Emergent Mental Illness/Jailed/In Crisis

A young friend of mine, female, 30, is in crisis. Currently she has been in county jail for 3 weeks. She has been ‘4011.6’ for a dozen arraignments. Last week the judge ordered a more extensive psych evaluation. The Public Defense Atty says that she must participate voluntarily in the exam. We are terrified that she will manage to come to court and the charges, which are minor, will be dismissed and she will be released and then disappear into night. She has been evicted from her housing and has no where to go.

In the late summer she exhibited some odd behaviours; made suspicious comments about ‘The Government’ making lists of people and that doing genealogy on line was risky because it wasn’t ‘safe’. At that time it just seemed odd. She also became hostile to her mother out of the blue, accusing her of toxic behaviour. Her mother asked that they see a therapist and she agreed, but then never actually would engage, and claimed that the therapist was on her mother’s ‘side’ and wouldn’t see her. Her mother asked that she choose a therapist she was comfortable with but she never did. The Gaza crisis seems to have triggered a major event for her. She just lost it, and became confrontational and aggressively hostile with friends and co workers and house mates. She began to claim she was being persecuted for being Jewish. She and her live in boyfriend has a trip to Italy in late Oct. The trip went badly. She told her mom that when she looked in the mirror she no longer saw her face. She has claimed that her boyfriend has a ‘stick’, of violent and inappropriate images of her, that he is uploading to the cloud and dark web, and has asked her father to ‘do something’ but can not actually tell him where these images are. She asked her mother to give her a star of David brooch that her grandmother had given her mother. Mom thought about it, but she was being so nasty, and seemed to be looking for a fight so she said no. She was worried she would wear it and use it to pick fights. The daughter came into their home (where she has not lived for many years) and stole the brooch while they were out. She still had keys. They changed the locks. Over the holidays she was strange and hostile to her parents, mom especially, and to long time family friends. Family, the (now x) boyfriend, friends and co workers have tried to get her to go for help but she refuses, claiming it’s not her, she’s fine, it’s everyone else against her. She has told her mom to vacate her home, as it is not “safe for her father to live with his wife” because she is “so toxic” and demanded a timeline from her mom on moving out. In January her parents came home to find the locks on their home had been changed by their daughter. The police said they couldn’t do anything. They had the locks changed to digital locks with cameras and bluetooth so if she tampers with them again they will know. That was a surreal day! Her behavior at her house was so difficult her house mates had all moved out. The landlord began eviction processes. We called mental health crisis team and they visited her. They said her behaviour was concerning but that she went inside and closed the door and they couldn’t do anything. Not a clear danger to herself and others. Three weeks ago she got into a fight with a housemate at 1am. She threw a rock from her window at the housemate out on the sidewalk and it hit a car, damaging it. The police were called and arrested her. We have been told she is not talking to anyone, not the public defense atty, the mental health jail division, the private atty her parents hired to try and help her. Her cell mate is complaining about her lack of personal hygiene. She has decided that shampoo, deodorant etc are toxic poisons and refuses to use them. We are told she is talking to herself, and pacing the cell. She has declined all visits from her parents and from me. In September when this seems to have begun she was a valued professional working as a project manager, and doing coding workshops for underprivileged girls to help them get introduced to the sciences. She was in a stable loving relationship that had been going on for over 2 years. she had housing and a car and health insurance. All that is gone in just a few short months. We are trying to learn how to navigate the judicial system that seems willing to just let her sit in a cell until she ‘decides to come to court’ and a mental health system that says 'we don’t have a diagnosis and can’t do anything without her participation. Some attys who are knowledgable have suggested that her parents begin the process for a conservatorship. We are at a loss. I was hoping that people here might have some suggestions for how to traverse this emergent path. It’s all just… heart breaking

Your friend needs to have the possibility of a physical illness ruled out as well as the psych evaluation.

The process for a conservatorship, even if its temporary, is good advice.

Find the local NAMI chapter, make a lot of phone calls, and try to find someone who is familiar with the judicial system and mental health options where your friend is located.

Letting our family members sit in jail while we hope a judge orders something besides a dismissal of charges is not unusual, keep searching for answers.


