Her Story Made the Wall Street Journal — She’s Still in Psychosis

Our daughter E will be 35 in October. A talented chef and artist, she possesses a huge heart for helping others. She is a wise, old soul—if you embrace such dispositions. She has thrived on her own, with support from her network and care providers. She studied Art Therapy and Holistic Therapies—with a curiosity and understanding of the mind/body connection, epigenetics, and van der Kolk’s work on trauma—The Body Keeps the Score. Incarcerated at the county jail since August 2022 with a brief detour of homelessness after being released on a clerical error. She was re-arrested for failure to appear, taken to a local hospital, and returned to jail in August 2022.

In May 2024, E charges were dropped and a bed was available at a state psychiatric facility. At the last minute, the facility refused entry. The explanation I received from the MH lead at the county jail was that she was awaiting a forensic bed for her 9th competency restoration round at another state hospital. She ended up in a private psychiatric hospital, where they tried to release her without supports to a homeless shelter after 2 weeks.

E was eventually transferred in a state psychiatric facility Mid-August and has recently been moved to the “discharge unit.” We have no idea what or where social workers are planning for her discharge. Without a release of information, staff will not share anything with us.

Our most recent journey begins in April, 2021, when an ex-boyfriend on probation began smoking meth with E. Actually, I think the stress, and disconnection we all felt during the disruption and isolation of the COVID quarantine affected all of us deeply, and especially those already struggling. Within weeks, she was failing several college classes. In May 2021, I returned home after a warning call from my partner; E was yelling at a glass of water on the floor. I tried to talk with her and called the local crisis response team, whose website states response as soon as possible. An officer returned my call 24 hours later. If there is a way to be realistic your communication about response times—that would be helpful to parents. By then, E had hopped in her car, left home, approached an officer on foot in a a nearby city alley claiming pursuit by the “galactic core” arrested (DUI), hospitalized “stabilized,” and transported to jail. (At the hospital—I know the mental health social worker, the MH social worker, by name—recite the back-story to her, and beg her to put E on an M1 hold. We both know she is will be back.) Within a month, E (now living with a friend in another city) received a DWAI after blacking out on fentanyl, hitting another car at a busy another city intersection—deeply shaken as she knew pedestrians could been injured. Again, hospitalized and released. 2 days later, EMTs were called to revive her after her friend found her listless his apartment, with blue lips and fingers. Also Fentanyl.

Our advocacy group has discussed an acuity scale for serious mental illness or SMI. In our home we have DEFCON. E starts devolving (decompensating) and the countdown begins. At times, she’s been feeling good and meddles with her medication. Other times, the inability to refill a prescription means reduced dosage until depletion. There is a sweet spot in which she seeks refill. Without meds, psychosis enters within days—delusions return; her life-saving anti-psychotic medication forgotten. We can always see and feel the crisis coming: at best, it’s a trip to the ER for extreme anxiety; at worst, another arrest, additional charges, incarceration, and/or institutionalization.

From April 2021 to April 2022 E spent 106 days in the ER, hospitals, jail, detox, the crisis center, homeless shelters, respite care, the TRT program, a private psychiatric hospital, another hospital, or another facility. On many occasions, further victimized by the trap of early release while still unstable—because of the IMD limitations of coverage—resulting in numerous encounters with law enforcement. E was in a private psychiatric hospital during a major wildfire; patients watched as flames approached the property and the various gas/oxygen storage tanks. Some were evacuated to another hospital, eventually ending up at another facility. Released from another facility during January 2022 inclement weather, clothed only in disposable scrubs with no undergarments, E was dropped at a bus stop at 7 a.m. by a custodian. There was no shelter. The bus for the long distance trip never arrived. I left a message for my supervisor and drove across the state to retrieve my unstable, confused, and vulnerable daughter. People had stopped to share clothing or allow her to use their phone. Wrapped in a blanket covered in dog hair from someone’s back seat and a hodgepodge of shirts, a sweater, and a hat, E darted through a busy intersection to dive into my car.

