Raising Phoenix: The Knotted Intersection Between Education, Behavioral Health and Homelessness

Amy SilvermanSeptember 1, 2023
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Illustration by Michael Hirshon
Illustration by Michael Hirshon

In the second of her three-part series on mental health, our columnist tugs at the knotted intersection between schooling, behavioral disorders and homelessness.

I’ve been thinking a lot lately about the bully at my elementary school. 

Not because he bullied me. He didn’t, at least not that I recall. It was more that this was a kid everyone knew – and feared. He threw tantrums, picked fights, hit other students and seemed to always be getting kicked out of school. 

Because it was the 1970s, teachers, parents and other grown-ups joked openly that this kid was going to end up in prison one day. As you might expect, his classmates started saying it, too.  

A few decades later, on a whim, I punched some keys on my laptop and learned that the bully – now a full-grown man – was indeed serving time. Behind a thick mustache, the mugshot was unmistakable.

The bully’s crimes were not the worst, though things didn’t look so good. Drug possession and stalking arrests, to start. Later charges included indecent exposure and disorderly conduct.

I’m ashamed to admit that it wasn’t until this summer that I really began to wonder just what was behind that little boy’s behavior. Was he simply a rotten nut, like the nasty children touring Willy Wonka’s chocolate factory? Or was there – is there – a medical explanation? And, if so, could that have changed the trajectory of the kid’s life? 

Forty years later, we haven’t made a lot of progress toward answering that question, or changing the way society views a second-grade bully. 

To be honest, I haven’t made a lot of progress, either. After decades as a journalist, it’s only now that I can see a pattern emerge. 

You’re probably going to say, “No duh, lady.” But – bear with me. 

It’s all about behavior. Specifically, violent behavior. We don’t call it that anymore. We’ve refined our language. Now we talk about “complex” behaviors, often (but not always) when discussing a person with intellectual or developmental disabilities (IDD) who has a dual diagnosis of mental illness.

Violent. Aggressive. Disruptive. Dangerous – to both the person and the people around them. 

This is nothing short of an epidemic, and while it touches every social construct you can imagine – including the education, legal and criminal justice systems – it really is a health-care crisis. 

And I’m not just talking about mental health. Until medical institutions come at this with a holistic approach and make it a priority, it’s going to get worse. Way worse. 

Consider the second-grade bully. What was making him act out at such an early age? Possibly trauma at home. Maybe untreated mental illness at a young age, but my understanding is something serious like bipolar disorder or schizophrenia is almost impossible to diagnose in a child or even a young teen. 

It could be that he is on the autism spectrum; such diagnoses were rare in the early 1970s when he and I were in grade school. Or ADHD. Maybe a learning disability like dyslexia caused struggles with classwork, and he was acting out of frustration. 

Or it could have been physical – a chronic stomachache or something simpler. Maybe he wasn’t getting enough to eat.

Could there be a host of explanations for complex behaviors? And what are we doing to address the root causes? 

The answer to that second question is easy but painful. Not much, from my vantage point.

Arizona lawmakers have basically dismantled our public education system in an effort to find ways to keep their children away from kids with these complex behaviors. The troublemakers are either hidden in the back of special-education classrooms at public schools or someone’s creating entire schools to warehouse them. 

It’s not surprising that seclusion and restraint rates in schools are skyrocketing. Ditto for suspensions and expulsions. 

And the uncomfortable truth is that once these kids are adults, it gets so much worse. Our jails and prisons are de facto mental-health institutions, and I roll my eyes as I type this, because it feels pointless. It’s become a trope, a cliché, the kind of thing that readers gloss over. 

Despite media attention, things have only gotten worse. 

Even if you’re lucky enough to stay out of jail (and even that’s debatable – I’ve reported on people who only received mental-health care once they were incarcerated), the world is not prepared for you. There’s no housing for someone who has violent outbursts, no job for a constant antagonist. No friends, romance. The next best thing – the only thing – might be street drugs. Which leads to crime and homelessness and – you get the picture.

Yes, that’s simplistic, but it’s also how I’m beginning to make sense of all this. By now, you’re probably yelling at your copy of the magazine, “Stop making excuses for these rotten apples.” 

But what if they’re not really rotten? What if they are asking for attention and help in the only way they know? 

I think of the boy I wrote about more than 20 years ago who painted the walls of his cell at a Phoenix juvenile corrections facility with his own blood. Intricate designs that took hours before anyone noticed. 

Or another boy whose mother was told – when he was 14 – that the only way to get him help was to call the police the next time he hit her. A judge took pity on the family and sent the boy to an inpatient facility in Texas, because no such place existed in Arizona, and ordered the state to pay for monthly visits.

The young girl whose parents – terrified she would be attacked on the streets or overdose – surprised her with a forced visit to a wilderness camp for troubled teens. She died of dehydration the first day. 

We do not know how to help the children. 

And then there are the adults, including those with intellectual and developmental disabilities. Communication is often a challenge – and a frustration. At least once a week, I hear from another parent of another adult child with an intellectual disability. The person is in crisis – waiting days at the ER for any kind of physical examination that might explain these behaviors and usually discharged before it happens, only to return to the parents’ home or the street if it’s not safe for them to be at home. Then it happens again. 

Or there’s violence at a group home; often, the perpetrator is the person with the intellectual disability. Sometimes staff and that person get into an altercation. 

Arizona officials do not know how to handle these and many other scenarios. We talk a lot about funding, but the truth is that in some instances the state is paying more than a million dollars a year to keep one person in one group home, with as many as six staff members at a time. All at taxpayer expense, and guess what? The person still has a horrible quality of life and is often unsafe. 

There’s quiet talk of some kind of semi-secret task force that Governor Katie Hobbs has started, meetings of stakeholders in the mental health and IDD arenas. Supposedly, the topic of “complex behaviors” is on the agenda. 

We have tried leaning on state agencies – AHCCCS, the Department of Economic Security, the Department of Health Services – to handle this difficult population, until they die or go to prison, anyway. It’s not working. 

So, broaden this out, big time, Governor. Include educators, prison officials, representatives of the legal system and please, someone, get the attention of health-care professionals. Phoenix is exploding with bioscience research and new medical facilities. Someone in our city is more than equipped to research the mind-body connection. 

And, for crying out loud, listen to families, the ones who reach out to me because no one in government will take their call. 

Stop pretending this isn’t a problem we all share. Maybe that second-grade bully is just a bad seed, a rotten apple. Maybe not. Either way, it’s likely too late for him. 

But not for countless others.