Thank you hope,
We don’t have a way of having her assessed for physical illness, but in the absence of that, and the presence of a plethora of symptoms, your confirmation of the conservatorship is appreciated. My husband is meeting this afternoon with a group of Attys who work with military vets, a population that has similar struggles and will be asking for a referral to an appropriate atty to begin the process.
Oddly there seems to be no NAMI chapter in San Francisco. I have searched but they don’t have a presence here. I was surprised. If anyone knows more I would appreciate hearing about it.
I have reached out the Jewish Family Services because she has mentally tied up so much of her psychosis with the Gaza situation. I thought perhaps she would be more willing to talk to someone she would perceive as being on “her side” than others. But that isn’t helpful until she is released from jail. Yesterday the court continued her arraignment until tomorrow since it is clear she is not likely to come, allowing us to have a much needed day off from sitting in court in case anything happens. A more comprehensive psychiatric evaluation has been ordered by the court. It will be the middle of March before we will see if there are any results of that effort. It’s killing me to imagine her sitting in a cell, unable to advocate for herself and being so limited on what we can do from our position. I guess, when it’s raining and cold out I am grateful we know where she is, and that she’s warm and dry. We hope she is safe. I am anxious that if the court doesn’t divert her into a program she will either be on the street or in our home. I am trying to prepare for that as best I can by reading about situations like this. I’m reading “I’m not Ill, I don’t need help.” Frankly I am a bit scared of the possibility.

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Good luck, these situations are complicated.


I’m so sorry about your friend. i’m going through a similar situation with my son who is 46 and has been mostly stable and taking his medication for schizophrenia. Last year he decided to lower is dose and than refusing medication. Also, delusional and paranoid. He lost his apartment he lived in for 20 years because he caused so many problems. Escalated into him attacking several of his neighbors. Last year I ex-parted him and he spend 3 weeks in the hospital. His behavior was so awful they put him in a coma for a day. He came home a bit better and back on his meds and again stopped taking them and used mushrooms and weed. He was than marchment acted and baker acted at this apartment complex for his bizarre behavior. He spent a month in jail refusing all help and they let him back to the hospital and continued to refuse help. when released he was rearrested for trespassing. he was released from jail twice and arrested twice. we talked to him about staying in the shelter but he can’t follow rules and doesn’t remember anything. I spent months last year staying with him and trying to get him back on his meds. He is awaiting a competency exam for court in jail. If he fails that may be our only hope for the judge to order him to go to hospital and force treatment. But as far as I can tell these patients who are not able to think clearly have the right not to take meds. I am also very afraid for him. he is also in a wheelchair because he has one leg. He has been aggressive, violent, and we can’t take him in to our home in this condition. i’m so sorry for all the friends and families suffering with the disease that is so under served. It has broken my heart into pieces. Before this I would talk to him daily and go to see him once a week. I would take him to doctors appointments. he’s a talented musician and artist. the book i recommend is I am not sick, I don’t need help. i also looked into guardianship but the attorney starting fee is $4000. some people have spent much more than that and still don’t get the guardianship. We are just standing by and praying for the best.

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Reading about your son is so sad Carlie. Thank you for sharing your experience. I am reading the book (I am not sick) that you and many others have recommended. It’s so discouraging realizing how huge this looms for my girl’s future, and that of her family. And mine. I am trying to get a handle on the LEAP technique. I am worried that when the moment comes, as it must eventually, I will be unable to recall and follow thru on its precepts. I am generally a very frank person. Filtering in this way is very foreign to me. I don’t know if I will be any good at it and worry that I will blow my chance to connect with her. Her mom and dad are so overwhelmed by the experience they haven’t been able to even read the book. Today mom was talking about our girl “walking a very fine line” as if ANYTHING that her daughter is doing is calculated at this point. I could have wept for her and our girl. So I am pretty much it. And often in the past when our girl couldn’t talk with her folks about something because it was too charged, I have been someone she reaches out to as a sounding board. So it makes me as good a candidate as any I guess. Our youngest daughter is high functioning on the spectrum, lives at home, and requires a fair amount of support. So I am already the ‘emotional support person’ for one. The thought of two boggles my mind. In court today I felt so despairing. We are in week 5, and she has yet to be arraigned. I read that early treatment is key to preventing more dire outcomes in the future and she is sitting in a cell while her brain just, what, dissolves? And the court has no sense of urgency. I think on Wednesday we will see a change. The judge is fed up with the delays and says she will arraign her in abstentia on Wednesday if she doesn’t appear. A mental health evaluation report that the judge requested weeks ago is due on Wednesday as well. The defense atty is planning on asking for a decision of if our girl is competent. The paths that lead forward are sort of murky. There is a criminal path, and the judge can send her to a state hospital. There is a mental division that would create a ‘plan’ that would involve treatment, services, parole essentially and an expunged record at the end of some set time period. Charges (which are ironically incredibly minor, as in; she threw a rock from her window and it hit a parked car) could be dropped and she could be released. That seems not likely as the prosecuting atty has a good understanding of what is going on and what a disastrous outcome that might be. But no guarantees. It’s a crap shoot. and a literal catch 22. I am putting clean sheets on the guest bed, and fresh towels out, in case. I don’t know if they will release her. I don’t know if she will talk to me if they do. I don’t know if she will come home with me. I don’t know much, do I… I guess I am in good company :broken_heart:

