Health & Medicine

Did Mike Lehmkuhl have to die? How California’s mental health system failed one family

Mike Lehmkuhl crawled out from under the brush at his campsite near downtown Sacramento, where for months he had been sleeping on flattened cardboard boxes, eating scraps of fast food, hiding like a hunted animal. Standing before him was a private security officer in a crisp tan uniform.

It was shortly after 1 p.m. on a cloudy, cool Saturday in January. The security guard, Adam Kelly, had been cruising the area as part of his regular patrol of the city’s River District and pulled over near Lehmkuhl’s site. The business district paid his company to curb crime in the area, and to roust the homeless people who regularly set up camp there.

Lehmkuhl, gaunt and gray with a scraggly beard, grabbed one of the large tree branches that windstorms had scattered about the property, Kelly later told police. The security guard reached for his belt, where he carried a Taser on one side and a firearm on the other.

Lehmkuhl charged, Kelly said, so he grabbed for his Taser but tumbled backward. As Lehmkuhl swung, Kelly pulled out his gun. Seconds later, the guard was on the ground with a broken arm, and Lehmkuhl lay dying with bullet holes in his chest, left shoulder and back.

Lehmkuhl was 58 years old, a onetime churchgoer and building contractor who had been living on the streets for seven months. Like hundreds of other homeless people in Sacramento, he was mentally ill. In his case, schizophrenia had set in relatively late in life, filling his head with voices and visions his family and friends could not hear or understand.

He fought their efforts to get him into treatment, so the people who loved him turned to police, the county and courts, pleading for someone to intervene before he hurt himself or someone else. But, as has happened for so many families, he slipped away into madness all the same. And the people who tried to save him were left wracked and exhausted, beaten down by a system that sets a dauntingly high bar for holding a patient for involuntary treatment, even if his life is unraveling.

Sacramento police interviewed Kelly after the shooting, and after reviewing the evidence, recommended against charges. The District Attorney’s Office cleared the security guard of criminal culpability, concluding he had reason to believe his life was in imminent danger when he fired his gun.

The Lehmkuhls did not challenge the decision and even said they felt sad for the guard. But in the months since Mike’s death, his brother Jack and father, Ray, have wrestled with questions that will never be answered. How long was he camping by the river? Was he alone? Had he wanted to die?

And somewhere over the years, amid all their efforts with law enforcement and spiritual advisers, counselors and psychiatrists, wasn’t there something someone could have done to save him?

Seeking deliverance

He was the goofy guy, the one who would show up at a party wearing a baseball cap with a horsehair ponytail trailing down his back. The one you counted on to bring tubs of frozen treats, packed in dry ice, on group camping trips. A standout wrestler at his Bay Area high school and accomplished gymnast at Sacramento State. The kind of guy who talked to people in grocery lines and offered to pick friends up at the airport.

Courtesy of Ray Lehmkuhl
Mike Lehmkuhl’s life had spiraled out of control by the time he was shot to death, at age 58, at his homeless camp in Sacramento. Once a homeowner and building contractor, active in his church, Lehmkuhl began showing signs of schizophrenia a few years ago.

Michael Thomas Lehmkuhl was born Nov. 10, 1957, in Lafayette, the middle child of three brothers. His father, Ray, was a Bay Area building contractor, and his mother, Barbara, a homemaker. His parents divorced when he was in high school, and Mike moved to Sacramento in the 1970s to attend college. He stayed on after graduation, and followed his dad into the building trade, as did his brothers, Jack and Craig. He lost Craig, his older brother, to leukemia in 1992, and his mother to a heart attack two years later.

Mike was reckless with money, his dad thought, but managed to run a contracting business and buy a home on a quiet street near Country Club Plaza. He attended Sunday Mass at Presentation of the Blessed Virgin Mary Parish Church, and was godfather to three children of close friends. He had been in love at least once but had yet to find the right woman to marry.

Dave Leatherby, owner of the iconic Sacramento-area ice cream parlors that bear his family’s name, was a close friend since their college days. Mike “was always upbeat, always happy,” Leatherby said. Another pal, commercial real estate broker Pat Cummings, called him sanguine.

Then the voices arrived.

