When Jagger Reep moved into his own apartment, it was his first taste of independence. His mom, Melissa, scoured Salvation Army and Goodwill to piece together the one-bedroom unit, coming back with a bed frame, couch, coffee table and more to help her son settle in. And it was the perfect location, too – kitty-corner to Melissa’s place in Concord. His mom could check in, often with a home-cooked meal in hand, but when she ventured back across the street, Jagger was left alone to his independence, as most 21-year-olds aspire to have.

Jagger, now 23, still lives across the street. But his apartment hardly resembles what it was when he moved in 18 months ago. Most furniture is now in a dumpster. His mattress sits on the floor. Paper plates and plastic cutlery fill his cabinets. The majority of his belongings have been destroyed in fits of rage.

And the glimmer of hope for a life of independence is now a dull reminder of the troubles he’s faced over the last five years. Jagger spends most days alone, sitting on the mattress on the floor. His mother goes to bed most nights wondering if she’ll see her son in the morning. Jagger has been hospitalized nine times in the last five years for suicidal ideations. He’s tried different medications, therapy and a slew of counselors. But in a state that, like others, is facing a severe staffing shortage of service providers, the Reeps aren’t sure where else to turn.

“I’m watching him die a slow painful death here,” said Melissa.

Struggles emerge

When Jagger was in school, the different avenues of support were clearly laid out for kids like him who had autism. He was diagnosed in kindergarten and he received support right through high school graduation. Melissa knew she could check in with teachers and counselors, and she always had someone to tell her he should meet with an occupational therapist or enroll in Medicaid.

More than anything, school introduced Jagger to the stage. He found his confidence singing and dancing. At Concord High School, he performed in different shows and danced with Concord Dance Academy.

He continued to perform as a freshman at Plymouth State. He was in a spring production of The Little Mermaid. and he made the President’s List both semesters.

But that summer, ahead of his sophomore year, he was escorted to the hospital by Concord police after his first suicide attempt. He was 19 years old.

He was sent home 10 days later with new medication and a list of providers to contact.

“It was an alphabetical list, and we just started at the top,” said Melissa.

His second attempt at suicide came shortly after, followed by a stay at the New Hampshire State Hospital.

That was two years ago. Navigating the complex system of adult behavioral health support in the state is a fraught, isolating experience, said Melissa. With little directions or communication between providers, she’s trying to piece together services for her son – each with their own screenings, wait lists and complications.

Mental health and support for people with developmental disabilities is already a taboo topic, she feels. But she hopes public conversation about Jagger’s experience could change the inadequacies he’s faced. But in the interim, with a critical shortage of employees stemming from the pandemic, getting Jagger the consistent help he needs has been a near-impossible task.

In need of help

When Jagger was first discharged from New Hampshire State Hospital, his mom called Riverbend, a community mental health center in Concord, in hopes of starting cognitive therapy and other services, like the state hospital had suggested.

Instead, she was told they had a six-month waitlist.

In the interim, she was calling emergency services twice a week, sometimes three times. Concord police often showed up to her house, calming Jagger down or escorting him to the hospital.

He still turns destructive in fits of rage, said Melissa. Jagger acknowledges that as well.

“A lot of my anger at throwing things on the walls and stuff can just scare people when I know I wouldn’t hurt anybody,” he said. “It just feels as though everyone thinks I’m out to harm them. I just feel like I’m always the villain. I’m always a bad person.”

Eventually, he began to see a counselor at Riverbend and he moved into his own apartment. Slowly his support team was built – he had his counselor and a case manager, and a weekly delivery of medication was set up.

But even then services were limited, said Melissa. He’d meet with the counselor for an hour a week, then the case manager for an additional hour. That hasn’t been enough.

“He desperately needs daily check-ins, which is where we thought Community Bridges would fill in that gap,” she said. “There would be somebody there the rest of the days to take him shopping, help him maybe find a job someday, help him to organize his apartment and clean, and keep him on task.”

Community Bridges is one of 10 area agencies in the state that provides support for people with developmental disabilities, like autism.

Jagger qualified for services at Community Bridges a year and a half ago, and his mom hoped that the agency could provide weekly hours of “community support services” – where they come to the homes of people who live independently and help with daily tasks.

But 18 months later, he has yet to start this program.

A slim workforce

As a result of the pandemic and an aging workforce, the nonprofit is faced with a stark staffing shortage, leaving many on a waitlist for services.