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I’m so glad your reading the book-it’s hard to do when interacting with someone psychotic-I tried it and seemed to work but when I left him he did what he wanted-didn’t seem to remember anything- I believe my son has been off his meds so long now it’s going to take time for him to return to baseline- I called his lawyer last week in regards to his competency exam-I figure it hasn’t happened. He never called back. I try not to worry about what is or what isn’t happening-it’s a sad situation.your friend is lucky to have you and hope that she will listen to reason. Seems silly to spend so long in jail for a small thing-praying for a good outcome-make sure you take care of yourself first-


I am so sorry @Sarafina that your friend is going through such a stressful situation, however, you must relax and wait for the system to work, however slow it is. There is a very good chance she has a severe mental illness and the path to resolution may be long, and the struggle lifelong. No one can really know right now. If this is her first psychotic episode, perhaps medicine could quell it, if she accepts it.

I can tell you Sarafina that my knowledge of schizophrenia, the court system and small miracles are the reasons why my daughter, about to turn 40, has had a good life outside of psychosis for years now. She fell ill at age 32. Her symptoms started with talking to herself, pacing, dropping out her personal hygiene and becoming unable to work successfully. I didn’t know what was going on with her and thought she was just “misbehaving”. But it was the start of her scizophrenia. Over the next three years, she was hospitalized five times, arrested twice, and finally forced onto medication after a judge ordered her release from jail but transfer to a psychiatric hospital. Her recovery started because I went to her arraignment and asked to speak. I asked the judge for help keeping her medicated. He got the psychiatric evaluation he asked for, she was physically checked out too, as our jail has a hospital. She was released from jail, sent to a psychiatric hospital and given a long term injection which she is still on monthly and which returned sanity to her over a course of months/years.

It will be a long road for your friend if she doesn’t have the capability to recognize she is ill. I renovated my home to make a “safe” studio apt for my daughter and to cut down the amount of noise coming from her room when she was screaming at night in conversation with her “voices”.

If you take your friend in, be aware that her behavior could really disrupt your life, and in the end, legally you may have to evict her to get her to leave. Sad, but true.

If there is no NAMI in San Francisco, call the closest one to you and speak over the phone to get ideas. My heart is with you trying to help your friend. I couldn’t give up on my daughter: love is a strong tie.


Hi @Carlie, you are trying to fight the good fight for your son, so very hard, I know. Just so you know, that the med my daughter is on took the psychosis she suffered down incredibly well the first month, but she was still obviously very delusional and hallucinating voices for many months after her first injection. It slowly got better each month with each shot, but took years for her to really appear better to everyone. And for her to stop hearing and talking to voices except when alone. Now, no one would every guess that she has a mental illness and she is a stable working member of society as a housekeeper in a nursing home. She used to be an office cleaner before her illness.


That’s so good that she is doing so much better. She is so lucky to have you by her side. I hope my son gets another chance to be stable again too.

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Using LEAP will become natural, it just takes practice. When our family members have anosognosia, LEAP can keep them in our lives. I am so sorry to read that her mother says she is walking" a very fine line". Understanding schizophrenia can take quite a while for some people. We are told that the major reason parents will have issues between themselves is because they are at different levels of comprehension. My husband did not fully understand schizophrenia for a long time.

Relax the best you can, I think that is why NAMI stresses in their Family to Family course that our family members’ issues can take years for progress.

I know it’s worrisome when we hear that early treatment is key to preventing more dire outcomes, unfortunately, keeping ourselves unstressed is more important.

