Ricardo Muñoz family photo

A young Ricardo Muñoz, second from right, poses with family members in this undated photo.

 

THE ISSUE

LNP | LancasterOnline’s Dan Nephin wrote an in-depth story, published Monday, about the last day lived by Ricardo Muñoz, 27, who was fatally shot by a Lancaster city police officer Sept. 13. Nephin detailed Muñoz’s struggles with mental illness and his family’s many attempts to get him help.

Daisy Ayllon, an attorney for the family of Ricardo Muñoz, put it plainly and powerfully: “As a society, we have a responsibility and a duty to care for the most vulnerable individual members of our society and when we fail to do that, we fail as a society.”

Muñoz and his family were failed by our society — a society that while filled with people with mental illness, declines to prioritize their care.

It is true that Muñoz was awaiting trial for stabbing four people in March 2019. But his family members say he acted in self-defense after he was assaulted and had his video game stolen. They say they never feared violence from their son and brother — not even on his last day, when, as they told Nephin, he was upset and agitated, experiencing one of what the family came to call his “episodes.”

The story Nephin tells will be familiar to others who have watched in pain as family members have been overtaken by mental illness.

It’s the story of a “happy, smiling child” who becomes a teenager. He runs cross country at his high school and does well enough to graduate and gain admittance to Thaddeus Stevens College of Technology.

Then he becomes a young adult, and begins to experience the symptoms of schizophrenia: hallucinations and paranoia. He has trouble concentrating and cannot keep a job. He struggles to make himself understood; he becomes incoherent. He retreats to his bedroom, listening to music and playing on his phone, forgetting to shower and eat, losing contact with friends and drawing ever inward.

This detail in Nephin’s story struck us as among the saddest: “The only times he would actually come out and spend time with us as a family was Thanksgiving or (Christmas). But right after he finished eating, he would go right back to his room,” his sister Deborah Muñoz said.

We wonder if he came out of his room hoping those holidays would be like they were when he was a happy child. We wish they could have been, for him and his family.

More broadly, we wish his family would have been able to get him the help they say they tried repeatedly to get him.

This part of Nephin’s story will be familiar to other families: As Muñoz’s “mental health worsened, the family had trouble obtaining care for him. Because he was an adult, he was able to refuse care.”

This was the case even though he’d been diagnosed with paranoid schizophrenia and spent 12 days in March in Lancaster Behavioral Health Hospital, where he was prescribed an antipsychotic medication.

At one point, his mother, Miguelina Peña, took him to New York, where his biological father lives, to see if he could get help there. And, according to Nephin’s account, Muñoz was admitted to a mental health facility in New York.

The family still was trying to get him help on his last day — they were trying to get him involuntarily committed, their only option.

His sister, Rulennis Muñoz, said she first called a crisis intervention center in Lebanon County, which the family had previously contacted. She told Nephin that she was directed to call the police nonemergency number, which she did.

“But after describing the situation to the person who answered, she was advised to call crisis intervention again,” Nephin wrote. “She never got the chance to make that call.”

A Lancaster city police officer, responding to a 911 dispatch, arrived at the family’s city home. Muñoz exited the home and charged at the officer with a knife. The officer fired several shots, killing Muñoz.

Two things are important to note.

— The overwhelming majority of people with mental illness do not commit violent acts. Indeed, according to the American Psychiatric Association, they are far more likely to be victims of violence than perpetrators of it.

— As the Muñoz story makes tragically clear, it remains difficult in Pennsylvania to get help for a loved one experiencing a mental illness crisis without calling the police to have that person involuntarily hospitalized.

Theoretically, there could be another option: assisted outpatient treatment, which, according to the Pittsburgh nonprofit news organization PublicSource, is “a technical term for a kind of involuntary treatment, such as mandated therapy or day programs while living in the community.”

Pennsylvania changed its involuntary treatment standards in 2018 — it was the 47th state to do so, according to PublicSource. 

Before then, involuntary treatment was reserved for those who were a “clear and present danger” to themselves or others, and it meant involuntary hospitalization. There was no other standard for court-ordered treatment, no other option.

A state law enacted in 2018 says that a person can qualify for assisted outpatient treatment if there is “clear and convincing evidence that the person would benefit” from it. 

But counties in Pennsylvania, citing costs, have opted out of providing assisted outpatient treatment.

Judith Erb, executive director of Lancaster County’s Behavioral Health and Developmental Services Department, explained in an email that the 2018 state legislation didn’t provide additional funding for assisted outpatient treatment, which would involve not just service costs but court costs.

And, she added, “there is no clarity on how to enforce the commitment if the individual does not comply.”

We understand that this is complicated. But there have to be more options for families than calling the police to have a loved one involuntarily hospitalized.

We noted in an editorial last month that Erb’s department has a budget of about $14 million this year — to provide not just crisis intervention and mental health services, but also early intervention services for infants and toddlers and services for people with intellectual disabilities, in a county of more than 545,000 people.

We also noted the shortage of mental health care providers in Pennsylvania, and cited a 2017 University of Southern California study that found that more than a quarter of the approximately 1 million adult Pennsylvanians who experienced “serious psychological distress at least once in 2015” reported “an unmet need for mental health care.”

Clearly, more resources need to go into providing mental health services.

Muñoz’s mother would pray “every day so that God would heal him,” his sister Deborah Muñoz told Nephin.

But he needed earthly assistance, too. And our society failed to provide it.