The school board eventually became involved in one of the IEP meetings, resulting in arrangements that were promised but never accomplished. An IQ test later revealed that, at only five years old, he had the auditory comprehension of a child twice his age and a verbal vocabulary stronger than that of many adults. I ultimately enrolled him in an outside dyslexia program so he could learn to read, write, and spell, while the school appeared more focused on containing his behavior. At that time, his behavior primarily consisted of being loud and making noises, likely stemming from boredom and inadequate academic stimulation.

This pattern continued throughout elementary school and into middle school. Eventually, he was removed from his school and placed in a special education classroom in another city. This led to his first psychiatric hospitalization. By the age of twelve, he was effectively “sentenced” to an alternative school, which became a major turning point in his life.

​Because of his social anxiety and poor emotional regulation, he had never truly formed friendships outside of sports. At the alternative school, he began associating with other boys. One day, they walked to a nearby chain store where he stole an item costing less than twenty dollars. Feeling guilty, my son turned the item over to the school resource officer at the alternative school. Without my permission, the officer contacted the store and arranged for my son to apologize. As a result, he was placed on probation because the store enforced a zero-tolerance theft policy.

I believe it is important to note that this same “alternative” and supposedly rehabilitative school would frequently call me regarding his behavior and then leave both of us alone in the principal’s office so that I could physically discipline him. I never did. Instead, I would plead with my son to choose better ways to cope with his anger. At twelve, my son already had a juvenile record, a probation officer, court involvement, community intervention programs, therapists, psychiatrists, continual medication changes, and an ever-growing list of diagnoses. He had officially entered the justice system.

At nearly every behavioral incident, he was placed in juvenile detention — shackled and chained — for being a child who could not “sit still” in a classroom and who acted out because of inadequate interventions and support. This led to placements ranging from a wilderness program to two separate detention centers across the state. The state officials stepped in and suggested he be removed from my custody and placed in a group home. Due to no negligence of my parenting, but to the inadequacy of the system built to “help” him. I denied this request, stating that my child would remain with me. No matter how my son behaved, the hours I missed from work, or how many times I cried in the shower so nobody could hear, he was my little boy who I would always love and fight for. 

By fifteen, he stopped taking his medications and refused to attend school. He agreed to move in with his biological father to start high school, hoping that a change in environment might help. It did not. Within a few months, he was placed on probation again for allegedly “bullying” a girl after making an inappropriate but nonsexual comment. After another incident, he was once again placed in a detention home.

This particular facility, however, provided exceptional care. During his time there, he fully committed himself to his education and excelled academically. With accommodations that addressed his dyslexia, he caught up on assignments and earned credits at an impressive pace. Upon release, he was stable, hopeful, excited to attend a traditional school, and eager to play sports again. He returned to live with me in another part of the state.

However, when I attempted to enroll him in school, we learned that because the detention center was not contracted with the local school district, he was given only two options: either take an unassisted standardized exam or start over in the ninth grade. Despite all the hard work he had done, he should have been entering the eleventh grade. Faced with those choices, he decided to quit school entirely. That was when everything truly fell apart.

At sixteen, he was left without the skills necessary to enter the workforce, unable to pass a standardized test, and deeply angry that his academic achievements had effectively been disregarded. Like so many tragic and familiar stories, he fell in with the wrong crowd — older adolescents who influenced him negatively. He began smoking marijuana, staying out late, and living without direction or purpose. He was defeated.

During this time, he committed his first serious crime. He was persuaded by two others to rob a local convenience store using an airsoft gun. He walked away with only thirty-three dollars. At seventeen, he was placed in county jail, where he remained until he turned eighteen and received a sentence of twenty years, split to serve two. He was then sent to prison, where he endured experiences I cannot even begin to imagine.

He will turn twenty-seven this year. For the past decade, his life has been consumed by the vicious cycle of addiction, incarceration, homelessness, and despair. He is a devastating example of the school-to-prison pipeline.

Although my son never received a formal diagnosis, Bipolar disorder was considered because of his episodes of mania. At the time, we were told he was "too young" for a definitive diagnosis. He entered the prison system at seventeen and has not received an updated psychiatric diagnosis since he was fifteen, despite continuing to display symptoms consistent with schizoaffective disorder.

