Beci Johnson is 21 years old. She's been having anxiety attacks since she was 16. Symptoms include agoraphobia, claustrophobia and a fear she can't identify. This year has been her worst. She's often unable to leave her apartment, and sometimes she can't bring herself to take a shower. The latter, she admits with an embarrassed laugh, can last for as long as a week.
She's a qualified auto mechanic, but her illness makes it impossible for her to do the job she trained for. "I try to go for interviews and I can't. Nothing seems real. I don't know what I'm afraid of."
Instead she keeps a roof over her head by working from home as what she euphemistically calls "a telephone actress." The job pays little more than her rent--her phone has just been cut off, so she's working out of a friend's house.
Around the middle of last month, a friend became so concerned about Johnson's inability to cope that she advised her to get help. "I didn't realize how bad she was until I gave her a ride to a job interview. We weren't even two blocks from her apartment before she had a panic attack. She kept saying, 'It's so bright and so open.' Her whole body was trembling and she was hyperventilating. I realized that she couldn't go outside during the day."
The friend gave her the number of ComCare, the agency responsible for care of the mentally ill in Maricopa County. Johnson called the number and explained what was wrong with her. She didn't get much in the way of comfort.
"The lady who answered stressed me out. She seemed like she was in a big rush. She asked me weird questions, like did I like to cook. She almost made me have an anxiety attack. She said they'd call me in July to give me an appointment."
What's she supposed to do until then?
She shakes her head. She doesn't know the answer to that.
ComCare is in financial crisis. The agency's ineptitude has left it more than $7 million over its budget. It has responded by cutting services to 13,000 of its 40,000 clients, and it looks likely that some of its 1,200 staff members will be laid off this summer.
But it would be erroneous to suggest that a crisis at ComCare is the same thing as a crisis among those unfortunate enough to be its clients. In this county, mentally ill people with low or no income live in a perpetual state of crisis.
Compared with others in the same system, Beci Johnson is lucky. She's not actually suicidal, and she's not violent. She has friends, and will probably find a way to survive the next few weeks.
Brian Stevens (not his real name) has been a client of ComCare since May 1991. His mental problems go back further than that--he was diagnosed schizophrenic while still in high school. When he approached ComCare, the agency wouldn't treat him at first.
"They said they were waiting for my SSI to go through--it was just about money," he says. "They had a sliding scale, but I didn't have the money to pay for it."
He finally qualified for treatment eight months later. He says it took ComCare about a year to diagnose him, even though he told the agency about his diagnosis in high school. Before diagnosing him, ComCare tried to get rid of him.
"They wanted to discontinue me as a client because they thought I was malingering. They thought I was overreporting psychotic symptoms--they thought nobody could be that crazy. I had visual and auditory hallucinations, severe mood swings and social phobia. I would spout nonsense and wouldn't be able to stop. I suffered from paranoid idealization--I thought the TV and the government were watching me.
"I requested a change of doctor. They had to go through due process to get rid of me. During that time, I wasn't getting medication--it cost about $500 a month, and SSI only gave me $480, which I needed for food. I went to four different doctors, and finally got diagnosed. Now that I had a diagnosis, they got money from the county to pay for my medication."
But, before diagnosing him, ComCare was willing to prescribe Prozac and Haldol as long as Stevens could pay for it.
Like Johnson, Stevens, now 23, once made a crisis call to ComCare. Unlike Johnson, he felt both suicidal and violent. Like her, however, he was told he couldn't have an appointment until a month later.