Ketema Ross is a writer, poet and activist living in Spokane, Washington.

On the morning of June 24, 2007, I kicked in my elderly neighbors’ door and brutally beat them with a broom handle. I then immediately called the police to tell them what I had done. I was arrested and charged with first-degree burglary, second- and third-degree assault and third-degree unlawful imprisonment.

If my motive for this attack had been a dispute over money or drugs, my story would be common, hardly remarkable. Had there been noise complaints from either side, a tawdry affair, a parking dispute or any other conflict, the public would have understood. Not approved, but understood. The community would rightfully have demanded justice, in the form of punishment, stating: “You did the crime, now do the time.” Based on a plea offer I received, that time would likely have been three years in prison. Then, despite the fact that there would have been an approximately 75 percent chance that I would reoffend, I would have been released, likely on parole but otherwise a free man, and rejoined society. The fact that most convicted criminals remain dangerous does not provide grounds to keep them locked up forever. They still have rights.


But my motivation for the attack was very different. It was caused by a mental illness. I sincerely believed that I had to attack them, at the order of the president and CIA, in order to stop a terrorist attack. I did so despite the fact that I very much did not want to. I had no conflict with my neighbors; I had never exchanged even a word with either of them. While I now regret what I did with every fiber of my being, at the time I thought I was doing the right thing.

I was found not guilty of the charges against me, by reason of insanity. But with the way our society operates, I may have been better off had I been motivated by evil, anger, greed or malice and been found guilty. Society understands malice. We understand retribution. But we do not understand mental illness and are often unable to see the humanity in those with mental illness. Thus, instead of being locked in a prison for three years, I was locked in a mental hospital for seven years. And I am one of the lucky ones. I know many others who have recovered from their illness but still have spent decades, even their whole lives, locked inside mental hospitals, simply because we choose to fear rather than understand mental illness. It is just so much easier and more convenient to throw people away. Many people with mental illness would love to have the rights that are given to convicted criminals.

***

In my early adulthood, I completed my Bachelor of Arts degree at Colorado College, worked as a claims adjuster for a major insurance company and attended Yale Law School for one year. I was, and still am, a good and decent human being with compassion for others and a loving heart. It was during my time at Yale, after becoming increasingly angry, frustrated and disillusioned with the law, that I had my first “psychotic break.” I believed that the federal government was following me and would kidnap and torture me because of my “revolutionary” beliefs. I fled the country in the fall of 2001 for Caracas, Venezuela, in fear for my life. I returned a few weeks later, destitute and homeless.

I would be in and out of various psychiatric wards more than a dozen times over the next six years. I strained or ruined several relationships with friends, family and romantic partners, would struggle with unemployment and was using drugs in an attempt to “self-medicate” the voices in my head, the virtually constant overwhelming fear and anxiety, and the crisis of losing my identity as a successful scholar and academic. I had completely given up hope of a fulfilling life and believed (and often attempted to prove) that death would be a better state to attain than my own nightmare existence. When I committed those atrocious acts, I believed I was the only one who was sane, that everyone else was wrong, evil or actively conspiring against me. I believed I was following the will of the Almighty when I did what I did. This scares people. I understand completely, because it terrifies me as well.

On June 24, 2007, still believing that I was working for the federal government, I called the police after the assault. I thought they would take me in and debrief me about the violent action I had just taken against my neighbors. It was not until after sitting in a cell at the Whitman County jail for a full two months that the reality would hit me: I was not a member of the CIA. I had been tricked, my own sick mind had led me to commit an act that I will forever regret. I was not to be rewarded, but punished.

If I had taken a plea offer from the prosecutor, the form of that punishment would have been three years in a state penitentiary. There was another possibility, though: I could plead not guilty by reason of insanity and, if I confessed to my criminal activity on that terrible day and the court agreed, I would be sent to a mental hospital for an “up to life” maximum commitment.

The six months after the assault would pass very slowly as I waited to learn my fate. I was treated for my apparent mental illness with medications and was eventually transferred to the jail’s general population. The dangers of life in the jail as well as the realization, guilt and pain related to what I had done took over my days.

