Personal Reflections on Wellness and Decompensation: Lessons from Our Family’s Journey

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I offer the experiences of my son and daughter as personal anecdotes to highlight the importance of early intervention in addressing wellness issues. Through their struggles, I’ve seen firsthand where better tools could have potentially improved outcomes. With this hope for better solutions, I share our family's story.

 

​​​​​​​​​​​​​​​​My Son Justin’s Decompensation Journey

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My son has historically experienced gradual decompensation over several months. In his most recent psychotic episode, he received his Invega injection. Still, he ceased taking his other medications two months prior, despite a court-ordered mandate requiring compliance as a condition of his release from a lockdown facility. During daily conversations, I noticed a shift in his tone, a subtle but distinct change in energy. It wasn’t until mid to late November, three months later, that we saw an apparent, rapid decline in his behavior—what is often referred to as the “slippery slope.” His psychosis worsened, and he lost the ability to make sound decisions.

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In late November, after three months of non-compliance, I requested wellness checks through the Lakewood, Colorado Police Department. My son claimed he was taking his medications and assured us he was “just fine.” He presented himself well enough that the responding officer concluded he wasn’t “at risk to self or others.” In the follow-up conversation with the officer, he explained, “We don’t like to take anyone against their will because of the risk they may resist, and there’s always a danger of escalation.” While I understand this concern, it ultimately led to further decompensation for my son, who grew more volatile and continued to spiral.

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There were two more wellness check attempts. The first time, my son was hospitalized briefly but released while still symptomatic, exhibiting mild psychosis. Another week passed before we managed to have him apprehended again, but only after he became so agitated that he committed two felony assaults during an acute psychotic episode. He was then hospitalized for three months at a cost of $219,000, covered by Colorado Medicaid, to stabilize his condition.

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​​​​​​​​​​​​​My Daughter Raquel’s Journey: Decompensation and Tragic Loss

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After a six-month hospitalization, my daughter was stabilized through innovative treatments, including yoga and art therapy, at the Ft. Logan Mental Health Institute in Colorado. We were filled with hope. She transitioned to an assisted living halfway house in Boulder, Colorado, where she made significant strides—compliant with her medication and abstaining from self-medication with drugs and alcohol. She took college classes for six months, and it seemed like she was on the path to wellness and earning her degree.

 

However, an old acquaintance in Boulder re-entered her life and began offering her wine. Over the course of a month, her drinking escalated, rendering her prescribed medications ineffective. Despite the worsening signs, no one at the facility noticed her increasing alcohol consumption or the subtle return of her decompensation.

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In August 2019, Raquel went missing for over a week. Tragically, she was found deceased, floating in an irrigation ditch with a blood alcohol concentration of 0.32%. 

 

As I reflect on these painful experiences, I can’t help but wonder: What could have been done differently to prevent these outcomes? I firmly believe recognizing signs of decompensation and intervening sooner could help stabilize episodes, ultimately saving individuals, families, the criminal justice system, healthcare providers, and payers from devastating consequences. 

I hope that, through innovation and vigilance, we can change the course of mental health care and save lives.

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—Ron Perkes, Founder, National Labs