The social worker’s exhortation was included in a report issued Tuesday by the D.C. inspector general’s office, which concluded that despite many efforts to help James, 71, city agencies did a better job of cleaning up his property than saving his life.
His death illustrates the difficulties of rescuing someone who doesn’t want to be helped, the report said. City officials responding to the case were met by many obstacles, including James’s repeated refusals of help and the “rigidity and ambiguities” of the city laws governing who can be involuntarily committed and when. But the efforts by dozens of employees and several agencies ultimately fell short, the report concluded.
“It does not seem reasonable that the significant time and resources expended wrestling with the problems caused by [James’s] unusual and aberrant behavior resulted in saving the offending property, but not the life of the property owner,” the report says. “It is a sad commentary that the collective efforts so dutifully exerted by so many had no effect on the egregious and dangerous living conditions in which the District resident placed himself.”
Although the report did not call for disciplinary against any employees, it urged the city to change its involuntary commitment law to make it easier to rescue those who refuse aid.
For nearly 50 years, during a career that spanned every president from John F. Kennedy to Barack Obama, James worked in the White House Office of Records Management, where he read and catalogued many of the documents that flowed through the Oval Office. But in 2009, as he retired, the well-dressed, quiet Howard University graduate who liked to talk philosophy with his neighbors started to show signs that he was in trouble.
His story was chronicled in The Washington Post after his death in August, and the inspector general’s office launched its review of how the city responded shortly after. The 81-page report included photographs of the fetid squalor in which James lived. He had no refrigerator, and dead rats clogged the bathtub drain at his Northwest Washington rowhouse.
More than 70 D.C. employees tried to help James over a 21
2-year period leading up to his death. Adult Protective Services went to his home at least 17 times, according to the report. Department of Mental Health employees visited at least nine times. Police and emergency crews responded several times, as well.
“To their credit, almost all of the District agency employees involved in this case exhibited a professional interest and willingness to assist” James, the report says. Although the communication between agencies was “extensive and well-intentioned,” they “did not translate into specific actions that might have helped” save James.
The report singled out Adult Protective Services for “lapses in its investigation of the case.” The agency was not aware that James had been hospitalized on several occasions. And even though several city agencies were involved in trying to help him, no agency took the lead. An intervention they coordinated together “was not effectively planned, communicated, or executed, and was not productive,” the report said.
The report also criticized mental health and social service professionals for being “unwilling to look beyond the most conservative interpretation of the terms ‘mental illness’ and ‘self-neglect.’ ”
Instead, the officials responding to neighbors’ alarms about James found him to be capable because he was courteous and well-spoken. According to the report, one even said he had “an elegance about him.” In a discussion about James going to the bathroom on his front porch, often in front of others, another social worker said that “some individuals grow up on a farm where it was normal to use an outhouse or to relieve oneself outdoors.”
But the report noted that “common sense should have raised an alarm.”
In October, Beatriz “BB” Otero, deputy mayor for health and human services, issued a report about James’s death, which was released last week. She urged better collaboration among city agencies and the creation of a database that would track every interaction agencies have with city residents. Otero also suggested a review of the law that governs how and when city agencies can step in to involuntarily commit someone.
In an interview, D.C. Council member Jim Graham (D-Ward 1), chairman of the Human Services Committee, said a change in the law is already under consideration. “The fundamental question for the council is whether we should be modifying the involuntary commitment law,” he said. “In this case, had the law been worded differently there might have been a different reaction.”
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