DETERIORATING WITH HIS RIGHTS ON w/Sylvia Mignon

​From a young age, my son Cameron was described by others as a highly intelligent and an intuitive “old soul” willing to share his wisdom. Now twenty-seven years old, Cameron suffers from schizoaffective disorder, a debilitating brain disease that combines the symptoms of schizophrenia and bipolar disorder. This condition manifests as psychosis and mania. He has struggled with it for nine years. When not in the grips of his illness, Cameron is a kind and gentle young man.
 
Over the years, Cameron has had seven hospitalizations, including eight months at a state hospital. During periods of psychosis, he has often required involuntary medication. He has experienced being restrained in straightjackets and handcuffs and was even reported as a missing person in 2019, which prompted media coverage to help locate him. During psychosis, he has often had to be involuntarily medicated.
 
On August 25, 2021 while in a state of psychosis, Cameron took a van from his workplace and led police on a slow chase through four towns, amassing fifteen legal charges. This incident was the top story on local news that evening. When the chase ended, police drew their guns before arresting him and taking him into custody. He was subsequently hospitalized again.
 
According to the Department of Mental Health’s (DMH) Human Rights Handbook (2007), clients can be involuntarily treated if the court determines they are incompetent. After three psychological evaluations deemed Cameron incompetent, a judge ruled that he met the criteria for treatment. In December 2023, Cameron was found Not Guilty by Reason of Insanity on all charges stemming from the 2021 incident.
In October 2022, Cameron moved into a group home and initially adjusted well. However, in January 2024, he refused his monthly Invega Sustenna injection. The group home staff supported his decision, citing his “basic human right” to refuse medication, despite the court’s determination of his incompetence. Staff claimed Cameron had to consent to the injection, even though anosognosia—a hallmark of schizophrenia-spectrum disorders—renders him incapable of recognizing his illness or the need for medication. Tragically, this refusal of medication led to predictable consequences.
 
The standard of care in schizophrenia-spectrum disorders should be to involuntarily medicate the client if necessary. Unfortunately we had to wait for the inevitable, another psychotic episode. On June 15, 2024, Cameron, in a state of psychosis, walked away from the group home. Two days later, police located and transported him to the emergency room via ambulance. He was later admitted to an inpatient psychiatric unit, where he remained for five-and-a-half months, experiencing persistent psychosis and mania.
 
During the inpatient stay, the staff determined that Cameron’s previous medications were no longer effective, but failed to find a viable alternative. The unit lacked the resources to manage his poor impulse control—another hallmark of psychosis—or to establish behavioral limits. This created an unsafe environment for Cameron, other patients, and the staff. Despite my repeated concerns, little was done to address these issues.
 
The hospital’s solution was to encourage the filing of fourteen assault and battery-related charges against Cameron to pressure DMH to transfer him to a higher and more restrictive level of care. For months, I fought to have Cameron transferred to the state hospital, where he had previously received effective treatment. Despite being a long-term DMH client, his name was merely added to the state hospital’s transfer list, which has a wait time of up to two years. If DMH had acted promptly, these legal charges—and the associated trauma—could have been avoided.

​On December 3, 2024, Cameron was sent to Bridgewater State for a twenty-day evaluation. I was not allowed to communicate with the evaluating psychologist. The resulting report aligned with the hospital’s position, treating Cameron as a criminal rather than a severely mentally ill young man in desperate need of care. Based on this evaluation, Cameron was remanded to jail on December 23, 2024, where he remains incarcerated instead of receiving the treatment he so urgently needs.
 
The system in Massachusetts has failed him. Like many others with severe mental illnesses, Cameron sits in a small, barren jail cell, punished for being sick. In his heart, Cameron is a kind and gentle young man. This experience, like it has for so many families in Massachusetts, has caused immense stress, heartbreak, and emotional exhaustion. Our mental health system creates trauma for families. Caregivers are left overwhelmed by anger, frustration, helplessness, and worry. On top of this, families often bear significant financial burdens when the system fails their loved ones.
This experience has shown me that families must unite and lead the call for change. We need to advocate for Assisted Outpatient Treatment (AOT) in Massachusetts. AOT is an evidence-based, court-ordered outpatient treatment program that is currently allowed in forty-eight states and Washington, D.C. Massachusetts and Connecticut are the only two states without this vital program.
AOT has been proven to reduce rates of homelessness, incarceration, and hospitalization. It improves overall self-care, reduces violence, and prevents suicide. Additionally, AOT holds the mental health systems accountable, ensuring that families are no longer left to navigate these crises alone. Currently, there is no accountability, and families are left with no help when their loved ones suffer from anosognosia and are too sick to know they need help.
 
As Cameron's legal guardian, conservator, and Social Security payee, I have Rogers Guardianship Authority, which provides for the mandating of his antipsychotic medication in both inpatient and outpatient settings. However, this authority is unenforceable outside of a hospital setting—another glaring reason why Massachusetts must pass an AOT law.
 
The AOT bills for the new legislative session have been filed in the Massachusetts House of Representatives and Senate. If you live in Massachusetts, please contact your Senator and Representative and urge them to co-sponsor these critical bills. Together, we can create a system that supports families and helps those like Cameron receive the care they desperately need. ∎