I am sharing my experience because I know now that it is not unique.

For many years I lived with an untreated psychotic illness and severe lack of insight into my condition. During that time, my illness repeatedly intersected with the criminal justice system. I have been arrested, jailed, and tased during episodes of psychosis. Each time, the jails were informed that I had an underlying psychiatric condition, yet I was still processed through the jail system rather than transferred for medical care.

In several instances I remained in jail untreated until my release, at which point I sought care at a hospital. The system responded to a medical emergency with incarceration rather than treatment.

I have continued vulnerability to psychosis, but insight into the seriousness of my illness developed only recently. Lack of insight is a well-recognized feature of psychotic disorders, yet it is rarely understood by courts or systems responsible for responding to people in crisis.

Medication has helped stabilize my condition, but treatment itself can be complex. Many antipsychotic medications significantly affect dopamine systems that regulate motivation, energy, and cognition. These side effects can make adherence difficult and can complicate recovery. For many years I did not fully understand this balance, and the consequences were severe.

Another difficult reality is the legal pathway often presented to people whose illness leads to arrest. I was repeatedly advised that pursuing a Not Guilty by Reason of Insanity (NGRI) defense could result in commitment to a forensic psychiatric hospital. I was told this environment could be more destabilizing for me than the legal consequences of the charges themselves. Because of that, I never pursued NGRI and instead accepted reduced charges. Those charges remain on my criminal record and have affected my ability to obtain employment.

This creates a painful dilemma for people with severe mental illness: accept criminal penalties for actions that occurred during illness, or risk long-term commitment in a forensic system that may not provide the stability needed for recovery.

These realities are rarely discussed openly.

Today I remain medically vulnerable but stable and engaged in treatment. With the insight I have gained, I now use my voice to raise awareness about the intersection between severe mental illness and the justice system. I speak publicly, including through my professional writing and advocacy, because many people experiencing these conditions cannot speak for themselves while they are ill.

I am sharing multiple aspects of my story because they reflect systemic problems that affect many others: untreated psychosis, lack of recognition of anosognosia, incarceration instead of care, the difficult trade-offs surrounding NGRI, and the long-term consequences of criminal records for people whose actions occurred during medical crisis.

Psychosis is a medical emergency. When the system responds with jail instead of treatment, the result is not justice. It is a failure of care.

I am speaking now because these realities need to be understood if meaningful reform is ever going to occur.