Mental illness demands humane, civil treatment

Tony Zichi didn't choose to have schizophrenia.

Tony Zichi didn't choose to kill 88-year-old Ruth Terrell, although he stabbed her multiple times.

Indeed, Tony Zichi chose to save her - save her from the rats only he could see that were crawling over her and other elderly residents of the adult care home in Alamance County where state mental health workers had placed Zichi, knowing of his mental illness and history of violence.

He didn't choose to be placed in an environment so unfitted to his needs.

And certainly no one should ever forget that Ruth Terrell did not choose to die.

Zichi hasn't made many choices in a very long time, well before Mrs. Terrell died in May 2005 from complications from the wounds received two weeks earlier.

A bright kid with a winning All-American look, Zichi had excelled in soccer and did so well academically that he was given a scholarship to a prestigious private high school. But, a couple of years later, his world began to slowly dissolve, with the increasing aggressive outbursts and delusions that are so often symptomatic of schizophrenia.

He didn't choose to have a mental illness. It chooses you. It chooses you at any age, any income, any education, Christian, Atheist, Buddhist, black, white, man, woman, child.

As their son's condition deteriorated, Cathy and Mark Zichi did what all parents would do, or at least should. For years, they persistently and desperately tried to find help for their son, particularly in the form of a secure psychiatric facility that could house and treat him. They would have never chosen the adult care home in which the tragedy took place.

So who did have a choice? You could simply answer "the state" in the guise of the state's mental health system. But no more oxymoronic phrase has ever been uttered in North Carolina than "mental health system."

The one individual with a choice now is Alamance County District Attorney Rob Johnson, who could simply agree to a pretrial hearing to let a court decide if Zichi was sane at the time of the offense. The outcome of such a hearing might well mean Zichi would spend the rest of his life in the most secured portion of a state psychiatric hospital where he could receive the needed level of care for his illness, rather than prison where his condition would almost certainly deteriorate.

It would not only seem the reasonable and humane choice to make, but determining Zichi's sanity now would seem to be the fiscally responsible thing to do in terms of tax dollars. Certainly Zichi's schizophrenia is well documented and common sense would seem to dictate a sanity hearing be held.

But, perhaps afraid of the public perception of not prosecuting someone for such a heinous act, Johnson's office presses ahead in efforts to stabilize Zichi and charge him with first-degree murder. Zichi remains in the Forensic Unit of Dorothea Dix Hospital, where he has not spoken in more than three months.

For most people, the hell, the desperation, the hopelessness of being the parent of a child with a severe mental illness are unimaginable. Imagine being Zichi's mom and dad, knowing your son is too sick to ever enjoy freedom again and realizing that he needs to be separated from society for the rest of his life. But there's no mystery in their wishes that he not needlessly suffer more than necessary from his schizophrenia, and that his illness be treated and not criminalized.

Unfortunately, Tony Zichi is just a flash in the chaos that's ultimately the result of the public's choice to ignore mental illness. We can blame it on the politicians, but until enough people start caring enough about the Tony Zichis of the world, the 11-year-old spending the night in a magistrate's cell after a bipolar rage because there is nowhere else to keep her, the young adult strapped to a gurney more than 53 hours waiting for a psychiatric bed to open somewhere in the state, nothing will truly change. Until the public starts caring about the lost childhoods and the hopes and aspirations of adults just dropping away, until we choose to care and to demand humane and civil treatment for individuals with mental illness, funds for research, until we demand caring, nothing much is going to change.

Truly, the only entity that can choose for Tony Zichi now is the state of North Carolina, most notably represented by District Attorney Johnson.

Tony Zichi likely wouldn't have chosen to be at the crux of any civil or human rights issues. He probably would have chosen to go to college, start a career, marry, be a dad and kick a soccer ball around the back yard with his kids on Sunday afternoons.

But Tony Zichi didn't have a choice.

We do.

David Cornwell is executive director of North Carolina Mental Hope, an advocacy group whose mission is to increase awareness and support for mental health issues.