They Call Him Crazy

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Mental patient Rodney Yoder is taking on the psychiatry establishment

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Yoder's calls and letters touched many. Reporter George Pawlaczyk of the Belleville News-Democrat began writing stories about Yoder, and other papers followed. A columnist for the Natal Witness, South Africa's oldest newspaper, took up Yoder's cause. So did Dr. Patch Adams. Adams worked in the er at St. Elizabeths, a Washington mental hospital, during the '70s and '80s. Previously, in 1963, he was himself a patient at a psychiatric hospital for two weeks. He says he learned more from fellow patients than the distant doctors, and he felt a personal connection to Yoder's case. "I wasn't bullied by his intensity, as I think many are," he says.

Bullied, annoyed — or frightened. Most folks wouldn't appreciate Yoder's insistent calls; he can rant if he doesn't get quick action. Chester now prohibits Yoder from calling at least a dozen people who have complained about his phone manners. Even Equip for Equality, the nonprofit that accused Chester of writing spurious reports on Yoder, reluctantly told the facility earlier this year that Yoder had begun making inappropriate calls. Group officials say he left a message in January in which he promised to "f___ you up the ass in the newspapers" for not fighting hard enough for him.

In his vulgar way, Yoder actually had a point. Although it is a large, federally funded organization designed to monitor institutions like Chester, Equip for Equality has never investigated the facility — even after it discovered those allegedly false reports. For years, some patients' advocates have complained that Chester provides inadequate care. Just in the past year, a state commission has substantiated charges that Chester has improperly confiscated patients' property, denied their privacy and failed to keep one patient from spreading his feces around a bathroom until Chester's human-rights committee got involved. "We've had longstanding, very serious concerns about Chester," admits Barry Taylor, Equip's legal director. "But we have limited resources."

Chester's worst failure may be Yoder himself, a man who — according to the facility — hasn't improved under its care. If Yoder is paranoid, certainly the worst approach is to omit information from his record and violate the painstaking procedures for committing someone. (Appellate judges have overturned three of Yoder's 13 commitment orders because of improprieties.) Some argue that Chester officials aren't so much hostile toward Yoder as negligent. "My fear is that they just don't care enough about Rodney to take any action," says Mark Heyrman, a Chicago law professor who once represented Yoder. "If Yoder is mentally ill and does not recognize that, then they need to medicate him. If he's not mentally ill, they should let him go. But they know when they have to do anything with him, it's going to be a big hairy mess."

Will Yoder ever get out? One could imagine a treacly Patch Adams and a fiery Thomas Szasz swaying a jury. But state officials will argue that everyone else is better off with Yoder behind Chester's 14-ft. fence. They will say his failure to cooperate with treatment is evidence of his illness, which, even if misdiagnosed in the past, still exists. "The system is not perfect," says Vallabhaneni, the psychiatrist who wrote Yoder's incomplete commitment evaluation in 1991. "But that doesn't change the real picture of what Rodney Yoder is: he is very, very ill." Even Hardy admits that "there have been some mistakes made along the way, and you can say those mistakes may have exacerbated his condition. But he shouldn't leave there." Some state lawyers have privately argued that by holding Yoder for so long, the state is turning him into a martyr. But Hardy and Vallabhaneni point out that Chester will be blamed if Yoder is freed and hurts someone.

For his part, Yoder imagines living out his years in a little chalet on a Vermont mountain. "I could write about psychiatry and send people cranky e-mails," he says with a grin. He says he has no intention of harming anyone. It's unclear what impact the decision in his case will have on the broader issue of patients' rights. If he wins, the "psychiatric survivors" movement may have a new poster boy, and other states might look more carefully at patients who may be sick or may just be antisocial. Of course, finding the line between the two is the trick. What Yoder may tell us is that we're a long way from figuring out the difference between being ill and being a jerk.

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