May is Mental Health Awareness Month, a time to reflect, raise awareness, and inspire change. For me, this month brings back memories of a painful chapter in my life—four years of homelessness from 2003 to 2007, while struggling with severe mental illness. During that time, I suffered from delusions, paranoia, and hallucinations, but I was unaware of my illness due to a condition called anosognosia. I thought I was destined for greatness, but in reality, I was just another homeless person in Los Angeles County, struggling with both homelessness and mental illness.
As we observe Mental Health Awareness Month, I reflect on what could have helped me during my darkest days. The following are four key changes I believe could address the critical needs of those suffering from psychosis across the United States.
1. Increased Availability of Psychiatric Hospital Beds
I should never have had to endure four years of homelessness while severely mentally ill, confused, and unprotected. Unfortunately, accessing psychiatric care is an immense challenge in the U.S. Today, psychiatric hospitals are under-resourced. In the 1940s, there were half a million psychiatric hospital beds, but after the deinstitutionalization movement in the 1960s and 1970s, that number plummeted to just 40,000. Only the most severely ill patients now qualify for admission. As a result, patients are often released too soon, even if they are still in need of care. I was one of the many who had to suffer for years before qualifying for a hospital bed in 2007.
2. Better Access to Long-Acting Injectable Medications
After my first hospitalization, I, like many patients with psychosis, stopped taking my antipsychotic medication. This led to a quick relapse. Unfortunately, many patients make this mistake, often unaware of the risks. The best way to prevent relapse is the use of long-acting injectable (LAI) medications. LAIs are effective in helping patients stay on their medication, even if they are too ill to recognize their condition. However, these medications are rarely offered, especially during a patient’s first psychotic episode. I strongly believe that LAIs should be more widely used, as they can significantly reduce the risk of relapse and improve long-term outcomes.
3. Early Use of Clozapine for Treatment-Resistant Psychosis
For individuals who don’t respond to the first two antipsychotic medications, clozapine should be considered. After failing five other medications, I was finally prescribed clozapine, which proved to be life-changing. Clozapine is the most effective treatment for those with treatment-resistant psychosis, yet it remains underutilized. It can not only improve psychotic symptoms but also reduce the risk of suicidality. In hindsight, I should have been offered clozapine much earlier in my treatment.
4. Public Education on the Risks of Marijuana Use
Although I never used marijuana, I’ve witnessed its harmful effects firsthand in my advocacy work. Many individuals who develop psychosis later in life do so after using marijuana, even in limited amounts. While marijuana is often perceived as a harmless substance, it poses significant risks, especially for those with a family history of mental illness. Public education is crucial to inform people, particularly young users, about these dangers. Not everyone who uses marijuana will develop psychosis, but the risk is real, and awareness is key.
Join Me in Supporting Mental Health Reform
This Mental Health Awareness Month, I urge everyone to join me in advocating for these essential changes. The needs of people struggling with mental illness cannot be ignored any longer. With better access to care, improved treatments, and widespread education, we can make a real difference. Recovery is possible, and with continued progress, we can give those affected by mental illness the opportunity for a better life.
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