Throughout all of this, some may ask: where was I, his mother? I was there from the very beginning, fighting and begging for help for the two-year-old child who first showed signs that he needed additional support. Yet in a society where behavior, socioeconomic status, and race often determine who receives compassion and assistance, real help never came — unless it arrived in the form of shackles or another diagnosis.

My son is truly a good man. Although he is currently sitting in a jail cell, he is working hard to overcome the difficult circumstances life handed him. His road may never be easy, but I will continue to stand beside him when every other system has failed him.
No mother should have to spend decades fighting for help while watching every system around her respond with handcuffs instead of hope.

Before my mind fractured, life was simple. Aside from classic teenage angst, my daily loop was surf, school, sleep, and repeat. I had friends I loved, a good life, and a general sense of whatever happens, I’ll figure it out. Up until then, I’d been able to navigate life's obstacles and bounce back quickly. It was easy to assume things would just stay that way. There was nothing a good night with friends, a solid surf session, and maybe a little bit of bud couldn’t fix.

My brain had other plans.

By the time I turned 20, a dangerous delusion took root. I became convinced that I was simply a misunderstood genius. I told myself I hadn't reached my true potential yet, and that was the sole reason I was experiencing these psychological problems.

To a neurotypical mind, that idea doesn't hold water. But when you are dealing with budding psychosis, accepting that something is fundamentally wrong with your brain is a hard pill to swallow. My mind spun an intricate narrative about a cosmic battle between good and evil, and I was right at the forefront of it. It didn’t have to make sense to anyone else, because it made perfect sense to me.

They say there are five stages of grief, denial being the first. Living with untreated schizophrenia is a form of grief. Except, staying in that first phase of denial feels like you’ve been condemned to live in limbo for the rest of your life. You are constantly chasing a "shining alternative" just on the other side of your thoughts. Your brain tells you that if you can just clear one more obstacle, or do one more extraordinary thing, it won't be a mental illness anymore. Everyone will finally see you as the genius who changed the world.

Sounds odd, right? But I can almost guarantee that if someone reading this has survived a psychotic break, they are reading this thinking, oh yeah, that's totally normal.

When I was finally discharged, I immediately fell into the classic trap: “Hey, I’m feeling better now, why the hell do I need these meds?” It didn't register that the meds were the exact reason I felt stable.

I abandoned my treatment and spent the next two years down a dark, stressful rabbit hole. My family and I fell into a toxic routine: they would yell at me to see a doctor, I would pretend to agree, ditch the appointment, and we’d go right back to yelling. Looking back, I can't imagine how frantic and exhausting I must have been to live around.

Finally, my dad drew a hard line in the sand. He gave me a choice: take the medication, or get out on the streets.

Naturally, I thought it was a bluff. I called it.

Turns out, my dad wasn’t bluffing. It was sleep on the concrete, or take the pills. Faced with the reality of homelessness, I finally relented. I chose the meds.

Progress was slow. It took multiple trial-and-error adjustments and a few different psychiatrists before we saw real stability. Because of the threat of the streets, I kept showing up to those appointments. Finally, we found a doctor who clicked, and an antipsychotic regimen that took effect. Slowly, the cloud began to lift.

My own mind would have never noticed the difference, but the changing reactions of the people around me gave me insight. I received my formal diagnosis of schizophrenia around that time. It was another profound wave of grief. The diagnosis was the final nail in the coffin of my delusions; my days of assuming I was just a misunderstood genius were gone. I had a chronic brain disease instead.

Despite the grief, I started to dig myself out of the hole. I reached back out to old friends. My family and I stopped yelling and started healing. Still, an overarching feeling remained: I'm always going to be different. I didn't know a single soul who had schizophrenia. As far as I was concerned, anyone with my condition was either locked away in a hospital or struggling on the streets. I constantly feared I’d end up back there myself.
But I didn't.

I went back to school and finished my Associate’s Degree. Then I got accepted into a four-year university. I quit smoking weed. I felt a sense of clarity and success I hadn't known in years. There was finally a clear path forward, and all I had to do to keep it was something as simple as popping a little pill at night. If you had told me that a few years prior, I wouldn't have given you the time of day.

