Most people enjoy sharing the antics and anecdotes of their “crazy” family members, but few people share the stories of true mental illness. It’s neither funny nor redeeming. There’s no punch line. Worse, it’s taboo.
My sister has been sitting in a tiny room in the ER at the local hospital for almost 48 hours as she awaits a bed at a state facility. Almost 48 hours ago, I called the police on her. I had to call the police because I could not get her to seek treatment voluntarily, she had threatened to kill her neighbors, and she had written frightening almost incomprehensible notes in her journal about being controlled by Satan. As she sat on the stairs and I tried to get her to go to the local mental-health crisis center with me, I was alarmed by her expressionless face as she stared straight ahead, unable to make eye contact. She responded with clipped sentences (“It’s not a mental-health problem.” “I don’t want to get into it.“) and then proceeded to talk to herself in a soft indecipherable whisper. In her journals, I found evidence that she thinks multiple people reside in her.
For almost 48 hours, my sister has received virtually no mental-health treatment. The hospital no longer has a psychiatrist on staff. When she was admitted, she was ninth in line for a bed in one of the two state hospitals. As an involuntary committal with zero ability to pay, my sister has limited options for receiving treatment. Osawatomie is also under renovations, further limiting the number of beds available for people like my sister and increasing the likelihood that she’ll be released before she’s genuinely stable again. Osawatomie has been under fire repeatedly for overcrowding issues and earlier this year even stopped receiving involuntary admissions, leaving people like my sister and their anxious families with no relief. When my sister does get admitted to Osawatomie, she’ll be held for a minimum of three days. Her potential stay at a facility where she will actually receive mental-health treatment is almost as long as her current stay in an emergency room. This is the state of mental healthcare in Kansas.
This rodeo is not my first venture into the arena, but I also had no idea how far my sister had spiraled in the last year. When I saw her on Thanksgiving, she was quiet and withdrawn and didn’t answer a lot of questions, but she interacted with everyone. I just assumed, as she had claimed, that she wasn’t feeling talkative. I had no idea that the week before she had gone to a neighbor’s house asking to see their six-year-old son who alone could crack the CIA code she desperately needed to solve and that, upon being denied this request, she mentioned that her soul was dead and that she could release it by killing everyone.
The family members of an adult with mental illness have few options when their loved one refuses treatment. My sister has most likely not taken any medication since the last time she was committed to Osawatomie for suicide ideation and afterward weaned herself off the mandated visits to mental-health professionals. I can’t force a 31-year-old woman to take medications or to seek help. I can only have her committed if she is an imminent threat to herself or to others. She has to tell me or the police that she’s a threat to herself for her to be involuntarily taken in for a mental-health assessment. As ill as she is, this isn’t my sister’s first rodeo either; she’s fully aware that she can deny, deny, deny. Deny she did, and she’s still doing as she sits in the little room in the ER awaiting admission at the overburdened state hospital again.
This commitment proceeding is so much sadder than last time. My little sister has been inching further and further away, and with all these new symptoms—the talking to herself, the delusions, the possible multiple personalities—I wonder now whether we’ve crossed some terrible threshold where I have to give up that modicum of hope that one day I’d have a sister again. She’s gone when she writes that she’s a robot, that she’s destroyed galaxies, that she’s the messiah, that she’s Satan and when she frightens that poor neighboring family. She is gone even as little sparks of her glimmer through. She flashes moments of her compassionate self when she jumps up automatically and shines a brief brilliant smile when I ask for a hug in that stupid little room. She’s gone again when she sits back down and stares without expression straight ahead in complete silence.
My mom has accused me of being cold toward my sister over the last few years, and I have been. I have not been cold because I stopped loving her but because I do love her. I miss her terribly—the her she used to be. The woman she should be today. This stranger is not my sister even as she is my sister. This dichotomy is my relationship with my sister: estranged and sepulchral. I worry about her even as I cannot and do not spend my life worrying about her. But now, instead of the nagging fear that she’ll hurt herself one day, I also have to worry that she’ll hurt a stranger. When someone you love is severely mentally ill and refuses treatment, you spend your life waiting for the next inevitable crisis.