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Mental health court helps save a troubled talent from the street

A talented young violinist's descent into mental illness and crime is checked by generosity and San Francisco's Behavioral Health Court. Now Kim Knoble is playing again.

October 13, 2013|By Lee Romney
  • A promising musician, Kim Knoble nearly hit bottom after mental illness, homelessness and a felony charge. Now she's playing again, with help from family and San Francisco's Behavioral Health Court.
A promising musician, Kim Knoble nearly hit bottom after mental illness,… (David Butow / For The Times )

SAN FRANCISCO — Kim Knoble's past tracks an arc of promise, mental illness and descent into what her parents call "living hell." But Knoble is not homeless, in prison or dead — outcomes common with stories like hers.

Instead, on Wednesday, the woman with a head of wild red curls plans to walk into the St. Francis Yacht Club, tell her tale of recovery and lift the instrument she did not touch for a decade to play Massenet's "Meditation From Thais."

Now 31, Knoble was mastering Mozart violin concertos by the time she hit middle school. As a high school senior, she played with the San Francisco Symphony Youth Orchestra — while doubling as concertmaster of its Marin counterpart.

Then, on a music scholarship at UC Irvine, her brain began to change.

She thought the FBI had tapped her phone, that Hollywood producers were sending her messages. She started using drugs. Years of difficulty followed: Hospitalization. Rehab. Relapse. Tough love. And homelessness.

What brought Knoble redemption was the crime she would commit. Agitated and off her medication two years ago, she pushed a 75-year-old man down the stairs of a city bus. He was injured. She was arrested.

But Knoble was fortunate. She was accepted into San Francisco's Behavioral Health Court, which in lieu of incarceration offers comprehensive treatment, housing, vocational services and more under the supervision of a Superior Court judge.

That judge — Garrett L. Wong — will be among those cheering Knoble at the court's 10th anniversary celebration Wednesday. Introducing her will be David Chiu, president of the San Francisco Board of Supervisors and a violinist who was among a chain of community members who helped place the instrument in Knoble's hands a year ago.

"It felt," she said, "like I had my soul back."

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Knoble's family moved to Marin County's Mill Valley when she was 3. With her older sister, she spent hours at San Francisco's Fisherman's Wharf while their father, photographer Dickran Knoble, and mother, Elaine, sold their art.

Her parents soon split, and her mom married Michael Tugendman, a jeweler who brought lively political discussion to the home. Knoble picked up a violin in fifth grade and took to it instantly. By high school, with $2,000 saved from baby-sitting, she bought a treasured instrument from world-renowned violin maker Roland Feller.

Though her grades were not stellar, she won a full music scholarship to UC Irvine. "She was so musical," professor Haroutune Bedelian said. "Music was part of her."

But by her sophomore year, Knoble was drinking, taking drugs and entering a realm of psychosis.

"She called me one day and said, 'When I fell as a kid and hurt myself, where did I hurt myself?'" Elaine Tugendman recalled.

"Your leg," her mother answered, baffled, and Knoble retorted, "No. It was my head, and you're not my mother."

After she attempted suicide, the family brought her home. It was, Knoble said, "when the beginning started — of everything."

During a monthlong hospitalization, Knoble was diagnosed with severe bipolar disorder. She took up with gang members and began using amphetamines. She was on and off her meds, in and out of rehab.

Once, after she followed a boyfriend to San Francisco, she called home and vowed to kill herself, believing "everyone" had eyes on her. When her parents alerted a city mental health team, Knoble cut her parents off.

She landed on the streets of San Francisco's Tenderloin for a year. The family filed missing persons reports, but when Knoble was located, she often rejected their overtures. Her social worker at Citywide Case Management searched too.

An exhausted Knoble finally begged her mother to help her get a hotel room and they made a deal: Knoble's Social Security checks would go to her mother. Each time she showed up at Citywide to take her medication, she'd get $10. It seemed to work.

But two years ago, Knoble felt so good she stopped the meds. Within three days, her thoughts were racing, paranoia rising. Four days later, on a crowded bus, a man elbowed her as he headed for the exit. She pushed. He fell out the open door and cracked his head.

She was charged with felony elder abuse and was looking at prison time when her public defender mentioned Behavioral Health Court.

To qualify, a participant's mental illness must be severe and the crime linked to it. The commitment to accepting treatment is key. Knoble's victim did not object. She would get help and, if she stuck with it, keep her freedom.

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There are an estimated 44 mental health courts in California, and the Judicial Council's Administrative Office of the Courts has encouraged each county to adopt the model.

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