Underfunded Health Care Made Jails Warehouses for Those With Mental Illness

AMY GOODMAN: Are prisons and jails America’s “new asylums”? Today we spend the hour looking at how a disproportionate people facing mental health challenges have been swept into the criminal justice system, where they lack adequate treatment. At least 15% of men and more than 30% of women in jails have a serious mental illness, such as schizophrenia, major depression or bipolar disorder. This is the focus of an incredible documentary by filmmaker and psychiatrist Ken Rosenberg. The film is called Bedlam.

DOCTOR: OK, it’s a very busy day today.

NURSE 1: Mental illness is not something people want to hear. It’s not something they want to talk about.

NURSE 2: I’m calling from LAC+USC. I was calling because we have a patient here. She’s here in our psych ER.

GAVIN NEWSOM: The state of mental illness in this country is beyond the trite notion of crisis. It’s at a point of comedic absurdity. The number of people that we’ve just completely given up on is just staggering.

UNHOUSED PERSON 1: A lot of people down here suffer from mental health issues, and that’s why they’re down here.

UNHOUSED PERSON 2: I suffer from it. These people suffer from it. And there ain’t no help nowhere. It’s just sad.

PATRISSE CULLORS: We have historically not fought for people with mental illness. But people are rising up and saying we are sick and tired of our families being thrown away.

PROTESTERS: No justice, no peace!

NURSE 1: As long as doctors tolerate these working conditions and the outside world won’t know what’s going on, then nothing will ever get better. The definition of insanity is repeating the same thing over and over and expecting different results. The way we treat mentally ill in this country is insane.

DOCTOR: I’m afraid that’s the system.

AMY GOODMAN: That’s the trailer for Bedlam. It’ll be airing on PBS Independent Lens. One of the voices you heard was that of Black Lives Matter co-founder Patrisse Cullors. In the film, she and director Ken Rosenberg and many others share their personal experiences of family members who have chronic psychiatric conditions that have pushed them into the path of police officers, emergency room doctors and prison guards in Los Angeles County. Patrisse’s brother Monte has lived with schizoaffective disorder since he was a teenager. Ken’s sister struggled with schizophrenia.

After the film premiered at the Sundance Film Festival last January to a standing ovation, I sat down with Patrisse Cullors and Ken Rosenberg, who’s also an addiction psychiatrist affiliated with the Weill Cornell Medical Center here in New York City. In October, he published his book Bedlam: An Intimate Journey into America’s Health Crisis. I asked him why he chose the name Bedlam.

DR. KENNETH ROSENBERG: Bedlam was the first mental institution in the world, started in Bethlem, England, and was nicknamed “Bedlam” because that was just how people got to know of it. It is a name now synonymous with chaos and craziness. And I think it very much describes what’s happening now in America, that the mentally ill are on the streets, they’re in the jails. They’re part of a system that is utterly insane. They lack treatment. They lack research. They lack resources. So, hence the name Bedlam.

For me, this is a professional film and a personal film. It’s a film, I have to say, I’ve always wanted to make and, in some ways, kind of dreaded making, frankly, because I never thought that I would share my personal story. In fact, until I was 40 years old, I never told a soul that my sister was schizophrenic. I grew up in a time and a place when it was — I’m Jewish — it was called a shonda, the Yiddish word for “shame.” And I think that although I became a psychiatrist to help families like my sister, it took me many years to be prepared to share that story.

When I made this film, I made the film to show the tragedy and the trajectory of the seriously mental ill in America, particularly in Los Angeles, which is the epicenter of the crisis. But I also realized that the families didn’t know why I was telling this story, the viewers didn’t know why I was telling this story. And I needed to really be honest with them. And people like Patrisse and her beautiful, kind brother Monte volunteered to be in this film to share their stories. So I thought, at some point, a couple years into it, the least I could do is share my story. So, when you watch the film, you know the person behind the camera, as well as the people in front of the camera.

AMY GOODMAN: Your sister is the reason you became a psychiatrist?

DR. KENNETH ROSENBERG: Yes. When I was 14 years old, she was institutionalized. My parents would not allow her to be in a hospital very long. And when they took her out of the hospital against medical advice, it was pretty much then and there, at 14 years old, that I decided I was going to be a psychiatrist, for a couple of reasons. One is because I thought, “Well, maybe I could do some good,” where I saw no good being done.

And secondly, psychiatrists seemed to understand what the hell was going on, understood what was going on in my family and in my world. And so, for me, being in the family therapy session, in which my parents announced, understandably, that they had enough and they were taking my sister out of the hospital, I thought, “Hmm, this guy” — he was a guy — “this psychiatrist, really understands things. I want to join his ranks.”

AMY GOODMAN: So, you tell the history of how the mentally ill are dealt with in the United States. Talk about that, through deinstitutionalization and what we’re seeing today: The mental asylums of our country are this nation’s jails and prisons.

