The Journal. - A Lawyer Says He Doesn't Need Help for Psychosis. His Family Disagrees.

Episode Date: May 10, 2024

WSJ’s Julie Wernau wanted to test a hypothesis: are there more mentally ill homeless people now, compared to before the pandemic? That question led her to Rob Dart. Once a successful lawyer, in 2022 he went into a downward spiral, which his family has not been able to stop despite their best efforts. Further Reading: - A Lawyer Abandoned Family and Career to Follow the Voices in His Head  - A Lawyer’s Slide Into Psychosis Was Captured in a WSJ Profile. He Tells Us His Story.  Further Listening: - America's Maternal Mental Health Crisis  - Evicted on Wood Street: California's Housing Crisis  Learn more about your ad choices. Visit megaphone.fm/adchoices

When Rob Dart was growing up, he was good at just about everything. He was voted the Renaissance man in high school. He was the captain of the football team. He got straight A's except for French. This is Rob's sister, Jennifer Dart. Can you describe Rob before? Yeah, I call him the real Rob. He was the nicest person.

He was always putting his friends and his family first. One of his high school friends told me that Rob was the designated driver for the parties. So he was just never wanting to put anything in his system that would jeopardize his brain because he knew how smart he was. Rob went on to Duke University and then to law school. He moved to California and started a family. And he and Jennifer stayed in touch. Hey, Jennifer, it's Rob. Just calling to say hi. Hope you're doing well. Hope it's not too late to call. You can call me back later if you want doing well. Hope it's not too late to call. You can call me back later if you want to or tomorrow.

I love you. Bye-bye. We definitely have been close until he got sick. Of course, I go back and listen to his voicemails and look at old pictures and have wonderful memories with him. Hopefully, I'll be able to have that relationship again. You talk about the real Rob. What do you call this Rob? So I just call this the sick Rob. That's not the Rob I know.

The sick Rob. That's what my mom always reminds me, that this isn't Rob. He's sick, which is true. Today, Rob Dart suffers from psychosis. At 44, Rob's homeless and living on the streets of Los Angeles. And everything his family has done to get him help has failed. I think my brother is an extreme example, but a great example of how the system does not work. Welcome to The Journal, our show about money, business, and power. I'm Kate Leinbaugh. It's Friday, May 10th. Coming up on the show, Finding Rob. To Los Angeles, take to the fields of the USA for your next vacation. Ready to kick off?

Discover exciting games and events. Plus, find amazing hidden gems in cities full of adventures, delicious food, and diverse cultures. You'll love it so much you'll want to extend your stay beyond the matches. Get the ball rolling on your soccer getaway. Head to visittheusa.com. Rob Dart first started hearing voices about 10 years ago. You just never think that your brother has schizoaffective disorder. This was in his 30s. Everything I had read said that schizophrenia,

schizoaffective disorder starts more in your teens. So, and he's just, it was so brilliant, you would never think that something like this would happen. What exactly is a psychotic disorder? In some ways, when we talk about psychotic disorders, it's this like umbrella term for what can be actually a very diverse array of symptoms. That's our colleague Julie Wernow, who covers mental health. There are delusions. Sometimes there's hallucinations, which can make people think, you know, that they are convening directly with God or that they're running for president of the United States. Or it could also make them think that, you know, there's people recording everything that they do. How is it treated? Well, the first

line of defense is antipsychotic medication, which is something that Rob was on. They are very difficult medications to be on. Weight gain is so common and so difficult that people often end up with other things like diabetes. Some people have tremors. After his diagnosis, Rob went on these medications and went on with his life in LA. He had a job, an apartment in Pasadena. He shared custody of his son with his ex-wife.

Things for Rob were pretty stable until about 2020. It really changed in the pandemic. I was investigating sort of why we were seeing more people on the streets who seemed to be having delusions. And it turns out there are more people on the streets who seem to be having delusions. And it turns out there are more people who have had psychotic episodes since the pandemic. A lot of gaps in care happened, but it was particularly bad for people with psychotic disorders.

Around the country, insurance claims related to psychotic episodes rose 30 percent since 2019. And at the same time, many patients stopped connecting with their doctors. That can be a problem for people on antipsychotic drugs because regular check-ins are considered a standard part of care. This is part of what happened to Rob. He really had just lots of time alone and no one to really check in on him. He didn't have a partner. His therapist went online.