Life wasn't suddenly sunshine and rainbows, but I finally had control over my own mind. I joined a fraternity in college. One night, I stood up in front of a room of 50 guys and said out loud for the first time: "I have schizophrenia." That was massive for me. I laid bare my darkest secret to a room full of dudes. That community single-handedly helped cure the deep stigma I held against myself for being labeled with that word.

Of course, recovery is rarely linear. While my social anxiety was gone, an alcohol problem took its place. I started drinking heavily enough to drop out of school. I went back to working as a surf instructor, constantly worrying, how the hell am I going to support myself doing this? Then COVID hit, and like many others dealing with mental health struggles, the isolation hit hard. I sat around drinking rum smoothies at 10:00 AM because "COVID rules" meant nothing mattered.
​
The turning point came when they finally opened the beaches back up. Despite the heavy drinking, surfing still sounded better than sitting on the porch knocking them back all day. I hit the waves every single day for nine months. Through that, I realized something vital about myself: if I am motivated by something, nothing can stand in my way.

When the unemployment funds ran out, a buddy hired me for a manufacturing job at a small company. He told me if I did well, he’d move me into the sales office. That was my golden ticket. I had conquered psychosis; now it was time to conquer self-sufficiency. At that point, the thought of having schizophrenia was no longer a voice telling me, "You can't do this." So I did it. I outworked everyone, made it into the sales office, and finally had something concrete to put on a resume other than "surf instructor." I was legitimate. I ran with that opportunity faster than anything before.

Eventually, I transitioned into a corporate sales role. I’d never worked in an environment like that in my life. But I thrived. I won sales competitions, brought home awards, and became a highly valued contributor to a team. After years of believing my life could never be normal, I had built something unassailable.

Brain & Behavior Research Foundation. (2018). Homelessness and Mental Illness: A Challenge to Our Society.

Bureau of Justice Statistics (BJS). (2021). Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates (NCJ 252643). U.S. Department of Justice.

Centers for Disease Control and Prevention (CDC). (2024). National Violent Death Reporting System (NVDRS) Surveillance Summaries.

Council of State Governments (CSG) Justice Center. (2020). Mental Health Courts: A National Snapshot and Summary of Multi-Site Evaluations.

National Institute of Mental Health (NIMH). (2023). Severe Mental Illness (SMI) Prevalence and Treatment Statistics.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2023). Criminal Justice and Mental Health Systems Integration.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2024). Current Statistics on the Prevalence and Characteristics of People Experiencing Homelessness in the United States.

Treatment Advocacy Center (TAC). (2023). Homelessness and Serious Mental Illness: A National Data Brief Summary. Office of Research and Public Affairs.

U.S. Department of Housing and Urban Development (HUD). (2023). The Annual Homeless Assessment Report (AHAR) to Congress. Office of Community Planning and Development.
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World Health Organization & High-Income Countries Research Consortium. (2021). The prevalence of mental disorders among homeless people: An updated systematic review and meta-regression analysis.

Myth of Autonomy: Left Behind on the Street Corner

​I write these words not as an academic observer, but as a survivor of Bipolar I who has lived through the terrors of active psychosis. And I am going to tell you a raw, unfiltered truth that is incredibly difficult to disclose because of the crushing weight of societal stigma: My psychosis was triggered and accelerated by substance use.

Years ago, I was encountered by law enforcement while visibly psychotic, delusional, and intoxicated. Because I had not yet crossed the narrow imminent danger threshold required by our broken legal standards, the law barred those officers from intervening. The system forced them to leave me behind.

Think about the absolute absurdity of this design: we have mandated that police officers—who are not psychiatrists and are not trained in clinical diagnostics—must act as the frontline arbiters of a medical threshold. We have forced law enforcement to make complex neurobiological determinations that belong in a hospital, not on a street corner.

The state strictly demanded that we wait for a catastrophe. Because of that sanitized, legally mandated delay, I later tried to take my own life.

