name,'' Feight says. ``Two minutes and they'd know if it was going to be a good blood-drawing day or not. The rapport was mutual. There were seldom problems, but they were prepared for it. They'd do the small things, the Mickey Mouse Band-Aids,'' for example.
A change in doctors or dentists ``may seem small, but it's a major factor in kids like Jacob,'' Feight says.
Feight also lauds the cooperation and interaction between Comprehensive Mental Health Services and the city's schools. Jacob is a second-grader at Holland Elementary. He spends part of each day in a class for seriously emotionally disturbed children and the rest of the day in the regular classroom.
Of course, there is always room for improvement in any service-delivery system, Feight says. But the Consumer and Family Affairs Board she sits on includes people who receive and give help in all three divisions of the Community Services Board. ``It's to make sure that problems are dealt with, that clients get the best possible services.''
This communication is especially critical in situations of dual diagnosis, in which a person suffers from more than one of the three disabilities, such as a person with mental illness who also is a substance abuser.
Feight works hard both publicly and privately to ensure that Jacob has as normal a life as possible. He plays soccer and takes swimming lessons, among other things.
Jacob looks up from his car play with a big smile. Mid-afternoon sun is shining on his face, and his freckles (he calls them ``angel kisses'') are more evident now.
``Look at him,'' Feight says. ``He's normal, like everybody else's little boy.
``I'm looking forward to a happy ending.'' MEMO: The support group for parents of children and adolescents with emotional
and mental disorders meets at 7:30 p.m. the first Tuesday of each month
at Beach House, 3143 Magic Hollow Blvd.
ABOUT THE AUTHORS
Staff writer Jo-Ann Clegg and correspondent Nancy Lewis bring
different perspectives to their combined look at the Community Services
Board. Clegg worked for Comprehensive Mental Health Services for 15
years, retiring in 1991. She has worked as a free-lancer for the Beacon
even longer and became a staff writer last year. Lewis moved here from
Connecticut in 1994 and has covered various social issues for the
newspaper as a free-lance writer.
[Also see a related story, see page 14.]
ILLUSTRATION: [Cover, Color photo]
Staff photo by D. KEVIN ELLIOTT
A COMMUNITY SAFETY NET FOR MENTAL ILLNESS
Staff photos by D. KEVIN ELLIOTT
Jacob Smith has a ``Jekyll and Hyde'' personality, says Vickie
Feight, the aunt who has cared for him since he was 2. Jacob calls
her ``Mom,'' and she and her husband, Victor, count him among their
five children.
KEYWORDS: MENTAL ILLNESS MENTAL RETARDATION by CNB