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The Man in Rom 117 Andrey Shevelyov would rather live on the street than take antipsychotic medication. Should it be his decision to make?

By Ellen Barry


Ellen Barry spent many hours interviewing Andrey and his family and reviewed hundreds of pages of medical and court records for this article.


Alone with his mother for the first time in almost a year, Andrey Shevelyov had a question: Could he come home?


She sat beside him and stroked his head. The hotel room had a sour, rancid smell, and clothes lay mounded in a corner. His fingernails were long and curved and ridged with dirt. In jail, they cut off his hair, which had been matted and infested with lice.


Clean-shaven now, Andrey looked younger than his 31 years, like the gentle, artistic boy he had been before the psychosis took hold. “Zaichik,” his mother called him, a childhood nickname. Bunny rabbit. She pushed a strand of hair over his ear. He lay back on the bed and smiled, and a dimple appeared on his cheek.


“I like living with you also,” said Olga Mintonye, but it was not an honest answer.


Three years ago, when he stopped taking his antipsychotic medication, her son withdrew into delusions, erupting in unpredictable and menacing outbursts. Fearful of being evicted from their apartment, she and her husband, Sam, sought a no-contact order to keep Andrey away.


Since then, he had lived in a tent, wandering Vancouver, Wash., in ragged clothing and carrying machetes for protection. Twice, he had been in jail, ranting in his cell about the C.I.A. Three times, he was confined to psychiatric hospitals, where guards wrestled him down so he could be injected with antipsychotics.


Now they were together in Room 117 in a budget hotel overlooking the interstate. The county had allotted $8,400 to house him temporarily, as part of an effort by the state to divert the stream of severely mentally ill people from the criminal justice system. It was enough to keep him in the Red Lion Inn for eight weeks.


Before the money ran out, Andrey had to make a choice: Would he accept that he needed treatment, as his parents hoped, and move into a group home? Or would he go back to living in a tent? Was there another way?


These are questions challenging the whole country. As affordable apartments all but vanished in American cities, a whole tier of people with disabling mental illness were forced onto the street, where they now live in numbers large enough to disrupt civic life. Many of them are shunted into the criminal justice system, only to return to homelessness upon their release.


In an effort to interrupt this cycle, many communities are expanding involuntary treatment, a practice the country repudiated decades ago. Patient rights groups warn that forced treatment alone will never work — that in the absence of a robust social support system, it only feeds people with mental illness back into the circuit of catch-and-release. Better to persuade them to accept treatment.


So, in this precious window of time, Olga would try.


“What’s next?” she asked her son.


She had offered him clothes, a hot meal, books to read, but he didn’t want those things. All he wanted was to sleep on her couch for a little while.


“I won’t get in the way,” he said, now pleading.


This was the problem, she told him: He scared people. At one point, convinced that she and Sam, his stepfather, were body doubles remote-controlled by the C.I.A., he smashed the rear window of their car with a flagpole, and they called 911.


“You sort of,” she said carefully, “have an idea that your behavior was inappropriate.”


She gulped and just said it: “Some medications do help. You have that condition, that medical condition, that has to be addressed.”


Andrey knew this was coming, and he had an answer. He did not accept the diagnosis of

schizoaffective disorder, or that his thoughts were delusions. If it was a choice between taking medication and living outside, he would choose outside.


Still, he wanted to be near her, so he looked for a compromise. “There are a lot of forested areas outside where we live,” he said. “I could set up a tent.”


“Set up a tent,” Olga repeated dully. She was standing by the ironing board, and she began to cry.


Into the woods


Up until his mid-20s, Andrey could blend in with the stoner bohemians of the Pacific Northwest.


In high school, he was a bright, if lazy, student, with a tight group of friends who were all avid gamers like him. After he graduated, Sam and Olga hoped he would go on to college for art or music, but didn’t push. They both worked as stage hands, with good union jobs, and he seemed eager to do the same.


Then things unraveled. His roommates kicked him out, and he moved to the couch in Sam and

Olga’s one-bedroom apartment in Vancouver. At work, there began to be “incidents,” odd and threatening behavior that upset his co-workers. Sam and Olga made him an appointment with a therapist.


At first, he was open to treatment, his medical records show. “I feel like I’m driving my friends away,” he told a therapist in 2018, when he was 26. “I used to be able to talk to people,” he said. “Now they’re not interested.”