DR. KENNETH ROSENBERG: That’s correct. The jails are the de facto mental asylums of the day. You know, deinstitutionalization began in the late ’50s, early ’60s. Well-meaning individuals did it, President Kennedy among them. We had these new drugs, Thorazine coming onto play, lithium coming into play. And so, for the first time, people with serious mental illness were able to leave the asylums, and they were able to live outside the asylums. The asylums at the time were dreadful places, for the most part, where people were not getting care, and there were quite a number of scandals about them. In fact, Life magazine ran an article in 1946 with the title “Bedlam.” That’s was what Life magazine called it. And it was actually about a mental hospital not that far from where I lived, called by Byberry, which was closed. So, from well-meaning individuals, and probably for the best of reasons, the institutions were closed, and mentally ill people went out and, hopefully, President Kennedy said, would be welcomed into the — what he called the welcoming arms and warmth of the community.

Well, unfortunately, that warmth never came. And shortly, the community mental health centers that he built never came. And when President Reagan took over, the money for the community mental health centers, the few of those that were built, dried up. So, essentially, we did this: We took people out of the asylums, put them onto the streets, and now put them into the jails. We made being mental illness a crime. And we treat them like criminals. And, of course, they become cycled in and out of the criminal justice system, exposed to all the things that happen, all the traumas that happen. Of course, poverty becomes a part of this cycle. Poverty makes mental illness worse and may even cause mental illness, in some way. So, we’ve made the situation so much worse through deinstitutionalization. Bringing back the asylums is not an answer, but bringing back care surely is.

AMY GOODMAN: President Kennedy himself, his own sister, Rosemary, tell her story.

DR. KENNETH ROSENBERG: Well, Rosemary was born with some kind of birth defect. It’s not clear. It was never so clearly documented. Probably some form of mental retardation. And as often happens, as she got older, into her young adulthood, she became more psychotic than anything else, and she got the treatment du jour, the treatment of the day, which was a frontal lobotomy. That’s the treatment that won the Nobel Prize in 1949. That’s the treatment that a rich and powerful person with a mentally ill child was able to get. A frontal lobotomy, performed by none other than Walter Freeman, who was a neurosurgeon who toured the country with an ice pick in his station wagon and did thousands upon thousands of frontal lobotomies. And we thought that was the best we had to offer. And perhaps it was, which is quite dreadful. Rosemary did not do well. She had to be institutionalized for the rest of her life. And as a result, President Kennedy, when he took office, wanted to take care, in some way, of people like his sister, the mentally retarded, and people with serious mental illness. And that was part of the genesis of deinstitutionalization.

AMY GOODMAN: Patrisse Cullors, talk about your life story, with your brother Monte.

PATRISSE CULLORS: So, I grew up in the neighborhood in Los Angeles called Van Nuys. And it was — there was four of us in my mother’s home. She was a single mom. And my brother Monte was one of my first best friends. In the film, you’ll hear Ken talk about his sister in the same way. And it was, you know, really amazing growing up with him. He was fun and funny and playful, and I could talk to him about everything.

AMY GOODMAN: What was the age difference?

PATRISSE CULLORS: We’re only about three years apart. So, at a certain point in his own life, we started to see different issues. We didn’t know it was mental health issues.

AMY GOODMAN: He was your older brother?

PATRISSE CULLORS: Monte’s my older brother, yes. He’s three years older than me. And I believe if Monte received early care, early intervention, he would have probably ended up not having to spend majority of his life inside of a jail cell. But instead, in our community, we were given criminalization. And I remember some of the first signs of my brother’s depression, what I now understand as depression, as anxiety. I remember him having pretty bad mood swings. And then, when he was 18 years old, he was diagnosed inside of the Twin Towers, a Los Angeles jail, correctional facility, where he was also tortured by the sheriff’s department.

AMY GOODMAN: Talk further about that. He started being arrested when he was like 14?

PATRISSE CULLORS: Yes. He was —

AMY GOODMAN: You were 11.

PATRISSE CULLORS: Yes, his first arrest was at 14 years old, and he was kicked out of middle school and didn’t end up going to high school. You know, he started using drugs around that time, as well. And now, you know, from everything that I know about mental health and substance abuse, they often go hand in hand. It’s called dual diagnosis. And, you know, my mother — we went to lots of jail facilities to visit him. We also went to a lot of rehabs to visit him. And he was never treated for mental illness, not until he was, in fact, incarcerated.

AMY GOODMAN: You talk repeatedly in the film, Patrisse, about, if you will, the illness of shame and how that intensifies any situation.