Then came a blessing: After pleading not guilty by reason of insanity, I was committed to Eastern State Hospital in Medical Lake, Washington. I was diagnosed with chronic paranoid schizophrenia, the chief symptoms of which were deeply ingrained delusions that I worked for the CIA, command-type hallucinations that I was receiving orders from the CIA and president via satellite, which resulted in the violent actions of that horrific morning. I steadily took the medicine I was prescribed to treat symptoms of psychosis. I began the process of recovery.

The medication worked. After about two years, I was no longer experiencing the psychosis that caused my earlier conduct and thus was no longer dangerous. I was able to walk the grounds of the hospital and take supervised trips into the community, without ever doing or saying anything even vaguely dangerous. I assumed that I would soon be allowed to leave the hospital, with continued treatment and monitoring, and spend time with my family again. But I was very wrong. The state was going to keep me locked up for another five years, at a cost to taxpayers of approximately $250,000 per year, simply because it could.

The reality that I would not be leaving the hospital took time to set in. It happened after my first “offense” of using a pillow stuffed with books as a weight for working out. I was accused of “destroying state property” and lost weeks of time toward the all-important next category. I was angered, hurt, devastated. This experience served as a prelude to the next several years. No matter what I did, or how well I was, I could not overcome the system. The system works to serve its own ends, not those of patients.

This was made crystal clear by another event in 2009, after I had recovered enough to walk the hospital grounds and take supervised trips into town. One patient abused the privilege and walked away from an outing. He was eventually found and didn’t hurt anyone; he just couldn’t resist the urge after decades in the hospital. The media whipped up a panic. The state legislature responded by passing a bill requiring all patients to obtain a court order before being allowed supervised walks on hospital grounds or trips beyond the facility. These orders could, of course, take months to get. This bill passed both chambers unanimously. The citizens of the state, through their representatives, chose to act entirely out of fear and punish all of us collectively, rather than see us as individuals and trusting the doctors who know us best.

In Washington state, many patients would have served only six months in county jail if they had pleaded guilty but ended up “maxing out” their five-year maximum commitment to the hospital. Others were found not guilty of more serious offenses and so will likely never be released, even when they have substantially recovered, even in a supervised conditional release. A recent study of Washington state hospitals found that patients are more likely to be released to the coroner’s office than to the community on conditional release.

While I am grateful for the care I initially received, life in a mental hospital is often torment, with constant loneliness, hopelessness and depression. It can also be terrifying, as patients who are truly dangerous are often on the same ward as people who were charged with check fraud. All of this became exponentially worse when the legislature took away what little freedoms we had and the hope of being released. You can imagine what effect it would have to not be able to take a walk and get fresh air, leave your house on occasion or visit family. Now imagine that instead of being trapped in your home, you are trapped in a mental hospital, even though you are well. Add to this the realization that your confinement is indefinite. You would struggle not just for your sanity, but also your humanity.

The sheer drudgery of living in a state hospital, combined with the countless pitfalls that beset patients, has convinced me that I recovered despite, not because of, my confinement to Eastern State Hospital. Life at the hospital feels like an enormous, endless exercise in futility. Hours pass like years, and years pass like hours. We suffer because we cannot express our remorse for the criminal activity we committed and be truly heard by our treatment teams, let alone our victims. We suffer because the cold, sterile environment that is to make us better sucks away our identities and, if we’re not careful, our very humanity.

Life at the hospital was difficult when I arrived in December 2007. Yet patients were allowed to visit each other’s rooms, play musical instruments with one another, share food and compact discs and otherwise be social. But then the walk-away happened and all hell broke loose. Patients were placed on lockdown—even those patients who had court-approved visits to town could not leave the hospital grounds. At a record pace, state laws were passed taking away re-integration trips and placing a state panel over the hospital as another level of scrutiny to any form of release. Hopelessness abounded on the forensic wards at the hospital. Shortly afterward, a patient was murdered at the hands of another patient.

Then came the mandate from the federal government that visiting one another’s rooms was too dangerous. Everything from guitars, to compact discs, to stereos, to shoelaces, belts and potted plants was deemed a “dangerous” item. They were henceforth removed from patient access. On my ward, there was almost a full-scale riot when these mandates were passed down. More policy changes followed making it a punishable offense for a patient to share food with another patient. While staff potlucks were carried out mere feet away, patients could help one another only by passing food in a bathroom or to a roommate, as these were the only places on the wards not monitored by camera 24/7.

