- Category: Crisis Response, Family Inclusion (HIPAA), Refusal Treated as Capacity
- Tag(s): Anosognosia / Lack of Insight, Co-Occurring Substance Use, Homelessness, Severe Deterioration
- Location(s): CA, San Diego
I Watched My Child Disappear — the system told me to be patient.
Six years ago, my child was a university graduate with a job, independence, and a future that felt wide open.
They were intelligent, thoughtful, and driven, the kind of young person you expect to see building a career, forming relationships, and contributing to society. Then something changed. Soon, my child lost their job. Stability followed.
At first, it was frightening and confusing. I heard them arguing with voices I couldn’t hear, screaming into their closet as if trying to escape something unseen. They paced for hours, unable to sit still, unable to rest. They stopped sleeping. They isolated in their room, trapped in a reality I could not reach.
They told me the voices were cruel. Their thoughts were terrifying.
I called for help. I attended Nami classes and groups and started educating myself.
Over and over, I called Mobile Crisis Response Teams, police, and crisis lines, trying to explain what was happening. But because there were no visible injuries — no blood anyone could point to — I was told they needed my loved one consent to intervene.
Consent — from someone gripped by fear of psychiatric hospitalization and unable to recognize their own illness.
Every day became the same: 24 hours of internal torment.
I kept calling.
During the second year of their illness, I reached a senior leader in the county’s behavioral health system. I described everything: the decline, the danger, the urgency. His advice was to call the police if my child was in danger — and to file for conservatorship.
It sounded like a solution, but I didn’t yet understand what that meant.
Later, I learned the truth: conservatorship requires a documented history of severe decline — hospitalizations, an inability to care for oneself, often homelessness.
In other words, my child had to get worse.
Much worse.
What followed were years inside a system that documented my child’s decline but did little to stop it. We entered IHOT program and later Assisted Outpatient Treatment (AOT). When my child entered the program, they were still housed and not as traumatized by their condition. There was still a chance to intervene and prevent further unnecessary trauma. But meaningful treatment never came.
Instead, I was told to be patient and told, “We go at their speed and meet them where they are.” I was called a “helicopter mom” for pushing for more help while not seeing even any tiniest progress in their condition. My attempts to escalate care, even filing CARE Court petitions, were dismissed because my child was considered “engaged” in the system.
Engaged.
While their condition worsened.
Over the next three years, at best the system tracked my child’s case while watching how their condition was escalating.
That is not treatment for serious mental illness.
During those years, my child was handcuffed by police—confused, frightened, treated as a problem instead of a person in medical crisis. They were taken to crisis facilities like CMH Rosecrans sometimes twice in one week.
Each time, after about 24 hours, they were released.
Back to the street.
Back to the same untreated condition.
Back to the same danger.
They began using alcohol just to quiet their mind enough to sleep. Over time, that turned into drug use. Eventually, they became homeless.
They were physically assaulted. Wounded. Traumatized.
At one point, they cycled through three different emergency rooms in 72 hours— only to be released each time.
Over and over again current system responded to crisis —but never prevented it or provided meaningful continuous care.
When I asked for help, I was asking for medical care. Instead, I was told to call the police. And when police had enough evidence to put them on 5150 holds, hospitals released them back onto the street.
I was left to manage something no parent is equipped to handle alone. As a result, my own life began to unravel — I lost my job as a result, as I could no longer focus on my work responsibilities.
Today they are under a conservatorship and beginning to understand what happened to them. They see the years they lost — years when their peers were building careers, relationships, families. They tell me they don’t know who they ARE anymore.
They know they need help now— real help. Trauma therapy for what they endured. Help support to rebuild their life, relationships and find purpose all over again. The person they once were still there.
With the right care, they still have a chance.
This was trauma that did not have to happen if the system had provided timely, meaningful, continuous care —if the professionals responsible for treatment had intervened instead of simply documenting her decline.
This illness, combined with a system that failed to respond, has taken so much from her. It allowed neglect to persist in the name of protecting their autonomy. The system requires individuals to “hit rock bottom” before meaningful help is offered — and for some, that wait becomes a death sentence, justified in the name of protecting individual rights. No one chooses this and no one can predict this. And no mother should be told to be patient while their child disappears.
My child deserved better.
And so do all the others still waiting..
*Each story is shared by someone impacted by untreated SMI, lightly edited for clarity, never for meaning.
THE ASK
The author’s message for legislators:
- I respectfully ask you to consider meaningful reforms to better support individuals living with serious mental illness (SMI) and the families who care for them.
- Update privacy laws, including HIPAA, to allow appropriate family involvement in care, especially in cases where individuals lack insight into their illness. Families should be treated as partners in support, not as adversaries.
- Reevaluate the current standards around refusal of treatment. After a documented diagnosis or initial hospitalization, there should be a defined period — such as one year — where timely, structured intervention is prioritized. Serious mental illness is not a temporary condition like a cold or flu; without proper treatment, it only worsens and can place individuals at significant risk.
- Reform current outdated system that too often documents decline instead of preventing it. Waiting for individuals to reach a point of crisis, trauma, or homelessness before meaningful help is provided is not acceptable care.
- Make early intervention a reality, not just a concept. Timely treatment can prevent years of suffering, reduce long-term costs, and save lives.
- Find appropriate ways families are included as part of the care team, as is done in many other countries. Families bring critical, real-world insight and are often the first to recognize changes and seek help.
- We don’t ask for more money into Mental Health – we ask meaningful implementation of laws and accountability.
- We don’t need the system that continues to be funded to document their decline. And no one is held accountable for the trauma that this neglect allows.
- These changes are essential to creating a system that is compassionate, respectful, effective, and truly responsive to the needs of those living with serious mental illness.
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