PATRISSE CULLORS: Absolutely. I grew up in a very private home. My mother, because she was a single mother, I think she felt a lot of her own shame about being a teenage mom, being poor. We didn’t talk about a lot of things, including my brother’s substance abuse and mental illness. I would — I ended up straying from that, and I found a lot of solace in being honest and transparent about what was happening. I found the movement. I ended up joining a local organization. While they weren’t dealing with mental illness or law enforcement violence, they were talking honestly and openly about issues of racism and poverty. And I started to make the connection of how I grew up and what was happening to me, my family, and my brother, in particular.

AMY GOODMAN: Patrisse Cullors, co-founder of the Black Lives Matter movement, one of the people featured in the documentary Bedlam, directed by Ken Rosenberg, which is set to air on PBS Independent Lens next April. When we come back, Patrisse describes how she tried to get help for Monte, her brother, while he was in prison and after he was released.

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AMY GOODMAN: “Don’t Let Me Down” by Joy Williams, here on Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman, as we continue to look at how prisons and jails have become America’s “new asylums.” That’s the focus of an incredible new documentary called Bedlam. Earlier this year, I interviewed director and psychiatrist Ken Rosenberg, whose own sister struggled with mental illness, and also one of the people he features in the film, Black Lives Matter co-founder Patrisse Cullors. During the film, Patrisse’s brother Monte is in and out of jails and psychiatric situations. I asked Patrisse how she sought help for her brother Monte while he was incarcerated and also upon his release.

PATRISSE CULLORS: My brother was 23 years old when he was released from his first prison sentence. And during his time in prison, we would receive letters from him telling us that they had put him in the psychiatric wing of the jail facility. And my mother and I were confused. We didn’t know he had any psychiatric issues. And so, we also didn’t know that we could call anybody. We can call a warden, or we can call a prison psychologist. So, we just sort of took his word that — you know, that they were messing with him.

When my brother was released from state prison when he was 23 years old, I went and picked him up from the Greyhound station. I hadn’t seen my brother in four years. I was so excited. I took my friends with me. And when I saw him, I was very disturbed. He had been released in boxers and flip-flops and a white undershirt. And I sort of looked around. Is this sort of some — like, thinking, “Is this some sort of joke?” And he had these dark sunglasses on, and his whole posture was completely different from the brother that I remembered going inside. So I remember, you know, putting him in the front seat and asking, “Monte, are you OK? Are you OK?” He was sort of hunched over, super quiet, and he said, “Yes, I’m fine.” And he had a sort of tight mouth. And when we got to the house, my mother said — you know, she kind of pulled me aside. She said, “Something’s wrong with my son.” I said, “No, nothing’s wrong. Like, he just got out of four years of prison. Like, it’s going to take some time for him to acclimate.”

Five days in, my brother was completely psychotic. He was, I mean, completely out of his mind, and we did not know what to do. I didn’t know what to do. My mother didn’t know what to do. None of my friends had dealt with anything like this. So I called a good friend of mine, actually a teacher of mine, and said, “You know, this has happened to my brother. Do you know — do you know what’s happening to him?” His partner happened to be in school of psychiatry, and she said it sounds like he’s in the middle of a psychotic episode.

AMY GOODMAN: What was he doing?

PATRISSE CULLORS: He was putting on two pairs of shoes. He was babbling. He was up; he hadn’t slept. So my mother and I were taking shifts, trying to stay up to see if he was OK. He was writing things on the wall with toothpaste. I mean, it was just literally watching someone deteriorate.

So, I was told to call the police. Actually, I was told to call the ambulance, by the woman who was in psychiatry school. And I called the ambulance. And I made the mistake in telling the ambulance that my brother had just been released from prison. And they said, “We don’t pick up convicted felons. You have to call the police.” And I battled with them for a few minutes. I said, “I refuse to call the police. My brother has been tortured by the police in prison.” And I ended up calling the police. And they came, and I had a long talk with them outside. I said, “What do you plan on doing if my brother gets violent? I don’t know if he will. I’ve never seen him like this.” And they said, “Well, we’ll just tase him.” And I sent them home.

And we eventually were able to get my brother in the hospital, but it was — that was my introduction to my brother’s mental illness. Nobody warned us. There was nobody telling us — no case manager, no case worker giving us the 411. We just had — it was trial and error. And it was incredibly, incredibly scary.

AMY GOODMAN: So, when he was in prison, he was in solitary confinement a number of times. Is that right?

PATRISSE CULLORS: Yeah, he spent a significant amount of time in the SHU, a segregated housing unit.

AMY GOODMAN: And you also realized and then started educating yourself — and, as you do, educate everyone else at the same time. But this issue of him going to court and not being in a criminal court. You found out that there was some kind of mental health exemption or court that you could take him to, so he wouldn’t again go through the criminal justice system.

