Court Helps Violinist Tackle Mental Illness and She Makes Music Again

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By Lee Romney

SAN FRANCISCO—Kim Knoble’s story was in some ways typical: A loving childhood and supportive family. The onset of severe mental illness. The roller coaster of despair, denial, recovery, relapse, addiction, sometimes homelessness. And finally, a crime.

As a reporter for the Los Angeles Times, I had written some version of this tale a number of times since I began covering mental health issues in 2005, and I had heard many similar accounts—that never saw print—from distraught relatives of loved ones battling mental illness.

Often, their sons or daughters did not get help or stick with treatment before tragedy struck. Some were victimized. Some died. Others landed in the criminal justice or state mental hospital system, where they finally got treatment, sometimes against their will. I spoke to many such patients when covering the hospital system.

Institutionalization brought stigma and a criminal history. Though it often brought some form of consistent treatment, it also might subject vulnerable people to physical assaults and other abuse from fellow patients. Release was frequently followed by a repeat of the same traumatic situations and events that had led to the initial criminal charges—drug and alcohol abuse without treatment, and unstable housing, for example.

This revolving-door story was difficult to cover. It felt hopeless, and the elements were too often the same. In 2007, however, I was introduced to San Francisco’s Behavioral Health Court. In contrast to many other such mental health courts sprouting across the country, this one did not shy away from violent offenders, as long as the crime was directly tied to mental illness.

When I visited the court, I saw how an elaborate support network—of housing, drug treatment, group counseling and medication management—under the guidance of a firm yet caring judge gave participants a fighting chance to stabilize and even thrive. (Although many mental health advocates believe that such intensive services should be available to those with severe mental illness before they commit a crime, others point out that those in the throes of such illness are often unable to recognize that they are sick, and therefore reject treatment or fail to stick with it. The prospect of incarceration provides a very real incentive for them to accept treatment through behavioral health courts.)

By 2010, studies were affirming the success of such courts, and San Francisco’s was a standout. I reported on the trend:

The sources I had developed with San Francisco’s court paid off. Among them was Jennifer Johnson, a deputy public defender who helped build the program from the ground up. Last fall, as Johnson prepared for the court’s 10th anniversary celebration, she turned to me to write the story of a gifted young woman who had been transformed under the court’s guidance.

Finally, I had an opportunity to write something about the system that worked, about somebody who had evaded prison or worse to reconnect with her true self.

Kim was raised in Marin County by loving parents who were artists. She took up the violin as a young girl and excelled. By high school she was playing with the San Francisco Symphony Youth Orchestra, while doubling as concertmaster of its Marin counterpart. She won a music scholarship to the University of California, Irvine, where she experienced her first mental health struggles. Kim had bouts of delusion and paranoia. She attempted suicide.

Back home, over the next decade, she said, she struggled with addiction to crack and meth and wound up homeless for a time, wandering San Francisco’s Tenderloin in her socks. She would take medication for stretches, then stop. She was in and out of drug treatment. Her parents had been unable to help her, though they had tried repeatedly. They feared she would die, and were strained by the grief and stress of witnessing her self-destruction.

Then, in 2011, off her medication and agitated, Kim pushed an elderly man on a bus in San Francisco’s Chinatown. He fell out the open door and was injured. She was facing prison time for assault when her public defender told her about the Behavioral Health Court. Her diagnosis was adjusted. On a more effective medication cocktail, with housing, group counseling, drug treatment and steady support, she regained her balance.

What she was missing was music. In the fall of 2012, Kim’s stepfather contacted a nonprofit organization that worked with those dealing with mental illness to see if anyone had a violin to spare. The executive director put the word out, and the query spread through San Francisco’s relatively small music community. When Kim’s story of struggle and success made it to David Chiu, chairman of the San Francisco board of supervisors and a violinist himself, he contacted the San Francisco Symphony, which bought an instrument for her.

Kim’s improved health became evident, not just in her words but through her music. At a court anniversary event, she would perform solo, playing Jules Massenet’s “Meditation” from “Thais.”

Her story is one that many families who have never experienced mental illness can relate to. Kim had a stable childhood—with violin lessons, the love of her parents and siblings, and a college scholarship. As awful as it is to say, she was palatable to the public in that way, though of course no more worthy than those born to abuse and poverty. I knew that many people who often turn away from stories of despair and illness (and even recovery) would open their ears and hearts to Kim. And they did. Her story was picked up around the country, and blogged by a number of mental health organizations. NBC News followed it. Emails flowed in from readers.

Kim is articulate and frank about her disease, her past and her present. She has pledged to tell her story widely, to combat the stigma and shame that shadowed her for so many years.

Lee Romney covers Bay Area and Northern California news for the Los Angeles Times’ San Francisco Bureau. She began reporting on California’s state mental hospitals in 2005 and has remained committed to telling stories about those dealing with mental illness and the mental health system. Lee started at the L.A. Times in 1992. She has a master’s degree from UC Berkeley’s Graduate School of Journalism.

Read her coverage:
Mental health court helps save a troubled talent from the street

A journey from mental illness to music and a standing ovation