At Community Bridges, there were 53 open positions out of 160 at the end of February – meaning one-third of jobs are vacant, according to Ann Potoczak, the executive director.

“I feel as though we had an opportunity for everyone to help me, and we just didn’t have enough staff,” said Jagger. “We still don’t.”

And at community mental health centers across the state, staffing shortages are also making it more challenging to meet demands.

In February, there were 383 vacant positions across the behavioral health association workforce, which is comprised of 10 agencies. When full, there are almost 3,000 staff members. Of these vacancies as well, 334 positions were working day-to-day with patients.

With legislators working through the upcoming state budget, the New Hampshire Community Behavioral Health Association is calling on lawmakers to increase funding for mental health centers to address the workforce shortage.

And with a scaled-back workforce, services are also impacted. Riverbend paused group therapy with the pandemic in 2020. Jagger has yet to see the service return since.

“Groups ending is so sad,” he said. “You would think it would be a COVID problem. But it’s not. It’s now a staffing problem.”

And over the last year, he’s also changed counselors unexpectedly.

“He had a counselor for two years that he developed a relationship with. Nobody told him, ‘Your counselor that you develop your relationship with is no longer with us. We’re working on finding a new one,’ ” said Melissa. “Nothing.”

Some weeks now he meets with a new therapist at consistent times. Other times, he can go weeks between appointments.

“He recently went three weeks with nothing, and I didn’t get a phone call,” she said. “He’s been basically there for a year and a half living in that apartment with no support.”

Few options remain

Melissa knows the help her son needs in an ideal world would be to live in a residential program. She envisions a service where he has support from counselors and other residents. He’d have a schedule for meals and medication, but he wouldn’t feel trapped, either.

“He really needs a set of eyes on him all the time … to make sure he takes his meds, to make sure he’s eating. He needs somebody there; he doesn’t really need to be locked up,” she said. “He needs to be able to come and go as he pleases. He needs a place where there’s a shelter and a person.”

But in the interim, Melissa feels like she’s running out of options.

“We’ve tried pills; we’ve tried hospitals. I sent him to Utah for nine weeks for outdoor therapy,” she said. “We’ve tried all the non-invasive things.”

She recently filed for guardianship for Jagger, which was a move she didn’t want to have to make. But since he is 23 years-old, he falls in a gray area of care. He’s an adult in the eyes of service providers. But when his mother is constantly worried about whether or not he’s alive, she doesn’t feel he’s capable of making his own medical decisions.

“I wake up in the morning and first thing I do is look for your text messages,” Melissa said to Jagger while sitting next to him during a recent interview. “I go to bed at night and I lay in bed wondering, ‘Will I wake up in the morning and have you still be alive or will you be in the hospital?’ Every morning. I’m watching you die a slow death. I don’t know how else to say that.”

And for Jagger, consistent counseling and support could mean he could reconnect with friends or even find his way back to the stage. But for now, he is isolated in his apartment, where he doesn’t even let his mother in, due to the catastrophic mess.

“I sit and ruminate all day about the same issues,” he said. “It just doesn’t seem like anybody has the answers yet to mental health.”

If you need help

National Suicide Prevention Lifeline: Call 1-800-273-TALK (8255) for free and confidential support for people in distress, prevention and crisis resources for you or your loved ones and best practices for professionals.

Veterans: Veterans and their loved ones can call 1-800-273-8255 and press 1, chat online or send a text message to 838255 to receive confidential support 24 hours a day, 365 days a year. Support for deaf and hard-of-hearing individuals is available.

Crisis Text Line: Free, 24/7 support for those in crisis. Text 741741 from anywhere in the U.S. to text with a trained crisis counselor.

Trans Lifeline: Call 1-877-565-8860 for a hotline staffed by transgender people for transgender people. Trans Lifeline volunteers are ready to respond to whatever support needs community members might have.

Disaster Distress Helpline: Call 1-800-985-5990 for a 24/7 national hotline dedicated to providing crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster.

The Trevor Project: A national 24-hour, toll-free confidential suicide hotline for LGBTQ youth. If you are a young person in crisis, feeling suicidal or in need of a safe and judgment-free place to talk, call 1-866-488-7386.

The LGBT National Help Center: Call 1-888-843-4564. Open to callers of all ages. Provides peer counseling, information and local resources.

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