Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Welcome to why Not Me
?
The World podcast, hosted byTony Mantor, broadcasting from
Music City, usa, nashville,tennessee.
Join us as our guests tell ustheir stories.
Some will make you laugh, somewill make you cry.
Their stories Some will makeyou laugh, some will make you
(00:28):
cry.
Real life people who willinspire and show that you are
not alone in this world.
Hopefully, you gain moreawareness, acceptance and a
better understanding for autismaround the world.
Hi, I'm Tony Mantor.
(00:53):
Welcome to why Not Me?
The World Humanity OverHandcuffs the Silent Crisis
special event.
Joining us today is RuthJohnston.
She will share her personalexperience with her autistic son
, who subsequently developedschizophrenia, and discuss how
this led to her establishing AOTfor Allegheny County in
Pennsylvania.
I'm delighted to have her joinus, bringing a wealth of
(01:15):
knowledge on this topic.
Thanks for coming on.
Thank you, it's my pleasure.
Can you tell us about yourautistic son?
Speaker 2 (01:23):
My son is 38 now, so
he's a little older.
Nobody was identifying autisticunless they were counter-autism
back then, and so he wasn'tidentified until he was a
teenager and never had servicesand things like that.
I never had the experience ofbeing the parent in the IEP,
meeting and working with it.
I homeschooled him and we justdealt with the bumps.
(01:46):
I love him dearly and it was onthe one side it was great
delight and on the other sidesheer terror and misery because
he was not easy and when he was,when he was 13, we started to
see the onset of that'ssomething I should talk about
what it looked like for him tostart to get schizophrenia,
because it look over.
It took at least 10 years toknow that's what it was.
(02:09):
That's important.
I look at the parents who haveautistic kids and I almost have
a bad attitude because there'san overwhelming sense of we're
going to take this school tocourt, we're going to make sure
everything is perfect, you'regoing to do all of these things
and I'm thinking when they turn18 and some of them get
schizophrenia, you're not goingto know what hit you because the
(02:31):
legal system is not like that.
It's not at all like that andbasically what I'm advocating
for in my county is that now ourstate law permits us to set up
an assisted outpatient treatmentprogram and what that does is
it permits treatment to be civilcourt mandated based on
evidence.
That's not just danger,pennsylvania.
(02:54):
For any other kind of mandatedtreatment they have to meet a
danger standard.
You tell someone with anautistic kid that they've just
shepherded through school.
They think everything's goingbetter.
Levi was starting college andhe suddenly couldn't concentrate
.
He wasn't interested.
And eventually he's in thelegal system and you're told
you're literally told, mrsMother, there's nothing we can
(03:16):
do.
You have to wait for somethingto happen and hope it's not very
bad.
And in our case, when somethinghappened it was that he killed
my mother while she was eatingbreakfast.
That's pretty bad.
Meanwhile you have reams ofevidence that things are bad.
None of it matters.
Speaker 1 (03:35):
Yeah, that's pretty
sad to hear you say you're
working for change in yourcounty Now does that include
involuntary help as well?
Speaker 2 (03:44):
That's exactly what
it is.
It's instead of waiting forthem to get dangerous and fall
into the criminal system.
Instead, you have a processthat you could go through a
civil court and in a sense, it'smandating them to have
treatment.
In another sense, we can lookat it as it's mandating the
county not to just convenientlylet them fall through the cracks
(04:05):
.
Speaker 1 (04:06):
Now you have to go to
the court system in order to do
this.
Is that correct?
Speaker 2 (04:11):
Yeah, it's a civil,
probably a probate court judge
that's set up to do this.
Speaker 1 (04:16):
I was talking with a
lady just the other day.
Her brother is living with hersister.
He's having some severeemotional issues.
I believe he was one of thepeople that you're talking about
that just does not want anyhelp.
They felt he needed help.
He didn't.
There was nothing they could do.
They could call the police.
(04:37):
They would come out.
However, the police couldn't doanything unless he was a threat
to himself or a threat toothers.
Ultimately, they just wound upleaving.
How does this get changed?
They couldn't help him unlessthey went to court.
If you go to court sometimes ittakes a long time Then because
of it, the issue could developinto something much, much more
(05:01):
harmful.
Speaker 2 (05:01):
That's right.
So there are two pieces to whatyou asked.