PATRISSE CULLORS: So, there’s always been a mental health court. But it’s only given to certain groups of people. Monte should have been — first of all, Monte should have never been incarcerated. But in his times of incarceration, he should have been given the offer of treatment and the mental health court. The reason why my brother, in a lot of ways, this last time of incarceration, was given mental health court is because now I’m Patrisse Cullors of Black Lives Matter, and I know everybody in local office, and so the minute my brother was incarcerated, I emailed the sheriff himself, former sheriff. I emailed the undersheriff. I emailed the ACLU. And I said — you know, I basically said, “Get my brother help.” And they all know what they did to my brother. And not everybody has that access and resource. And so, Monte was lucky enough to go to a mental health court and end up getting some sort of treatment. Not the best. It should have been way better than he received, but he didn’t end up in a jail cell. But then I think about people like Todd, who — Todd should have been able to be released that day, and, because he had an old strike on his record, was sent back into jail.

AMY GOODMAN: So, Ken, Dr. Rosenberg, talking to you in both your capacity as a director and also a psychiatrist, Patrisse just mentioned Todd. Tell us about Todd’s story and the different track he ended up being on.

DR. KENNETH ROSENBERG: Well, Todd’s story is painfully typical. The mental institutions, as we say, are the jails. So, where do people with serious mental illness end up? They end up in and out of jail.

AMY GOODMAN: Can you tell us percentages?

DR. KENNETH ROSENBERG: Oh, lord. I mean, in the jail, I think — we think it’s one out of four people in the jail have a serious mental illness. We know that there are 2,000 people, as we speak, in Twin Towers jail with serious mental illness. We know that there are at least 20,000 to 25,000 people sleeping on the streets of Los Angeles with a serious mental illness. The numbers are mind-blowing. But —

AMY GOODMAN: And even the guards and many are talking about — I mean, the one thing they may agree with activists on is the issue of they need help. They need training. I mean, if the mentally ill —

DR. KENNETH ROSENBERG: Right.

AMY GOODMAN: —are going to be put in the prisons, these guards are definitely not trained to deal with them.

DR. KENNETH ROSENBERG: Yeah. I mean, we have people on all sides of the aisle involved in this film, Republicans and Democrats, because I think that no matter how you look at it, this is, as we keep on saying, an insane process. If you’re just interested in dollars and cents — hopefully you’re not, but if you are — you know that this is an utter waste of funds. If you have any care for your fellow humanity, humans, you know this is a terrible way to treat people.

So, you asked me about Todd. His story is painfully typical of people who end up cycled in and out of jail. They don’t get any kind of jail-assisted or judge-assisted treatment, which is extremely powerful, something called assisted outpatient treatment, which means that you don’t even have to end up in jail. You just have to have a great need for that. And there is a process in place, on the books, in which people could get, you know, treatment, or family members could help their loved ones get treatment.

AMY GOODMAN: So they’re sentenced to treatment instead of jail.

DR. KENNETH ROSENBERG: Yes. And also, you know — well, there’s two things. There’s mental health courts, which is, if you commit a crime, then you have the option, hopefully, of going to a mental health court, where the judge says, “You know, clearly, your problem is mental illness. And, you know, you committed a minor offense, but you have strikes against you, and before you know it, you’re in and out of jails, and you’re in and out of the streets.” That’s mental health court.

There’s something else called assisted outpatient treatment, in which if you have someone who is refractory to treatment, doesn’t get better, is in and out of hospitals, even if they have not committed a crime, you could get them a judge to say, “Hey, look, you need treatment, and my job is to help you get treatment, before you end up in the criminal justice system.”

Todd got neither. Todd got, you know, what most people get, which is — you know, it’s just the gavel was banged, and he ended up back in jail. And he ends up back on the streets and back in SROs. And —

AMY GOODMAN: And Todd had AIDS.

DR. KENNETH ROSENBERG: And Todd had HIV, as well. So, Todd was always trying to struggle not only to deal with mental illness, but to deal with physical illness. Unfortunately, that’s very common, right? Because one begets another. Poverty begets mental illness. Trauma begets mental illness. Mental illness begets more poverty. It’s an utter downward cycle.

AMY GOODMAN: Describe what happened with your sister. And I’m sure, even to this day, this is very difficult. But you do it so poignantly in the film.

DR. KENNETH ROSENBERG: Right.

AMY GOODMAN: So, you have different situations. Patrisse and her brother Monte has been dealing with this as a mental illness for a long time now —

DR. KENNETH ROSENBERG: Right.

AMY GOODMAN: — and has opened up her family, whether or not at the beginning they wanted to talk in this way. Yours, you went a different track, because your parents were so closed to this idea —

DR. KENNETH ROSENBERG: Right.

AMY GOODMAN: — of revealing what happened to Beth.