Another one seems to have maybe quit the practice. In 2022, Rob stopped taking his medications. And, you know, no one was around to see it. He was working from home. And little by little, the people in his life started to notice that things didn't seem quite right. When I called him, I could tell that he wasn't taking his medicine because he was speaking fast.

He was in a manic state. And eventually he stopped talking to me and my mom at all. He blocked me from Facebook. He wouldn't return my text or my calls. I had gone from Rob calling me almost every day, leaving me these sweet voicemails, To him not calling me at all. When was it clear that things were, like, really bad for Rob? My mom started hearing from people who lived at his apartment complex

that he was walking around in his underwear sometimes, talking to himself. People could hear him talking through the walls or walking down the street talking to himself. Rob's psychotic disorder had returned. He started to experience delusions, and he posted about them on Facebook. He thought that he heard satanic voices and that people were trying to hypnotize him. Eventually, Rob lost the ability to hold his life together. He believed he needed to pull his money out of the American banking system. He stopped paying rent, stopped going to work, stopped taking care of his hygiene. Okay, I feel like we went fast from like not taking medication to total collapse.

Was it fast? It was pretty fast. I think within three months, he had lost his job. Within six months, he had lost his home. Within a year, he'd lost custody of his child. And then he was homeless. Did he ever seek out treatment? No, he didn't think he was sick.

His sister Jennifer did think he was sick. And she wanted him to get treatment and go back on his medication. But Rob wasn't talking to her. Which is very scary when you're across the country and he won't respond to any of our calls or texts because at that point we hadn't heard from him in months. And eventually you decided to go see him. Right. Someone had said that they had seen him sitting in front of a Starbucks with bags, and that image just broke my heart thinking about my brother sitting in front of a Starbucks

with plastic bags. Jennifer went to L.A. because she thought maybe Rob would talk to her if he saw her in person. Maybe she could convince him to get some help. My brother was sitting there at Starbucks staring into space with one cup of water. He had nothing with him and I barely recognized him. His hair was, you know, very long hair, long beard. He was totally tan. I didn't even know we could get that tan. My family has pretty fair skin, so I didn't even know that was possible. But he was so tan and skinny. His pants, he was dirty. His clothes, his teeth were yellow, but his eyes were the same. He has these beautiful blue eyes.

but his eyes were the same. He has these beautiful blue eyes. So I was thinking that Rob was still in there. Yeah. And I called his name and at first I thought he looked up and smiled at me and I said, Rob, do you know who I am? Because he just looks so lost and he said, yes, I know who you are

and I don't want you to be here. Please leave. Rob wouldn't let his sister help him to get medical treatment. And in most states, if an adult doesn't want to be admitted to a hospital, they can refuse. That makes it hard for people like Jennifer to get mental health care for friends or relatives without their consent. And in Rob's case, he was sent to a hospital several times, but was released because he didn't want to stay. So almost a year after his first hospitalization in the pandemic, he ends up in a hospital bed

where his friend had sort of tricked him into going to the hospitals. And they commit him. They've got everything in place, you know, to make sure this time he stays. And Rob actually argues before a judge from his hospital bed for his own sanity and convinces the judge that he should be released. And they let him go. Julie wanted to find Rob to ask him about his side of the story. She emailed him and tried to reach him on Facebook, but she didn't hear back. So earlier this year, she flew to L.A. So I got in, dropped my bag at my hotel, and now I am on the streets looking for Rob.

So I'm at this Starbucks. The store manager there said he definitely knows Rob, but he hasn't seen him in weeks. Julie checked places where people had seen Rob. Another Starbucks, and that they haven't seen him there in almost a year. She tried just walking around neighborhoods where she thought he might be. So, I'm going to walk on this road here because there's a lot of homeless people on it and I'm hoping one of them's Rob. But ultimately, Julie didn't find him. I just keep feeling like I see him, you know, and then I turn and it's somebody else. Julie resigned herself to not hearing Rob's side of the story.

But then she got a message on Facebook. All of a sudden, he pops up and he says, Hi, Julie, I'd really like to hear about the story that you're writing. Rob and Julie decided to meet up. That's next. Imagine you're in Ottawa strolling through artistic landscapes at the National Gallery of Canada. Oh. Then cycling past Parliament Hill.

