LULU GARCIA-NAVARRO, HOST:
People with mental illness can end up cycling in and out of the jail system, especially when they're unable to get treatment. For immigrants who are undocumented, getting trapped in that cycle can be especially risky. Christine Herman at member station WILL has this story that begins in central Illinois, inside the Champaign County courthouse.
CHRISTINE HERMAN, BYLINE: I'm seated in the front row of the courtroom. To my right, there's a young man wearing a white button-down shirt and dress pants, his hair parted neatly. He stares nervously at the floor as we wait for the judge.
UNIDENTIFIED PERSON: All rise. Honorable Judge Brett Olmstead presiding.
HERMAN: The 21-year-old is here to plead guilty to a criminal charge of property damage. It actually happened at his parents' house. He had gotten into a fight with his brother-in-law and broke a window, yet another out of control moment from his recent struggle with mental illness. The judge reads aloud a warning that he gives to defendants in any case. But it's especially relevant to this particular young man.
BRETT OLMSTEAD: First, if you are not a U.S. citizen, you are hereby advised that conviction of the offense for which you have been charged may have the consequences of deportation, exclusion from admission to the United States or denial...
HERMAN: This warning is now standard practice to make sure that noncitizens are aware that they could face deportation if they plead guilty in court. The young man was given 12 months' probation. Afterwards, I follow him out to the hall and ask if we can talk. He agrees, but he doesn't want to be recorded.
We're protecting his identity since he was brought here from Mexico as a toddler and is living in the U.S. without permission. He felt more comfortable leaving the courthouse to talk, so we sat down at a coffee shop across the street.
It's there he told me that a couple years ago, life was good. He was living on his own, working and taking classes at community college. But all that changed when he started hearing voices and began struggling to keep his grip on reality. He withdrew from friends and family, including his dad.
JOSE: (Speaking Spanish).
HERMAN: The young man's dad says he felt his son was totally lost, yet somehow unaware of it. His father is also undocumented, so we'll refer to him by his middle name, Jose. We spoke through an interpreter.
JOSE: (Through interpreter) He asked us for help, but we didn't know how to help him. He'd say, Dad, I feel like I'm going crazy.
HERMAN: Last year, he was hospitalized twice and finally got diagnosed with schizophrenia and bipolar disorder. He also used marijuana to cope. Once, he began driving erratically, saying his car was telling him what to do. A month after that, he started having urges to kill himself and sometimes felt like hurting others. Jose says his son had always been respectful and kind. But when he was 19, he became more argumentative and even threatened to hurt his parents. The psychiatric hospitalizations didn't seem to make a difference.
JOSE: (Through interpreter) He's not really focused on reality, so it's worrying. And what I wish is that he would accept that he needs help and that there'd be a place where he could get that help. He says no, that he doesn't need help. But he doesn't realize the problem he has.
HERMAN: He did meet with a therapist a few times and was taking medication he was prescribed in the hospital. He says it helped. But without insurance, he couldn't afford $180 a month for the prescription. When he stopped the meds, he struggled. And he kept getting in trouble with the police.
CARRIE CHAPMAN: When you don't have status, it's particularly excruciating.
HERMAN: That's Carrie Chapman, an attorney and advocate with the Legal Council for Health Justice in Chicago. She represents many clients who have this double burden. They lack the legal status to get the health care they need, and so they live with an untreated mental illness.
CHAPMAN: If, for example, that makes it difficult for you to control behaviors, you can end up in the criminal justice system.
HERMAN: And once you're in the criminal justice system, she says you risk getting deported, like the judge warned that day I was in court. Chapman says the stakes are extremely high for these clients, and everyone in their family knows it.
CHAPMAN: You are concerned that your young adult child is facing what's really sort of a terminal condition. If that person ends up being deported, they may go to a place where they have even less access to state-of-the-art mental health care. And it could be a death sentence for them there.
HERMAN: There are about 4 million adults like Jose and his son in the U.S. They have no legal status and no health insurance. That's because most undocumented people aren't allowed to get Medicaid, Medicare or insurance through the Affordable Care Act.
When I caught up with Jose's son a few months ago, he still didn't want his voice on the radio. But he said he's back on medication and feeling better. He now works as a landscaper and hopes to get back to college someday to study business. But he fears his criminal record could stand in the way. And it makes him a target for immigration sweeps. His dad Jose says that's what worries him.
JOSE: (Through interpreter) If he gets deported, he'll practically be lost in Mexico because he doesn't know Mexico. I brought him here very young. And with his illness, where's he going to go? They're essentially putting him on the street.
HERMAN: Some advocates say a good first step would be to expand Medicaid to everyone, regardless of legal status. A handful of states do allow undocumented kids to get Medicaid, but once they turn 19, most of them lose that health coverage.
For NPR News, I'm Christine Herman in Champaign, Ill.
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