So one of the pieces is howresponsive would the court
system be?
Would it act quickly?
And I think that depends on thestate and county, and right now
my county has nothing.
So there's nothing at all andeven if it takes three months, I
guarantee you'll still wantthat help in three months.
(05:22):
I think usually they try tomake it more responsive.
The other thing is whatevidence are they looking at?
In Pennsylvania there's a verystrong leaning on the danger
standard.
You've got to be able to provethat they were in clear and
present danger, either within 30days or absolutely.
(05:44):
You can predict it within thenext 30 days and otherwise you
got nothing.
Whereas if you have somebody,especially an autistic kid and
they've always been a little bitweird I don't mean that in a
bad way, my son was delightfullyweird, I loved his mind and
talking to him they just becomea little stranger and everybody
(06:05):
says, oh, it's just autism, ohit's teenage years, oh it's the
transition years.
By the time you realize thatit's something else and it's a
brain disease, by that timeyou're dealing with somebody
who's sunk in pretty deep.
You have all kinds of evidence,like they claim that the food
is poisoned.
Levi would lose his car in theparking lot and he'd call the
(06:28):
police to report it stolen andthey would come and help him
find it.
We had lots of things writtenwhere he was helping the angelic
army to defeat Satan.
He had war plans.
He had diagrams.
There was all this evidencethat he had a severe psychotic
illness, but none of it countedunless it was clear and present
(06:51):
danger to self or others.
Basically, when you're in astate or a county, you've got
nothing you can do, and so asystem that would allow you to
submit that as evidencebasically assisted outpatient
treatment in addition to movingit into civil court.
They accept other evidence, andso suddenly you have a place
(07:13):
where you can go with this.
Speaker 1 (07:15):
That makes complete
sense.
Your son was first diagnosedautistic, correct?
Speaker 2 (07:21):
Yes.
Speaker 1 (07:21):
Then, as he got older
, his psychosis started
developing over a period of time.
Speaker 2 (07:26):
That's right.
So when he was 13, he suddenlylost the ability to do math.
He'd never been an Asperger'skid that was good at math.
That was not his set of gifts.
He was doing very advancedeighth grade math in eighth
grade and all of a sudden hejust lost the ability.
He couldn't do anything.
He started spending a lot oftime just staring at the wall
(07:50):
running through the woods.
He didn't know what was wrong,and so that just continued.
And then he'd get a littlebetter and then it would get
worse.
When it really got bad, I'd saywhen he was 23 or so it was
clear.
And then he just went off andlived with a non-custodial
parent.
By the time he came back he was26 and we were in crisis.
Speaker 1 (08:10):
So was that crisis
deemed anosognosia?
Speaker 2 (08:13):
Yes.
Speaker 1 (08:14):
Can you expand on
what that is to the listeners
for us?
Speaker 2 (08:17):
Okay, let me explain.
Anosognosia is just a Greekword.
That means not knowing your ownmind.
It's a description of a braindefect that you get.
It crops up in other things too.
Some people who have a stroke,especially if it's on the right
side, it may take them a coupleof days or a week to understand
(08:38):
that they're paralyzed.
And their neurologist will sayto them try to move your hand.
And they say I just don't feellike it.
It's paralyzed.
No, it's not, and so that'sanosognosia.
Or you have anorexic girls whoreally believe they're fat and
cannot tell they have theproblem.
That's anosognosia andbasically severe bipolar
(09:01):
disorder and schizophrenia andschizoaffective.
These things can do that too.
The part of the brain thatshould be able to tell that
you're talking slowly, thatyou're not making sense, that
you're lost, the part of thebrain that can tell those things
is damaged and they cannot tell.
Levi believed that he had aPortuguese accent, which he
(09:25):
didn't.
At times he couldn't understandour speech.
I would explain that to him andhe'd just say I think you just
weren't making sense.
So he'd say you were goingthrough something.
No, I wasn't.
That's anosognosia.
Speaker 1 (09:37):
I've heard from
several different people this
can take a long time before itdevelops into something so that
you know that there's a seriousproblem.
Speaker 2 (09:47):
That's right.
Speaker 1 (09:48):
So it could take
three, four, five, six years
before it actually shows itselfas a problem.
That's right.