In that session, he told the therapist about the family tragedy, a reservoir of pain he had walled off for years. When he was 8, he watched his twin sister, Sasha, drown in a duck pond in a neighbor’s yard. The children were alone. He had tried to save her. “I’ve thought about it to exhaustion,” he said. “I’ve incorporated her into these stories I make up.”


No one knows what causes schizoaffective disorder, the diagnosis he eventually received. For decades, scientists sought an answer in individual genes, only to conclude that hundreds, if not thousands, of genes are most likely involved, and that genes only set the stage. Other things must happen to trigger the disease; research studies implicate infections, cannabis use and childhood trauma, the kind of stress that leaves an imprint on the brain.


To his parents, there was no mystery. Sasha’s death had changed everything. “It’s obviously the trigger,” said Sam.


In journals, which his family shared, Andrey described “evil thoughts and voices” that accused him of killing his sister. “I’m guessing these voices are meant to drive me insane or kill myself or something I would never do,” he wrote. “I’m writing this to try to convince the people messing with me to stop. So, can you all stop? Pretty please.”


The therapist diagnosed him with schizotypal personality disorder and recommended

“intervention to prevent further deterioration.” But, she added in her notes, “client states he is not interested in psychiatric medication at this time.”


A few months later, Sam and Olga took him to an emergency room, and doctors sent him home with a prescription for Zyprexa, an antipsychotic.


For the next two years, Andrey took the pills, but he hated how they made him feel. This is not unusual; antipsychotic medications are deeply flawed, with side effects that are themselves disabling. They slow cognition, flatten the experience of pleasure and lower energy. They can cause ravenous hunger, leading to major weight gain.


Andrey says he stopped taking the medication because it caused erectile dysfunction. No physician determined whether this was the case, and his reasons quickly became beside the point. Things became so chaotic in the small apartment that in December 2020, Sam and Olga asked him to check into a hotel.


When the hotel kicked him out, he set up a tent in a wooded area near Pearson Field Airport, on the north bank of the Columbia River. Video journals that he recorded on his phone show him with tangled hair, surrounded by trash, rambling about underground vaults and sex traffickers. He would perform “shamanic dances” at the end of the runway, and sometimes the pilots would dip their wings at him when they took off. He seemed happy.


He was also sometimes scary. In one video, he tries to force his way into an apartment building, claiming he must rescue a porn star who is being held hostage. When residents call the police, he gets right in a male officer’s face. “Have you ever raped before?” he calls out insistently, filming the officer with his phone. “Sir, are you a rapist?”


The officer, exasperated, writes him a ticket. Still in scrubs from a recent hospitalization, Andrey wanders away, screaming, again and again, “Genocide Hindu Indians!”


‘Locked up like a rat’


Andrey had entered the circuit. In Washington State, as in most of the country, the choice of whether to accept treatment for psychosis rests substantially in the hands of the individual. A 1975 Supreme Court decision set the bar for involuntary treatment high, ruling that people who pose no danger and are “capable of surviving safely in freedom” cannot be confined to a psychiatric hospital against their will.


If a person faces serious criminal charges, however, the right to refuse treatment is almost entirely swept away, because, according to a 1960 Supreme Court decision, adjudicating a mentally incompetent person is a violation of constitutional rights. So at this point, people like Andrey can be forcibly medicated, judged and released, after which they are once again free to refuse treatment.


Andrey’s medical records chronicle this nonsensical pattern. He “feels he is being lied to and being kept against his will,” read the intake notes from his first involuntary hospitalization, which began four months after he stopped taking medication. “Why do you guys keep me locked up like a rat?” he asked his doctor on Day 5.


With the court-ordered treatment, that changed. “The patient,” the doctor wrote on Day 12, was “agreeable to Zyprexa.” He was also counting the days until his release. “It’s great here,” he told the doctor, “but I’d rather be homeless.”


Within a year, he was back in a psychiatric ward, diverted there after smashing his parents’ windshield and landing in jail. “After patient was medicated, he then spit on staff face,” wrote a nurse at Cascade Behavioral Health Hospital, where he stayed for about a month.


For a second time, he was medicated against his will and cleared for release, though discharge notes sum up his progress as “no change.” When staff offered him help finding housing, Andrey “expressed that he would like to be homeless when he discharges.” Staff obligingly dropped Andrey at a shelter, and he returned to living in a tent.


