by Joseph Merlin Bowers

Last night I moderated a small family support group attended by three families. All three families have an adult seriously mentally ill child that they are trying desperately to help. One young lady suffers from extreme anxiety and depression. another young lady is psychotic, delusional and experiencing grandiosity.  A young man is also delusional experiencing grandiosity.

All three families are upper middle class, highly intelligent and successful. They have enough resources and desire so that one would think they could succeed in getting their children the help they need. The problem is that they are being stymied everywhere they turn by an extremely dysfunctional system.

The young lady experiencing anxiety and depression is in treatment and taking her medication. This has to date been only mildly effective. She is currently on leave from her job which she has performed quite well for some time. She is intelligent and competent, but she is afraid to go back to work. This lady gets in a place where she doesn’t believe she can do anything on her own and just wants to lie in bed covered completely by her blankets.

She has attempted suicide three times. Her mother believes that she wants to die. Even when seeming to have a good time, inside she wants to die. The mother believes that one day there will be a successful suicide attempt. To the mother there is no doubt that this girl is a danger to herself. Unfortunately most authorities have a very narrow definition of this. It sometimes seems like no one qualifies who isn’t holding a loaded, chocked pistol to their head or something of equal severity.

Before leaving the small town I lived in for many years in Wyoming, I was trying to get the local police forces involved in crises intervention training. Speaking with policemen I heard a number of stories similar to the one where a woman told the responding officer that she hadn’t committed suicide only because she had failed to find the bullets to her gun. Taken to the state mental hospital, she was released in less than twenty-four hours.

The young man experiencing grandiosity doesn’t believe he needs help. Already a felon because of his mental illness, he is in danger of being found violating his parole. Sadly going back to jail might be the best thing that could happen to him.

The lady experiencing grandiosity has been delusional for a very long time now. All the authorities know this to be true. She has been arrested and at least once put in the state hospital and stabilized. After her release she soon decided she didn’t need the meds and again became delusional. There was no support system. She wasn’t living with her parents. If she had been they wouldn’t have known what med she was supposed to take, how much or when her therapy appointments were. How is a care giver of an adult with mental illness supposed to provide adequate care?

As far as I can tell, the only people who get supported after release are those who have committed a serious crime, been found not guilty by reason of insanity and committed to the state hospital. Under these circumstances they get excellence treatment usually and great support upon release.

The girl is currently in jail waiting for a hospital bed to open up. The hospital is under tremendous pressure to open up beds because there are no where near enough beds to meet the need. When this girl is admitted, if she doesn’t have an NGRI she will be kept barely long enough to stabilize and turned out with no support system in place. AOT often requires a lot of work and commitment. Sadly her father fears that she has been psychotic for so long that she may be beyond help.

He has taken to telling people that only after there has been a blood sacrifice are the necessary steps taken with the seriously mentally ill. I have to wonder if he is right. Has it really come to that?