DR. KENNETH ROSENBERG: Right. So, my sister was very, very sick. And I ended up, when I was 16, as soon as I could drive in Pennsylvania, where I grew up — I ended up taking her personally to a mental hospital, more than once. And, you know, we tried to provide her with treatment. She was extremely resistant, as were my parents. The treatments really didn’t have that much to offer, frankly. That was part of the problem. But unlike Monte, we were able to find her treatment and not a jail cell, which was, you know, quite a remarkable thing when you think about it.

But Merle ended up, you know, not getting proper treatment. And when I was starting college, actually the first month I started college, she unfortunately jumped out the window and nearly died, breaking, as I say in the film, nearly every bone in her body. And, of course, it’s terrible and tragic. And I actually —

AMY GOODMAN: Your parents said she was running from an intruder.

DR. KENNETH ROSENBERG: My parents told everyone that there was an intruder in the house. But I knew that the only intruder was in her head and was the voices in her head, which probably commanded her to jump out the window. So I stayed home for two years; I didn’t go away to college. I stayed home for two years to try to help her and help my family. And then, after she could walk, pretty much in the second year, I transferred to college and went to college in Boston, and really never came home and never went again into her room, until just about a year ago in making this film, and decided that, you know, I would kind of confront that demon, if you will, you know, in the room in which she jumped.

I should say my parents died. My older sister died. So, in 2005, I was kind of left in charge of Merle. And by then, she had resisted every possible effort to treatment. We were, unfortunately, engaged in a battle, that I was losing. I found a convalescent home for her to go to. She refused. She didn’t want to see a doctor. She said, and persisted in saying, there was nothing wrong with her. Her problems were maybe spiritual, but not psychological. And then, sadly, I finally called the police. My parents had said, “Never call the police on your sister.” But for two weeks she did not pick up the phone, and I finally called the police, and they found her dead in her bed.

AMY GOODMAN: So, this is what prompted you to make the film?

DR. KENNETH ROSENBERG: Exactly. She passed away in 2005. And, you know, in 2010, my kids were, thankfully and successfully, launched as adults — and no small feat there, as well, right? And I thought, “You know, what’s the most meaningful thing I could do with my life at this point?” And I love my patients. I love being a psychiatrist. I love being a filmmaker, made four films for HBO. But I thought that at this point in my life what I could really do is make a film about the tragedy of the severely mentally ill, for my sister, but more so for millions upon millions of Americans, and, in some ways, for myself, as well.

AMY GOODMAN: Patrisse, as Ken was doing this film, you co-launched the Black Lives Matter movement. You founded the Dignity and Power Now. Talk about the convergence of race and class, and when someone is mentally ill, what happens to them when police intervene, what they do to them based on their race and class.

PATRISSE CULLORS: Well, I think it’s important for people to understand that in each city, each county, each state, they decide how they’re going to respond and relate to people with mental illness. In Los Angeles County, the decisions that have been made have largely been around investing resources into criminalizing people with mental illness. And what you’ve seen are mostly poor folks, mostly black, mostly brown, mostly women who are domestic survivors — domestic abuse survivors, and people who are at the margins, trans folks, street sex workers. I mean, really, these are the folks who have been left to fend for themselves.

And when you have a mental illness and you don’t have family support, you know, I think that was something that was — I always feel like I’m not doing enough, and that my family, like, if we just — you know, if we could just do this more or this more. And watching this film, out of all of the subjects in the film, I realized that our family is doing a lot, and you could see the difference. You could see the difference around the outcomes for each of these folks. And it reminds me that we’ve really left it to family members to have to be the caregivers, and when we’re not trained to do so, and when we have our own lives, and many of us either have to give up our lives or sacrifice our lives, and not because we don’t want to, but we need more resources, we need more support. And I remember on one of my brother’s last hospitalizations, you know, me yelling at the social worker. It was like, “What am I supposed to do when he comes home? What else is there for him? You all have to help us figure this out.” And we’ve, luckily, been able to build really great relationships with the other doctor in the film, Dr. Dias. And my hope — my hope is that folks watch this film and come out the shadows, come out the shadows for themselves and talk about their mental illness.

AMY GOODMAN: Talk about Ezell Ford.

PATRISSE CULLORS: Ezell Ford was a young black man from South Central. He lived with schizophrenia. Everybody in the community knew it, including law enforcement, LAPD 77th Precinct. And he would go and play basketball every day at the basketball courts. And on his way home from playing basketball, he was apprehended by LAPD, by two officers, who shot him in the back. And those officers had actually — he had had confrontation with those officers in the past, and they knew about his history of mental illness. And when his mother came forward, Tritobia Ford, she told, you know, the public, “My son didn’t deserve to die. He had mental illness.” And ’til this day, we don’t know why those cops shot and killed him. But what we do know is that more than half the people who are killed by an officer, whether it’s by a Taser or a gun, have some form of mental illness.