Five or six years ago, friends and relatives said, Mike started complaining about the whispers in his head. Demons, Mike called them. Evil spirits commanding him to hurt himself and other people. He was being spiritually tested, he said, and vowed not to give in.

People close to him weren’t sure what to make of it. Mike had always been eccentric. Was it a spiritual crisis, as he said? Was he showing signs of mental illness? Was he maybe just playing a joke?

Courtesy of Chris and Conni Levis
Mike Lehmkuhl with longtime friend Pat Cummings, left, before Mike’s illness.
Courtesy of Chris and Conni Levis
Mike Lehmkuhl, posing with the children of close friends, before he was diagnosed with a late-onset form of schizophrenia. Mike was convinced the voices he heard were demons who had come to test him, and vowed not to give in.

At first, Jack recalled, the episodes seemed to come and go. The brothers occasionally had disjointed phone conversations, when the discussion veered to demons. But, for stretches, Mike would seem his old self, drinking wine, talking real estate and joking with friends at birthday celebrations and group outings. Jack knew his brother was lonely for romance, and his business was struggling. He hoped the odd behavior would pass.

By the summer of 2011, it was clear this was more than a phase. The brothers were driving home from a family reunion when Mike, in the passenger seat, began grabbing at the sides of his head, and “emptying” his hands out the open window. “What are you doing?” Jack remembers asking, both amused and annoyed. “Getting rid of the demons!” his brother replied.

In 2012, the bizarre behavior became more frequent and open. When he visited Jack in the Bay Area, Mike would stow crucifixes behind family pictures. During dinners at the home of his good friends Conni and Chris Levis, owners of Tapa the World restaurant in midtown, he would flush the toilet over and over to “drown” the demons. The couple eventually told Mike, godfather to their oldest son, he no longer was welcome in their home, because he was scaring the children.

At one point, Mike’s father persuaded him to see a doctor, who diagnosed schizophrenia. Mike attended a few counseling sessions and started on medication that seemed to help. But the drugs fogged his brain, he said, so he quit taking them.

As the months passed, his living situation deteriorated. He stopped working and paying his bills. Leatherby and Cummings regularly stopped by with groceries and other support. They led a chorus of friends urging him to get treatment.

He was not sick, Mike would tell them all, spitting the words like venom. He was under attack and needed spiritual intervention. Jesus had promised to help, he said. But Jesus had let him down. He wanted an exorcist.

Cummings and Leatherby, like Mike, were active in the Catholic Church. In the fall of 2012, with Mike insistent that dark forces were at work, they decided to seek the services of a priest. Maybe it was a matter of the soul, they reasoned. Maybe “deliverance prayers,” to drive out evil spirits, would help. At the very least, meeting with a priest might offer comfort.

They asked a friend, the Rev. Chuck Kelly of the Sacramento Catholic Diocese, to join them at Mike’s home. During the session, Kelly told Mike that Jesus does not command people to do bad things. “Jesus doesn’t talk this way,” he said in gentle tones. He laid his hands on Mike’s head and shoulders and blessed him. He asked that God guard Mike from demons and dark powers.

“Amen,” the men said in unison.

Before he left, Kelly sprinkled holy water throughout Mike’s home to cleanse the space and ward off spirits “not of God.”

“We don’t know in these cases whether the issue is chemical, or spiritual, or psychological,” Kelly said in a recent interview. “We want to try to deal with any spirits attached to Mike that might be causing him to listen to these voices that he is attributing to Jesus.”

But in the weeks ahead, Mike’s agonies mounted. Deputies came to the door because neighbors were complaining about his nighttime rants. He lost weight and stopped shaving.

One morning in late 2012, members of his congregation arrived for Mass to find copies of a two-page letter Mike had written scattered about the building. In it, he denounced Jesus for urging him to molest a friend’s daughter, and putting images in his head of her dressed as a prostitute. He said Jesus had swindled him out of $30,000.

It was time to get Mike to a hospital, with or without his cooperation.

Imminent danger

Leatherby and Cummings conferred with Mike’s father and brother, and decided they would reach out to law enforcement. Sacramento County sheriff’s deputies had the authority to place Mike on a “5150” psychiatric hold, which could open the door to the county mental health system.