Six months later, Andrey was in jail for threatening a grocery store clerk. “Mr. Shevelyov was not wearing clothing and not consistently wearing clothing,” wrote the psychologist sent to his cell to assess his competency. “Mr. Shevelyov’s jail-issued clothing was in his toilet, which he explained was because ‘I was protesting war criminals illegally holding me.’”


Deemed incompetent, he was sent to a state psychiatric hospital. “He vehemently denies having a mental illness and adamantly refuses to take medication,” wrote the admitting doctor. This stay was more violent. Once, after grabbing a nurse’s arms, he was bound to a bed with five-point restraints, with straps around his waist, each ankle and each wrist.


After two weeks of forced medication, however, Andrey “presented as calmer,” assuring staff that his theories were just his “active imagination.” When he was discharged, his mental status was given as “W.N.L.,” which stands for “within normal limits.”


He was returned to jail to await trial. The prosecutor, eager to clear this penny-ante case, agreed to release him if he pleaded guilty to a misdemeanor. He was released and dropped off at the Red Lion, a free man.


Andrey had always been frank about his intentions. Asked by a doctor to describe his short-term plans, he said, “I am ready to leave and start my new life as a homeless dude.” Asked if he would continue taking medications, he said, “Depends if I have to.”


A portrait of Courtny Ryser Lewis sitting on an outdoor staircase of the Red Lion Inn. She has close-cut blond hair and wears a black hoodie.


Courtny Ryser Lewis stopped by to talk to Andrey about accepting treatment. “I’m trying to be honest with you,” she told him, “because I’m your best friend.”Credit...Michael Hanson for The New York Times


One afternoon, about three weeks after Andrey left jail, a woman with closely shaved blond hair knocked on the window of his room at the Red Lion.


Andrey’s friends had dropped away as he got sicker, his conversation a fire hose of paranoia and fantasy. But not Courtny Ryser Lewis — she stuck like a burr. Courtny was a free spirit, her forearms wrapped in tattoos, but she was also the earnest child of evangelical Christian missionaries.


When Sam and Olga told her Andrey was being released, Courtny offered to speak to him about accepting treatment. They had a short time to get through to him, she felt, while he still had traces of medication in his system from jail. “I’ve got the most — I don’t know if this is the right word — the most sway,” she said.


By then, Andrey had settled in. Buzzing with ideas, he had resumed recording video diaries, sometimes for hours a day. He had spent $665 on dozens of heavy-duty pencil pouches, which he was fashioning into a suit of body armor. “I’m, like, the happiest dude ever,” he said.


His parents prodded him to think about the future, reminding him that he would have to leave the hotel in a few weeks. Andrey was in no hurry. He had said no to a spot in an “adult family home,” something his case manager offered, and refused visits from a PACT team, which provides intensive services for mentally ill people living independently.


He felt he had options: If the caseworker couldn’t find an apartment that suited him, he could always pick up a tent for $40. “If I have to live outside to avoid pharmaceutical garbage,” he said, “I would do that.”


When Andrey opened the door, Courtny took it all in — the smell, his dazed look. She was so nervous that she had written down her arguments on a piece of paper.

She tried to explain how he appeared to his friends. How, after he began living in a tent, it was as if he had dropped off the face of the earth. Andrey was stung by this. His response was bitter, sarcastic.


“All I was working on was saving the world,” he said.


“You were not,” Courtny said. “What changed?”


This offended him. One of his videos had prompted the U.S. military to withdraw from

Afghanistan, he said.


“No one’s going to listen to you, Andrey,” his friend said.


“Why?”


“Because you’re not sane,” she said.


“What?” he said.


She repeated it. “You’re not sane.”


“I’m trying to be honest with you,” she added, “because I’m your best friend.”


Andrey’s response was icy. They weren’t best friends, or even friends. “We’ve never done

anything together,” he said. “There is basically not any memories there.”


Courtny saw him, for a moment, as a stranger would. She left the room midsentence, without saying goodbye.


‘It’s like a bomb went off’


Sam, Andrey’s stepfather, understood. After eight years of trying to get through to Andrey, he, too, had reached some kind of limit.


