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Club Meds

"I'm old," says 20-year-old Lynda Sue Dale, nervously running her long, painted nails through her dark hair. "I been old for a long time. I don't really have a life, a social life, no more. I spend a lot of time in my apartment, staring at the TV or whatever...
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"I'm old," says 20-year-old Lynda Sue Dale, nervously running her long, painted nails through her dark hair.

"I been old for a long time. I don't really have a life, a social life, no more. I spend a lot of time in my apartment, staring at the TV or whatever. But I still can't help myself sometimes. What I have is real uncontrollable."

Lynda is a slight, striking young woman with a quick mind and a mercurial temperament. She zigzags about her life like a freeform jazz soloist, riffing like a precocious child, a flitty teenager or a world-weary woman.

She is speaking softly for the moment, sitting on the edge of a bed in the cramped living room of her mother's apartment. Lynda lives in the same complex.

Minutes later, she demonstrates what she means by "uncontrollable."

Lynda hears a baby's howl outside the apartment door. It's her 2-year-old, Devlin Jr., who's being looked after by her mother's longtime companion, Linda Bauer.

Lynda jumps up to see what's happening, which turns out to be nothing. The baby's just playing. But she takes the opportunity to berate Bauer.

"I thought you said you want what's best for me," Lynda shrieks. "Yeah, right. I thought you said you'd come through for me this one time, so I could tell my fuckin' story! It's my fuckin' story!"

Bauer shakes her head and walks away. Lynda's mother, Nancy Dale, looks as if someone has driven a stake into her stomach.

"You hear how many times she says the word 'me,'" Nancy says, lighting a cigarette with shaky hands, as her daughter tries to compose herself. "It's always about 'me' and it's always about how Lynda Sue is a victim. It's never about anything or anyone else."

That does it. Lynda starts to sob. Her longtime counselor, Ruth-Ann Robinson, hands her a tissue, asks Lynda to try to compose herself, then comments, "This is the way it is for Lynda -- up, down, up, down, up, down, minute after minute. It gets very tiring, for her and everyone around her."

Lynda has good reason to be weary. She's had a tumultuous relationship with law enforcers since she was 9. At 13, she lived with a sexual deviant (now in prison) old enough to be her grandfather. She's served time in juvenile jails. She's worked as a stripper on and off since she was 16. She gave birth to her son shortly after her 18th birthday. She was convicted late last year of beating her then-boyfriend -- the father of her son, D.J. -- with her fists, and was fortunate to evade jail.

Lynda Sue Dale has a serious mental illness. Among other things, she's bipolar, which a textbook defines as "a common, recurrent severe psychiatric illness that affects an individual's mood, behavior and ability to think clearly."

She loses control in a flash, often for no apparent reason, and can be a danger to herself and others. Those who love her worry constantly for her own safety, that of her son, and for themselves. She needs intensive help from all corners -- family, social service, behavioral health -- if she's to have a chance at the pursuit of happiness.

Even under the best of circumstances, Lynda and others in similar straits would confound any agency charged with her well-being. But that's their job. Despite Lynda's notorious record, however, the State of Arizona and its hired hand, ValueOptions, balked at providing help for months after she asked for it last February.

Authorities then rejected Lynda's application seeking sanction as a seriously mentally ill person. The reason? ValueOptions claimed it couldn't determine if her problems are caused by a mental illness, or by alleged substance abuse. And because it couldn't, it had chosen to do nothing for her.

Lynda claims she hasn't abused drugs or alcohol for years, though she admits to dabbling on occasion. Her mother, who sees Lynda almost daily and doesn't sugarcoat things, confirms Lynda isn't abusing anything these days. "Except those around her," Nancy Dale adds.

ValueOptions is a sprawling, for-profit managed-care company under contract with the state and Maricopa County to provide mental-health programs. The Virginia-based firm signed a three-year, $510 million deal that started in February 1999.

After three months of stonewalling, the firm -- actually a ValueOptions subsidiary, Alternative Behavioral Systems of Arizona -- abruptly reversed itself in Lynda's case May 9. It informed her in writing, "you have been determined eligible for seriously mentally ill services at this time."

This was a pleasant surprise. Little in Lynda's life had changed since she'd been neglected in February, other than she'd told an ABS employee that she'd been interviewed by New Times.

Her case offers a revealing glimpse into the local mental-health system's fickle, often cruel nature. A troubled young woman with a long and documented history of mental illness is told she hasn't made the cut for services because she's got substance-abuse problems which she may not have; several months -- and several manic episodes -- later, boom, she's in.

"I'm supposed to be the crazy one," she says, "but they keep going back and forth like they're crazier than me. I don't know if I'm coming or going."

Lynda Dale is right. The mental-health system that's now grappling to treat her does exhibit many dysfunctional symptoms that some of its clients do -- paranoia, irrationality, finger-pointing.