By then, Mike was no stranger to the Sheriff’s Department. According to records, deputies were called to his home at least 25 times between 2012 and 2015, responding to concerns about his welfare or complaints about his erratic behavior. But he was never detained.

Staffers from the county’s Adult Protective Services program also visited at the request of friends and neighbors, Leatherby said, but Mike ran them off.

To hold someone under California’s 5150 law, law enforcement or mental health authorities must find the person to be a physical threat to others or in imminent danger of harming himself. A man running into traffic, for example, or holding a knife to his throat, legally could be held against his will. People also can be held if they are deemed to have a grave mental disability that prevents them from obtaining food, clothing or shelter.

Mike, it seemed to his friends and family, was both a danger to himself and gravely disabled. But the law, they found, leaves plenty of room for debate.

In early 2013, Leatherby and Cummings drove to the Sheriff’s Department and made their case. They said they spoke to a sergeant, who listened to their stories about Mike’s voices and rants, his weight loss, the fact he wasn’t working and had not made house payments for more than a year.

Dave Leatherby, owner of the iconic Sacramento ice cream parlors that bear his family’s name, turned to police, the Catholic Church and the county in his efforts to get Mike Lehmkuhl into treatment. “Mike didn’t want help, and he just kept falling and falling,” Leatherby said.

The officer, they recalled, told them the department’s “hands are tied” in cases like Mike’s. In the sergeant’s estimation, Mike was not an imminent threat.

“You’ve got to be kidding me,” Cummings remembers telling the officer. “Mike is going to do something. Something is going to happen.”

But the possibility of “something happening” is simply not enough to place someone on an involuntary psychiatric hold, Sheriff’s Department spokesman Sgt. Tony Turnbull said in an interview.

Deputies encounter mentally ill people in the county on a daily basis, but they cannot detain them simply for acting strangely, Turnbull said. Last year, the department got 3,092 calls initially classified as 5150, records show. Over the course of the year, they transported about 2,000 people to hospitals or mental health facilities for evaluation.

Some cases are tough calls, Turnbull said. Officers must walk a line between protecting someone who may be mentally ill and violating his civil rights. The state’s welfare law that governs involuntary holds includes strict safeguards that emphasize due process at every step.

“It can be extremely tough to assess,” Turnbull said. “We’re not doctors. We’re not psychiatrists. We do the best we can do in the field.”

With law enforcement unwilling to step in, Mike’s family and friends decided to try another intervention. In February 2013, his father, Leatherby and Cummings went to his home on La Verne Way, which was in foreclosure.

They found the door unlocked, and inside, a chilling scene: crucifixes and religious figurines smashed across the floor. Books burned and scattered. Steak knives thrust into walls that were smeared with feces.

Mike’s water source was a garden hose. His electricity came from an extension cord to a neighbor’s house. In the backyard, a rope noose hung from a telephone pole.

Cummings and Leatherby took cellphone photos. Once authorities saw the pictures and Mike’s letter to church members, they thought, he surely would be committed for treatment.

The three men hung around until Mike returned home. When he showed up, he appeared calm, even cheerful. “Hello,” Mike said with a smile. “What are you guys doing here?”

Leatherby put a hand on Mike’s shoulder. Everyone was scared, concerned for him, he told his friend. “Come on, Mike, let’s go to the hospital,” his father said. “Look around. You need help.”

Mike was silent for what seemed a couple of minutes. Then, finally: “I guess I do need some help.” The group hustled him outside, and Mike got into Ray’s car.

Silently, father and son made their way to Sutter General Hospital.

Burden of proof

It took hours of tests, talking and paperwork. But finally it had happened. A licensed clinical social worker at Sutter General signed the paperwork required to keep Mike on an emergency psychiatric hold. He would be taken by ambulance to the Sacramento County Mental Health Treatment Center on Stockton Boulevard. If, after three days, psychiatrists believed he was still dangerously unstable, he could be held an another 14 days for treatment; if deemed unstable again, he could be held an additional 30 days after that.

Mike was admitted to the hospital on Feb. 18, 2013. His medical records, obtained by The Bee with permission from his family, describe him as mostly calm, but adamant that he did not want a long-term stay. He never admitted he was ill and refused to sign hospital paperwork. He did agree to take a low dose of Zyprexa, which is prescribed for psychotic disorders.