At the beginning, Sam studied motivational interviewing, a type of counseling that aims to elicit behavior change gently and gradually. He and Andrey went together to meetings of the Hearing Voices Network, a peer support network for people who experience hallucinations.


But the more he coaxed Andrey to acknowledge that he had a mental illness, the more Andrey lashed out. The stress in the household became so intolerable that Sam briefly checked himself into a psychiatric hospital.


Sometimes Sam felt he was wrestling with the disease, trying to haul Andrey back from a

remote, dark space. “It’s almost like an entity that defends itself,” he said. “It’s trying to

completely take him over.”


Kim Schneiderman, the executive director of Vancouver’s regional chapter of the National Alliance on Mental Illness, urged Sam and Olga to scale back their expectations. If a person is refusing treatment, but poses no immediate danger, she said, “there is no way to get them help at all.”


When this sinks in, “parents give up,” she said. “They just quit having any interaction with

them.” Sam and Olga would not give up, she thought, but she advised them to get some

distance so that Andrey was not at the center of their lives.


Friends had given Sam similar advice. Tom Sangrey, a close friend since middle school, said years had passed before he could say it plainly: You can’t help him if it ruins your mental health, if it ruins your marriage.


“It’s like a virus,” he said. “It affects everyone it touches. It’s like a bomb went off in the family.”


Finally, in October 2022, Sam drove back east to stay with his mother. He had not really

distanced himself; he and Olga spoke on the phone every day, sometimes for hours. He spent his days writing emails about Andrey’s situation to prosecutors, city officials, newspaper reporters, anyone he thought might help.


But he wouldn’t be going to see Andrey in that dark, cluttered room. The only person left to do that was Olga.


Housing or medication?


Sam and Olga had concluded that only involuntary treatment could break the cycle for Andrey — something open-ended, combining long-term injectable medications with intensive therapy and counseling.


They are part of a much larger ideological shift taking place, as communities grope for ways to manage ballooning homeless populations. California, one of the first states to turn away from involuntary treatment, has passed new laws expanding it. New York has made a billion-dollar investment in residential housing, psychiatric beds and wraparound services.


Sam had staked his hopes on Washington’s new involuntary treatment law, and found it

maddening that this fall, when Andrey was released, the new system was not yet active. His frustration was often directed toward civil rights advocates who oppose forced treatment.


“They have an agenda, but the agenda is not to help him,” he said. “Their agenda is to let him just be crazy. Whether that includes violence, assaults, living in degradation, living in his own filth, starving, eating moldy food. That is his right.”


One day, as he made his rounds of phone calls, Sam found himself debating Kimberly Mosolf, director of the treatment facilities program at the nonprofit organization Disability Rights Washington.


She laid out her case: Forcing someone like Andrey to take medication again would backfire, leaving him more resistant to treatment, not less.

She pointed to data from the Seattle area, which showed that almost a quarter of people compelled to take medication had been forced to do so more than three times before. Seven percent of them had been forced 10 times or more.


“We are looking at a churning effect,” she said. “These periods of brief incarceration, brief civil commitment, they are destabilizing. That is what the data tells us.”


She advised a gentler, slower way forward. If Andrey got permanent housing, with no strings attached, outreach workers could build a rapport and gradually broach the subject of medication. This approach, known in the policy world as “housing first,” has emerged as the primary strategy for addressing homelessness in American cities, allowing officials to chip away at tent encampments without encroaching on civil liberties.


This was the path that opened to Andrey.


He got the call on a chilly, gray day at the end of November. He was in his room, recording a torrent of new ideas — that his mother had been inseminated with Joseph Stalin’s sperm, that the government had planted a bomb in his brain and detonated it. The front desk called to say his caseworker had come to visit. She had great news.


The local housing authority was offering him a one-bedroom at Central Park Place, a low-income apartment building on the grounds of Vancouver’s Veterans Affairs hospital. The residents there were mostly veterans, but rooms were also set aside for people with mental illnesses. The rent was $590 a month, and could be covered by his disability check.


This placement solved several problems at once. He would no longer be at risk of freezing to death, or jamming up the courts, or frightening pedestrians. For the caseworkers, it was a rare triumph. And for Andrey, it meant that the pressure was off: He had a safe place to live that was not contingent on taking medication.