I survived that void through sheer, terrifying luck and the economic stamina of a middle-class family who acted as a human shield against a broken system. But survival should not be a genetic lottery. Navigating a medical crisis shouldn't demand that a family possess an elite educational background or a financial runway just to fight weaponized privacy walls.

When opponents fight structural legislative backstops like California’s SB 1016 or Massachusetts’ S.2973 (The Continuum of Care Act) under the banner of protecting civil liberties and self-determination, I am forced to demand an answer to the ultimate question: "Where is the liberty in an early grave? Where is the self-determination in a tent on Broadway or a cell in a county jail?"

To offer someone absolute "freedom" while their brain is suffering from a stage-four medical emergency isn't compassion. It is a sanitized, state-sanctioned form of abandonment. For decades, our nation has fiercely protected a Right to be Sick, while systematically ignoring the fundamental Right to be Well.

Co-Occurring Disorders: Institutional Game of Hot Potato

When co-occurring disorders surface, this broken system collapses entirely into a game of institutional passing-the-buck. It is deeply uncomfortable to admit to histories of alcohol and cannabis abuse. We live in a culture that weaponizes addiction, using it as an excuse to say, "Well, they did this to themselves." 

But breaking the silence is a non-negotiable part of the conversation if we ever want to fix our broken laws. If we don’t talk about co-occurring illness honestly, we are leaving the sickest among us behind.

Locked in the agonizing early stages of psychosis, I turned to alcohol and cannabis to quiet the noise and numb the pain. Like millions of others caught in a neurobiological crisis, I didn't know I was pouring gasoline on a biological fire.

America's psychiatric infrastructure completely refuses to treat co-occurring disorders simultaneously. We have drawn an imaginary, bureaucratic line between addiction and severe neurobiological illness. While an acute psychiatric ward will admit someone under the influence, they routinely discharge them the moment the immediate crisis drops below the legal hold threshold.

But when that individual tries to enter a substance use rehab or a detox facility to address the underlying addiction, the doors are slammed shut. Traditional rehab networks completely refuse to accept or accommodate individuals with Severe Mental Illness who are actively symptomatic or struggling with medication compliance.
​
The system shuffles vulnerable human beings back and forth like cargo between networks that refuse to coordinate, leaving the sickest among us completely stranded in the gap.

Timeline of Systemic Failure

My perspective was forged by over thirty years of navigating a system that often feels explicitly engineered to fail the individual.

• 1992 (The Ivy League Void): While a graduate student at Harvard, I reached out for help during a crisis and poured my heart out to a resident clinician at the university’s mental health clinic. I walked back to my apartment, only to receive a phone call from her stating, "I don’t think I can help you." Following a suicide attempt born directly of that clinical abandonment, I woke up under the blinding emergency room lights of a Cambridge hospital. A nurse looked down at me and said, "Lay still, you did this to yourself."
• The California Cycle: Years later, after graduating, the cycle repeated. My sister found me soaking in backyard sprinklers following a suicide attempt during a profound psychotic break. This incident occurred exactly one month after local police had refused to detain me for clinical treatment because I wasn't dangerous enough yet under the imminent danger standard.
  
  

Following these crises, I became a permanent prisoner of medical bureaucracy. I was boarded on ER gurneys for days, only to be moved by ambulance like cargo at 4:00 AM because an administrator needed the bed. I eventually learned to expertly lie to psychiatric evaluators just to escape a process that offered nothing but a glossy brochure and a discharge paper.

From the ivy-covered walls of Harvard to the sterile tiles of the ER, the message from society has been unshakeable: Wait for tragedy, then blame the victim.

Anosognosia Pipeline: Off the Edge of the Neurological Cliff

When we honor treatment refusal during active psychosis as an exercise of "autonomy," we are participating in a structural illusion. The fundamental crisis of our advocacy movement is that we introduced the word "mental" and went straight off a physical cliff.

Severe Mental Illness is not a behavioral problem, a spiritual journey, or a collection of eccentric lifestyle choices. It is a physical, no-fault biological brain disease. But because the law treats it as a "mental" issue separate from physical health, we have created a standard of law that is literally killing us.

