I Knew the Young Man Rambling at My Door. It Broke My Heart

Sixty-two years ago, I was born into a dysfunctional family filled with fragile minds.

My mother was schizophrenic. My father, likely bipolar, was verbally and physically abusive. In my teens, both my brothers were homeless and one would later be diagnosed with Bipolar II and PTSD.

In the 1970s, society's response to my mother's illness was temporary institutionalization and electroshock therapy. I remember being frightened and confused when I saw the feral look in her eyes the night before her treatment.

My father's illness was never diagnosed. My older sibling would be—but only after twenty years of traveling across America as a homeless person. The negative impact of serious mental illness on the trajectory of their lives is undeniable and was unabated by a relevant societal response.

In America, the struggle to respond effectively to Serious Mental Illness (SMI) continues today.

SMI is defined by the National Institute of Mental Health, as one or more mental, behavioral, or emotional disorder(s) resulting in serious functional impairment which substantially interferes with or limits one or more major life activities. Sadly, SMI impacts fourteen million people and is a contributing factor to some of the more troubling challenges we face in American life.

For example, while the lack of affordable and available housing is a significant factor in our ever-increasing homeless population, per the Department of Housing, approximately 25 to 30 percent of the homeless are seriously mentally ill.

While four million reports are made to Child Protective Services (CPS) annually, according to psychiatryonline.org, parents with serious mental illness were eight times more likely to have CPS contact and 26 times more likely to have a change in living arrangements compared with parents without a serious mental illness.

And acceptable levels of gun access and availability are critical issues our society must confront; per the Violence Project database study of mass shootings since 1966, more than two-thirds of the perpetrators had some history of mental health concerns. Per the Treatment Advocacy Center, at least one-third of mass shooters had untreated SMI.

Oftentimes, SMI is not the problem—but it's undeniably a part of the problem.

Although we are more accepting and assertive in addressing the many issues surrounding our general mental well-being as a nation, many who suffer with SMI remain discarded and left behind.

I lived it firsthand as a child in the 1970s—and saw it again as a retiree in the fall of 2022.

One sunny afternoon, a familiar, albeit thinner young man stood at my front door. It was a former neighbor's son. I'd not seen him in years though I was aware of his serious mental health challenges.

After a rambling, disjointed preamble, he asked if he could spend the night in my home. I hesitated. My wife was inside, and not understanding the boundaries of his behavior, I regretfully declined.

Head down, dejected, he turned and slowly walked away. It broke my heart to think the young man I'd known since his preschool days would likely sleep outside for the night.

I decided to call the local police, who arrived quickly accompanied by a mental health care worker. They knew about him and promised to conduct a search, but could only offer him short-term shelter for three nights.

As the authorities pulled away, I stood alone in silent reflection. How sad, I thought. My mother was ineffectively institutionalized fifty years ago. And today, America's gone the other way.

Per the Treatment Advocacy Center, in the 1950s, there were 337 available inpatient psychiatric beds per 100,000 people. In 2014 there was less than 30—a 90 percent reduction and a long-term trend toward deinstitutionalization that continues today.

On the surface, it appears we couldn't get it right back then, so we simply threw our hands up and walked away.

Unfortunately, this mindset will no longer suffice because the problem is only getting worse. A CNN/KFF poll conducted in October 2022 concluded that 90 percent of adults in the U.S. say the country is experiencing a mental health crisis.

A few days later, filled with guilt and concern, my wife and I reached out to the young man's father. Before the call, I confess to skepticism, even anger toward him, suspecting he'd abandoned his son to his illness and the streets, much like I felt my father had done with my siblings fifty years earlier.

But I was wrong, the father hadn't failed him. The system had. He'd taken his son in, but his volatile behavior made the situation intolerable. He also reached out to his community for support but the limited resources available were short-term and unsatisfactory.

His son soon disappeared and landed on our doorstep. The sight of him that day reminded me of how close I'd come to being homeless when I was an adolescent, how my family and the system failed my siblings years before, and how society today often fails those struggling with SMI and accepts their teetering presence on our city streets as an acceptable state of being.

SMI is no doubt a complicated issue but what can we do?

Perhaps, we can start by conducting an aggressive national campaign to raise awareness about the 988 Suicide and Crisis Lifeline, a free National Hotline for Mental Health Emergencies, separate from 911.

In the CNN poll above, half of adults said they'd heard nothing about it. There must also be appropriate resources available at the community level when calls come in or other local SMI issues arise.

In the American Rescue Plan, the Biden Administration allocated $5 billion to HHS to support mental health and substance use support programs. Maybe this will help.

However, in the case of the mental health care worker who responded to my call a few months back, she shared my deep concern but couldn't offer a truly impactful solution. Honestly, she appeared just as frustrated as me.

The 988 Lifeline is a free resource for those in need or those dealing with a mental health crisis in their family.

But Washington, along with state and local government, must further commit appropriate resources and bi-partisan willpower to better treat, shelter, incorporate, and care for those with SMI.

The quality of their lives, as well as ours as a more safe and compassionate society, would be enhanced by a successful effort.

Can't we do better for our fellow citizens? Can't we do better for ourselves?

David Pruitt is a 1st generation college graduate, licensed CPA, retired CFO/CEO (Performance Bike), and author of the well-received memoir, Relative Distance the powerful and emotional story of his and his siblings' distinctive but successful life journeys beyond a dysfunctional upbringing.

All views expressed in this article are the author's own.

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