Last week my mom texted me that a police officer had just stopped by her office and asked her to call the coroner's office.
"It's about Kevin," she said. My heart sank.
We'd been trying and trying the past three-and-a-half years to get Kevin the treatment he desperately needed. He had symptoms of so many illnesses: schizophrenia, schizoaffective disorder, borderline personality disorder, bipolar. He'd been in and out of jail, homelessness, and sober livings since relapsing on methamphetamine after several years of sobriety.
Once, in 2019, I got a call to my cell phone. "Hi, I'm an off-the-clock social worker and I ran into someone named Kevin wandering around Home Depot. I'm standing next to him right now. He said to call you." I asked him if he'd called the police. He did. I was soon on the phone with a police officer.
"Can't you take him in? He needs treatment," I pleaded, exasperated.
It seemed as though the police officer had received a trauma-informed training of some kind. He believed me that Kevin was experiencing psychosis and needed help. "Probably 90% of our homeless population here in San Luis Obispo have schizophrenia or some other type of similar mental illness," he explained, "but legally I have no grounds to take him in—and even if I did, he wouldn't get the treatment and care he really needs."
That's psychiatric care in the United States in a nutshell.
Kevin passed away from a drug overdose on January 28, 2022, in a hotel room in San Luis Obispo, California. He was 33 years old. The toxicology report showed that methamphetamine, MDMA, marijuana, morphine, and the dreaded fentanyl were all in his system.
Kevin had, at one point, been someone I loved very much, and who loved me, too. We were a romantic couple from roughly 2016, when we met at a music festival, until early 2019, when it became clear that his mental health was deteriorating, and instead of getting the professional help he needed, he was going to keep self-medicating with methamphetamine, something he'd been sober from for several years when we'd met.
I wouldn't say that he was ever the love of my life or someone I saw myself spending the rest of my life with. When we met in 2016 I'd been awakened to my own child trauma story, spending time in a psychiatric hospital and then finally getting the medication and therapy needed to treat my long-time major depressive disorder, which I'd been ignoring.
He had just finished a long stint in in-patient rehab and when we first met we talked and talked about our shared history as meth addicts, child trauma, dropping out of undergrad due to substance misuse, and our mutual sadness at the high expectations we'd had for ourselves that were dashed when we couldn't seem to shake this addicted alter-ego.
Kevin had been a megastar in high school—winning second place in cross country in the state of Oregon, arguably the most competitive state in which to be a runner, gaining the popularity by his peers to be voted class president, achieving a 4.0 GPA, and earning a full scholarship to attend an Ivy League university, Columbia, in New York City. He dropped out with just one year left and spiraled into addiction and a lot of other messy events. I met him at a relatively high point in which he had begun picking up the pieces and secured a good job at a sports startup company in San Diego.
I had a someone similar trajectory: 4.0+ GPA high school student, beauty pageant winner, president of multiple service clubs, state honor choir winner. I had won a coveted spot of admission to UC Berkeley. But then I couldn't do it. I dropped out of college halfway through my sophomore year to go to rehab for my meth and cocaine addiction. I could never reconcile how these two people within me seemed so different—how could they be the same person?
When, in 2016, at age 31, a therapist read me the following list and asked me to answer yes or no, I finally started to answer the question that had haunted me my entire adult life.
Do You...
1. Sometimes feel like you don’t belong when with your family or friends?
2. Pride yourself on not relying upon others?
3. Have difficulty asking for help?
4. Have friends or family who complain that you are aloof or distant?
5. Feel you have not met your potential in life?
6. Often just want to be left alone?
7. Secretly feel that you may be a fraud?
8. Tend to feel uncomfortable in social situations?
9. Often feel disappointed with, or angry at, yourself?
10. Judge yourself more harshly than you judge others?
11. Compare yourself to others and often find yourself sadly lacking?
12. Find it easier to love animals than people?
13. Often feel irritable or unhappy for no apparent reason?
14. Have trouble knowing what you’re feeling?
15. Have trouble identifying your strengths and weaknesses?
16. Sometimes feel like you’re on the outside looking in?
17. Believe you’re one of those people who could easily live as a hermit?
18. Have trouble calming yourself?
19. Feel there’s something holding you back from being present in the moment?
20. At times feel empty inside?
21. Secretly feel there’s something wrong with you?
22. Struggle with self-discipline?
My answer was "Yes" to nearly every question. Whoa. "What is this list?" I asked her.
Read this book," she told me, and handed me a copy of Jonice Webb's Running On Empty: Overcoming Your Childhood Emotional Neglect. I took a photo of the cover and when I got home, I downloaded the audiobook from Audible. I listened to the whole book in one go, staying up until the early hours of the morning.
The next day I called several of my closest friends. "Tell me everything about your childhood," I demanded. It turned out I had self-selected my friends based on our shared trauma all along. I listened for the first time to people I'd known for years or my whole life about their horrific stories of childhood abuse.
Three days later I checked myself into a psychiatric hospital. The carefully constructed world I had invented to survive my childhood came crashing down. Everything was a lie. I wasn't a special person on a special mission (my daydreams included both meditating in a cave alone somewhere forever AND saving the world). I was just like everyone else who'd been neglected as a child. My delusions were my defense against a loneliness so potent that I often thought it could kill me.