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Pandora, be love. What does be love mean to you? I definitely would say my be love role model is for sure my sister. Unconditional, infinite love. Something that is never ending, that you know is always there. Never questioned. Never questioned. No matter if you fall off a cliff, she's there to catch you, you know. Never questioned. Never questioned. No matter if you fall off a cliff,

she's there to catch you, you know? Be love. Shop now at Pandora.net. Julie went back to L.A. to meet Rob in a neighborhood called Silver Lake.

I went up there, you know, about a month ago on a Monday. Julie went back to L.A. to meet Rob in a neighborhood called Silver Lake. I went up there, you know, about a month ago on a Monday, and we spent most of the day together. Hi. How many? Three. We did the interview at a diner. Can I bring you guys something to drink?

I'd love a cup of coffee. Coffee, yeah. I have fresh coffee. We talked about books, and we laughed a lot. Did he seem lucid, or was he delusional? Both. He seemed both. Most recently, I was a plaintiff's attorney working in class actions, consumer class actions mostly. They talked about Rob's life before and also about his life now.

The problem with Silver Lake is it gets cold at night. So if you're homeless, you know, it's harder to sleep. It's colder here than over in Manhattan Beach? You know, it probably is. Even during the day. But most, I know, it probably is. Yeah. Even during the day. But most, I notice it more at night. Yeah.

Do you ever get scared? Sometimes. And I try to have, like, walls around me somewhere, like in a corner or something. Because you're just out on the beach, you know, like someone could just, like, come up to you from any angle. You know, it would be kind of hard. I think about this a ton.

And, you know, we'd talk about normal things, and then he would very easily just kind of, like, slip into something that was a delusion, because to him, it's all one thing, right? It's his reality. And so, you know, we're

sitting at the diner, and he just kind of le reality. And so, you know, we're sitting at the diner and he just kind of leans in and says, you know, I don't usually tell people this because it sounds a little crazy, but, you know, people are using these keywords to hypnotize me and I never know when it's going to happen. And it's erasing my memory. And so sometimes I forget things. You know, it's like, so once you like headlock someone you could probably like put in like a hypnotic code to like make them like you know just not remember it's like here's what i give you and now like now you remember this stuff and now and then we would just kind of go from there i asked him why you know what happened with your, like, being a lawyer,

and he'd say, I, you know, like, it was vague, you know? It was like something about people stealing his intellectual property and, like, making him do entertainment instead of law. You know, at a certain point, it seemed like a lot of what I was doing was somewhat law and somewhat entertainment, if that makes sense. Like, not entertainment law,

just like pure entertainment. It's like, I'm doing law and I'm doing entertainment. And that's just the way things are right now for some reason. It's something I've asked, since asked some psychiatrists about, because I said, why does this happen? Like, when he would start to talk about something and I was trying to understand his reality, often it would just kind of unravel into these like a lot of words that seem like they should make sense, but they just never would add up. And I couldn't quite figure it out. And apparently that's quite common. After you met with Rob, what did you tell Jennifer? I called Jennifer and her mom together from my hotel room that night.

And I said, I understand why you love this guy. We had a great day. And Jennifer asked, did he say anything about us? And I said, he did. He said he doesn't want to talk to you. If he were to get treatment and go back on his meds, could he get back to the real Rob? What his friends and family call the real Rob?

Um, I think it's unclear. I think from what people tell me, you know, what psychiatrists say, what people in this field say is that, you know, the outcomes for someone who's been in this state for this long get worse and worse the longer it goes on, but that people do recover. And what recovery looks like might not be what the people in his life want it to look like. It may be that, you know, he gets to a place where he can distance himself

from these ideas and delusions enough to kind of focus more on things like, you know, his own basic hygiene and getting a job, but he might not ever let go of them. If a person doesn't believe that they're sick and doesn't want any help, it is almost impossible to bring them back. I mean, I watched his family go through months and months of all the things that you think you're supposed to do for someone in this situation. And nothing worked. And he's still out there. What's going to happen to Rob now?

Well, Rob is going to be homeless. He said it sucks. Literally, is what he said. He doesn't really seem to have much thinking about the future. It's very like in the here and now. Like, how am I going to eat today? Where am I going to sleep today? Where am I going to sleep today? Is it safe? I think one of the more overwhelming things about the day was just how clear he was about how lonely it is to be someone who is homeless and who people kind of avoid.

and who people kind of avoid. Sometimes when it's cold, if I have food or something or not, I'll end up just walking until I kind of get tired, and then I kind of just lay down. Sometimes if I'm in a residential area, I just walk until I get tired, and then I just lay down.