How could any facility release a vulnerable person in this manner?

Late June 2021, E was taken to a general hospital after running down a busy street in the city in her socks, flagging cars. Her psychiatrist paused medication when detoxing E at a crisis center and neglected to reinstate it before entry into a transitional residential treatment program in another city. On release from the hospital, a three-day waiting period — sometimes referred to as a “falling off the wagon” period — was imposed. The looming 4th of July weekend and Monday holiday turned 3 days into 11 before re-admittance. E spent 2 nights at a shelter before scrambling through a high window in our living room. This was the third time in a month she had gotten into our home by forcing open a window. Nothing had been taken or damaged, but this time, she refused to leave, and we called the police. Officers were able to transport her to a shelter. Attempting legal action to force residency in our home, I sought a protection order in August. We also custom fit blocks of wood in all of our windows so they could not be forced open.

Failing to appear for charges of DUI and DWAI, E turned herself in during September 2021, served 10 days in jail; and was sentenced to 2 years probation, UAs, and the a court program. We engaged the a voluntary program to facilitate transportation, scheduling, and possible housing. E remained non-compliant with UAs and PACE attendance. There was no accountability. I spoke with her Probation Officer about imposing consequences and was asked, “What do you want me to do?” “Your job!” I replied. Responding to E’s condo numerous times for disturbing the peace and a known “high-utilizer,” or high flyer, police eventually don’t even bother talking with her—watching from a distance and leaving. Her roommate and landlord noted passersby dropping off jackets off for her on cold winter nights. He couldn’t understand why the officers did not engage. This inaction and lack of communication only served to reinforce her mystic powers as a goddess and healer. She believed the police could no longer see her, and she was above their jurisdiction. She collected 3 more arrests for drug charges, and trespassing at a grocery store—testing positive for a trifecta cocktail of LSD, ketamine, and meth. I don’t know how this happens for someone on probation. Isn’t there a protocol?

The next 10 months were filled with and fueled by chaos—ER visits, multiple hospitalizations, car impounds, arrests, drug use, homelessness, numerous failed living arrangements, phone calls to come rescue her from one place or another—including a rescue from interviewing with Sister Wives of the Mormons.

At every opportunity for intervention—the system failed E. More charges were accrued, more untreated psychosis permitted, more harm accumulated.

In July 2022 E was unlawfully evicted from her condo; victim services paid for a motel room until early August.

I was with E July 2022 when she attempted to refill her prescription for anti-psychotics at Mental Health Partners in a nearby city. She was denied service, released from care for missed appointments. The next reinstatement interview was August. E was not informed of her rights as a Medicaid patient to an appointment within 7 days. She did not know to ask for a supervisor, or to call her Regional Accountability Entity for support. Her case manager refused to speak with me—claiming a revoked ROI. In calls to her primary care provider, and her behavioral health provider, E calmly explained her circumstances and was denied service. She and I both sit stunned with the knowledge that without intervention, within days she will be psychotic and homeless.

My partner and I left for a planned trip early August. E was pursuing a sober living vacancy at a sober living program. At the airport for our return flight home, my partner received a call stating his truck was blocking the road heading the wrong direction on a one-way street in our neighborhood. I called the police who went to our home and cleared the site. We met officers upon our return and noticed tools, electronics, jewelry, and cameras were taken. The disturbed drawers and cabinets, along with the heavy tools and tanks removed suggest both E and her boyfriend were involved. My truck was also missing.

Deputies recovered the truck, some tools, and belongings at a motel. E was arrested on probable cause August. The boyfriend denied access to the motel room and walked out later in the day. He was arrested in September, sentenced in March and released into the a community reentry program after time served. Per statute, restitution must be joint and several or not at all. This hardly seems fair. He’s in the community and she’s still in jail. It’s not a crime to be mentally ill, but our system treats individuals with SMI as if it were.