As board-certified forensic psychiatrist and NSSC Board Member Dr. David Hager recently laid bare in Psychiatric Times, poor illness insight is a ubiquitous neurological deficit known as anosognosia. An individual with schizophrenia and anosognosia has a reduced capacity to participate in informed consent. They are neurologically unable to recognize the need for treatment, yet our civil mental health system is built on informed consent and patient autonomy—a framework that presumes the very capacity their illness has taken from them [1].

Dr. Henry A. Nasrallah, Editor-in-Chief of Current Psychiatry, establishes that anosognosia is fundamentally a disorder of consciousness—a metacognitive deficit driven by structural abnormalities and localized gray matter loss within the brain's right hemisphere and bilateral insula [2]. This is not a rare clinical anomaly; it is a pervasive, defining baseline of severe brain disorders. Multi-site epidemiological data reveals that anosognosia is present in an overwhelming 57% to 98% of patients suffering from psychiatric psychoses [2].

​Beyond my own survival, I have stood on the front lines of this crisis as a Certified Peer Support Specialist on an Assertive Community Treatment (ACT) team in San Diego. I have walked our streets and looked into the eyes of my SMI brothers and sisters rotting with their boots on. I have been the one offering a clinical hand and the physical keys to free, permanent housing—only to have those life-saving offers flatly turned away.

Why would a human being choose a freezing concrete sidewalk over a warm, safe bed?
​
It is not a lifestyle choice. It is a genuine neurological deficit in self-awareness located in the brain's right hemisphere [3]. When we grant unbridled autonomy to an individual in the depths of a psychotic break or a manic surge who lacks all insight into their condition, we are not giving them freedom. We are handing a blind person a map to a cliff and telling them it is their civil right to walk off the edge.

We would never take an individual suffering from advanced Alzheimer’s or dementia, stand them before a judge, and expect them to execute a complex social contract or accept voluntary medical care [4]. We universally recognize that their organ is failing them, and we step in with compassionate, surrogate, structure-driven decision-making.

The operational outcome of treating this neurological blindness as a mental choice is entirely predictable. Bound by voluntary, consent-based service models, the civil outpatient clinic simply closes the case file of a psychotic patient who misses an appointment and drops them from the caseload.

The system waits for blood to be shed.

An estimated 77,000 individuals with psychotic disorders are currently warehoused in American jails and prisons—nearly three times the number of individuals in state psychiatric hospitals [5]. Meanwhile, over half of our nation’s remaining state psychiatric beds are completely occupied by forensic patients because the civil safety net collapsed upstream. We have structurally mandated that a jail cell is the only waiting room left to see a doctor. 

Families are left asking the ultimate, haunting question: "Why does a loved one have to commit a felony just to get admission to a hospital?"

Checklist of Abandonment: The Injustices We Endure

When we strip away the sanitized legalese and look at the actual reality of our healthcare landscape, the current system enforces three foundational injustices against my SMI community. Like all human beings, we deserve to have this broken architecture dismantled and replaced with the unshakeable National Standard of Care our coalition champions:

Injustice 1: Linguistic Deception (Mental vs. Physical)

• The Reality: By labeling severe neurobiological brain disorders as mental issues rather than physical organ failures, the law has stepped off a dangerous cliff. This artificial division allows the state to protect a person's civil right to slowly die untreated on a public sidewalk.
• Our National Standard of Care: We must legally classify Severe Mental Illness as a physical, no-fault medical emergency. Psychosis must trigger the exact same mandatory, compassionate, and immediate diagnostic and treatment protocols given to a patient presenting with an acute stroke or advanced dementia.
  
  

Injustice 2: Autonomy Trap (Anosognosia as a Choice)

• The Reality: The civil outpatient system uses voluntary, consent-based service models for individuals who are actively blind to their own condition due to anosognosia. When a symptomatic individual fails to participate in a voluntary contract, the system simply closes their file and walks away.
• Our National Standard of Care: We must mandate clinical accountability. When an individual lacks the structural capacity to participate in informed consent, the healthcare system cannot be permitted to abandon them. The law must compel continuous, community-based clinical engagement and trauma-informed support

​Injustice 3: Forensic Waiting Room (Jails as Hospitals)

• The Reality: Because the criteria for civil medical intervention are kept impossibly high, the state has structurally mandated that a jail cell is the only waiting room left to see a doctor. We force families to watch their loved ones commit a felony before the state will grant them access to a psychiatric hospital bed.
• Our National Standard of Care: We must fund and build a proactive, community-based continuum of care that intervenes during the early, manageable stages of neurobiological deterioration, ensuring that a medical team—not a police officer or a correctional guard—is the arbiter of recovery.