“The hospital brought me here for a quick evaluation,” he told a social worker upon arrival. He said he was hearing voices, and wondered “if the voices are of Christ.”

By the time Leatherby visited later in the day, Mike was desperate and seething. He said he had been tricked into hospitalization. He felt betrayed. “Dave, get me out of here,’” he pleaded. “I don’t belong in here! There are crazy people in here!”

In those first days, Mike saw nurses, social workers, psychologists and psychiatrists. They documented his recent history, including the letter he had distributed to members of his church.

“Patient says he hears voices of ‘Jesus’ telling him to harm himself,” a clinician wrote in his medical record. “Patient says that ‘Jesus’ is physically pushing at his eyes and caused great pain in his back because the patient stopped listening to ‘Jesus.’ 

“I’m just a guy with some spiritual issues,” he told them. “I’m just trying to figure out what is wrong.”

A day after his arrival, two nurses and a psychiatrist signed paperwork seeking to hold him for another 14 days. But Mike told his treatment team he wanted out. By law, he was entitled to a certification hearing, which would take place the following day.

Sacramento County holds dozens of certification hearings each month for patients fighting a recommendation for commitment. By design, such hearings put a premium on a patient’s civil rights.

Family members are discouraged from attending the hearings, but may appear as observers if the patient agrees. If they have information that might bolster the argument for further treatment, the law states, they can give it to the hospital for consideration at the hearing.

According to hospital records, Mike agreed to allow only Leatherby to be present at his hearing. Leatherby said he does not recall being notified about the session.

At the hearing, Mike would be represented by a “patient advocate,” typically a staffer from a counseling center paid by the county to fight for the client’s wishes. On the other side would be a clinician from the county facility who would present the case to hold him for intensive treatment.

The officers who preside over such hearings typically are private lawyers paid by the county. Last year, for example, the county spent about $250,000 on such legal services. The hearing officer would listen to both sides, then decide whether probable cause existed to keep Mike against his will.

Unlike formal court hearings, the sessions are not recorded, and no transcripts are kept. A one-page document summarizing the hearing officer’s decision is the only record of Mike’s session.

Mike reported to his hearing, in a conference room at the psychiatric hospital, on the afternoon of Feb. 19, 2013. He was represented by Rae Mierke, a trained counselor. At the time of Mike’s hearing, she worked for Consumers Self Help Center, which last year earned more than $417,000 as the county’s primary source for patient advocates.

The record is unclear about who argued the case for holding Mike. The hospital typically is represented by a psychiatric nurse or social worker, according to county officials. In some cases, the staffer has had no previous contact with the patient whose case is being heard, and relies strictly on the hospital’s report.

William Parklim Yee, a veteran Sacramento attorney, presided over Mike’s hearing.

Neither Yee nor Mierke, both of whom have participated in numerous certification hearings, would comment directly on Mike’s case, citing privacy concerns. But they agreed to speak in general terms about how such hearings work.

Mierke said that, based on the law, it is up to the clinician to meet the burden of proof that a patient is in danger of harming himself or others. With a patient’s freedom on the line, the advocate’s job is to present information backing up his claim that he is stable enough to be released.

Mike Lehmkuhl in a police mug shot taken after his arrest on suspicion of trespassing in March 2015, after he became homeless.

Homelessness, Mierke said, “is not in itself enough to hold someone.” Nor is hearing voices of Jesus, or delusions of grandeur. If a homeless patient says he has sturdy camping gear, a safe place to sleep and access to food, Mierke would report that information to the hearing officer, she said. “If he told me his mom is going to let him stay with her, I’d bring that to the hearing,” she added.

Mierke said advocates should make a “reasonable effort” to confirm a client’s statements about his circumstances, but they often are subject to a time crunch. By law, certification hearings must be held within four days of when they are requested. Advocates may juggle as many as a dozen cases a day, and may have only a few minutes to meet with each client prior to a hearing.

The procedure typically lasts 15 minutes to an hour.