So when, six months into dating Kevin, he started to share his grandiose delusions with me, I thought, "These sound weird, but also familiar." I stayed curious.
It would be two more years, with many great times like the idyllic trip we took to Yosemite, sprinkled in between the chaotic ones, before I would realize that his delusions weren't like mine. He wasn't growing out of his with insight. He wasn't choosing help and healing. He kept choosing numbing and escaping.
He talked to me about how he thought he was a Hindu god, reincarnated. His visions of the Book of Revelations coming to life included his idea that he himself was the dragon. He fixated on demons. Everyone became a demon who was plotting to destroy him and turn him into the dragon from the Bible. Soon he would orchestrate the end of times.
"Kevin, if you don't tell your psychiatrist the truth about what's going on for you, you're not going to get the help you need," I said to him in the Spring 2019, many months after breaking things off officially as a couple. He did go in and tell the truth and he was prescribed Abilify, the anti-psychotic drug. He never did tell me his official diagnosis and he never did take a single Abilify pill.
My mom and I helped him check into an addiction treatment center in Santa Barbara in June 2019. He had one more relapse and homeless stint that included a night in jail before finding a sober living home that seemed to work for him. I let him know that I needed to get on with my life and that we couldn't talk anymore.
I knew he'd relapsed again a few months into the pandemic in 2020, but I still maintained radio silence for my own sanity. I'd heard that he was back in San Luis Obispo County where I lived. Every time I saw someone manic on the sidewalk, obviously tweaked out on methamphetamine, I worried that it was him. I sometimes scanned the obituaries in the local newspaper wondering if I'd see his name.
Then I got the text from my mom last week.
So it was done.
It should come as no surprise to anyone that Kevin's ACE score was an 8 or a 9. I can't help but feel enraged as I think about all the ways that society let him down, at literally every level.
He once relayed a story to me about his childhood in which his mom had gone to jail after receiving her third DUI. Social services had apparently not been alerted that she'd left two small children at home alone, Kevin and his brother. So they remained home alone for several days before a family member thought to check in on them. I can't remember all the exact details but Kevin was somewhere between five and eight years old.
Later, in college, when he was facing mental health and addiction challenges, not only did he not receive any care, Columbia University asked him to pay the tuition for the semester he'd dropped out of, despite the full tuition need-based scholarship he'd received. This was tuition he did not have the means to pay. Columbia was holding his transcripts ransom for this tuition and without these transcripts, he was unable to transfer to complete his degree at another institution.
Jail for stealing seemed to be the only opportunity for him to get some sober time under his belt. The treatment options available to him at his price level (i.e., free) were The Salvation Army and others like it, heavily influenced by religious teachings, which were often shaming and based on outdated willpower models of recovery.
For severe mental illness such as schizophrenia or bipolar with psychosis...there's just...pretty much nothing. It's hard to fathom that we offer just...nothing. But that's what I found during this whole adventure.
My grief and profound sadness come when I imagine the life Kevin imagined for himself. He'd seemed to have the brightest future, escaping poverty, and having the whole world available to him. He'd been studying anthropology and had wanted to travel the world. He loved learning about other people. He loved discussing ideas. He had dreams of continuing to race in running and triathlon events—events I saw him win. He was a shooting star and there was a spark in him that would have taken him to the top of anything he set his mind to. If only he'd had his full mind available to him.
This story has a tragic ending. For those of us who do this work, we know this all too well. Many of us entered this work due to first- or second-hand experience with people just like Kevin.
Thank you for the work you're doing to ensure that future children get the care they need to prevent ACEs, increase resiliency, and prevent mental illness and substance misuse. Thank you for the work you're doing to create systems of care including treatment for everyone who needs it. It's slow-going and often thankless work. Personally, I've been feeling beyond burnt out trying to care about everyone who deserves to be cared about, and with the loss of Kevin last week, I really feel I've reached my edge.
I find solace with the words of a favorite author, Norman Maclean, who wrote in A River Runs Through It, which was turned into a film in 1992. A father, who is a minister, is mourning the loss of his adult son, who struggled with gambling and alcohol addiction:
Remembering Kevin Elder (1988-2022) with love. Thank you for teaching me that my heart was capable of being so much wider than I ever imagined.
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Tune into Ep20 of my podcast, Latchkey Urchins & Friends for more on this story. Our podcast can be found on Spotify, Apple, or any podcast player.
Anne and Alison process a heavy week of the loss of the life of loved one Kevin Elder, who had struggled with severe mental illness and substance use disorder. Anne compares his life with the life of her brother, John Romine. They interview another Kevin, who has chosen to keep his last name anonymous due to the nature of his work with psychiatric patients. Kevin Anonymous is a psychiatric nurse who sees some of the most intense mental health cases at the hospitals he’s worked at. We talk about how the care for the people who are just “too much” for society is simply not enough—we are not offering true care to those most in need. We process the grief of having tried to help and love and finding that it wasn’t enough. We talk about the strong link between childhood trauma, mental illness, and substance misuse disorder (addiction).
00:00 Intro with Anne and Alison
44:43 Interview with Kevin the psychiatric nurse
Click here to listen on Spotify.
Click here to listen on Apple.
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