And adults in homeless shelters and prisons or jail are more likely to have a mental illness than those in the general population. More than 26% of adults in American homeless shelters have a serious mental illness, according to a 2010 report by the US Department of Housing and Urban Development, and a US Department of Justice special report released in June shows 14% of state and federal prisoners and 26% of jail inmates have "reported experiences that met the threshold for serious psychological distress." Even more inmates, 37% of those in prison and 44% of those in jail," had been told in the past by a mental health professional that they had a mental disorder."
Too many adults with mental illness go untreated. Nearly 60% went without mental health services in 2014, according to the Substance Abuse and Mental Health Services Administration, and odds of getting treatment often fall along racial lines. For example, African-Americans and Hispanic Americans accessed mental health services at half the rate of whites, the administration found in 2015.
In a number of ways, one might say, McDermott was lucky -- not least of all because of the mother who raised him.
Hours before McDermott was born, his Uncle Eddie -- diagnosed with paranoid schizophrenia -- was taken away by ambulance and institutionalized.
The reality that mental illness ran in the family shaped how Cindy Cisneros-McGilvrey, the Bird, watched her son. She tried to stay positive and not worry, but there was no denying that Zack, her middle child, concerned her, McGilvrey says. Early on, he was difficult, volatile, prone to pounding his fists and holding his breath till he turned blue. He trusted few, and McGilvrey says she lost babysitters because of him.
By the time he went off to elementary school, though, he'd adjusted socially. Her son was highly intelligent and funny, but he was also a smartass who "suffered no fools," she said. Boredom drove him to torment others, and he liked to make people uncomfortable. He'd do striptease acts, which was ironic given what transpired as he unraveled in New York years later.
When he was in law school at the University of Virginia, McGilvrey worried about his excessive partying. Given her brother Eddie's history, which included abuse of drugs, her own struggles with depression and her father's alcoholism, she says she issued warnings.
"Zack, you know the odds aren't in your favor," she remembered saying to him. "Let's not play Russian roulette with the gene pool."
McGilvrey, an educator in Wichita, Kansas, who helps adults of all ages earn high school diplomas, was vigilant. She read up on mental illnesses. She attended counseling with her children after her divorces, first from McDermott's biological father and then from his stepfather. The Bird watched out for her boy like a hawk.
McDermott doesn't dispute that he was a handful.
"I was an awful kid," he said, ticking off his offenses. "I'd been arrested five or six times, got into a lot of fights, totaled a couple cars and partied way too much from 14 on."