The referee’s job during those sessions is to “impartially evaluate the information presented by the facility and the advocate,” Yee said. Court officers must make their decision based “only on what was in front of them,” he said.

“As a hearing officer, you are not there to make a diagnosis of the person in front of you. That would be frightening,” he said. “You look at the documents. You consider what brought the person to the hearing, and what is presented by the facility and the advocate.”

In his handwritten comments about the evidence presented at Mike’s hearing, Yee noted that Mike had been diagnosed with an unspecified form of psychosis, that he had no electricity or running water, had a “scattered thought process” and “mumbles and hears voices of Jesus.”

He also wrote that Mike had started on medication and reported that the voices had decreased. He noted that Mike denied being suicidal, and said he wanted to continue with outpatient treatment.

Above his notes, Yee checked a box declaring that “there is not probable cause” that the patient “is a danger to self or others or is gravely disabled.”

“The person may no longer be involuntarily detained,” the document states.

Mike was free to go.

In the discharge papers issued later that day, a counselor wrote that Mike was leaving against medical advice and “additional treatment was recommended.”

“He has a plan for safety that includes calling primary care physician, friends, contacting suicide prevention and engaging in healthy pleasures,” the counselor wrote.

The hospital record also notes a frantic call from Ray, after Mike told him he had been released.

“Who was the idiot that let him go?” Ray asked, according to the notes. “He’s not ready.”

A stranger among us

For his family and friends, Mike’s release marked a devastating turning point. Their sense of helplessness was gut-wrenching. They were angry, and tired, and out of ideas.

Mike returned to his foreclosed home on La Verne Way, and the voices that plagued him. His father, by now in his 80s, was ravaged by a mix of grief and frustration. Confounded by the system, and his son’s unwillingness to help himself, he started to let go.

Ray Lehmkuhl keeps photos of his son Mike in his home office in Lincoln. Like others who loved Mike, he was devastated when a hearing officer ordered Mike’s release from a mental hospital where he was being held for psychiatric treatment.

Leatherby and Cummings continued to check on Mike, but he no longer wanted their friendship. Jack dropped by every few weeks for a time. But the day came, about a year after the hearing, when he no longer recognized his brother.

“His hair was sticking up, his eyes were wild,” Jack said. “He looked like Charles Manson.”

In January 2015, Jack attempted another welfare check, this time with Cummings. Mike emerged with an air rifle and started firing. The pellets missed the men, but pierced the windshield of Jack’s car. They called deputies, and two squad cars screeched up. But officers did not take Mike into custody.

A couple of months later, sheriff’s deputies came to the home again, this time to evict Mike.

Increasingly dirty and thin, he took to walking the streets, suitcases in hand, sleeping in bushes and other shielded spaces near his foreclosed home. Leatherby occasionally spotted his friend near his ice cream shop on Arden Way, and would approach with offers of food and a shower. “Please give me a chance to help you,” Leatherby called out. Mike told him to go away.

Twice in the spring of 2015, Mike was arrested and charged with burglary after trying to enter residential garages. He pleaded no contest to misdemeanors, and spent a few weeks in the county jail in the summer of 2015.

After his release, Mike seemed to vanish. Jack figured he had hopped a train, or taken a bus out of town. Worn out, defeated, his brother and friends did not search for him.

“Mike didn’t want help, and he just kept falling and falling,” Leatherby said. “And no matter how hard we tried, there was nothing any of us could do about it.”

Clues in the brush

Mike spent his final months in a makeshift campsite, shrouded in brush, adjacent to the parking lot for the shuttered Rusty Duck restaurant in Sacramento’s River District, where he had worked as a waiter back in college.

“He was a good guy,” said Charles “Chuck” Rowe, a wiry man who had his own campsite nearby.

Pat Cummings, left, fought for years to get Mike Lehmkuhl into treatment, even as he watched his friend’s life unravel. After Mike’s death, he met with some of the homeless men who camped near Mike in the River District in the final months of his life.

Because Mike rarely left his camp, Rowe regularly brought him food from a nearby McDonald’s, he said. He reflected on his friend on a March afternoon, sipping a beer near the spot where Mike died.

“He was mellow, the most passive person I’ve ever met,” Rowe said. “He was my friend. Even though he was living in a bush, I could see the intelligence in him.”

