Off His Meds?

I recently was at a large public gathering at the finish line of a relay race.  There were thousands of people milling around….runners who had finished, family and friends who were cheering runners on, officials, and vendors.  The scene was pretty chaotic.

I wonder how many people were aware of a young man in a rust colored jacket, purple scarf and dark-colored ball cap.  He walked hurriedly through the crowd all over the venue.  Sometimes he walked away from the group on a raised sidewalk along the lakefront.  More than once, he hurried toward the lake front as though he might jump in, but stopped at the very edge.  The constant activity of the group seemed to agitate him.

From a distance, I could see him talking, and I thought it might be on a cell phone.  However, I was close enough on multiple occasions to realize that he wasn’t on a cell phone.  He would say something in a high squeaky voice, and then answer himself in a low growling voice.

Once I had noticed him, I couldn’t help but look for him and check on what he was doing.  I saw absolutely no security at this event.  I suspect that the majority of the time a schizophrenic off his meds is harmful only to himself.  But, we have all read of other cases when a psychotic episode has resulted in harm to others.  Maybe he is one of the “public characters” in that small city and was known to the officials and viewed as harmless.  But, his frantic activity made me ill-at-ease.

I do not know what the solution is to the mental health crisis that is obvious in our society.  Closing institutions and supposedly integrating the mentally ill into society has not worked very well.  It has increased homelessness, and jails are full of psychiatric cases which guards are not properly trained to handle.  Having spent 3 months of my time in nursing school at a truly dreadful psychiatric institution, I can attest that institutionalization is a nightmare too.  One of the wards we were assigned to as students had no head nurse.  The aides were so sadistic and unmanageable that they could not get a nurse to stay there.

Having a family member with mental health issues has made me aware that the mental health care system is difficult to access and that once accessed there are barriers to receiving continuity of care.

The young man in the rust colored jacket may have been off his meds, but he appeared clean and neat, so someone must be watching out for him.  There are many for whom that is not the case.