May 15, 2016 7 min read

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Editor’s note: This is the first in a series exploring mental health issues in Washington and Greene counties.

Thin scars snake across Arthur Dowler’s hand, a permanent reminder of the day he angrily punched a fist through glass.

It was one of countless self-destructive outbursts that have punctuated Dowler’s life: He tried to hang himself when he was 8 years old, he has swallowed razor blades and cut his wrists.

His wife, Margaret, whom he met at the former Trinity Open Bible Church nearly three decades ago, recalled an incident in which Dowler picked up an old refrigerator on the porch and threw it in the middle of the road in a fit of rage.

Over the years, Margaret has seen the man she knows – funny, sweet and compassionate, with a green thumb and an ability to prepare a delicious filet mignon or homemade lasagna – disappear at times.

“If he gets really frustrated, his temper flares and he throws things,” said Margaret. “He’s got mood swings. Some days he can be way up, and other days he’s down in the dumps.”

At 28, while serving a 10-year sentence in Washington County Jail, Dowler was diagnosed with bipolar disorder. Diagnoses of anxiety and post-traumatic stress disorder followed.

“I spent that time getting my life back together, but it’s a struggle every day for me,” said Dowler, 50, of Washington, who volunteers with National Alliance on Mental Illness of Southwestern Pennsylvania, cooks at Circle Center on Wednesdays and is an ordained minister through Universal Life Church. “It’s like being in a room with no windows, just one small door that you can’t get out, and you get thrown in there with nothing. I went to prison, but this is a mental prison … and no one has the capability of getting you out of there other than you.”

Dowler is not alone.

An estimated 43.8 million American adults – about 1 in 5 – have a diagnosable mental illness, defined as various conditions characterized by impairment of a person’s normal cognitive, emotional or behavioral functioning.

Nearly 10 million Americans have a serious mental illness, including conditions like schizophrenia, bipolar disorder and major depression, according to the National Alliance on Mental Illness.

While the federal government allots about $130 billion toward mental health each year, it is estimated that only half of people with mental illness in the U.S. receive the treatment they need, while millions go without.

A 2013 review by the House Energy and Commerce Subcommittee on Oversight and Investigations concluded the federal government’s approach to mental health is a “chaotic patchwork of antiquated programs and ineffective policies spread across numerous agencies with little or no coordination.”

Those who experience mental illness too often wind up in hospital emergency rooms, jails and prisons, on the street, or dead.

“We simply don’t have enough services,” said U.S. Rep. Tim Murphy, R-18th District, who has introduced legislation to overhaul the country’s mental health system. “Do we have some good programs? Yes. Do we have enough programs? Absolutely not.”

Among the problems: a nationwide shortage of nearly 100,000 psychiatric beds, a critical shortage of psychiatrists and child psychiatrists, and HIPAA laws that prevent family members from getting information on their loved ones, said Murphy.

Also alarming is a Centers for Disease Control report that suicide in the United States has reached its highest level in nearly 30 years.

Locally, mental health service providers say they’re seeing an increase in both the demand for mental health services and the complexity of cases.

Karen Bennett, administrator for the Greene County Department of Human Services, said the number of child and adolescent psychiatric referrals for in-patient services to Southwood Psychiatric Hospital that her department handles has quadrupled over the past three years. “Right now, it blows us away. There just are not enough beds when kids need to go to the hospital. It’s a huge problem,” said Bennett, who also cites funding cuts, insurance gaps and HIPAA laws as impediments to service. “The good thing is we’re identifying them before they’re adults, which is important because we don’t want them to end up in the adult system.”

As part of early intervention, the Human Services Department developed a program with Central Greene School District to provide a full-time therapist in grades kindergarten through 12, and a much-needed child psychiatrist is opening a practice in the county on July 1.

“I’m hoping kids can stop falling through the cracks when they get a discharge plan,” she said.

Said Lynn Loresch, executive director of the Mental Health Association of Washington County, “The people we are being asked to help now are sicker than they’ve ever been before. Their cases are more complex, there are more dual diagnoses, and we’re seeing patients who need treatment for both mental health and substance abuse.”

Jan Taper, administrator of Washington County Behavioral Health and Developmental Services, said Washington County faces the same issues as mental health service providers across the country, but she believes Washington County is doing a good job of providing programs and treatment for the mentally ill, despite the challenges and fiscal limitations.

Taper said the closing of Mayview State Hospital in 2008 provided funding to develop several programs that didn’t exist in Washington County.

Three base service units – the gateway to getting into the mental health system – exist in Washington County, along with a 24/7 crisis line. The hotline number is 1-877-225-3567.

“Sometimes, doing something that looks controversial enables you to do something else,” said Taper. “If we hadn’t closed Mayview, we never would have had the services we have today. I’d be hard-pressed for you to show me there are needs that aren’t being met. Are there glitches? Oh, yes. Are there more resources needed? Yes. You can never have enough residences. But I’d have to say Washington County does a good job.”

Another obstacle that remains is the stigma associated with mental illness.

“Mental illness is still viewed in the culture as a weakness instead of an illness, something to be feared,” said Loresch. “There are many people with mental illness who do quite well; there are many success stories. People need to know that there is hope. With the proper support and medications, people can lead happy, productive lives.”

That’s what Dowler is working to do. He writes poetry, reads the Bible daily, buys supplies for the Circle Center and people in need, helps organize NAMI’s annual anti-stigma walk, and wants to start a street ministry.

“Basically, I want people to know it’s not what you take with you, it’s what you leave behind. I think about this a lot. I want everybody to know that I tried my best, even though sometimes my best wasn’t good enough. I want people to know there is help out there, if you reach out,” said Dowler. “I want to help other people who tell me they have bipolar disorder. I want them to know they don’t have to go through it alone.”

For information about mental health care services available in Washington County, call BHDS at 724-228-6832. In Greene County, contact the Greene County Department of Human Services at 724-852-5276.