If it takes that long todevelop, how can you figure it
out so you can handle it betterand hopefully nothing bad
happens?
Speaker 2 (10:05):
You can't.
That's the problem.
You can't.
That's the problem.
Essentially, back in the 60sour legal system changed the way
we handled mental illness totake away most involuntary
treatment because, especially inthe 60s, it was being seen as a
civil rights issue, and soeverything was shifted so that
(10:26):
the people have to want thetreatment.
If you have anosognosia, youcan't, and so the only time
there's anything you can do isif your state and county have
changed the law and set up aprogram so that you can get an
assisted outpatient treatmentorder where you can give them
the evidence, basically evidencethat they won't be able to live
(10:48):
safely in life, like losingyour car, getting lost, thinking
your food is poisoned.
These are all factors that arenot predicting in a good way and
that gets used.
If you don't have that, thenliterally you can take them to
an outpatient thing and theycan't make them take medicine
either.
They can convince them.
Levi said you guys are justpersecuting me for my religious
(11:11):
beliefs.
And everybody told us againwait for quote unquote something
to happen and hope.
It's not very bad, it'smaddening, it's wrong.
Speaker 1 (11:22):
Absolutely.
You've got such a wide spectrum.
To use the autism analogy, youcan have someone having a
psychotic event, and it could bea mild one compared to someone
having a very severe eventhappening, where they could be
seeing things such as youdescribed.
(11:42):
They do bad things because theythink they're actually helping
the person that they're hurting.
Speaker 2 (11:48):
That's right.
Over time, and so with Leviagain, because he was not
typical, ok, you can get a lotof schizophrenia stories that
sound like this my son was afreshman at Yale and he was on
the football team and then hestarted to get weird.
Ok, great, you know what?
My son wasn't?
My son was always strugglingand it was always hard, and so
(12:11):
when he started to have moreproblems, we couldn't tell.
So by the time we were sure myson wasn't.
My son was always strugglingand it was always hard, and so
when he started to have moreproblems, we couldn't tell.
So by the time we were sureyou're right, it's a genuine
damage.
Gizephrinia is more likeAlzheimer's than it is like
bipolar disorder, and so thetime you see this getting worse,
yeah, Sure, Now you're tryingto get change in your county.
(12:38):
What kind of steps are youtaking to do that?
So first of all, we had to getlegislative change in the state.
I did a little bit when I couldback then, just sharing the
story.
Most of that was carried out bytreatment advocacy center,
having a negotiator go in andstart working with the
legislator and the counties andthe people who are against it,
and worked out a bill and in2018, it was signed into law.
But what the bill did is itmodified our Mental Health
(13:01):
Procedures Act to permit aprogram but specifically, every
county on January 1st can get awaiver, which essentially means
until somebody creates a programspecifically for this and opts
in the law is not in effectanywhere.
So basically, it just kickedthe can down the road to the
(13:21):
counties.
But that's okay because you canwork with a county State's
really bigger than I can do.
I've talked to the county healthdepartment, told my story.
That didn't really get anywherebecause they just they don't
believe that my son would haveobeyed a civil order.
I think he would have.
He was a very law-abiding guy.
He liked cops.
He didn't want to be in trouble.
Speaker 1 (13:42):
That's one thing
autistic people are very well
known for, and that is they arevery structured.
Speaker 2 (13:51):
Yeah, I can't say, I
wouldn't describe him as
structured, but yeah, he didn'twant to be viewed as bad and he
didn't want to hurt anybody.
He would say I don't want tohurt anybody, so I think he
would have obeyed a civil court.
They call it the black robeeffect.
Put someone in front of a judgeand the judge says, son, you're
going to be working with thisteam, and they go okay, I think
it would have worked.
But when I talked to the county, apparently they just dismissed
(14:13):
it.
They just didn't believe.
So I've gone and I've tried totalk to other people.
I've talked to some of thejudges.
I've sent letters to all of thejudges, the police chiefs.
I'm trying to create videoswith interviews that I think
would be interesting to them andthen promoting them, not to the
general public but specificallyto anybody I can find.
(14:34):
That's in that layer of peoplethat work in the county and run
into untreated mental illness,ambulance doctors, nurses,
social workers, police, jailjudges, lawyers.
So I'm trying to get aconversation going among them
and help them to understand,because none of them had even
heard of it.