So it's kind of just like next to a sidewalk, and I kind of just lay down. So it's kind of just like next to a sidewalk. Mm-hmm. And I kind of just lay down. Before we go today, we wanted to tell you about a new series coming out on Monday. It's called Trillion Dollar Shot, and it's about a new class of blockbuster drugs. The series is hosted by our colleagues Jessica Mendoza and Bradley Olson, and they're here now to talk to us about it. Hey, guys. Hi. Howdy. It's nice to be in studio with you.

So great to be in studio with you. So great to be in studio with you. So excited to have you guys on also really effective for weight loss. And there's been sort of a big zeitgeist moment around them. Everyone's talking about them. They came up at the Oscars. Elon Musk was using it recently. Oprah came out with a special. So they're absolute blockbusters.

I think this is one of the biggest business stories of the past few years. In fact, the reason that we're calling it Trillion Dollar Shot is that because these drugs have become so successful, even with all the questions still surrounding them, the two companies behind them are actually racing to become the first trillion-dollar pharmaceutical company in history. But at the same time, people have a lot of questions about them as well, even as, you know, they've hit the mainstream. How safe are they?

How is this affecting our cultural conversations about obesity, about weight? How can people afford them? And so we wanted to get into all of that with the series. And Brad, you're here because you have some firsthand experience with these drugs. That's right. That's right. That's right. I took one of the drugs and lost 40 pounds. I took it over about five months.

And it just led to this just big explosion of emotion and kind of unexpected feelings and things I learned. Like what? and things I learned. Like what? Well, like kind of makes you reflect on identity and willpower and, you know, how we treat people who struggle with their weight or how we've always treated them, right? Like this is a you problem.

You're big because you made bad choices, you know? And I think if there's a magic pill that fixes it and you're not big anymore, then it makes you think maybe it wasn't me. Maybe I'm not just some big failure, you know. Among the big drug discoveries, where is this going to rank? Some analysts have said one of the drugs could be, you know, one of the highest grossing pharmaceuticals of all time. Now, adjusted for inflation, I think it would be in the neighborhood of statins and a few other ones, but

Adjusted for inflation, I think it would be in the neighborhood of statins and a few other ones, but massive, massive. The first episode will be in your feed on Monday morning. Here's a sneak peek. All of a sudden, just the weight starts falling off, you know, eight pounds the first month. I felt like it was a miracle. Three pounds the second month. Life-changing for sure. Ten pounds the third month. That's how powerful this medication is.

Then it just was like, how is this happening? I could tell it was working, and I could tell that it was changing my relationship with food, and I liked that. This type of success has meant huge windfalls for drug makers. We said, oh, Jesus, this can become a big, big drug. It's been a boon. There's no denying that. You know, the demand is higher than what we can deliver to people today.

And that demand for these drugs is reverberating across society. And I thought, well, I'll stay on this for life because it's so helpful. And then I realized what it was going to cost me. They're just bank breakers. Okay, if I can't get the drug, what can I take instead? What's close? There are so many people even selling bathtub Ozempic.

There was a lot of excitement. There was a lot of skepticism. And I can imagine a future where life expectancies are actually increasing because of this class of drugs. Whether you think these drugs are a miracle or you're skeptical of what they promise, they're changing how we approach one of the most intractable issues in our society, obesity. And it's just the beginning. That's a preview of Trillion Dollar Shot, our new series.

Check it out Monday. That's all for today, Friday, May 10th. The Journal is a co-production of Spotify and The Wall Street Journal. The show is made by Annie Baxter, Catherine Brewer, Maria Byrne, Victoria Dominguez, Pia Godkari, Rachel Humphries, Ryan Knudsen, Matt Kwong, Jessica Mendoza, Annie Minoff, Laura Morris, Enrique Perez de la Rosa,

Sarah Platt, Alan Rodriguez-Espinosa, Heather Rogers, Pierce Singey, Lai Ying Tang, Jeevaka Verma, Lisa Wang, Catherine Whalen, Tatiana Zamis, and me, Kate Leinbaugh. Our engineers are Griffin Tanner, Nathan Singapak, and Peter Leonard. Our theme music is by So Wiley. Additional music this week from Nathan Singapak and Blue Dot Sessions.

Fact-checking by Kate Gallagher, Najwa Jamal, and Mary Mathis. Thanks for listening. See you Monday.