The professionals who operate the system and the government bureaucrats paid to oversee it repeat a similar refrain: We don't have enough money to do things the way they ought to be done.

Certainly, public behavioral-health systems are underfunded, and Arizona's ranks about in the middle of all states on the basis of per capita funding.

But it's not all about money. A recent study of Arizona's mental-health system notes that "many concrete and measurable service improvements could be implemented without more money."

That's a rather passive way of saying the system does lousy with the money it does have. The court monitor assigned to oversee implementation of Arnold v. Sarn -- a class-action lawsuit that mandates sweeping services for Arizona's seriously mentally ill -- was far more direct in a report issued last month.

"Findings of this 2000 review are disheartening," Linda Glenn wrote in her update. "The current mental health system has installed multiple procedures and practices aimed at limiting services, but has no evident mechanisms, infrastructure, or adequate resources to ensure that individuals with a serious mental illness receive the services they need." (Emphasis added.)

Glenn seems to be saying that becoming a member of the fairly exclusive club -- about 14,000 in Maricopa County -- guarantees nothing.

Treatment for the seriously mentally ill in Arizona is more triage than long-term. At its best, the system provides prompt treatment at an urgent-care center, or a heart-to-heart with a sympathetic case manager. At its worst, it does nothing, or makes it so difficult for people to get services that they don't bother to try anymore.

Others, such as Lynda Dale -- her protestations to the contrary -- often can't decide whether they truly do want help, except on their own, often untenable terms.

"That's part of the illness," explains Ruth-Ann Robinson of the New Start Counseling Service, who has treated Lynda sporadically since 1996. "Getting your meds and this and that is nice, but it doesn't necessarily make you that much better. Being seriously mentally ill is a lifetime thing."

Lynda's travails aren't extraordinary to those who work inside Arizona's mental-health system. Nor does it startle those who know firsthand how people with mental illnesses can devastate their loved ones.

"She's capable of almost anything," says Nancy Dale, a certified nursing assistant who lives with her other daughter, Crystal, and Linda Bauer, "and I just don't trust her or the system to keep her from hurting herself or somebody else."

As unstable as Lynda is, however, she's more fortunate than thousands of other county residents with enduring mental problems. Too many other troubled souls don't know how or don't want to apply for benefits, or they give up the fight when the system overwhelms them with paperwork and other hurdles.

Lynda also is lucky in that she isn't homeless, has a phone, and has a mother who helps her time and again, at great emotional and financial expense.

"Bless her heart, she caused us to lose just about everything over the years," says her mother.

That's not hyperbole. Nancy describes being evicted from apartments after repeated loud brawls with her daughter, and having had to quit jobs so she or Bauer could keep an eye on Lynda during the day.

"I'm a mother saying this, and I don't like saying it, but I don't like her sometimes. And I don't want anyone to get seriously hurt because of her."

Lynda Dale was born in April 1980, the product, her mother says, of a date rape. Lynda was two years younger than her half-sister, Crystal, who was born during Nancy Dale's marriage.

Nancy is white, as is her ex-husband. Lynda's father was black, which would become a consuming issue for the little girl as she grew up.

"I always was treated different because I'm like a black person in a white family," Lynda says. "It was always Crystal this, Crystal that, 'Why can't you be like her?'"

"There never was a lot of love between us," Crystal says of her relationship with her younger sibling. "We could never be tight, because no one can be tight with her."

Crystal has had her own struggles: As a youngster, doctors diagnosed her as a dyslexic, and she had to take special-education classes throughout her school years. A dropout, she says she later earned her general equivalency diploma, and now holds a steady job.

Says their mother, "I think I knew when Lynda was a baby that there was something wrong. She'd be up all night just sitting in bed, never sleeping, never eating. Then she started tearing up her clothes, and cried constantly. Later on, she defied everything I'd tell her, and what the teachers would tell her at school."

In elementary school, Nancy says, "Lynda ran smack into prejudice. She couldn't understand why kids didn't like her because of her skin color. 'Why do they hate me? I didn't do anything to them.' But she also got good at shifting blame. She called CPS [Child Protective Services] on me a bunch of times, when she'd get mad about something I said or tried to make her do. She was depressed. It was scary."

In December 1987, Nancy took Lynda to Charter Hospital for psychiatric treatment. During Lynda's weeklong stay there, a psychologist noted that she spoke of the racial prejudice she'd been facing.

The psychologist said Lynda was displaying "strong patterns of manipulation, poor internal controls, poorly developed social skills, and strong feelings of being victimized, [which are] part of a general chronic depression as well as a rather strong oppositional attitude."

She was 7 at the time.

Nancy had lost control of her wild child.