When I explain to them what AOTis, they say why don't we have
(14:55):
that?
I say I don't know, ask thecounty.
The step I'm taking is, havingtalked to the county directly,
talked to assistant director atthe county.
That went nowhere.
So now I'm trying to reachthese others, have a meeting
with judges and explain it tothem.
I did an interview with somesocial workers in police
departments and they were veryenthusiastic.
(15:16):
The director of the biggestoutpatient psychosis clinic,
after getting some of mymailings, called me and said
tell me what you're doing andhow can I help, because we want
this, everyone wants to havethis program, but the county for
some reason doesn't want tomake the change.
I'm just trying to figure outhow to get through that.
(15:37):
I really wish that.
I just know that in my countythere are going to be some
autism lobbying parents groupsand I wish I could get through
to them that this is for them.
Let's say you have an autistickid in fifth grade and it's 2013
, and you hear my story on thenews.
You don't think to yourselfthis is a kid like my son.
(15:58):
You think some crazy person.
I want to read you something,if I can, from the transcript
from his sentencing.
We had some autism expertstestify.
We were asking the judge togive him a very short sentence
so that he could go into somekind of hospital or program care
, and the judge did not.
The one expert talking about itwas Nancy Minshew at University
(16:22):
of Pennsylvania Medical Center.
Speaker 1 (16:24):
That's very
interesting that she contributed
.
What were some of the findingsthat she talked about?
Speaker 2 (16:30):
She noted that he had
been diagnosed in her program
and then went on to say that shehad done a literature search.
She found studies showingbetween 5% of autistic kids
growing up to have paranoidschizophrenia and 34% on the
upper end.
She said that's a broad rangeand there just hadn't been
(16:52):
enough studies with adults.
We need more time.
But just to go for maybe 20%.
If one in five of the autistickids that are in school, their
parents have no idea that thiscould be coming to hit them,
there's nothing that we can doabout the grief for that.
What we can do is set it up sothat when they start to see a
(17:14):
problem they can petition thecourt to get extra help.
Because the problem is, unlesstheir kid is severely autistic
and went straight at age 18 froman IEP to a guardianship, maybe
they're going to be okay.
But the kids who are more highfunctioning, the ones you
thought were going to go tocommunity college, it's those
(17:34):
ones.
They're not under aguardianship.
The way schizophrenia developsit's like it's on a timer and it
develops between, say, age 13and age, say, 26.
Those are the years and you'velost control.
I really think that this iswhat happened with, say Adam
Lanza.
I think that's what was goingon.
They knew he was autistic, theyknew he had Asperger's.
(17:57):
But I think something else wascreeping in and I read an
interview with his dad where hisdad said he thought that too.
And once they're 18, you loseyour power to force them.
And then you try to persuadethem.
We all know what it's likearguing with a stubborn,
autistic kid who thinks you'rewrong.
Speaker 1 (18:14):
Yeah right.
The interesting part of allthis is I have been doing this
podcast about a year and a halfnow.
I've heard autism, adhd, autism, bipolar.
I've heard so many differentautism co-occurrences that did
not surprise me.
(18:34):
This is the first time I'veheard of autism developing into
schizophrenia.
Speaker 2 (18:42):
I know, I know.
Speaker 1 (18:43):
So now to hear autism
could develop into that.
Between five to 35%, that's ahuge number.
Speaker 2 (18:53):
Yes, I know.
So he was sentenced in 2017.
It took a long time for him toget sentenced, from 2013 to 17,
because we had a lot of lawyerproblems that weren't his fault.
Basically, it was in sentencingthat I heard this testimony and
we were all shocked.
And then the second thing fromthis testimony, the judge when
(19:15):
she sentenced this wasn't thetestimony, but from the
transcript.
When the judge got to the end,she heard our experts who were
all saying I met with this man.
He's autistic.
He just doesn't know how to getthrough life.
He could be very smart in someways, but he's not going to do
well in prison.
Please don't put him there Withevery single one.
She said to them at the endjust answer me one question Is
(19:38):
there a program that would keephim on medication?
And they said no.
In other words, she was sayingto them does our county and
state have assisted outpatienttreatment?
And of course it didn't.
And so when she sentenced, shesaid given the facts of the case
, everybody knew when he killedhis grandmother, it was nothing
but psychosis.
