Eric Smith

Social Worker and Advocate: Eric Smith

See condensed story in Newsletter 14

My name is Eric Smith. I am a musician, composer, and a loving family member. I am also an alumnus of the University of Texas at San Antonio where I graduated magna cum laude in psychology in May 2018. I graduated with my Master of Social Work (MSW) degree in December 2021 and am now a licensed master social worker (LMSW) in the state of Texas.

I was diagnosed with bipolar disorder in my early/mid-teen years, but I was also diagnosed with schizophrenia and schizoaffective disorder many years later while I was a psych inpatient. Along with the first diagnosis of bipolar disorder I received in my teens, my parents were told to not be surprised if I also developed schizophrenia or schizoaffective disorder later in life. In short, psychiatrists who have seen me at my worst (my most symptomatic) have diagnosed me with schizoaffective disorder and schizophrenia, and psychiatrists who have not seen me at my worst diagnosed me with bipolar disorder. Throughout that journey, it appeared I would never rebuild my life, let alone recover. My first medications had bad side effects and were not working.

That all changed with Assisted Outpatient Treatment (AOT) and clozapine, both of which helped save my life. To understand how I eventually got there, let’s go back to when I was a teenager.

In 1997, at age 14, I was first diagnosed with bipolar disorder. In hindsight, it was clear I needed medical care for my mental illness, but neither I nor my doctors realized how serious my illness was. Able to function well enough, I convinced my doctors that hospitalization was not necessary. In my mid 20s, I experienced an extreme manic episode. At that point, I was hospitalized due to serious mental illness (SMI) for the first time.

In the days leading up to my first psychiatric hospitalization, I was incarcerated for an entire month because of non-violent behavior stemming from an acute psychotic episode. About that time, I met with the FBI in person (in reality) on multiple occasions to let them know about codes I believed I had broken to prevent assassinations of world leaders that would stop World War III. They scheduled time to meet with me at their San Antonio headquarters (in reality) and also in a major business parking lot. Looking back, I am surprised they were willing to meet with me. Breaking codes that didn’t actually exist kept me awake for several days straight. With the delusions, paranoia, and psychosis, I was about as far from perceiving reality as a person could be, which was scaring my parents. I had been living out of my car at the time, for a few weeks, and showed up at their house agitated and out of touch with reality. At that time, the police were called, and they warned me that if I returned to my parents’ house, I would be arrested for trespassing. Afraid and with no great alternative options, when I returned, my parents worked with the police to have me arrested for trespassing at their house.

My then-most-recent psychiatrist had told my parents the best chance I had to get the treatment I needed would likely come from me getting arrested for a low-level offense and then transferred to a state hospital bed if I was lucky enough for one to open up before the jail released me. While I was in jail, I was denied mental health treatment. I did not receive needed care for my mental illness until I was finally transferred to a hospital as part of a court order.

In jails and prisons, persons with SMI often do not get the treatment they need. Even worse, sometimes they do not receive any treatment at all, which was my experience. Jails and prisons are not designed to be providers of mental healthcare, nor should they be. Being mentally ill is not a crime. I see the real crime as the act of incarcerating those who need treatment for SMI. These individuals typically would never have been jailed had it not been for behavior stemming from unmanaged or poorly managed SMI. Thus, necessity for medical treatment should be the guiding principle of policy and practice for SMI without relying on the criminal justice system as a main entry point before treatment.

Prior to being prescribed clozapine, I was on the receiving end of treatment that was essentially trial-and-error, exemplified by a long list of failed medications over many years. All of the other medications– antipsychotics, benzodiazepines, anti-depressants, SSRIs, and others– had failed to meaningfully treat my symptoms. In 2011, while I was hospitalized for the third and final time, and as a last-ditch effort of sorts, my doctor prescribed clozapine.

Clozapine may not work for everyone, but for me it felt like nothing short of a miracle. Today, it is the only psychiatric medicine I require. I have been in meaningful recovery on clozapine for more than 10 years.

I was discharged from the hospital (for the third and final time) on clozapine, and then entered into San Antonio’s groundbreaking AOT program (for the third and final time). The program required me to meet with a judge a few times per month to track my progress as I continued to build on my recovery. The goals of these hearings included ensuring I was taking my medication as prescribed and evaluating my mental health, confirming that I still no longer required hospitalization.

Today, I credit the AOT team, clozapine, my family, and my dedication to recovery for enabling me to regain my health and life. The complimentary, symbiotic relationship between the judge, doctor, and the rest of the AOT treatment team completely changed my view of managing mental illness. This was the beginning of my realization that I should take ownership of my treatment, and my ability to do so. The way the AOT treatment team cared about me, and the fact that I finally found a medication that worked, allowed me to follow through on my medical care without needing to be court-ordered to do it. My AOT treatment team went from being a champion of my mental health and well-being to teaching me how to be my own champion, building upon my new-found ability to manage my illness.

The beauty of AOT is now something I have the capacity to more fully appreciate. Without AOT, I would at best be living under a bridge somewhere consumed by mental illness, but perhaps more likely than that I would probably be dead. Death is a tragic reality for many people suffering from SMI who do not receive the life-saving care provided by programs like AOT. Clozapine and AOT took me from a path of delusion and danger to becoming an accomplished, habitual honors student and graduate.

Today, as I continue my pursuit of helping others in a professional capacity, I hope to give back to the community. I am thankful for the second chance at life afforded to me by the treatment and care I needed: AOT and clozapine. Additionally, I thank all individuals and organizations who support AOT and other measures to help people like me and families like mine. I am especially thankful for the CURESZ Foundation for championing AOT and clozapine.