When Psychosis is a Medical Emergency, Why Do We Keep Waiting for Tragedy?

By NSSC Executive Director Ann Corcoran

With the recent tragedy involving Rob and Michelle Reiner, families like ours have been re-traumatized yet again. Across the country, we hear the same questions after these devastating events: How could this have happened? How do we prevent it from happening again?

And then, as time passes, the questions fade. The headlines move on. The urgency disappears. The laws remain unchanged.

Instead of early intervention, we wait for tragedy.

As Executive Director of the National Shattering Silence Coalition, a volunteer-led organization of caregivers, peers, and professionals working together to improve outcomes for people living with serious mental illness and their families, I can say this with certainty. Whether the tragedy involves a public figure or a family no one has ever heard of, we do not forget. Families like ours live with the consequences of untreated serious mental illness every day.

Many caregivers live in constant fear in a society that fundamentally does not understand psychosis or the fact that it is a medical emergency requiring timely treatment.

Recently, one of our members reached out in fear. Her son, a military veteran now diagnosed with schizophrenia, has been calling her and threatening to kill her. All of his delusions center on his mother. The fear has forced her to move multiple times and now live at an undisclosed address. Yet her son claims he has found her—and that he is coming to kill her.

What choice does she have?

She can call the police, knowing her son may be arrested and charged for making serious threats. But she also knows jail will not treat a no-fault brain illness. The only other option is to wait until he meets dangerousness criteria for involuntary commitment—often meaning she must wait until harm is imminent or has already occurred.

Neither option protects families. Neither option prioritizes treatment.

So she lives jumpy, hypervigilant, always looking over her shoulder. Fear becomes the norm again. Eventually, she decides the only way to breathe is to leave the state for a period of time—not because the danger has passed, but because the system has failed her.

This is the reality for far too many families.

Psychosis, by definition, means a person has lost touch with reality. Delusions and hallucinations are not imagined—they are experienced as real. It is impossible to predict when paranoia, voices, or distorted beliefs will escalate into a dangerous act. In my experience working with families who have endured acts of violence by a loved one, it is almost never because the person was violent by nature. It is because their reality was so profoundly distorted that they believed they had to act to save themselves or someone they loved.

Yet most of society does not understand this.

Law enforcement, policymakers, judges, district attorneys, correctional officers, and—far too often—even clinicians lack adequate education about psychosis and how rapidly it can escalate. Families are left navigating impossible choices while living in fear, shame, and isolation.

Safety plans are critical for caregivers of loved ones with psychosis, yet families are rarely educated about what psychosis means or how profoundly it impacts family dynamics. Instead, they are told to wait. Wait until things get worse. Wait until someone gets hurt. Wait until tragedy forces action.

This is not compassionate. It is not humane. And it is not prevention.

If we are serious about stopping these tragedies, we must stop treating psychosis as a behavioral issue or a criminal justice problem and start treating it as the medical emergency it is. That means laws that allow for earlier intervention, education for professionals across systems, and real support for families before fear becomes their daily reality.

The question is not how could this have happened. Families already know the answer.
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The real question is whether we are willing to act before the next tragedy forces us to ask it again.