(19:58):
He believed that her spirit wasgone and a demon was inhabiting
her body and that she waspoisoning our food.
Everybody got that.
She said knowing the facts ofthe case, I could give you as
little as five years in prison.
But I'm not going to do thatbecause you need to be in
(20:19):
treatment and you've resistedtreatment in the past and there
is no program to keep you intreatment.
I'm going to sentence you inthe standard range.
And she said 10 to 20 years.
Bang degree.
Oh, did you earn a collegedegree?
(20:51):
Did you do training programs?
Did you do group things?
They're not going to do thosethings.
Speaker 1 (20:57):
And plus, as much as
I hate to say this, autism and
schizophrenia have a tremendousamount of stigma that goes along
with it.
Yeah, and again, as much as Ihate to say it, schizophrenia is
probably even moremisunderstood than autism.
Right, when people think aboutschizophrenia, they only think
about the worst case scenarios.
Speaker 2 (21:19):
Because that's when
you hear about it, and you know
why.
It's because the law is oftenset up so that you cannot force
them into treatment until you'rein criminal court, and
therefore it's like you'retrolling them.
You're just waiting andwatching them get Worse and
worse and worse and worse andworse.
If we could treat them sooner,you wouldn't hear about those
(21:43):
things.
Speaker 1 (21:44):
I spoke with a judge
the other day.
I asked him what can we do toget this across to other people,
other judges, DAs, ADAs, howcan we make this better so we
can get better treatment, orbetter sentences with treatment,
so they don't wind up in thegeneral population of a prison?
(22:07):
He took about 45 seconds to aminute thinking of his response.
After that he told me two words.
Those two words common sense.
Speaker 2 (22:22):
Okay, common sense is
assisted outpatient.
It's basically it's where yousay we're going to stop giving
all the civil rights to thedisease and leaving the person
imprisoned in this brain illness.
That prevents them from sayingI need help.
The help is there.
Aot uses the services that areall there.
(22:44):
What AOT does?
It's like the laws set up.
If you were in a terrible caraccident, okay, and there's a
couple cars and there's peoplebeing hauled out of terrible
situation, the ambulances pullup and they say, with a
loudspeaker ambulance over here,folks come on.
That's what it's like.
Some people could do that, buta number of them are, I don't
(23:07):
know, unconscious, legs broken.
Aot is the stretcher, where yougo to where they are and you
put them on the stretcher, evenif they're not able to say yes,
please, you put them on thestretcher because you can see
they're unconscious and you takethem in the ambulance.
That's what they're not doingAgain.
Back in the 60s, before therewas as much known about brain
(23:30):
illness, there was an idea thatpeople were just manifesting the
problems their mother gave themand it seemed really unfair and
the idea that the medicineswould make you just sit and
drool and so basically legallymaking someone take medicine is
the equivalent of incarceration,and they use the same due
(23:51):
process things.
Aot creates a due process inthe civil court that can accept
evidence like he's talking toangels, and so you can actually
get help.
Because the way it's set up now, I think it made sense to them
in the 60s, but we know a lotmore now and it no longer makes
sense.
Speaker 1 (24:11):
Well, autism was
first diagnosed in the early
1900s.
They described autism as asymptom of child schizophrenia.
Speaker 2 (24:20):
And they called it
early, they called it
schizophrenia pricocs.
Speaker 1 (24:25):
You would think, here
we are, 2025.
Since 1910, we've come a longway.
Things have gotten better,Medication understanding's
coming along.
We're still not there.
Yet you would think the justicesystem would work with the
states, the counties, theCongress to make things better
(24:46):
so that in the end, it's awin-win for everyone involved.
Speaker 2 (24:51):
I know Listen.
The problem is that there's aloud lobbying voice against this
.
Actually, before I tell youthat, when you were talking
about medicines, I just want togo back and say that the picture
of somebody sitting anddrooling.
Let me explain.
When my son, he was briefly instate hospital, then he was
stuck in the jail on very cheapmedicines for a long time.
(25:13):
When he finally went into thestate system, they put him back
on a modern medicine, a fairlynew one, Abilify.
He began calling home threetimes a day for the short time
he could talk and he said to memom, when I'm on Abilify, I wake
up in the morning I can findwords, I want to do things and
(25:33):
there's nothing to do.
