When Anchorage real estate agent Rene’ Kennicott saw a picture of a naked woman bathing in the street off of Third Avenue, she posted it on Facebook.
She said she could tell the woman was having mental issues — though it was impossible to tell to what extent from the photo her friend had shared with her — and said that she thought posting the photo could spark action on mental health care for Anchorage’s homeless.
“Thank you Mayor Ethan Berkowitz,” she wrote in a post on the Save Anchorage Facebook group. “I applaud Anchorage’s governing body for making Anchorage such a beautiful toilet!”
It certainly sparked discussion on the group, which has become a gathering place for criticism of the Berkowitz administration. The post soon racked up over 300 comments.
Little discussion centered on mental health. Instead, much of it criticized the mayor’s policies for what people saw as incentivizing squalor and lewd public behavior. Some comments veered into personal attacks, blaming the pictured woman’s choices for her situation. Others blamed the homeless population for spreading disease across the city.
Kennicott stands by her decision to post the photo of the woman, even though she didn’t know her story at the time.
“It’s kind of a sad thing to say about our society,” she said, “But what I have found is when you post something and say ‘Oh, we need to help these people and we need to do this’ and you try to tug at people’s heartstrings and ask them to be compassionate, it doesn’t get anywhere.”
The mother of the woman in the photo sees things differently.
“She was an outstanding person”
At an immaculate Sand Lake townhouse, the woman’s mother, Jennifer, said that her daughter was a teenager with promise.
“She had been an outstanding high school student. She had gotten straight As. She was a soccer player. She was a yoga teacher. She was just an outstanding person. She had been going to college at UAA for her business degree,” said Jennifer.
She held a full-time job, rising before dawn to work at a coffee shop to help her single mother pay bills.
“One night I was sitting on the couch and she called me and asked me if I was listening to her through her radio,” Jennifer said.
After that, her daughter’s behavior became increasingly filled with paranoid delusions. She was eventually diagnosed with schizoaffective and dissociative disorders. Her friendships started to dissolve and she had run-ins with the police. In 2016 after a stint at the state psychiatric institution, API, things got worse.
“After she was released, she was — she actually attacked me with a gun, and a — and a butcher knife,” said Jennifer, her voice cracking.
Her daughter was charged with felony assault. We are not using Jennifer’s last name in this story because she fears her daughter may try to hurt her again.
Jennifer’s daughter is not a violent person, but her untreated mental illness causes her to misunderstand the world around her as threatening. Getting her help is profoundly difficult, but Jennifer tries to direct her daughter’s care however she can. She helps her find shelters and housing, and gives her a weekly allowance of money. In the past months, things have gotten worse. Her daughter was evicted from multiple apartments because of disruptive behavior. She floated in and out of shelters. She caught COVID-19. She attempted suicide by driving her car off of Point Woronzof.
Last Thursday, finally, she was admitted to the psychiatric emergency department at Providence after police found her bathing naked in the street. It was the third time she’d been picked up by APD for public nudity in 15 days.
Jennifer says after everything she’d done, hearing that a photo of her daughter at a low moment became the target of political ridicule on Facebook was hurtful, to say the least.
“Just as taxing as it is on taxpayer dollars, it’s even more taxing on family. And because that’s your loved one that has — that has no place to sleep at night when it’s raining and cold, and has no place to even know if they can get food because they don’t know how to manage themselves because of mental illness,” she said, holding back tears.
COVID-19-era mental healthcare for the homeless
While Jennifer’s daughter’s story is unique, her unmet mental healthcare needs are not, especially among the homeless. The problem goes back decades and is related to a combination of a lack of housing and services for the mentally ill and well as a legal framework in Alaska that sets a high bar for when the state can commit someone involuntarily.
At the Sullivan Arena shelter, many clients suffer from serious, untreated mental illness. In-patient treatment beds for the mentally ill are seriously limited. So is housing with support to help people stay on medication. And so, many people, unable to manage their lives because of mental illness, wind up on the street or in jails.