AMY GOODMAN: And you talk about the police knowing Monte, as well — they know him as a person in the community — and why community policing is so important, where they understand who the people are, the community is.

PATRISSE CULLORS: Yeah. And, you know, I argue, Amy, that police shouldn’t be the first responders to people with mental illness. We have to reinvest our dollars into real community care, real community mental healthcare. As we’ve talked about on this program before, Los Angeles is trying to build a $3.5 billion jail. And one of those jails is a “mental health jail.” And as we say, our slogan is “You can’t get well in a cell.” And we are —

AMY GOODMAN: “You can’t get well in a cell.”

PATRISSE CULLORS: Exactly.

DR. KENNETH ROSENBERG: So true.

PATRISSE CULLORS: And we are begging the County Board of Supervisors and the Sheriff’s Department to rethink this plan and to put those dollars into community-based solutions.

AMY GOODMAN: So, talk about the protest, because one of your — or, your most powerful solution always is activism. Talk about your protest.

PATRISSE CULLORS: Absolutely. In 2017, over 35, 40 organizations launched a coalition called JusticeLA. Our primary goal is to stop the $3.5 billion jail plan, one, and, two, get those dollars to be reinvested into community-based solutions, including community-based clinics that can deal with mental health and the mental health issues in our communities. We launched a protest where we built a hundred replica jail beds, and in those jail beds we were able to put them on the streets of Los Angeles right in front of the County Board of Supervisors building. Those are the decision makers. They get to say whether that jail gets built or not.

AMY GOODMAN: So, how many bunk beds did you bring out on the street?

PATRISSE CULLORS: We built a hundred replica jail beds. So, we worked with a studio who thought they were doing it for a film shoot, a Hollywood film shoot. And we broke the news to him a week before that: He built those jail beds actually for a protest. We hired all formerly incarcerated people to work on those jail beds, and we end up finding out that the person that was lead on building the beds had actually had his own run-in with law enforcement. And so it was incredibly meaningful for him to build those beds.

We put them out on the street. We held up traffic for eight hours. And we talked about the mental health crisis in Los Angeles County, but also that Los Angeles is a microcosm of what’s happening around the country. So, that protest, and the years of advocacy, has led us to getting the County Board of Supervisors to halt on the jail plan. It’s not over yet. In a couple weeks, they’re going to decide if they’re going to build the mental health jail or not. And actually, tomorrow we’re launching a petition to get them — to get the public to say no to it.

AMY GOODMAN: I mean, what’s so powerful about this film, Bedlam, is that we’re watching people going through their crises in real time. How did you get Monte, your brother, to agree to this filming?

PATRISSE CULLORS: I didn’t. He got himself to. Yes, we went through a lot of — we had a lot of conversations. We had like a dinner with Ken at some point. And when I first asked him about it, I said, “Hey, this is totally up to you. Like, you could do it; you don’t have to do it. Like, it’s up to you.” And he said, “No, I don’t want to do it.” And I said, “OK.” And then I called Ken. I said, “My brother doesn’t want to do it. Talk to you when I talk to you.” And he said, “OK, no problem. Call me if he wants to.”

And my brother went into the hospital, and he called me while he was in the hospital. He said, “I” — because at that point HBO was going to be producing the film with Ken. And he said, “You know, that guy that’s producing that film for HBO, I want to talk to him.” And I said, “OK. Why do you want to talk to him?” He’s like, “Well, I’m interested in doing the film now.” And I said, “OK. Well, why are you changing your mind?” And he’s like, “Why, there’s just a lot of things that happened in here, and I think people need to know about it.”

And this is in the middle of an episode. And I think it’s important for people to know that even when people are in the middle of a manic episode, that they can still make decisions. And I called Ken. I said, “My brother wants to talk to you. Here’s the pay phone number.” And Ken called Monte, and they talked. And Ken called me back and said, “Your brother said he wants to be a part of the film.” I said, “OK, great.”

So, that happened a couple times, that he would tell me he didn’t want to be a part of it, then he would say he’d want to be a part of it. And then, finally, he said, “Yeah, I” — you know, him and Ken built their own relationship. And I think that was really important. What obviously doesn’t get talked about in the film is that Ken is building a relationship with his subjects. We’re talking all the time. He’s not just calling when he’s going to film. He’s asking how my brother’s doing. He’s asking how I’m doing, how my mom’s doing. And we, at this point, have known each other for seven years, and we are with each other in some of the most intense crises. And for folks who — there’s sort of —

AMY GOODMAN: And, Ken, you’re a psychiatrist. He’s not only a director; he’s a psychiatrist.

PATRISSE CULLORS: Yes. And he’s a psychiatrist, and he’s had his own loved one go through a similar crisis. So, in some ways, it’s sort of — I don’t know if I could have done this film with anybody else. I don’t know if my family could have done this film with anybody else. And the subject, the topic is so sensitive. It is —

AMY GOODMAN: Did it change your mother’s view of mental illness and willing to be public about it?

