It Doesn’t Take Murder for Derangement to Terrorize a Family : Mental Illness: A sister tells how schizophrenia and the state’s crumbling support system made rejection the only path left open.

Last week, prosecutors say, Betty Madeira killed her mother, and the headline asked if the mental-health system had failed.

This is the right question to ask, and perhaps I--like others who have family members who are mentally ill--can answer the question better than most people. Betty Madeira is not the exception, the case that fell through the cracks. But she has tragically illustrated the problems of a wholly inadequate system.

My sister has a 20-year history of schizophrenia, compounded by alcohol and drug abuse. Years of therapy and the consistent support (emotional and financial) of her family did nothing to help her. She became increasingly delusional and violent, striking my mother on several occasions and stealing from us to finance her drug habit.

Unable to take (or give) any more, my mother packed up and moved to the Midwest two years ago, sparing us a scenario that could have unfolded as it did for Betty and her mother. At the same time my mother left, I moved and got an unlisted phone number; my brother and I told my sister that she was not to contact us. It was time for us to cut our losses, realizing, finally, that it was a question of survival--hers or ours.

We arrived at this point not easily, and after years of anguish. We are of the school that says families have responsibilities and take care of their own. But we were unable to make a difference and, at the end, unable to protect ourselves.

We had tried to find help within the mental-health system. My brother and I made endless phone calls, encountering numerous roadblocks. But my sister finally got into “the system”--which, as we learned, is a slippery thing indeed. She has been in “72-hour lockup” at least three times and has been placed in locked mental facilities for longer periods on several occasions. The system that sometimes takes in also soon tosses out--because, in the words of her social worker, “there is simply not enough room.”

Several things have happened to California’s mental-health system. Among them was the decision, made by politicians, to save money by closing mental hospitals and treating the mentally ill on an outpatient basis. But it is important to understand that the severely mentally ill don’t do what they’re told: They don’t stay in a facility unless the door is locked; they don’t take their medication unless it is given to them; they don’t feed, clothe or house themselves without assistance.

Trying to figure out why my sister is the way she is, why she went the route she did, is like trying to grab hold of air. As it turned out, finding help was just as hopeless, and impossible.

The last I heard, my sister was living on Skid Row. Thoughts of what her terror-filled life must be like keep me awake at night. But I fight back any feelings of guilt by remembering how she terrorized us all. And by remembering that we tried.