To the Editor:
Re “The Laws Designed to Protect My Son Could Very Well Kill Him,” by Madeline Till (Opinion guest essay, Jan. 29):
The anguish described by a mother whose son with schizophrenia has been abandoned to homelessness in the name of “rights” reveals not a personal tragedy but a national crisis and a moral failure.
For more than half a century, U.S. mental health policy has elevated a narrow notion of autonomy above every other ethical obligation — care, protection and prevention of suffering for those unable to care for themselves. In doing so, neglect has been recast as freedom and abandonment as compassion. Consequently, families are rendered powerless, clinicians are constrained, and people with severe mental illness deteriorate in plain sight.
Schizophrenia often destroys judgment and insight — the very capacities required to accept help. Insisting on full autonomy under these circumstances is not respect; it is abdication. Laws that permit intervention only when someone is imminently dangerous risks care arriving too late. The author’s haunting observation that her son may “die with his rights on” captures this cruel bind.
As a clinician who has treated people with severe mental illness for 40 years, I am continually frustrated by government policies that tie my hands in the name of giving the infirmed their rights and by the lack of available treatment facilities.
This is not a call to revive the asylums of the past, but to restore balance. Humane, medically supervised treatment is not coercion. Being left to freeze, starve and unravel on the streets is not freedom.
Jeffrey A. Lieberman New York The writer is a professor of psychiatry at Columbia University and a former president of the American Psychiatric Association.
To the Editor:
It is a beautiful sentiment to say a family standing by makes all the difference, but we have to stop framing this as a choice that families make. For thousands of us, standing by looks like sitting in a cold E.R. hallway for 72 hours while a hospital uses HIPAA as a shield to refuse us any information. It looks like being told to wait until they turn violent before the state will intervene.
We aren’t giving up on our loved ones; we are being locked out of their care. When people have anosognosia — which prevents them from knowing they are ill — the right to refuse treatment becomes a state-sanctioned right to die with your boots on.
A strong family unit cannot override a dopamine storm or a frontal lobe lesion. If the system relies on families to be the security guards, the nurses and the crisis counselors, it must also give those families the legal authority to actually save lives. Anything less isn’t supporting the person — it’s medical neglect disguised as civil liberty.
Celina del Castillo Phippsburg, Maine
To the Editor:
Madeline Till’s essay describes an experience that is all too common for those of us living with serious mental illness, but there are evidence-based resources not mentioned in her essay — clubhouses. Clubhouses, like Fountain House, are voluntary and community-based locations designed to support the recovery of people living with serious mental illness. In clubhouses, intentional communities are created, where members and staff work together to complete daily tasks.
Before Fountain House, my life was spinning out of control with multiple hospitalizations, but I am living proof that clubhouses change lives. After 22 years of membership, I serve as a Fountain House board member, and I am part of a community of people who are, like me, living with serious mental illness and thriving.
In Fountain House they found stability, community, connection and recovery after hospitalizations, substance use, homelessness and feeling discarded by society. I share this to convey how clubhouses can make a difference for those of us with experiences like her son’s. He deserves what clubhouses can give — a life of purpose, connection and community.
Debra Irwin New York
To the Editor:
Madeline Till’s essay regarding her son’s struggle with severe mental illness reflects a story all too familiar to many parents. The challenges she describes were foreseeable when large mental health institutions were closed with the intent of transitioning patients to community-based care.
The original vision was for funding to follow individuals into their communities to provide essential supportive services, including housing, case management, vocational training and day treatment. Unfortunately, the actual funding has been a mere shadow of what is required to meet the needs of those with serious mental illness.
Having worked in community mental health services, I have seen firsthand the revolving door many individuals face. We must do better for them and for their families.
Donna Nardini Lambertville, N.J.
To the Editor:
In 2014, Paul Gionfriddo, a mental health professional, wrote a searing narrative, “Losing Tim,” about his failure to rescue his son from schizophrenia. His son was a very ill young man who bounced in and out of institutions and jails, and whom he ultimately tracked down living in a filthy room with rats.
Now, in 2026, where are we in the treatment of people with severe psychiatric illness? Madeline Till, also a mental health professional, describes a family’s helplessness trying to obtain adequate long-term care for her son, also suffering from schizophrenia.
During these intervening years we have seen lives saved through complex heart transplants, marveled at the miracle separation of conjoined twins, had major advances in cancer treatment, and produced high-tech hearing aids.
These conditions elicit fund-raising, empathy, compassion and integrated care. None carry the mantle of stigma and the loneliness of being shunned even by some professionals. No parent of a schizophrenic child should actually wish he had cancer instead because we as a society have failed.
Sue Matorin New York The writer is a social worker in the department of psychiatry at Weill Cornell.
The post How We Fail the Mentally Ill appeared first on New York Times.