On the December morning when she arrived at the hotel to help him move, Olga was surprised to find him awake, his possessions packed away in six bags, itching to go. All that morning, he seemed like a different person — alert, motivated, funny. He charmed the manager at the apartment building, which was clean and bright, festooned with Christmas decorations.


He signed forms promising not to punch the walls, start fires, or smoke in the unit. The building manager asked him, apologetically, to indicate what should be done with his belongings “if something should happen.”


He blinked. “You mean, if I’m dead?”


She nodded. There was a small, awkward silence.


“Damn, dude!” he said, and everyone in the room cracked up.


“Bury me with my stuff!” he cried jubilantly.


They laughed again. Then the building manager, with a ceremonial flourish, presented him with a set of keys on a blue fob.


Beside the other residents, men in their 60s and 70s, Andrey seemed vigorous and charismatic, overloaded with the natural gifts of youth. His apartment was tiny but pristine, with a window looking out on a roadway drenched in sunshine. He walked his caseworker to the elevator bank and posed for a commemorative photo.


Then the door closed, and he was in the small room with his mother.


Behind the door


Cross-legged on his twin bed, Andrey began to talk. Switching on the camera on his laptop, he spoke about Nazis, George Bush, lunar men, Sandy Hook, Jeffrey Epstein, rape slaves, war crimes, lobotomies, LSD, the Yakuza, nanobots, the spirit world, underground vaults, genocide, the C.I.A.


“My plan for myself is, as fast as possible, be a world leader,” he said.


He understood that people might see him as lonely, here in this tiny room, but it wasn’t like that. “It feels like my sister’s soul is still in my body,” he said. “Like our souls fused, basically.” He felt less and less need for outside relationships. “I’m basically hunting the most dangerous men in the world,” he said. “And that isn’t the best time to have civilian friendships.”


Olga had been uneasy all day. She had seen Andrey withdraw before, disappearing into

psychosis. The windfall of the apartment, she worried, might be setting them all up for another failure — even, possibly, putting them in danger. As Andrey spoke for 15 minutes, then an hour, Olga futzed around, folding clothes and unwrapping cleaning products. Anxiety radiated off her in waves.


When she interrupted, trying to get him to focus on practical matters, he turned on her.


“Mom, listen to me,” he roared. “Stop thinking you’re in charge of me! I’m a tactical genius who saved the world!”


The outburst was loud enough to disturb his new neighbors, she warned him, but it was as if he didn’t hear her.

“OK,” Olga said. “I’m leaving now.”


“Stop talking to me, I aren’t talking to you,” he yelled. “I’m a 31-year-old man who saved the world a dozen times!”


Then he turned his attention back to the camera on his laptop. She wondered whether to say goodbye, but he seemed unaware of her presence. She slipped out the door, and he didn’t even look up.


He had been in the apartment for almost a month when the building manager spoke to Sam and Olga: Andrey was screaming during quiet hours, and some of the other men were afraid of him. When the manager knocked on the door, he didn’t answer.


It was evident, in his videos, that he was rapidly losing weight; his collarbones and cheekbones angled out. “I don’t feel hunger and I barely eat food whatsoever” is the way he put it. Sometimes, in the past, Andrey had feared his food was poisoned. So Olga stopped by, and the first thing she saw was the food she had brought him in a trash can.


“What is this?” she asked. He lunged at her, screaming. She tried to leave, and he blocked the door. She managed to get around him, and then she was in the hallway, shaking.


This marked a limit for Olga — she who had delivered his laundry, neatly folded, to his tent in the woods. On the phone with Sam, she finally made the promise: She would not visit Andrey alone again.


The two of them talked about buying a house in upstate New York, resuming their married life, leaving behind the scene of all that pain.


Andrey remained in the fortress of his apartment. Over the intercom, he answered the

questions of caseworkers and crisis response teams who had been called to the scene, but he refused their requests to enter.


If an eviction was in his future, it was weeks or months away, so he could carry on with his work, reviewing plans to arrest the leadership of the C.I.A. and oversee a war crimes tribunal. “Did you see that spirit in the background?” he asked the camera. A team of brave men was coming to join him, he said. All he had to do was wait.


One thing, though — he missed his mother. He spoke about her, his “truest love,” in his video journals that night, after he lunged at her. The message he wanted to get through was that she needed protection.


“I’m so sorry,” he said. “We weren’t there to save her. We did everything we could.”


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