His mom worried he’d wind up dead. But getting him committed was nearly impossible

When Vinny, a Seattle man in his 40s, is doing well, he’s sweet and funny.

When he’s sick, he’s mean to his mom, and can be aggressive toward strangers and neighbors. He’ll say he’s suicidal. And he’ll draw and draw. Thousands of intricate, single line drawings.

Vinny has schizoaffective disorder. For his mother, Kathleen, a retired college professor in northeast Seattle, getting him care has for decades felt like being at a door with a jiggly handle that doesn’t work.

When Vinny becomes unstable, Kathleen believes involuntary commitment is his best hope. Whether or not she can open the door to psychiatric care could determine whether he lives or dies.

“I don't know how to navigate this system,” Kathleen said. “Right now, I’m just trying to keep him alive.”

When Vinny goes through a psychotic episode, “His posture changes, his voice changes, and his eye movement changes,” Kathleen said. Even his body odor changes.

Vinny's been on medication for years, which has given him long stretches of stability. He lives on his own in a condo Kathleen bought him, less than two miles away. In that respect, Vinny is lucky. That is not an option for a lot of families.

He hangs out in coffee shops and lives on disability payments. In the past, he’s also worked in food delivery and security.

But Vinny recently started to worry Kathleen and his stepdad, Michael. He was showing up at their house, sometimes before dawn, where Kathleen would see him on their security camera, milling around in the dark, and then leaving.

“Vinny was paranoid,” Michael said. “And when he gets paranoid, no place is safe.”

Kathleen started getting texts from worried neighbors in Vinny's condo complex. One said Vinny talked about being suicidal. Another said Vinny punched the window of a parked car with a couple inside.

Kathleen and Michael have tried for decades to keep Vinny as stable as possible. Research shows that if you can get someone on medication after their first psychotic break, they tend to do better long-term. Stability is a positive feedback loop, but each episode of psychosis adds risk for further brain damage.

But to get Vinny committed, they needed to play a game of luck – and win.

First step: Call a hotline that deploys people called "designated crisis responders."

These are the gatekeepers – mental health professionals who have the legal power to send someone to a psychiatric hospital against their will.

Each time Vinny shows up at their house, Kathleen and Michael call the crisis responder hotline. And then they wait. They try to keep Vinny there, stalling him by offering food and money, and trying to keep him from having an outburst.

But it can take crisis responders days to arrive. And by the time they do, Vinny is gone. The case is closed, and the process starts over.

Every time Kathleen called the hotline, her cry for help popped up on a computer screen in downtown Seattle, 10 miles away.

Crisis responders are required to respond to calls from hospitals and jails first, within a few hours. But when regular people like Michael and Kathleen call, there's no time limit.

But one day, Kathleen and Michael finally got a lucky break. Vinny showed up at their house. Kathleen left a voicemail for the crisis responders and then, right away, called the police. The police, in some cases, can also involuntarily commit someone without a crisis responder there.

As an officer showed up at the door, Kathleen's phone rang — a crisis responder was calling her back. Kathleen handed the phone to the police officer, and suddenly a crisis responder was telling the officer which hospitals he could bring Vinny to.

After weeks of trying to make this happen, they had Vinny, a police officer, and a crisis responder — albeit by phone — all in one place.

That door to psychiatric care was creaking open.

The officer asked Kathleen to leave so he could talk to Vinny alone.

Listening from another room, Kathleen could tell Vinny was hiding his symptoms.

According to Kathleen, the officer asked, "How you doing, Vinny"? And Vinny responded, “Good.”

“What’s going on?” the officer asked, to which Vinny replied, “Nothing.”

Kathleen decided to walk in, knowing she would trigger his symptoms.

“I wanted them to see,” she said. “I walked in, and I was asked to leave. And then they let Vinny go while I was out of the room.”

The moment was lost. Vinny was back out in the world. Kathleen didn't know when, or if, she'd get another chance like this.

Kathleen dropped to the floor.

“I saw Vinny's imminent death,” she said. “I couldn’t be upright.”

The door slammed shut.

But there was another door, one Kathleen hadn’t considered until it appeared: the criminal way to psychiatric care. This door came into view not long after the visit with the cop.

Vinny had lost the keys to his condo. Kathleen drove over to install a PIN pad on the door, so he could still get in. While she was there, Vinny showed up, and, according to a police report, rammed the door, knocking over Kathleen.

When police arrived, they found Vinny too confused to understand his rights.

Once in the criminal system, everyone agreed Vinny did not belong there. The psychiatrist who evaluated him in jail, his defense attorney, a prosecutor, a judge — they all agreed Vinny was mentally ill. The judge ordered a crisis responder to evaluate him, and just like that, he was headed to a psychiatric hospital.

Kathleen and Michael held each other and sobbed.

Kathleen said she hopes her son will be able to express himself easily and freely again. That he’ll feel safer.

"I'll hear him say things like, ‘Life is good, Mom,’” Kathleen said. “He'll be sweet and funny –”

Michael chimed in. “He’ll be Vinny again.”

This is the second episode of “Lost Patients,” a collaboration between The Seattle Times and KUOW Public Radio, in partnership with the NPR Network.

Over six episodes, we tease apart the mental health system – showing why it’s so hard to get people into psychiatric care.

This episode was reported, written, and produced by Will James, Esmy Jimenez, and Sydney Brownstone. Liz Jones is the editor.

You can support “Lost Patients” by investing in the local newsrooms and the specialized beats that make this sort of storytelling possible. Please consider joining and subscribing at kuow.org and seattletimes.com.

Looking for mental health resources? KUOW compiled an "Acute mental health resource guide" that can help.