“Long-term stability” is the name of the game when it comes to seeking release from the hospital. This translates to remaining cool, not giving in to the temptation to voice human emotions (such as frustration or anger) and following a laundry list of rules that can take away category levels (a hierarchical numbered system of labeling patients and granting them privileges), at any given moment. It also means participating in a monotonous routine of waking up early for breakfast, taking medications, then lining up for the walk to another building to participate in the “treatment mall” for five hours on weekdays.

The treatment mall is the part of the program most despised by patients. Though all classes are considered by the hospital to be “active treatment” (and thus it’s a mortal sin in the eyes of the treatment team to not participate), classes (such as “Table Games,” “Sewing,” “Journaling” and “Volleyball”) are rarely changed and become a sign of the drudgery, boredom and hopelessness that pervade the hospital environment. The routine continues back at the ward, where patients are distributed mail (an intense 15 minutes), followed by yard time, dinner, then ward store, community meeting on some nights, more medication distribution, then snacks and most patients going to bed. Most patients’ lives revolve around phone calls from attorneys, visits from loved ones or trips to court.

Adding to the state of despair is that some patients have nothing to lose because they know they will literally die in the hospital. Unsurprisingly, some are known to try to sabotage patients who are “working the program” by trying to start fights with them. This does not deter treatment teams from punishing the cooperating patient one iota when it comes to the enforcement of policies and rules—despite the knowledge that they are being provoked by someone who is known for aggressive behavior.

I was granted my release by a judge who, despite the testimony of hospital employees, was willing to give me a chance in the community. The stories of patients who are not so fortunate are too numerous to count.

I and a group of other patients, represented by attorney Andrew Biviano and the watchdog organization Disability Rights Washington, filed a federal suit against the Washington state system last fall. It is our claim that patients at Washington state hospitals are being denied their constitutional and legal rights when they are punished for minor transgressions, denied access to the outdoors and the community and held for years past the point they could have been re-integrated into the community. None of the plaintiffs, including myself, will profit monetarily and, as I was conditionally released in January, I do not stand to gain in any way with the exception of seeing a grievous injustice addressed.

***

I am now applying for positions in the mental health industry as a “peer specialist,” hoping to use my training and experience to counsel others who are currently suffering from mental illness. I work out at the local YMCA, stay active in Narcotics Anonymous and am making connections in the local community. And for the first time in almost a decade, I prepare my own meals. I am responsible for my own rent and bills. I wash my own dishes.

I don’t pretend to be perfect. I don’t pretend to have answers to some incredibly difficult questions about what to do with those who commit horrible acts in the throes of psychosis. What I do is wonder. I wonder what it would be like to live in a society in which everyone admits that they are not perfect and we do not blame people for having a mental illness that they most certainly did not ask for.

The fact is that, statistically, I have a 0.6 percent chance of re-offending. The fact is that if I so much as have a beer in my refrigerator, break curfew, smoke marijuana in a state where that is legal or break any of a number of other stipulations to my newly found freedom, it will be taken from me. I do not want that to happen, so I take care not to break any of these conditions. But I still wonder. Is it fair? Is it fair that I must have practically perfect behavior in order to avoid being thrown back in the psychiatric hospital at a moment’s notice? Is it fair that I find my skin crawling when I hear the words “crazy,” “delusional” and “psychotic” tossed around without regard for those who live the reality of mental illness? Probably not.

I am encouraged by the stories of recovery I hear from others. I am encouraged by the words of wisdom I find in the Bible. I am encouraged by the changes I see in myself when I continue to take the medication I am prescribed because I want to continue living the new life I have been granted. I am encouraged by the people who are doing God’s work in this world—the Ebola workers, the nonprofit employees, the charity volunteers.

I had become isolated from the rest of the world long before I broke down my neighbors’ door and assaulted them in 2007. Society did not care about me until it felt the need to protect itself from me. But perhaps the next chapter in my life will be filled with a moral, and perhaps legal, victory on behalf of patients who otherwise have no voice. Perhaps the liberties and freedoms that this nation cherishes will be afforded even to those with no power. Perhaps we will all commit to the difficult task of reflecting on ourselves and discovering what it is that makes us feel so afraid, and how we can be more understanding.

Perhaps there will be many more meals prepared for the forsaken, the demonized, the scapegoated of our nation. Not in the confines of mental hospitals, but as part of a larger conversation on what mental illness truly is.

Until then, I have some more dishes to do.