Slipping through the Cracks

The other day a woman in her forties came in for treatment for the very first time. She had avoided the voices in her head, the visions she was seeing, and the extreme paranoia that dominated her day. She hid in her house, felt the FBI was keeping close watch on her, but this didn't send her scurrying to treatment - not able to sleep at night did. Is this uncommon? Not really.

Every year I see four to five of these individuals who slip through the cracks. They can function just enough, their support system gets used to their being sick, and they live in turmoil avoiding the treatment they desperately need. So they get used to the voices and the visions. Even the paranoia is a familiar friend. This is their normal. When does their normal affect the greater society? Is when they become dangerous to themselves or others, or are gravely disabled.

"The voices are now keeping me up at night. Why can't they stop?"

Many voices tell people to do bad things, named command hallucinations. It is not unlikely for command hallucinations tell people to steal, stab, or run into oncomming traffic.

I got quite an education when I began working here eight years ago. I had learned about psychosis in graduate school. In real life there is a real person, with real feelings, compassion, and a willingness to change for the better. In putting a face on mental illness it is easy to find compassion for the person upset and yelling at an invisable person next to them.

How did this person avoid treating the malady she has endured since her teen years? Fear of the unknown perhaps. Would you take a pill from somebody at a government facility if you felt the government was plotting against you? Sad but true. Mental illness is difficult for the average person feeling "Down in the dumps". This woman was at the other end of the spectrum, so wracked with internal abuse that her time had come for change. She had reached her bottom.

For drug and alcohol abusers hitting bottom refers to getting to such a low place in life, the only way to go is back up. This is when treatment becomes successful, people get motivated to change, and positives suddenly show up in their lives.

We gave her some medication and observed her reaction to it. A small grin could be seen on her face as she left our facility. A whole new world awaited her. My prayer is she continues to react favorly to the medicine and keeps her regular appointments with the mental health facility we referred her to.