Social workers at the shelter say they are doing their best to direct those in need to existing services. But with many lacking stable housing, it’s a lot easier said than done, said Katelyn Sheehan, who oversees the services at the shelter.
“The need outpaces the resources in every one of these institutions … And with the pandemic, we just see a compounding factor,” she said.
That puts pressure on a shelter like the Sullivan to accept people who can be disruptive to other guests. While advocates at the shelter’s resource hub can direct people in need to mental healthcare providers, it usually depends on people seeking help for themselves. Some people are so ill that they can’t direct their own care but still do not meet the state standard — being a danger to themselves or others — for commitment.
“We do have a number of clients who have severe enough mental health issues that day to day their lucidity kind of fluctuates,” said Erika Baumann, a navigator at the Sullivan. She said that if they can catch someone like that on a good day, they might be able to recommend care. Hopefully, they return to the shelter the next day for medications and can get to their appointments. Many don’t.
Jennifer’s daughter bounced in and out of the Sullivan shelter, where at least people could find her to make sure she was taking medications. She’d previously been evicted from other apartments and shelters for disruptive behavior.
“Disturbing her neighbors by staying up all night, knocking on their doors, just doing things that you do when you have mental health problems,” Jennifer said.
Advocates say finding stable, supportive housing for those with the most need is the most effective solution for getting people like Jennifer’s daughter help.
“It’s far easier to remember to take your medication two to three times a day when you have a house with an alarm clock, so that you can store your medications in the same place all the time, and you have this clock going off to help you remember to take it,” said Cheryl Charic, director of intensive services at Alaska Behavioral Health, which provides mental health care to homeless people.
But the public doesn’t always understand efforts for housing as a way to get people off the street. Instead, some see it as encouraging vagrancy. The Save Anchorage Facebook group began, in fact, with people opposed to city property purchases aimed in part at getting homeless people like Jennifer’s daughter into facilities with mental health support.
Alaska’s laws are another difficulty. As an adult in her 20s, Jennifer’s daughter is entitled to make her own health care decisions, even when she’s suffering from the sort of delusions that led her to disrobe in the street.
And when her mother called Adult Protective Services to get an assessment that would allow the state to forcibly hold her, they did it over the phone because of the risk of workers catching COVID-19. In the phone assessment, they decided she wasn’t a risk to herself or to others. So, she stayed on the street.
That’s not to say that in-person assessments would necessarily be better.
Charic, of Alaska Behavioral Health, pointed out that for state officials and providers, approaching someone who might be experiencing paranoid delusions in full protective gear can be counter-productive.
“It’s rough to approach a person with severe mental illness with a face shields. It’s a jarring moment when you see someone wearing all that gear,” she said.
Alaska laws favor the rights of people with mental illness to make their own decisions about care. It is one of just five states that require the certification by more than one professional in order to hold someone in emergency custody, according to the Treatment Advocacy Center, a national nonprofit advocating for reforms to mental health care treatment. The group says this requirement creates an “artificial barrier” to get people involuntarily committed. In a state-by-state evaluation of psychiatric treatment laws by the group, Alaska got a D.
But there are issues outside of law that make committing people who need help difficult. Lisa Sauder, executive director of Bean’s Cafe, said that there’s a deep-rooted cultural dynamic at play in Alaska. People tend to misunderstand mental illness as something someone can control. Many would blame a person like Jennifer’s daughter for finding herself in the street unclothed.
“In Alaska, we have very much a philosophy of ‘live and let live.’ And I think that’s kind of reflected in how we handle a lot of our adult protective cases,” she said. “I frequently hear that we allow people to make bad choices. And that’s hard when you’re looking at somebody that’s struggling with mental health.”
Jennifer hopes that by telling her story, people might remember when they see a mentally ill person on the street, that the person is someone’s family. The system has failed them.
“I don’t know what the answer is,” she said, “But something has to change.”
Her daughter is now at the Alaska Psychiatric Institute after spending the weekend at the psychiatric emergency room. She’s safe, her mother says, and that brings some relief. But once she’s let go, the cycle could repeat itself, as it has many times before.