Lynda's first juvenile "referral," for burglary, came in 1989, when she was 9. Lynda later told another psychologist she'd started smoking marijuana at the age of 10, about the time a west-side gang had "jumped her in" as a new member. Between 1989 and 1994, police busted Lynda 11 times on shoplifting charges.

In April 1992, Glendale police arrested Lynda for kicking her mother in the ribs and wrist, and for also assaulting her sister. That led to a monthlong stint at the Durango juvenile jail.

The following May, a juvenile judge ruled Lynda "incorrigible," and ordered her back to juvenile jail.

"I was on a weird mission," she says of that time, "a fuck-the-world thing. I considered myself a half-breed, a misfit. I'd dump my books in a ditch and laugh about it. I basically was a thug. I was doing crazy shit . . ."

Without elaborating, she adds, "And I never got caught for any of the big stuff."

She was expelled from just about every school she attended before dropping out for good after ninth grade. She became a chronic runaway who stayed wherever and with whomever she could.

Before her 14th birthday, Lynda -- whose street name then was "Kitty Kat" -- moved into the Glendale home of John Stull III, a man then pushing 50. "He was infatuated with me," she recalls, "though I never let him do anything. I needed a place to stay. I saw what he did with some of the other kids. He said he wanted to marry me."

Lynda finally moved out in the fall of 1994, around the time a ComCare psychiatrist evaluated her for treatment. (ComCare preceded ValueOptions as the contract mental-health-care administrator in Maricopa County.)

Glendale police arrested Stull in December 1994 on charges of sexually abusing another 13-year-old girl. He's now serving a life sentence at the Arizona State Prison.

In July 1995, Stan Cabanski filed a "psychoeducational" evaluation of Lynda with the county's Juvenile Court.

The psychologist concluded, "This is a very seriously emotionally disturbed young woman who at this time does present a serious danger, both to herself and to others. . . . It is questionable whether she can be worked with safely or effectively while she remains in the community."

Cabanski recommended Lynda's placement in an inpatient program. ComCare disagreed, closing her file two months later with a note that her "treatment goals have been completed."

In truth, she needed more help than ever, and wasn't getting it.

That month, a juvenile probation officer wrote, "I do feel that Lynda is a danger to herself and to the community. She is on her way to becoming a very sophisticated delinquent . . ."

Then, as now, those inside the system were at a loss about what to do with Lynda. "Since I am unsure of what would be the best treatment plan for the juvenile," the officer wrote, "I will not recommend a consequence at this time."

Lynda says she quit gangbanging when she was 16, around the time she found work as a stripper at the Jungle Cabaret, a club in downtown Phoenix.

"I told them I was 21, and they went for it," she says. That's noteworthy because now, at 20, she could easily pass for a 16-year-old. "Stripping came natural to me, and I was good at it, and I made some real money."

Lynda says her new skill led someone to invite her to dance -- clothed -- onstage during a hip-hop show at Desert Sky Pavilion in the summer of 1996. "There I was," she says, "dancing with Bobby Brown, and my homies are out there in the audience going, 'Look who's up there.' I went on tour with the show, and I saw a lot of places you're not supposed to see at that age."

(Lynda's counselor, Ruth-Ann Robinson, says she believes the Desert Sky part of the anecdote. As for going on tour, Robinson chuckles, then says, "Lynda has a lot of interesting stories. Some of them are even true.")

Lynda met the future father of her son at a traffic light in southern California when she was 16. She'd just moved there with a girlfriend and her girlfriend's mother. The couple loved each other deeply, Lynda says, but brawled constantly.

"We had a lot of fights where the cops had to come by," she says, bursting into tears at the memories, "but we had a lot of good times, too. I didn't know what I had."

Lynda was ecstatic when she learned she was pregnant in mid-1997. "I was so happy. It was, 'We'll have our own family now.' I wasn't taking any meds 'cause I was pregnant, and I noticed my mood swings were really wild until D.J. was born."

Lynda gave birth to Devlin Jr. on April 29, 1998, but the newborn's presence didn't help matters on the home front. In March 1999, police arrested Lynda on domestic-violence charges after a loud and vicious clash with her boyfriend at their Long Beach apartment. A California judge allowed her to serve her three-year probation term in Arizona.

Lynda moved back with her mother just before last Christmas, but the old stresses between the pair resurfaced. She rented her own apartment a few weeks later, and then applied for social security benefits and mental-health treatment.

Things had changed since Lynda had left Arizona a few years earlier. Perhaps most important, ValueOptions had started to deliver mental-health services to county residents in February 1999.

Records indicate that, during an interview with eligibility evaluator Elizabeth Rodgers, Lynda admitted she'd smoked marijuana and drunk some alcohol a few weeks earlier. But she also told Rodgers that her intake was occasional, not habitual as it had been in her early teenage years.

ValueOptions concluded Lynda was ineligible for treatment services: "It was not possible to determine if your symptoms are caused by a mental illness or by your substance abuse."