The area where the two men camped, roughly bounded by the American River, the Sacramento River, Sutter’s Landing Regional Park and North C Street, is just a mile from the lofts and restaurants of downtown Sacramento. Because of its river access, and its proximity to the Loaves & Fishes homeless services complex, the area is a haven for homeless men and women, whose trash piles, fires and unstable behavior can pose a menacing presence for area property owners.

The River District contracts with Paladin Private Security to patrol the community. The company responds to calls from businesses “that need help on issues that may be lower priority for police,” said district executive director Patty Kleinknecht.

Most Paladin guards carry firearms, said company owner Matt Carroll. The guards, who are paid $12 to $18 an hour, are trained in “the art of persuasion and mediation when cooperation is not forthcoming,” Those who carry guns take at least 40 hours of firearms training, he said.

Before this year, in more than 12 years in business, only one Paladin guard had ever fired a weapon at someone, Carroll said.

Map of Mike Lehmkuhl’s camp in the River District 

On Jan. 9, Adam Kelly was on routine patrol along Bercut Drive off busy Richards Boulevard. He piloted his car toward the Rusty Duck, a hulking landmark that backs up to the cottonwoods and oaks along the American River. A Chevron station, an apartment building and a small business park operate nearby.

Rowe remembers seeing Kelly’s familiar white cruiser stop on Bercut, a few yards from Mike’s camp, that afternoon. He paid little attention, he said, until he heard the unmistakeable pop of gunfire. He counted at least five booms.

Rowe set his tallboy beer on the ground, and peered across the parking lot toward the rickety remains of the old restaurant. Mike was crumpled on the ground.

Moments later, as police cruisers converged on the area, Carroll got a call from work.

“I have to go,” he told his wife as he headed for the door. “One of my officers just shot and killed a man.”

Carroll, a former sheriff’s deputy, drove to the scene, where he saw a bloodied body on the asphalt and his security guard in the back of an ambulance. City police had cordoned off the area with yellow tape.

For the next six or seven hours, police remained at the scene, conducting interviews and marking shell casings. Carroll said he spoke with a shaken Kelly before paramedics took him to a hospital. In a separate vehicle, emergency responders hauled Mike’s body away.

By the time he left, Carroll said, he had no doubt his guard was the victim of an attempted murder. Kelly had to kill Mike, or possibly die in the line of duty, he said.

Weeks later, the district attorney came to the same conclusion, determining that Kelly had committed no crime.

Lehmkuhl “armed himself with a tree limb and attacked,” said Sacramento police spokeswoman Officer Traci Trapani. The security guard tried to use his Taser but fell backward, after which Lehmkuhl continued to charge toward him, police said.

The security guard then “drew his firearm and shot the man,” Trapani said. An autopsy showed that three bullets penetrated Mike’s body.

After the shooting, Kelly took some time off, then transferred to another patrol area. He declined an interview request for this story, but told a reporter that the afternoon he shot Mike was “the worst day of my life.”

Mike’s relatives have not challenged the police account, even though one of Kelly’s bullets landed in Mike’s back. Maybe Mike was spinning around as Kelly shot, Jack reasoned. Who knows how it went down?

A couple of months after Mike’s death, Jack and Cummings decided to visit his campsite. Jack wanted to see where his brother had died, and get some sense of his life as a drifter. He shook hands with other homeless men making do in the River District, and saw a small cross that Rowe had crafted in Mike’s memory.

Mike Lehmkuhl’s brother Jack tries to decipher notes found at his brother’s homeless campsite, in the underbrush near the shuttered restaurant where Mike once worked as a waiter.

Jack crawled into the brush, and lifted the cardboard that once protected Mike’s back from the rocky ground. He found a flannel shirt, rotting canned chicken and a pad of yellow legal paper with scribbles he recognized as his brother’s. It was marked with numbers, an address in New York and a sketch that looked something like an angel.

None of it offered much comfort, or the insight he was seeking.

“All of us were worried that something bad was going to happen to Mike unless he got help,” Jack said, walking away. “But it’s still mind-boggling that he died this way.”

Cynthia Hubert: 916-321-1082, @Cynthia_Hubert