WEST BATH, Maine — Shannon Gilliam sat at her kitchen table on a recent sunny afternoon, angrily shaking a prescription bottle, listening to its one remaining pill rattle as she told of the years she’s spent battling — largely without success — to get her son help for mental illness and his subsequent heroin addiction.

“They never should have released him,” she said of her son Brandan Gilliam, 26, who was twice hospitalized earlier this month after bouts of the uncontrollable mania that overtakes him when he’s off his medication for bipolar disorder. “We’ve been trying to get him help for the past month. He was [involuntarily admitted] on Sunday night and stayed in the ER for three days. The doctor drugged him up and sent him home with drugs. Then yesterday he totaled his brother’s truck and went on a tear with his girlfriend.”

Just before midnight on July 13, Brandan Gilliam was arrested in Phippsburg and charged with domestic violence assault and criminal restraint. Because of two previous convictions for domestic violence terrorizing — his mom was the victim in those cases, once when Brandan Gilliam threatened to “slit your throat while you’re sleeping,” Shannon Gilliam said — the new charges are Class C felonies that each carry a maximum sentence of five years in prison.

A failed system

As elected leaders, medical professionals and the media debate how to deal with Maine’s opiate addiction and mental health crises, Shannon Gilliam lives amid the fallout of a system that’s failed her son.

She is angry with emergency room physicians who twice released Brandan Gilliam after brief holds. She doesn’t understand how a psychiatrist could have been convinced by her son that he was stable.

She’s frustrated that law enforcement often isn’t able to offer a solution that doesn’t involve jail.

She’s even angrier at a mental health system she says has failed her son, and her family, since he was diagnosed — a process she says took two years.

“They’re talking locking him up for a while,” Shannon Gilliam said. “The mental health system hasn’t helped us yet. Why would it help us now? And now he’s going to go to jail for being mentally ill.”

During the eight years since he was diagnosed, Brandan Gilliam has been in and out of jail more times than his mother can count, including five months last year after he was convicted for a second time of threatening to kill her. By his own account, he’s been admitted to three different psychiatric units on at least 13 occasions, including being “blue-papered,” or involuntarily hospitalized, at Spring Harbor Hospital once for several months.

At first he was prescribed Geodon, a newer antipsychotic, which Shannon Gilliam and her other children say kept Brandan Gilliam stable for a time. But when MaineCare refused to pay for it, he switched to Zyprexa, which doesn’t work as well, they said.

In April, after months taking Zyprexa and months without shooting up, Brandan Gilliam felt so good that he decided — as do many people with bipolar disorder — that he didn’t really need his meds, especially since he’d started working on a lobster boat and needed to get up early.

His mother and his sister, Brooke Gilliam, 21, pleaded with Brandan Gilliam to take his medication — they even ground it up and mixed it in his Pepsi — but he refused.

One day in June, Brooke Gilliam got two calls from friends who work at Phippsburg restaurants, saying Brandan Gilliam had arrived and was behaving erratically. The owner of Anna’s Waters Edge told her Brandan Gilliam had come into the restaurant, left and then returned, pulling into the driveway far too fast in his brother’s truck, and walking into the restaurant wearing different clothes and telling people he was his brother.

Brooke Gilliam called her mom, who said to tell the restaurant staff to call the police. By the time they arrived, Brandan Gilliam had gone.

Then he lost his job on a lobster boat after he began calling the owner in the middle of the night asking why he wasn’t picking him up, Shannon Gilliam said.

In the week before his July 13 arrest, Brandan Gilliam was taken to the Mid Coast Hospital emergency department twice and, despite pleas by his mother, released after a few days — once with a bottle containing 15 tablets of Ativan, an anti-anxiety medication that Shannon Gilliam said is not recommended for addicts.

Brandan Gilliam took 14 of the 15 Ativan pills he’d been prescribed and then stole his brother’s pickup truck and rolled it about a mile from their house, according to the family. Shannon Gilliam again called the hospital, begging that her son be admitted to the behavioral health unit.

“I said, ‘He’s psychotic. He crashed his brother’s truck, he’s hurt himself, and he’s lucky he didn’t kill somebody else on that corner,’” she said.

Shannon Gilliam said she was placed on hold, and then told her son had already been released.

That night, he was arrested in Phippsburg, allegedly high on oxycontin, after police say he assaulted his ex-girlfriend, the mother of his 4-year-old son.

Both Shannon and Brooke Gilliam said that Brandan Gilliam must be held responsible for any crime.