This disparity reflects a deeper, more insidious cultural crime: the total erasure of our humanity. When a person’s heart begins to fail, society does not look at them and say, 'There goes a walking heart attack.' They do not define their entire moral character, their intellect, or their soul by their cardiac arrest. They see a human being fighting a failing organ, and they rush to offer medical grace.

Yet, when the failing organ is the brain, our humanity is instantly stripped away. We are no longer humans fighting an emergency; we are defined entirely by our illness. We become our diagnoses. I am not a walking case of Bipolar I. I am a policy professional, a strategist, a sister, a daughter, and a human being who survived a stage-four physical organ failure. We deserve the exact same medical grace, the exact same standard of care, and the exact same basic human dignity accorded to every other patient on this earth.

Claim Your Position: Join Our SMI Peer Alliance

Those of us who live with severe brain disorders are no longer content to have our lives debated by academic theorists or sidelined by legislative committees. True systemic transformation cannot happen about us without us. The time for passive observation is over.

My fellow peers, the most profound insights into the SMI crisis do not come from textbooks—they come from the scars of the front lines. It is time to stop screaming into the void alone. It is time to turn our ground-truth into unassailable systemic power.

The politicians are not coming to save us. The bureaucratic committees are not going to vote our suffering away. The power to shatter this Standard of Neglect belongs to us, and it begins when we stand together as one undeniable voice.

If you are living with an SMI diagnosis and you are fed up with watching our community warehoused in jail cells and left under public sidewalks, claim your position with us today. Bring your lived experience to the table, and let’s build the national movement our 22 million invisible brothers and sisters deserve. Together, we will move humanity forward.

Join us HERE.

REFERENCES AND FOOTNOTES

[1] Hager, D. (2026). Anosognosia and the Criminalization of Schizophrenia: Implications for Clinical Practice. Psychiatric Times. Available at: https://www.psychiatrictimes.com/view/anosognosia-and-the-criminalization-of-schizophrenia-implications-for-clinical-practice
[2] Nasrallah, H. A. (2022). From the Editor: Is anosognosia a delusion, a negative symptom, or a cognitive deficit? Current Psychiatry, 21(1), 7-8, 14. doi:10.12788/cp.0210; Judicial Council of California (2024-2025 CARE Act Quarterly Reports).
[3] Leach, R., Fisher, A. (2023). Anosognosia and Bipolar I: The Right Hemisphere Neurological Deficit. Treatment Advocacy Center.
[4] Medical News Today. (2024). Anosognosia: Symptoms, causes, and treatment.
[5] Fuller, D. A., et al. (2024). The Jail-to-Hospital Ratio: A National Crisis. Treatment Advocacy Center; National Alliance on Mental Illness (NAMI.org).

For months, Melissa lived on the unforgiving streets of New York City. She contacted her family only a handful of times. Despite the uncertainty and fear, her sister Maria never lost hope that Melissa could still be found and helped.

As winter approached and temperatures dropped, Maria walked the streets of midtown Manhattan searching for her sister. Each day began with the same heartbreaking routine — calling hospitals, visiting police stations, and checking with the City Medical Examiner’s Office in the desperate hope that Melissa might still be alive.

Weeks passed with no answers.

Then, on January 24, 2025, Maria made a devastating discovery. While searching the Medical Examiner’s website, she found her sister’s name listed among the unidentified and unclaimed.

Melissa had died more than a month earlier, on December 18, 2024.

Her death certificate listed the cause of death as a fentanyl overdose. But Maria believes the true cause was the systemic neglect of her sister’s untreated serious mental illness.
Melissa’s story is a heartbreaking example of what happens when people with severe brain illnesses are left without consistent treatment, support, or protection. Tragedy can occur when they are too sick to understand they need help.