PATRISSE CULLORS: Absolutely, absolutely. My mom is a very private person. She didn’t want to be on film, on camera, at first. And then she decided she wanted to be on camera, because she said, “Trissey, you always do everything for us. You know, I’ll go on camera, and I’ll talk about Monte.” And you saw her in a couple scenes, and that took a lot for my mother to do that.

AMY GOODMAN: That’s Patrisse Cullors, co-founder of the Black Lives Matter movement and one of the people featured in the new documentary Bedlam, which will air this April on PBS Independent Lens. Patrisse Cullors is also author of When They Call You a Terrorist: A Black Lives Matter Memoir. I spoke with her and Bedlam’s director, psychiatrist Ken Rosenberg, at the Sundance Film Festival.

Since then, the campaign to stop Los Angeles County from building new jails at the expense of medical treatment and social services has been successful. In fact, on Thursday, the Los Angeles Times ran an editorial headlined “2019 was the year L.A. County finally said ‘no’ to new jails.” It describes how a planning group is now working with the supervisors on proposals for alternatives to incarceration and includes attorneys, activists and people who are formerly incarcerated. The L.A. Times writes, quote, “As the proposals come before the board, the coming year will test whether the county’s historic shift from incarceration to a system based on care — mental health care, medical care, reentry services, housing, peer support — is achievable and affordable, and whether it can prevent crime, reduce recidivism and repair broken communities,” unquote.

We’ll be back with Patrisse Cullors and Ken Rosenberg, director of Bedlam, after this.

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AMY GOODMAN: “You’re Somebody Else” by Flora Cash. This is Democracy Now! I’m Amy Goodman, as we continue to look at how prisons and jails have become America’s “new asylums.” This is the focus of an amazing documentary released this year called Bedlam. Earlier this year, I interviewed director and psychiatrist Ken Rosenberg and also one of the people he features in the film, Patrisse Cullors. As we concluded our interview, I asked him about one of the strongest lessons of the film: early intervention. But first I asked director Ken Rosenberg to tell the story of the woman Johanna, one of the people in the film who suffers both from mental illness and relies for help on the kindness of strangers, including the film crew.

DR. KENNETH ROSENBERG: Yeah. So, Johanna — I mean, you know, all these folks who we film — even Todd, who attacks his doctor — I mean, when you get to know them, you realize that they’re good, kind, loving people who have bad illnesses. So I think it really puts a human face on this illness. But Johanna is among those. I mean, she comes in. She’s manic, which means she has elevated mood, racing thoughts, doesn’t sleep for days, is psychotic, somewhat detached from reality, and comes into the ER in this state — rapid-fire talk, a flight of ideas — and then, you know, gets put to sleep, which is essentially what happens in the ER, in which people are given a, quote, “cocktail,” end-quote, which consists of sedating benzodiazepine, an anti-psychotic drug and maybe an antihistamine. And with that, they are put to sleep and transferred to another hospital or, in some cases, you know, sent back home, or, in some cases, stay in the ER for days, potentially weeks, looking for a bed.

So, Johanna, we follow, through her life. And she goes in and out of 10 hospitals. We see her at home. Her dad is not able to be at home with her. And as a result, her home is in shambles. And we actually take her — my fearless and brilliant camera crew, Joan Churchill and Alan Barker, take her to the ER. I’m on the phone from my office at the time. And she’s saying, “Ken, you’ve got to take us — take me back to the hospital.” And my wonderful camera crew goes, “Where the hell do we take her?” And the only place she’ll go is 50 miles away from her home at the L.A. County ER, which is the only place she feels she could get some help. And we follow her.

And she ends the film with some sense of — well, a great sense of recognition that she has a terrible illness, that the illness is not caused by the medicines, but by — caused by a brain dysfunction, which she really has to address. Now the medicines are really not very problematic. They put sometimes hundreds of pounds on people. They have many side effects. And this is, of course, a big concern of mine, because treatment and research is nowhere near where it should be. Can’t say that enough. So Johanna suffers from these side effects, including weight gain. But Johanna also demonstrates the sort of kindness to humanity that all the people in the film demonstrate, family members and patients alike.

AMY GOODMAN: Talk about the role of the pharmaceutical industry in funding and researching, treating serious mental illness, when the federal government doesn’t do it and private industry does.

DR. KENNETH ROSENBERG: Well, you know, what did Tennessee Williams say? You know, Blanche DuBois? We rely on the kindness of strangers. I mean, that’s where we’re at. We rely on the kindness of strangers. We cower in the corners, pretty much, as family members. Patients are too confused and diseased, in often denial. Part of the illness is a denial. It’s called anosognosia. It means that you don’t know that you’re sick.