“Brandan is violent when he’s not on his medicine,” Shannon Gilliam said, pointing to a stain on the wallpaper where a bottle of French dressing shattered after her son had thrown it at her. “He would fight with his brother and father. He’s tried to hit me.”

But whether from law enforcement or the hospital, seeking help for Brandan Gilliam when he is off his medication and becomes manic is complicated. If he refuses to be hospitalized, the next call often is to the Sagadahoc County Sheriff’s Office, whose deputies know the family well.

At one point, Shannon Gilliam obtained a protection-from-abuse order against her son so deputies could at least remove him from the home without taking him to jail, but she said that caused more stress because “the only thing that did was make me not able to call for help. If the EMTs had come into the house like I needed them, they would have had to arrest him because he wasn’t supposed to be here.”

‘We need to do better’

Tom Kivler, director of Behavioral Health at Mid Coast Hospital, said Thursday that aspects of the state’s mental health system “absolutely” have to be fixed, including an overall lack of mental health hospital beds and a time-consuming process that requires a mental health worker to call each hospital in the state to see if they’ll accept a patient.

“We need to do better for people with behavioral health issues,” Kivler said. “There’s no other diagnosis where if you need inpatient treatment, you have to call around and, ‘Well, that patient doesn’t really fit, he’s not acute enough.’ With any other condition, you’re diagnosed in the ER, and if you have a heart condition, you go to Maine Medical Center and you get that surgery.”

But Kivler said the “blue paper” process is limited, in part by design to ensure a patient’s civil liberties aren’t violated.

“There is a gray area where people are probably going to make questionable decisions, but we really can’t hold someone just because we think they’ll be engaging in high-risk behaviors,” he said. “We work, and we have a great emergency department and a lot of options with Sweetser and social services … but the reality is it’s up to that person to accept services if they need it, and a lot of the time people don’t want those services.”

Brett Strout, chief deputy at the Sagadahoc County Sheriff’s Office, agreed with Shannon Gilliam that there is no simple answer. He reiterated that law enforcement wasn’t designed and isn’t equipped to act as a mental health provider, even though they are increasingly being called on to do so.

“Unfortunately, when people can’t get the mental health services they need, for myriad reasons, their last resort is to go to the police, but we have limited options,” he said. “I will tell you, this is very frustrating for everyone involved — for law enforcement, for the mental health field and for families. Everyone that’s dealing with this guy knows problems are coming, but there’s no way to act on them or get him help until there’s a problem.”

Safer in jail?

In an interview room at Two Bridges Regional Jail last week, Brandan Gilliam’s speech raced as he described his mental illness, his addiction and the events that led to his arrest.

“I want to get out of here,” he said. “This ain’t the place for me. Everyone’s talking about getting [expletive] up. I’m trying to focus on my mental illness and my addiction. I want to focus on my kid, and teach him to play ball like my dad taught me.”

Brandan Gilliam would like to be moved to Spring Harbor Hospital, where, he said, “They’d put me on the [expletive] I need, and I could talk about what’s happening and how my meds are working. … I don’t want to hurt anyone or myself, but Jesus [expletive] Christ. There’s no beds anywhere.”

He denied hitting his ex-girlfriend, saying, “She went outside and stepped off the porch and hit her face on the ground. … I’d never punch a woman. I’m not that [expletive] person. I never was. … She’s my best friend, besides my mom.”

Looking at a photo of Brandan Gilliam’s ex-girlfriend’s bruised cheekbone, which the woman texted to Brooke Gilliam after leaving the hospital, Shannon Gilliam said, “If Brandan did that, she needs to tell the truth. Because we need to get him the help he needs, and jail isn’t it.”

Despite the pain he’s caused her and her other children, Shannon Gilliam still wants to find help for her son. But she’s at a loss as to where to find it and feels guilty knowing if he’s behind bars, at least it’s a temporary way to prevent him from hurting himself or others.

“Brandan’s my right-hand man,” she said. “He’s my everything. It’s been rough to watch him do this, although I’m so angry at him right now for [wrecking his brother’s] truck and for not getting the help he needs. … I tried to take care of him as best I can, and nobody will help me. He’s a good boy. He’s got a heart of gold, [but] I’m at a point where Brandan does need to help himself, but he’s so mentally ill he can’t even take the first step.

“I’ve been so stressed out trying to get him help. I have a heart condition, and I just kind of need a break from him,” she said. “I’m so afraid he’s going to hurt somebody. My biggest fear is that he hurts a kid or somebody [while driving], and I’m not going to recover from that.”