Her death did not have to happen.

At the National Shattering Silence Coalition, we believe Melissa’s life matters — and that her story must be told so that others do not suffer the same fate. Treatment saves lives. Neglect costs lives.


Melissa’s death was not only a heartbreaking personal loss — it was also the result of a system that repeatedly failed to provide the treatment she needed. Allowing someone with untreated serious mental illness to cycle through hospitals, residential programs, homelessness, and emergency systems carries enormous costs. In New York City, a single year of homelessness combined with emergency medical services, hospitalizations, police response, and medical examiner investigations can easily exceed $100,000–$150,000 in taxpayer-funded services per person. Yet the cost of consistent psychiatric treatment and supportive care is often a fraction of that amount. Melissa’s story is a tragic reminder that neglect costs far more than treatment ever would — in public dollars, in shattered families, and ultimately in human lives. Her life mattered, and with proper care, her story could have ended very differently.

My daughter Christina was a bright, kind young woman—a college graduate with a degree in sociology from UC Santa Cruz. She was smart, hardworking, and had no history of violence or criminal behavior. But like many families, we did not fully understand the severity of her mental illness until it was too late.

After leaving home for college, Christina began struggling with her mental health. Two years before the tragedy, she was placed on a three-day psychiatric hold for what doctors described as “mania.” She briefly saw a psychiatrist and was prescribed medication. However, despite experiencing delusions and auditory hallucinations, she was never clearly diagnosed with schizophrenia.

In 2010, Christina moved in with her father while preparing for nursing school. She excelled at first, earning straight A’s, but soon began failing tests and struggling to sleep. She was being treated for anxiety, but her symptoms worsened. She spoke rapidly, acted frantically, and her behavior became increasingly concerning.

The night before tragedy struck, we had agreed that Christina would move to live with me in Mount Shasta, where life was quieter, and I could help support her. She planned to see her psychiatrist the next morning to adjust her medication before making the four-hour drive.

That night, Christina’s untreated psychosis spiraled out of control. She believed she was being followed, that voices from the FBI or CIA were coming through her car, and that she had to stop a catastrophic world event. In the grip of severe psychosis, she entered her father’s room intending to harm herself. Instead, responding to commanding voices she could not control, she shot and killed her father.

Christina loved her dad deeply. The tragedy was the result of untreated severe mental illness—not drugs or criminal intent.

She was arrested after being found the next day in a park in Oakland, in a severe psychotic state. After evaluation, multiple mental health professionals determined that Christina had schizophrenia. She ultimately pled guilty and was found not guilty by reason of insanity, and in 2011 she was committed to Napa State Hospital.

With proper treatment and antipsychotic medication, Christina stabilized. She spent several years receiving treatment and was released in 2016 into a conditional release program. Since leaving the hospital, Christina has made a remarkable recovery. She completed a master’s degree in clinical counseling and has worked full-time in a mental health facility for the past four years. She takes her medication consistently and continues to see a psychiatrist regularly. Christina has not experienced another psychotic episode since the tragedy. Today, she understands her illness and remains deeply committed to maintaining her stability and living a healthy, productive life.

While Christina has a second chance at life because she finally received treatment, our family was forever changed. Mental illness fractured relationships and left deep grief in its wake.

Christina’s story is a painful reminder that when severe mental illness goes untreated, the consequences can be devastating for individuals, families, and communities.

But it also shows something equally important: treatment works.

​

My daughter, D, has a nine-year history of serious mental illness beginning at the age of eighteen. Over that time, she has received several diagnoses, including schizophrenia, bipolar I disorder with episodes of psychosis, depression, and PTSD. A neurological lack of insight, not believing she’s ill, often shattered her sense of reality. This is called anosognosia and resulted in her refusal of treatment. 

When her illness is controlled, D functions at a very high level. She has completed college courses, maintained employment, built friendships, played several musical instruments, and sustained meaningful relationships with her parents and family.

However, in the month preceding D’s arrest in January 2024, she had at least seven separate encounters with police in the southwest Washington area. During this time, she was in active psychosis and displayed increasingly intrusive behavior, including stepping into traffic, loitering, refusing to leave businesses, raging, and threatening people. Police provided hotel vouchers on multiple occasions, and we also paid for hotel rooms, but D would not stay longer than one night.