Why couldn't that have beendone before he was in the state
system?
So it's not at all that themedicine's turning into a
drooling monster now.
It's always getting better.
Okay, voices against it.
When you talk about people withmental illnesses, there's a wide
range, right?
There's bipolar disorders,severe and mild.
(25:54):
There's people with, obviously,schizophrenia, people with
anxiety disorders, people withpersonality disorders, people
with depression, severe and mild, and what ends up is they all
get grouped together and most ofthem do not need to be forced
into treatment.
They don't, and they know it,and many of them have had a bad
experience in the hospital andsome of them, when they get out,
(26:17):
they're very disruptive peopleand they want to protest and
complain.
Essentially, there are patientslobbying groups that are very
strong voice.
One of their slogans is nothingabout us without us.
Don't make laws withoutconsulting us.
If you're going to make a lawon the Rosebud Sioux Reservation
(26:41):
, go ask their people first.
That's how they're seeing it.
But the problem is they're notspeaking for the schizophrenics
and they specifically are notspeaking for my son.
They usually say oh, we don'tmean the lawbreakers, we're not
talking about them, they can'tthrow him under the bus fast
enough, so they'll get out thereand they'll say don't do
anything involuntary, it'sterrible, it ruined my life,
(27:04):
whereas the schizophrenics whodid get successful, involuntary
treatment, they're keeping theirheads down.
They don't want to stick out.
Most of them are keeping theirmouths shut.
So there's this very loud, veryaggressive lobbying group that
you can hear.
I'm not very happy with them,and so I feel like what I would
(27:24):
love to see happen is if theautism parents lobbies could
begin to get their minds aroundthe fact that realistically
maybe not their child, butsomebody they know who was in
their kid's grade or special edclass or somebody is going to
develop schizophrenia and theonly question is whether their
(27:47):
parents will be able to givethem good care.
Or will their parents behandcuffed by the laws and have
to wait till the autistic childkills somebody gets into the
criminal justice system?
I would love it if they couldget past the stigma of
schizophrenia, and I know that'sa huge ask.
It's like saying your child'sgoing to get leprosy.
(28:09):
And I know that.
I know that because when I wasfacing that, my child, my son
Levi, was my beloved, delightfullittle professor.
He lectured people at thelaundromat when he was three
years old about how airplanesstay in the air.
It's called the Bernoullieffect.
He was delightful.
(28:29):
I had to face that this washappening and I went through all
of the pain of that, all of it.
So I get that it's a big ask,but if the autism parents could
understand that all they have todo is accept it, enough to
begin lobbying for assistedoutpatient treatment, because if
their son or daughter does getthere, they're going to want it
(28:50):
and it's going to be too late.
Join me in trying to get.
There have got to be autismparents in my county that could
join me.
Speaker 1 (28:58):
How do people contact
?
You could join me?
Speaker 2 (29:00):
How do people contact
you?
I live in Allegheny County andI set up a website, aot4,
spelled out as a word F-O-RAOT4AlleghenyCounty,
a-l-e-g-h-e-n-y, countycom, andI also have that as a Gmail
address AOT4AlleghenyCounty atGmail.
(29:21):
At the website, I've got someinformation about assisted
outpatient treatment, about ourfamily story, about the legal
problems and a contact there.
I would love to have people,especially in Pennsylvania,
contact me, but I'd be happy totalk with anybody.
I might even be able to putthem in contact with people in
(29:42):
their state.
We just need people to start tounderstand that this is
important.
Speaker 1 (29:46):
Yeah, absolutely,
this has been great.
I appreciate you coming on.
Speaker 2 (29:50):
I was delighted when
I heard of your project, so
important.
Thank you for talking about it.
Speaker 1 (29:55):
It's been my pleasure
.
Thanks again.
Thanks for taking the time outof your busy schedule to listen
to our show today.
We hope that you enjoyed it asmuch as we enjoyed bringing it
to you.
If you know anyone that wouldlike to tell us their story,
(30:17):
send them to TonyMantorcomContact then they can give us
their information so one daythey may be a guest on our show.
One more thing we ask telleveryone everywhere about why
Not Me, the World, theconversations we're having and
(30:38):
the inspiration our guests giveto everyone everywhere that you
are not alone in this world.