How do I help her? My family has a history of schizophrenia. I grew up with both a grandaddy and aunt who had been diagnosed with paranoid schizophrenia, so I know just what it looks like. By the time my daughter was showing symptoms she was already on the streets self medicating with meth and heroin. This is a girl who was the senior class vice president, attended poetry club and was a member of ROTC. Within six months she had dropped out of college and was living on the streets. We’ve tried to have her in rehab but she just leaves within a few days. She needs to be formally diagnosed but I don’t know how to make that happen. The police won’t even take a missing persons report because as far as their concerned she’s just another drug addict. I don’t have health insurance and neither does she. She needs the kind of help people like me cannot afford. I have heard some news about what area of town she might be in (we have not seen or heard from her in over three months) but even if I were to find her…how can I possibly help her? At this point I feel my only option is to wait until I’m informed her body has been found.
I am sorry that you are faced with this very difficult problem. Among those with schizophrenia, these types of stories are relatively common. About half of those with schizophrenia cannot recognize that they are ill due to a neurological condition called anosognosia and subsequently refuse all treatments. The unfortunate result is that they suffer tremendously. Many will never receive needed life-saving treatments.
In the United States, in order to be forcibly hospitalized, an individual has to have demonstrated that they are imminently dangerous to themselves or to others.
The majority of states will also forcibly hospitalize somebody if they are “gravely disabled.” Though definitions vary by state, an individual is “gravely disabled” if they are unable to properly care for themselves due to their illness. In the case of your daughter, if you were able to locate her you may be able to make the case that she is “gravely disabled.”
Unfortunately, even if she were involuntarily committed, she would likely only be in the hospital for a relatively short period of time. The average psychiatric hospital stay is approximately seven days. The fact that she doesn’t have health insurance might mean that a hospital is less likely to extend her stay when she no longer is a “danger to self.” Hospitals are legally obligated to treat patients who are a danger to themselves or to others but once patients no longer meet this criteria and they do not have health insurance, patients are sometimes discharged, often before they are fully psychologically stable.
The unfortunate reality in this situation is that your daughter may be beyond your help at this point. If you can’t find her, then you can’t help her. You should do everything you can within your power to help her but then realize that you can do no more.
I would encourage you to contact the National Alliance on Mental Illness (NAMI). NAMI members can relate to what you are experiencing because many of their adult children are facing a similar challenge. NAMI members can also assist you with specific ideas about how you can help your daughter. Most communities have a local NAMI chapter. Utilize their skills and knowledge to assist you in this situation.
I would also encourage you to read the book “I’m Not Sick I Don’t Need Help” by Xavier Amador. This book thoroughly explains why some people with schizophrenia have difficulty understanding that they are ill and it advises families about how to deal with this very challenging situation. It is a “must-read” for individuals who have a loved one with schizophrenia. Please don’t hesitate to write again if you have additional questions. Please take care.
Dr. Kristina Randle