During that same month, D was placed on four involuntary holds ranging from 24 to 120 hours at three different area hospitals. Each time law enforcement brought her in, I advocated strongly for a continued civil commitment order. She was repeatedly discharged. There were no civil commitments pursued during this period. We were told there were no available beds in community mental health hospitals, and Washington state psychiatric hospitals were reportedly discharging civil patients to make room for individuals waiting in jail.

D was repeatedly discharged back to homelessness — without her ID, phone, money, credit or debit cards, glasses, and without any notification to, or coordination with, family. By failing to pursue involuntary treatment while she was hospitalized, multiple organizations and facilities failed D during the critical month before her arrest.

The cycle continued: police encounter, hospital evaluation, discharge — repeat. As her psychosis deteriorated further, she became increasingly confused, frustrated, and hostile while wandering the streets.

I placed at least three calls to the DSHS mental health crisis line (Clark County Crisis Services) and was told they would not send a designated crisis responder. I was told that when the situation became bad enough, I should “just call 911.”

One night at 2:00 a.m., PSU campus security called asking if we could come pick up D, who was hiding in the student union for shelter during an incoming ice storm. We brought her home. She surrendered a small pocket knife and marijuana she had somehow acquired while on the streets. Joe went to bed, but the following morning, D was in a raging psychotic state.

On the morning of January 10, 2024, D kicked holes in the walls, vandalized our home, threatened me, and ultimately assaulted me. She grabbed my throat. I immediately forced her hands off and was not physically injured, but locked myself in the bathroom and called 911.

The responding officers explained that under domestic violence protocols, they were required to make an arrest. Because a throat grab constitutes Assault II under Washington law, D was charged with a felony.

The civil mental health system requires that a person be a clear “danger to themselves or others” before intervention. But once that threshold is crossed, the response often becomes criminal rather than medical.

I advocated for D in court, submitting a Victim Impact Statement and requesting entry into the mental health court process. D could not obtain help through the civil system. She did not deserve a felony conviction, nor did she require a “not guilty by reason of insanity” defense. She needed treatment, a new caseworker, and stability so she could return to functioning in society.

D was in such a profound state of psychosis that she could not even be arraigned. She remained in Clark County Jail for over a month before being transferred to Western State Hospital for competency restoration. After ninety days in the state psychiatric hospital, she was returned to jail.

At that point, D was beginning to emerge from the fog of psychosis. From jail, she started arranging future services. Once she secured placement in a 30-day rehabilitation program, I paid a $500 bond to secure her release on $5,000 bail.

Upon release, D was unable to obtain her prescribed medication through the state system in a timely manner. We had to use our private family health insurance to ensure she received her urgently needed medication. Then, for her to qualify for the rehabilitation program — which accepted only Medicaid — we were required to remove her from our private insurance.

After a year of delays, waivers, and continuances with her public defender, D was finally admitted into the Clark County Mental Health Court process in the summer of 2025.
As part of that program, she was required to leave her halfway house — which she described as an “un-staffed insane asylum” — and move into a sober living house. There, she was accountable to chores, urine analysis testing, sobriety meetings, medication compliance, therapy, a caseworker, and weekly court appearances.

Reflect for a moment on the immense stress endured by D, the heartbreak experienced by our family, and the extraordinary financial cost to society for repeated police responses, multiple hospital evaluations, extended jail stays, a 90-day state psychiatric hospitalization for competency restoration, public defender services, prosecution, court proceedings, and the mental health court program itself.

All of this — the trauma, the criminal record, the enormous public expense — could have been avoided with timely, responsive civil commitment and access to stabilization when she first began decompensating.

Today, through medication, sobriety, improved sleep, and structured support, D has avoided relapse into psychosis for over two years. She has a job, a boyfriend, a supportive community, and is enjoying her life. She has successfully progressed through three phases of Mental Health Court and is entering the final fourth phase. Upon completion, her felony record will be expunged, allowing her to pursue better employment opportunities.
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We are hopeful for her future.​