That chicken-or-egg approach has been company policy since it came to town, though it may be about to change, according to court monitor Glenn. She says ValueOptions has agreed to presume an applicant is seriously mentally ill, even when concurrent substance-abuse problems may exist -- as they frequently do.

"It was crazy for them to deny her on the basis of that B.S.," says Ruth-Ann Robinson. "She's a master of spin control, but she's also incapable a lot of time of doing the right thing. Her mind just won't let her. That's called mental illness."

In late February, Lynda also sought social security disability benefits.

On February 27, Nancy Dale wrote on her daughter's application, "Lynda cannot cope with her two-year-old . . . [She] goes up and down emotionally. She may be loud, elated, hyperactive and energetic, or is in a sad, guilt-ridden depression. She gets extremely agitated and out of control over the most insignificant thing. She is physically and verbally abusive to me and other people. Lynda desperately needs help! She cannot function in society."

Psychiatrist Richard Rosengard interviewed Lynda briefly, scanned some paperwork, then penned an evaluation for the government. He must have caught Lynda on a good day.

"Her insight and judgment are relatively okay," Rosengard wrote in a March 31 report. "She certainly can care for herself, care for her son, [and] provide for her own activities of daily living such as cleaning, shopping and cooking."

As evidence of Lynda's alleged ability to hold a job, the psychiatrist cited Lynda's short stint as a lifeguard in California, and a brief gig at a supermarket in 1997.

Social security officials, too, rejected Lynda's application for financial benefits: "Medical records show that, while you may be depressed at times, this has not affected your ability to remember, understand or communicate with others. . . . We have determined that your condition is not severe enough to keep you from working."

Ruth-Ann Robinson -- a woman not prone to cutting Lynda much slack -- scoffs at the government's analysis. "Lynda can't last in any job for too long because her illness won't let her at this time," Robinson says. "For anyone to say otherwise is ridiculous."

After the double-whammy rejection from both ValueOptions and social security, Nancy Dale sought help from the Maricopa Advisory Council on Developmental Disabilities. The overburdened agency advocates on behalf of the seriously mentally ill. Later, Nancy hired a lawyer to appeal the Social Security Administration's decision against Lynda.

The latter appeal is pending. Lynda's acceptance into ValueOptions' fold came only after Nancy Dale contacted New Times about her daughter's plight.

"It doesn't surprise me that they gave this person's case a second look if she did mention the media," says a ValueOptions psychiatrist, who requested anonymity. "If you scream loud enough, you may get somewhere in this system."

ABS assigned Lynda to a case manager in late May. Lynda began to take her new medications, and spoke excitedly for a time about turning her life around.

But all the drugs and counselors in the world don't add up to a cure-all, for her or anyone else. As has happened often in her life, Lynda soon reverted to striking out verbally and physically against those who displease her.

Phoenix police have been called to Lynda's apartment complex at least twice in recent weeks to quell clashes between Lynda and her immediate family. Reports say that, on May 29, officers took Lynda to a crisis center for emergency treatment after she allegedly attacked her sister with a baby stroller. She spent a few hours there, calmed down, then returned to her apartment.

But things have been tense since then. Lynda spent most of her Fourth of July in the mode of a short-fused firecracker. Of all things, she threw a fit over the status of a baby's car seat. Her mother threatened to call police as the clash escalated, and then locked herself in her apartment. Lynda says she called the police herself, more out of spite than anything. No one was arrested.

Nancy and Linda Bauer tend to little D.J. much of the time, and his grandmother says she's terrified Lynda will harm him someday.

"Lynda Sue will feel terrible afterward, just like she does when she goes after one of us," Nancy says, "but she just can't stop herself from doing some things."

Lynda bristles at the suggestion that she'd hurt her baby.

"I'd never," she says tearfully. "Never, ever, ever."

Lynda is broke and out of work, and says her landlord has plans to evict her, perhaps before the end of this week. She fantasizes that ValueOptions might provide her a nicer apartment. The reality is that her case manager wants Lynda to move to a residential treatment center or, in the alternative, to the homeless shelter.

That's the last thing Linda wants to do. She plans to stay with a friend for a while. It's uncertain if she'll take D.J. with her.

"I don't need anyone's bullshit," Lynda says. "I'm past having people telling me what to do. I'd rather be on my own, making my own mistakes, trying to fix me."

She says she has a new boyfriend, who is 17. The young man and his family apparently have reintroduced her to church life. As evidence of her reinvigorated spirituality, she's rerecorded her answering machine message.

"God bless you," it now says.

Nancy Dale says she tries not to be overwhelmed by it all, a near-impossible task.

"The real Lynda, you really don't see her much anymore," she says. "There's a real sweet person buried under all this garbage."

Sheila DeBenedetto provided research assistance for this story.

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