Could You Become Another Artie Marinez Case?
Mental-health experts were asked what would happen to someone like Artie Martinez today under circumstances similar to his in 1955: He was taken to the Arizona State Hospital after he disrobed in public, and remained incarcerated there for most of the next 40 years.
* Dave Coons, staff psychiatrist at the Arizona State Hospital (ASH):
"These days, this guy [Martinez] surely wouldn't get into ASH. He might go to the county hospital for a time, or to a ComCare urgent-care center. . . . If he was lucky, he'd get intensive community treatment services; people who have been getting such services after their release from ASH generally have been doing well.
"But most likely, Mr. Martinez would end up in jail at some point. The criminalization of the mentally ill in Maricopa County is a reality--it's happened to many former ASH patients I know of, and it's very unfortunate."
* Charles "Chick" Arnold, Phoenix mental-health attorney and architect in the early 1980s (then as the Maricopa County fiduciary) of the landmark lawsuit Arnold v. Sarn:
"What should happen to Mr. Martinez and what would happen are two different things. What would happen is that he would present [be considered] as an emergency case at the county hospital . . . ComCare's urgent-care team there likely would be unable to communicate with him, and they would close their file. They'd find a way not to put him in their system--that's just the way of the world in Maricopa County in 1997.
"We're talking about ComCare, which is so underfunded, and he'd be kicked back out into the street. Eventually, he'd end up in the state's second-largest mental-health facility--the Maricopa County Jail. That's not a matter of falling through the cracks, it's tumbling through a chasm. At least this man was provided sanctuary 40 years ago, whether he actually needed it or not."
* Vicki Staples, a program representative for the Arizona Department of Behavioral Health Services, and ex-ComCare case manager:
"He'd probably go to a [ComCare] urgent-care center to be evaluated. Based on that evaluation, several things could happen: He'd be referred to ComCare's seriously mentally ill program, and . . . they'd probably try to keep him as long as possible to try to determine what was going on with him.
"I think there's many more safeguards these days, more ways to do the right thing. Sign language is pretty common now, and ComCare would get someone to talk with him that way. They'd contact his family and get as much information about him as possible--has this happened before, how serious was it, what kind of meds is he on. ASH as an option would be way down the road."
* Aimee Schwartz, medical director of state Behavioral Health Services and president of Arizona State Hospital's governing body:
"These days, people inside the system are far more highly trained to determine what kind of services that a patient really needs. In the old days, it was a given that you'd go to a hospital to be evaluated in mental-health cases. If you think about it, it was the same for other conditions--outpatient surgery wasn't even a possibility until recent years.
"The assumption was that it had to be an institution, all or nothing. But just because you need help of some sort doesn't mean you have to be stuck in a large government institution to get it. I'm talking about individualized services that can be provided, and at less cost than through a state hospital. I'd like to think that the system would do better by Mr. Martinez in 1997."
* Joel Dvoskin, a Tucson psychologist and former commissioner of New York's mental-health system; he was an expert witness for the State of Arizona in the Martinez civil case:
"For one thing, the quality of mental-health care is much better than it was 40 years ago, both in the preventative and treatment arenas. We've come light-years since 1955, no matter what anyone might have you believe. I'm not talking about the inevitable cracks in any system that the media often focuses on.
"What would happen to Artie Martinez in a cutting-edge system--which Arizona is in some ways, believe it or not--is that he'd probably go to an acute-care hospital, with the treating doctors shooting for a short-term stay, if possible.
"The social workers would move to learn about his family. . . . They'd go to work for this guy to see if he could stay in an apartment, or in an out-of-hospital setting of any kind. Artie was a difficult case, and nobody can really say what Artie could have done with a complete support system. I also can say for certain that, in 1997, he would have gotten better treatment when he first started to slip."
* Sue Davis, executive director of the Arizona Alliance for the Mentally Ill, and a member of ASH's governing board:
"He would probably go to some form of outpatient-treatment center--an urgent-care center, for example--to see if he was medically or psychiatrically all right. Once he was stabilized, I think he'd probably be taken home, assuming that he has a good relationship with his family. He hadn't hurt anyone, right?
"We all know that our state hospitals used to be the places where people would languish--people that society didn't want on the outside for whatever reason--and that's no longer the case. But there's another reality, too, and that is there's not enough money to treat people in the community who should be treated. Whether this man [Martinez] would be treated properly, I can't say.
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