Looking back, the bf spent six months in jail with more severe charges than E. She spent 22 months in jail for much lesser charges—due to the raising of competency. The majority of the time in psychosis—being in isolation at least once a week for over a year. While the state grants her SSI acknowledging she has one of the approved psychiatrist disabilities—they claim no responsibility for keeping her out of psychosis and allowing her gray matter to further deteriorate.

I contacted the jail with information on E’s known medications and dosages, and asked the team to request medical and psychiatric appointments. An automatic protection order prevented them from speaking with me. E refused the offered medication. This is common and expected with schizophrenia. That sweet spot was far behind us.

In September, the county jail, E was not wearing clothes, refusing to shower, screaming and yelling all day. She had not eaten for days and had been in isolation. A PR bond was issued to send her to a crisis stabilization center on an M1 hold.

E called the first part of October wanting me to come get her. I called the facility to alert them she was trying to leave. They could not confirm or deny she was there. She returned to jail almost immediately afterward. I called the MH team for information. A MH staff member suggested I contact a state representative. I was doubtful but sent an email. A state representative called me that evening, and I briefly shared her story, and asked if she could forward my email. The representative invited me to the weekly statewide SMI advocacy group’s weekly Zoom.

E returned to the facility. She called mid October wanting her boyfriend’s number to share news of her pregnancy. Yes, pregnancy. Still in mid-October she was returned to jail and found incompetent to proceed and restoration ordered for the October 17.

A jail trustee told the boyfriend's mother about the pregnancy in October. A day later, a covert virtual meeting was arranged between E, the boyfriend, and their attorneys. They agreed to terminate the pregnancy. I am in shock. How can a trustee violate this degree of privacy? Why can’t I talk with my daughter? If you are incompetent to proceed, how can you make the decision to terminate a pregnancy?

The procedure occurred in November at 12.5 weeks gestation. E named her Alyssa. I received a gut-wrenching letter from E describing her pregnant mom body and the trauma of excessive bleeding.

In December, nearly 4 months after her arrest, the protection order was amended, allowing communication. E was found incompetent a second time.

Letters received from E in January and February revealed that E was being coached to answer competency evaluation questions and working with housing coordinators to find a sober living vacancy under the auspices of continuing restoration in the community. She’s become more entrenched in her multi-dimensional, intergalactic delusions in which she is Gerbrudesh, Queen of Cassiopeia or a High Priestess working on Venturi to heal the universe. I am grateful her delusions are pleasant and empowering. It could be worse. She complains about her sleep, the food, and inability to go outside no more than twice a month. A Court Liaison was assigned to coordinate services.

In February, a conversation with the Clinical Care Coordinator at the community mental health provider revealed that the ROI claimed to have been revoked was actually in place - the case manager either did not check records, or decided she didn’t want to deal with me. I eventually filed a complaint, and the case-worker was let go about 6 weeks later. Did I have impact on this outcome? I hope so…

In March, E is found incompetent to proceed a third time. In March the a national newspaper contacted me to share our journey on competency wait times. During March, April and May, E quit writing letters. On rare virtual visits at the jail, her conversation is steeped in fantasy with no bearing in the real world. I am alarmed with her decompensation. Moved from general population to a more restricted area, she appears unwell and most of her time is spent sleeping with the blanket pulled over her head - her coping mechanism to shut out the world. The MH team is also watching her become increasingly debilitated.

In May, E talks of being transferred soon to a spa or a nice resort. A palace in India with good food and gold lace curtains. Disorganized, her voice drifts off mid sentence. There is talk of transfer to the state hospital; she is moving up the waitlist as decisions are made on a weekly basis.

The WSJ story is released online in late May, as well as front page.

In June, found incompetent a fourth time, E is transported to a another state hospital. A week later, I call to introduce myself and share information. They cannot confirm or deny she is there. In June I received a call from her social worker. We schedule a video visit in which E agrees to sign an ROI for me.