And with all this, the pharmaceutical companies make drugs, which make profit. And I can’t say I blame them. I can’t say I applaud them, either. But it’s an industry. They’re out to make profit. They have shareholders who are investing money when profit is to be seen. However, that’s all we rely on. We don’t have people marching in the streets, until, thankfully, people like Patrisse, who say, “No, we need more. We’re not going to rely on the kindness of strangers. We’re going to demand more,” like people with HIV did, like people with breast cancer did, and say that we really must have proper research, proper treatments. And that’s what we need.

We have the same molecules, essentially, that we use for treatment, that were invented 70 years ago. Seventy years ago, we developed lithium and Haldol. That’s what we’re using today. That’s just not right. And we can’t let the pharmaceutical companies create drugs that are kind of what we call — not a great term, but we call “me too” drugs, which are they take the same molecules, reinvigorate them, take away the side effect, make them a little bit better, but recycle the meds until they get off patent. And then, when the drugs go off patent, the pharmaceutical companies say, “You know what? Those old drugs, they’re not so good. We have a new drug that’s really good.”

AMY GOODMAN: And, of course, when you say “get off patent,” that means generics can be made, and the industry is losing profit.

DR. KENNETH ROSENBERG: And they’re not making a profit from it. And again, I can’t blame them. I think, as industries, the pharmaceutical industries do a lot of good. But is that what we should rely on? I mean, that’s not right.

AMY GOODMAN: One of the strongest lessons of the film, aside from we have to completely overhaul policy, punitive policy, the prison-industrial complex and incarceration, and how it relates to mental illness, but also early intervention. So, Patrisse, what would you say to people about how to detect this in loved ones and what you do?

PATRISSE CULLORS: I think, you know, there’s two things that I think about when I think about having a loved one with severe mental illness. One is family members being educated and educating others about the early signs. Like I said, my brother had early signs of mental health issues, and we had no idea what they were.

AMY GOODMAN: What were those early signs?

PATRISSE CULLORS: Severe mood swings, really low lows, you know, depression, what I now know as anxiety. And I remember one time my brother sort of locked himself in the bathroom for hours. He was maybe 16 years old, and I was 13. And I kept knocking. I said, “Monte, what’s wrong?” And he just couldn’t stop crying. And he — I remember him finally opening the door and saying, “I don’t know what’s wrong.” And we didn’t — we didn’t know. We had no clue. And so, those early signs, you can get help. You can go to a clinic and see a therapist. You could see a psychiatrist.

But the other thing is, we have to be advocates, not just for our own family members, but we have to change what is happening right now. We are living in a moment where policymakers, elected officials, are completely divested from supporting people with severe mental illness. It’s easy to ignore them. It’s easy to ignore the families. And it’s such a hard illness to respond to and relate to, that I think people don’t want to deal with it. They don’t want to deal with it. And so I strongly believe that now is the time to organize and advocate to change lives and change the way our institutions are dealing with our loved ones.

DR. KENNETH ROSENBERG: Oh, yeah, we really need to change. You know, there’s something called an IMD exclusion, by the way, which is a law on the federal books, in which the feds do not reimburse Medicaid funds, funds for the people who can’t afford insurance, if they’re in a psychiatric facility with more than 16 beds. So, if you’re in a — if you have a facility, if you’re building a hospital, a psychiatric hospital, 16 beds is your limit. Of course, we could build a jail with two or three or four thousand beds.

PATRISSE CULLORS: Three thousand three hundred beds.

DR. KENNETH ROSENBERG: But you can’t build a psychiatric facility with more than 16 beds and get federal money coming back.

AMY GOODMAN: How can that be?

DR. KENNETH ROSENBERG: How could that be? That’s the way it is.

AMY GOODMAN: Why 16?

DR. KENNETH ROSENBERG: Well, you know, this was developed in the Johnson era, and probably, again, for good reasons. They wanted to disincentivize big institutions. They wanted to incentivize community mental health. And they didn’t want to warehouse people in big hospitals. But it doesn’t make sense in 2019, does it?

AMY GOODMAN: That’s filmmaker and psychiatrist Ken Rosenberg, director of the film Bedlam, author of the book by the same title. Patrisse Cullors is co-founder of Black Lives Matter. Bedlam will air on PBS Independent Lens April 13th, 2020.

Oh, and this update: Patrisse Cullors told us, about two months ago, her brother Monte stopped taking his medication and was living on the streets. He was released from Sherman Oaks Hospital after being involuntarily detained by the psychiatric emergency team. She then found him at the Los Angeles downtown metro jail and bailed him out. He has been in the hospital since then. With the help of the Los Angeles Department of Mental Health and her staunch organizing efforts, Patrisse is currently in the process of getting conservatorship of her brother.