MENTAL ILLS, DRUGS ARE A SAD PAIR

BARTOW - Marc Gonzalez, whose drug addiction makes his mental health
problems worse, ran out of options when Circuit Judge Randall
McDonald sent him to prison for violating his probation.

He tested positive for cocaine use earlier this year, resulting in
the probation violation charge. He tested positive again on Dec. 4
and McDonald sentenced him to a year and a day in prison.

It wasn't the outcome his mother, Merrill Gonzalez, sought when she
took the desperate step of having him arrested last year for stealing
her car. When she couldn't find another way to have him involuntarily
committed for drug treatment she saw jail as a way of getting him the
help he needed.

"I still feel bad about what I had to do to ... but I had no other
choices at that point," Merrill Gonzalez said. "It's been up to him
whether to do right or wrong."

The problems Gonzalez and his mother faced - his addiction and her
inability to get him into treatment - aren't unusual. Substance abuse
and mental illness often occur together. That makes them harder to
treat, makes relapse more likely and increases the chances that
people with both conditions will go to jail.

Marc Gonzalez, 23, is among hundreds of mentally ill people who
illustrate Polk Sheriff Grady Judd's contention that jails and
prisons have become the chief mental health institutions here and
statewide. More than one inmate in 10 at the Polk County Jail is
typically on a prescribed medication for mental illnesses.

Polk County has few residential or inpatient treatment beds for
substance abusers. Most must rely on outpatient treatment, which is
something Marc Gonzalez couldn't or wouldn't commit to do.

Local treatment agencies say integrated treatment for people with
both drug and mental health problems is far more successful than
treating the conditions separately. But state funding rules in
Florida have made that difficult.

The Ledger first wrote about Gonzalez and his mother in July 2006. At
the time, he appeared to have a chance to turn his life around.

In Gonzalez's case, it's difficult to tell whether his mental illness
or his substance abuse came first or which is dominant.

He was in the Jail Alternatives to Substance Abuse program that
Tri-County Human Services runs at the Polk County Jail. After six
weeks in jail he was released on probation, without the referral to
an Avon Park inpatient treatment center his mother had hoped for.

The center, one of the few statewide that treats people with both
mental illness and substance abuse, has far more demands for its
services than it can handle.

He didn't follow up with outpatient treatment or Narcotics Anonymous.
He resumed using illegal drugs.

His mental health care was sporadic. He got legal medicines for his
bipolar disorder at Lakeland Regional Medical Center's emergency
department and was sent to a crisis stabilization unit, but never
received ongoing treatment, he and his mother said.

Mentally ill inmates are often put on probation rather than being put
into programs that treat their disorders, said Kelley Collier, a
lawyer who represented Marc Gonzalez. Many end up back in jail, often
for drug charges or probation violations.

"They need to have more resources," Collier said. "I've had many
clients where the parents have been frustrated. They try to get them help."

Gonzalez blames his inability to get off drugs on the lack of
resources in Polk County, the length of time it takes to see a
psychiatrist in state-funded mental health treatment programs and not
being referred to the inpatient center.

He's also gone through several operations for a cyst in his lower
back that kept recurring and became infected. Collier asked Dec. 4 to
have Gonzalez's prison term delayed two weeks for another surgery.

A decision on that request depended on whether a urine test that day
came back positive for illegal drug use. When it did, his time on the
outside ended. Gonzalez probably will be in state prison for seven or
eight months.

This time, his mother isn't the only one left waiting at home to take
his collect phone calls. So are his fiancee and their baby daughter.

Robin Williams Adams is Health/Medical Reporter at the Ledger.