The harsh realities of mental illness

Robert David Jaffee is a writer in Los Angeles.

Ten years ago, I slipped into a world of delusion. I’d had a psychotic break in March 1997, and now, like the aftershock to an earthquake, I was having a relapse. I had stopped taking my medications -- Zoloft and perphenazine -- not out of rebelliousness but because I was losing my bearings and had become absent-minded.

On the night of Jan. 22, 1999, I barely slept. My mind raced with thoughts that the CIA or FBI was trying to monitor my speech. I became convinced that the cat had been programmed by the government.

When my then-girlfriend, Barbara, finally woke up the next morning, I told her what I believed to be the terrible truth: I was going to be blamed for a synchronized series of murders across the country, and I needed to document my whereabouts to prove I was innocent.


My petite girlfriend tried to hold on to my wrists to prevent me from leaving. She was so strong that I figured she too had been trained by the CIA. Careful not to hurt her, I broke away and left her Glendale condominium, starting on a harrowing, six-hour trek across L.A. County, convinced that I was going to be assassinated.

Early in the day, I stopped in at Glendale Memorial Hospital on Central Avenue. My instincts told me that I needed help, and I thought a hospital would be a safe place. But while I was waiting to be seen, I heard the receptionist on a loudspeaker tell the orderly to “disarm the homeless person.” I assumed that she was referring to me, although I was neither armed nor homeless, so I fled.

On Venice Boulevard, I sensed that the heavens were beckoning me with music, and I considered jumping in front of a car. I didn’t, probably because deep inside I wanted to live. I also recognized that if I were to jump in front of a car, I would not only kill myself but also traumatize the driver.

I had long felt cursed. I had been named in Hebrew after my grandfather, who committed suicide years before I was born. Luckily, as delusional as I was on my crosstown trek, I still had some instinct for survival. I turned north on Sepulveda and made my way to UCLA’s Neuropsychiatric Institute, where I had been seeing a psychiatrist. After talking with me, he put me in the hospital on an involuntary 72-hour hold. It was the right thing to do.

Ten years later, I still take Zoloft and perphenazine. With that regimen, as well as a lot of guidance from my psychiatrist and love from Barbara, who is now my wife, I not only have survived mental illness, I have also thrived, working as a writer and living a productive, responsible and happy life.

Too many people don’t get the proper treatment. Every day, as I drive in Los Angeles, I see people who need help and aren’t getting it.


Partly this is because of the costs and limitations of healthcare. I once gave a talk to a self-help group in Pasadena, and was approached afterward by a recent high school graduate who had been kicked out of his house by his parents. He was living with his grandmother, who told me that he had exhausted the number of therapy sessions his insurance allowed. She didn’t know how he could get affordable help in the future.

Other people are too sick to know they need help. It’s hard to know how much of the region’s homelessness problem is because of mental illness. But a 2007 count of the homeless by the Los Angeles Homeless Services Authority found that of the county’s 68,608 residents identified as homeless in the study, 52% suffered from depression and 31% reported experiencing more serious mental illnesses.

Many mentally ill people living on the streets have refused treatment. I understand this. When I was on my trek, if a doctor had come up to me, I would have been terrified that he was going to harm or even kill me.

It is much better to encourage, rather than force, the mentally ill to get treatment. But what if they don’t respond?

If a man with diabetes collapsed on the street, we’d hospitalize him and give him insulin. The civil rights issues involved with forced treatment of the mentally ill are real and shouldn’t be downplayed. I can’t speak to what’s right for everyone. But I do know that for me, being involuntarily held at the hospital in 1999 allowed me to get back on my medication -- and may have saved my life.