Paragraph 9 reads: "Mann and Fields sought help. The diagnosis -- depression -- came as no surprise. He began taking antidepressants and receiving counseling. His family was supportive. When suicide began occupying his thoughts, it seemed St. David's Pavilion, a psychiatric hospital, offered safe harbor from the storm raging in his mind. He was voluntarily admitted July 3."

DEPRESSION SHOWS IT'S POWER , TAKES A LIFE -
Family man, friend to many is swept under tide.
Austin American-Statesman (TX)
December 1, 1996
Author: Leigh Hopper
Estimated printed pages: 5

Above a fountain in the beer garden at the Dog and Duck Pub on West 17th Street is a plaque honoring a man who, according to his friends, was something akin to the patron saint of conviviality.
Amba Mann, 60, made great fudge and danced a mean polka. He was the person who organized a Friday breakfast club, cycling trips, excursions to Europe. The retired chemical engineer was a happily married husband and the social hub for a wide circle of people. Insightful, witty, he was everyone's rock.

But early this year, something went terribly wrong.

An illness that gave no physical clue to its presence devoured him, taking his life within six months -- as swiftly as a deadly cancer.

His death is now the subject of legal proceedings and has prompted the Texas Department of Health to propose a $40,000 fine against St. David's Pavilion for violations in the state health and safety code.

Mann's story is proof that depression, which affects one in four women and about half as many men over the course of a lifetime, is an illness of incredible power. Inherited risk combined with stressful events, including the holidays, can upset the brain's chemistry in otherwise healthy, well-adjusted people.

Life changes difficult

In March 1995, Mann and his wife, Linda Fields, moved from their house on 37th Street -- the one famous for its thousands of Christmas lights -- so they could save money for a home in the Hill Country. In October 1995, Mann, a state employee for almost 20 years, left behind a second family of sorts when he retired from his job at the Texas Natural Resource Conservation Commission. On Jan. 9, his 90-year-old mother died.

``It was about a month after that I noticed -- he noticed -- things weren't right,'' Fields says.

He missed the old house, he regretted retiring, and his mother's death left him without the identity of a son. Each loss, taken alone, seemed manageable. But a ``black cloud,'' he said, drifted across his mind and stayed there.

Mann and Fields sought help. The diagnosis -- depression -- came as no surprise. He began taking antidepressants and receiving counseling. His family was supportive. When suicide began occupying his thoughts, it seemed St. David's Pavilion, a psychiatric hospital, offered safe harbor from the storm raging in his mind. He was voluntarily admitted July 3.

Despite the care he was receiving, regular visits from his wife and two grown daughters, Mann's emotional state seemed to worsen. He was keeping a journal, staying in touch with friends, but the black cloud in his mind was pushing the old Amba out.

Mann was suffering from a particularly intractable form of depression, a kind that can take some people six months to a year to overcome. A biological aberration in the brain causes severe depression, changing the way people think. Portions of the brain that have to do with hope, and the desire to live, don't work.

``They feel very guilty and they blame themselves in a way you don't see as much when people have hypertension or cancer,'' says psychiatrist Lauren Marangell, director of a mood disorders clinic at Baylor College of Medicine in Houston. ``So unfortunately, we've got about 15 percent of people with severe depression die by suicide. That rate is as high a mortality as you see with many more traditional medical illnesses. Yet most of these people are treatable.''

Mann began asking hospital staff if there was a ``widow's fund'' to help his wife when he was gone. Family members attempted to reason with him, but he would try to tell them ``the truth, '' that he would use up all their money and never get out.

Policies not followed

Mann and Fields agreed he should try electroconvulsive therapy, commonly called shock treatment, which often provides quick benefits for the severely depressed. He was placed on a suicide watch, checked every 15 minutes by a staff member. He could not shave, or even floss his teeth, without supervision.

Just before 6 a.m. July 22 as he was waiting -- unsupervised -- for his fourth treatment, he noticed something: The tiny warning light on the door's magnetic lock was glowing green instead of red.

Within seconds, he was on the street.

Within minutes, he was poised on a short barrier wall at the edge of Interstate 35 at 26th Street. Witnesses saw him in his hospital gown, arms lifted slightly from his sides.

At that hour, the lower deck of I-35 is dim and shadowy. A 28-year-old woman was cruising south on her way to work. As Mann saw her VolkswagenJetta drawing near, he jumped headfirst in front of it. There was no time for the woman to stop. Police said Mann died instantly.

The Texas Department of Health investigated the incident the next day and reported, ``The facility did not follow its own policies and procedures in regards to providing appropriate care to a suicidal patient which resulted in the patient's elopement from the facility and death.''

Extraordinary life

In other words, Mann was left alone, even though he was on suicide watch. Furthermore, staffers told the Health Department they knew theunlocked door posed a risk -- four months earlier, a mentally ill patient still wearing an opening for an intravenous tubeSt. David's Pavilion quickly corrected its security problems, the hHealth Department levied a fine, and now lawyers for the hospital and family are discussing risk, responsibility and money.

But on Oct. 25, which would have been Mann's 61st birthday, it was clear Mann's family and friends wanted to focus on the extraordinary life he led rather than the horrifying way he died.

That morning, Cindy Mann, one of his daughters, placed a cross and a spray of gardenias next to the interstate. In the afternoon, about 75 people gathered in the parking lot at the Natural Resource Conservation Commission to dedicate a small garden. Several were wearing Mann's trademark end-of-the-week attire, a red-and-white-striped shirt.

Afterward, everyone drove in a caravan to Mann's favorite watering hole, the Dog and Duck, where the plaque bearing his name was unveiled. Its inscription says:

``To absent friends in the hopes that they, wherever they may be, are drinking to us.''

Fond stories were told, pints were lifted in toasts until the sky grew dark. On the edge of the crowd, a longtime friend of Mann's said, ``If it can happen to Amba, it can happen to (any of) us.''

HELP FOR DEPRESSION

WHO

Austin/Travis County Mental Health and Mental Retardation, 447-4141.--Hotline to Help, 472-4357.--Williamson County's crisis hotline, 255-4489.

National Foundation for Depressive Illness, (800) 248-4344.

National Institute of Mental Health, (800) 421-4211.--National Depressive and Manic- Depressive Association, (800) 826- 3632.--

ON THE INTERNET

The Depression Home Page is a resource index and connection to online support groups. It was created by two third-year medical students at the University of Iowa as part of a preventive medicine project.

Reach it at: http:greed.isca.uiowa.edu/users/david-caropreso/depression.html
Caption:
Trisha Friend, lower left, leads a memorial toast as Amba Mann's family and friends raise their beer glasses at the Dog and Duck Pub, where they often met for a drink. Mann escaped from an Austin hospital and threw himself in the path of a car.

A garden was dedicated by Amba Mann's family, including his daughter, Jac quie Shivers, left, her daugh ter Katie, 9, his wife Linda Fields, Jeffrey Lake and Debo rah Mann Lake and Martin Twilla.
Caption:
Sung Park/AA-S

COLOR PHOTOS
Edition: Final
Section: News
Page: A1
Record Number: 0EA25E11677FE142