I requested contact information for E’s care team. I sent emails to the social worker and ask they be passed on. She tells me E is good. I don’t understand, she is imprisoned by delusions—the Queen of the white ants. How is this good? Her behavior is good. I thought another state hospital was going to be an improvement. It is—in terms of phone access, and E can go outside and get fresh air everyday in a concrete enclosure. She has work—a stack of competency evaluation flashcards to memorize. Two months after transfer, in August connected with her doctor. He made an interesting comment; “We are programmed to receive.” the unit has little to do with individual therapies or social workers who assist with programs or placement in the community. It's all about legal competency. There are opportunities for support in a less restricted environment on campus. Without knowledge or hope of change—why would anyone try? E has been “checked out but can never leave” for months. She is a “prisoner of her own device” steeped in delusional fantasies. I find this Hotel California reference an apt descriptor. Her doctor was grateful for the detailed information I shared - much more than a paragraph from the jail. Why the delay? Another 60 days of lost time and resources in this very expensive Hotel.

Court-ordered medication treatments began in late July. E can hold conversations in the real world and believes she passed competency evaluation August. I have written to the DA, her attorney, liaison, doctor, social worker, and forensic navigator with questions about her upcoming transfer. Being incarcerated and entrenched in delusions for so long, she lacks the resilience to recover. Intensive MH treatment, trauma therapy, counseling, career placement, residential, and step-down housing is needed. Recidivism is a real threat. At every turn, new challenges emerge.

Sept 2023 - I learned that E would be going back to the county jail. Her attorney filed a motion for a second competency eval (actually her 5th). another city transport received word from the state hospital that E was to be picked up, having not received the signed court order. Transport picked her up and was then turned back to another state hospital. They were attempting a return to E’s unit to show the order to find out next steps. Her attorney writes: “The court has NOT DETERMINED that she is in fact competent and is awaiting a second evaluation before making any decisions. There is zero need to transport E while she is getting better with the medication regimen and still awaiting competency.” Transport had not left the hospital and were told there was no bed available and to remove her, that 2nd evaluations are not done here. Her provider at the state hospital had cancelled the dismissal (a bed was available), but apparently the “group” making decisions for the waitlist said another state hospital is considered “once and done.” Transportation had no choice but to return her back to jail in another city.

In the county jail E refused medication. She has decompensated, becoming more and more detached. She will no longer attend virtual visits. In December 2023 I began to push for court-ordered medication. The regional mental health coordination team held a staffing with me, and then held a staffing with the mental health team at the county jail. This lead to the eventual dismissal of charges in May of 2024. Today is April 2025. The tragic story continues.

Would the psychosis, the break-in, the hospitalizations, the arrest, the pregnancy, the ITPC, the almost 2 years in jail been avoided had E received her meds?

I don’t have a crystal ball, but harm is done and psychosis inevitable when access to life-saving antipsychotics is denied. Our story is familiar to others the system has failed. Loved ones living with serious mental illness like schizophrenia or bipolar disorder are treated recklessly and without compassion compared to others with acute illness. Stage 4 cancer patients aren’t refused a bed and given a ride to the homeless shelter. Diabetics who miss a meal or had a drink are not shamed when seeking care in the emergency room.

Our loved ones require care; not cuffs. County jails are not equipped with the tools or the authority to function as mental health treatment facilities. The data show incarcerated females are twice as likely to live with mental illness; yet a significant gender disparity exists in the number of beds allotted for evidence-based restoration programs. Warehousing a person who is ill under the guise of legal competency restoration without proper intervention to return them to health is cruel and unusual punishment. The toll in human suffering and cost to taxpayers of continuing this systemic dysfunction is staggering. I call on each of us to address the barrier within our purview to co-create an elegant alternative to homelessness or incarceration for individuals with SMI.