Lilly* has schizophrenia. As if that isn’t enough, she was also born early, to a cocaine-addicted mother, with hydrocephalus. She also has bi-polar disorder, diabetes, and is legally blind. Her growth was severely stunted by all of her problems, and even though she is in her mid thirties, she is barely 4 feet tall. Lilly’s mother and her crack-dealing boyfriends abused her as a child.

Lilly’s aunt “takes care” of her. What she actually does is provide a place for Lilly to live. Auntie tries, and she tries hard. But she can’t do it. Auntie says Lilly is family, and family takes care of family. Auntie makes sure Lilly gets all of her medications every day, and makes sure she is well-fed and clothed.

Auntie doesn’t have much. She lives on a paltry disability check she gets, and her son contributes some of his earnings he makes selling drugs in the neighborhood. I can’t imagine how they manage to eat, much less afford their home. Auntie inherited the home from her mother when she died a few years ago, and somehow makes the mortgage payment.

Lilly doesn’t want for love. Her cousin, her Auntie, their extended family, and even the neighbors all care about Lilly. But Lilly is sick.

Lilly has psychotic breaks about three times a week, and has been for several years. She throws things in the house, punches walls, scratches cars with keys, screams, swings at people, and does all the things to be expected.

She can’t help it.

So the police go to the scene to make sure she doesn’t physically hurt anyone, and to try to stop Lilly from causing more property damage. They don’t arrest her, because she doesn’t need to be arrested. They call for an ambulance, because she needs mental help, and there is no such thing as a mental health house call where Lilly is. The call for the ambulance invariably triggers a call for a fire crew in their engine.

But the loud noise from the engine makes Lilly agitated, and the crew doesn’t really know what to do. They just know they aren’t needed there, but they have to be there until we can get there.

So we show up, and we spend the next thirty minutes doing everything we can to talk Lilly down.

I like Lilly, and I would like to think she feels the same way about me. We have a routine: I kneel down and remove my sunglasses so we can make eye contact, I touch her shoulder and introduce myself, and she screams at me. I tell her that I am here to take her away from what is making her upset, so she can go talk to someone if she wants to, or so she can be alone for a little while.

Lilly always agrees. Sometimes it takes longer to talk with her, but she always agrees.

Then we take her to the hospital her Auntie chooses, since Auntie has power of attorney.

The hospital staff is incredibly nice to her. They all say hello, and they smile. They allow her to keep her clothes on, and they give her a soda and saltine crackers.

Sometimes, a physician will sign an involuntary hold order, and Lilly has to go to an inpatient center for several days. But that doesn’t fix the problem.

I really don’t know what Lilly needs. I think she needs a nursing home of some sort, or at least an assisted-living facility. But I don’t know how that would help.

I just know the current situation isn’t working.

Poor Lilly is a horrible victim of a horrible situation, and she can’t help it.

*Not her real name, of course.