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Appreciate the words of wisdom. We had a court date for her this morning. Finally after 5 weeks we have some movement. The charges are suspended, She is being evaluated for competency. They say it will be 3 weeks, but there was conversation about if found incompetent then there would be treatment as appropriate, be still my heart!
It’s killing us that she will be in the jail for another three weeks, but she is under medical supervision, not in the general population.

Funny. Often at the end of a statement such as This I will say “There’s a light at the end of the tunnel and it might not be the train!”

but this time… It feels as if it might not be the train, but there isn’t a light either. It feels as if this tunnel has no end.

I suspect you have been reading enough to know it can be an endless tunnel.

Being under medical supervision instead of in the general population is huge. We missed the opportunity we had to get help for our son through the court system. We were doing our best to keep Mike from getting arrested - we didn’t know he had a brain disorder at the time - we thought he was suffering from side effects from his immunosuppressive.

Later, when we knew, we tried outside cameras with sound to see if he was threatening his dad so we would have something to take to a judge. We were never successful.

A family friend from years ago emerged when she heard about our son’s scz. Her daughter had threatened over and over to kill her mom and her sister. The day she tried to kill her mom, the family dog stopped the attack. The dad insisted they call the police, at this point, they all agreed she could no longer live with them. They pressed charges and she landed in a mental health court. The judge gave her a choice of meds or jail and she asked for jail. Every couple of weeks they would bring her back to court and the judge would ask the same question. After several months, she finally chose “forced” meds.

Your friend has a real opportunity for forced meds, be patient, it could be a long tunnel.

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We have a change in venue! Her mom texted me this afternoon that she has been relocated to the Psychiatric ward of our General Hospital. I am so relieved. I mean, it’s a complicated relieved, but still, I think this is a good step. I don’t quite understand how the process will go but at least she has medical people with eyes on her to start figuring out what is going on. We don’t know why she has been moved. It seems as if something must have happened with her to motivate the transfer because the court and the jail staff have been watching her for 6 weeks now and haven’t felt a need up until now to do anything. She still shows as having a court date Thursday for an Alienist to be assigned. I don’t think she has to be there for that to happen. I wish there was an instruction manual and a time line for how this all works. I guess it’s different in every case. I know enough now to know that with her anosognosia she will likely be resistant to meds. I hope we are able to use the injections rather than the orals. And I hope she responds quickly. I know it can take a long time. If she were a standard 5150 she would be able to refuse meds, I think. But if the Drs say she is not competent and needs medication be able to respond to the court then, it seems as if from what the judge said, they will require her to be medicated. Step one, right? I am hoping that if she is being moved into the mental health services that they won’t release her until they have a safe place for her, but I know that may be a futile hope. I don’t really know how much actually exists for housing and such. I am getting ahead of myself. One step at a time… But still, immense relief at the moment. Thank you again for all the kindness.

That is good news! I wish it wasn’t this tricky trying to help our adult family members. Paws crossed for forced, long lasting injectables!

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We have some progress. R was in the hospital for just a week. They started her on meds and by the end of the week she had some clarity and was able to see a few visitors. She said the reason she refused visitors at the jail was because she didn’t believe that they were people she knew. She had little recall of the event that led to the arrest. She was scared and confused. they returned her to the observation ward in the Jail and initially she was reluctant to take the meds and began to become less connected to reality. It’s been a few more weeks now and she has begun taking the meds consistently and is again becoming lucid. Not like her old self, but coherent.

The Alienist has been assigned, but we don’t know what they are doing. Currently it’s up in the air whether she will get a referral to mental health services or behavioral health services. Her next court date isn’t for two more weeks and I guess we will find out then. I haven’t been able to see her. Visiting is very limited and difficult to arrange and often cancelled. But at least she has agreed to meds, for now, and is lucid and aware. Her parents have spoken with her on the phone and she wants badly out of jail and to come home but they are not willing (understandably) to offer that to her without some evidence that once released from jail she will continue to get treatment and services that she will need. Just vamping until the next court date I guess, but I am relieved she has improved! Her mom is still struggling with it all but working hard to understand her daughter’s options and issues. Her dad is just drained I think. We are relieved to have had a break from the daily court appearances. I hope that the next one doesn’t start up that pattern of continuation as before.

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