how one family’s struggle exposes the gaps in america’s mental health system

edited by sarina e. guerra
formatted by justin orsino

When Francine Torres’s father, Jim, came to her one evening trembling and saying something was wrong in his mind, she didn’t know it would mark the beginning of a battle far larger than the crisis unfolding in her living room. She knew her father had always been volatile — unpredictable, moody, prone to outbursts and periods of withdrawal. But she never imagined that the moment he finally asked for help would be the moment she discovered just how impossible it is to get it.

His admission — “I think I’m slipping; I think I need a psych ward” — should have been the start of a straightforward process. It should have led to evaluation, support, stabilization, and care.

Instead, it opened a door into a system that experts have been warning about for decades…

a system chronically under-resourced, structurally patchworked, financially restrictive

…& Built in a way
that almost
Guarantees people
fall through
the Cracks.

Francine’s experience is not unique. It’s the story of thousands across the country — but it is also a window into the invisible crisis unfolding behind closed doors across Imperial Valley and the nation.

This is not just one family’s story.
It is a portrait of a system that fails exactly when it is needed most.

Jim’s confession came late at night, when the house was quiet and the weight of his words felt impossibly heavy. But when Francine started calling for help, she learned a truth that families are rarely told until they’re living it:

Most psychiatric facilities cannot guarantee help unless the person is already in danger — and even then, openings are scarce.

The nearest VA psychiatric ward was over an hour away. That would be only a minor inconvenience if it weren’t for a nationwide shortage of psychiatric beds.

• A report from the Treatment Advocacy Center found that the U.S. has fewer psychiatric beds per capita today than it did in 1850.
  
• Emergency rooms regularly board psychiatric patients for days or weeks, waiting for space.
  
• Entire counties — including some in rural California — have no inpatient psychiatric beds at all.

Francine called hospital after hospital, agency after agency, only to hear the same variations of the same line:

“He needs to be evaluated first, and we can’t say if we have space until he’s already here.”

For families in crisis, this is a logistical nightmare. It means hours in a car with someone who could destabilize at any moment, only to arrive and be told that no beds exist.

When Francine tried contacting county Behavioral Health, she encountered another failure: understaffing and long wait times.

She called their crisis line. The phone rang for so long she wondered if it was broken.
When someone finally answered, they told her:

“A crisis worker can come out, but it may take several hours.”

Not minutes. Hours.

This is a common story in California counties, where behavioral health departments face:

• Severe staffing shortages
  
• High turnover
  
• A lack of psychiatric specialists
  
• Heavy caseloads
  
• Long waitlists for services

And while these departments do the best they can with limited budgets, the reality remains:
mental health crises move much faster than the systems designed to respond to them.

One of the most devastating things Francine learned is that a person can be clearly in crisis and still not meet legal criteria for involuntary intervention.

A person can be:

• hallucinating
  
• paranoid
  
• confused
  
• shaking
  
• unstable
  
• refusing treatment
  
• unable to care for themselves

…and still be deemed “not a danger”.

The law requires imminent harm — specifically defined verbal or physical threats — before a person can be placed on a psychiatric hold (such as California’s 5150).

Families essentially have to wait for something alarming or violent to happen before help becomes accessible.

Francine didn’t want it to get that far.
But the system didn’t give her a way to intervene sooner.

In the days after Jim’s confession, Francine became what countless daughters, sons, and spouses become every year…

the De Facto
caseworker for a
Crisis she was
Never
trained to manage.

She documented every conversation, every mood shift, every episode — because she learned quickly that documentation is the only way to “prove” someone is ill enough to qualify for services.

Without it, the system defaults to disbelief.

She learned the language of crisis care: “psychiatric evaluation”, “involuntary hold”, “stabilization unit”, “outpatient referral”, “case management”, “pre-authorization”.

She learned how many agencies would redirect her:

“We don’t do that here — call Behavioral Health.”
“We can’t help unless he’s in the ER.”
“Try the crisis line.”
“Try the VA hotline.”
“Try calling again tomorrow.”

The system’s circular logic made everything harder.
Every delay increased the chance that Jim would change his mind or deteriorate.

At one point, Francine wondered whether she needed a lawyer.
She researched conservatorship — the legal authority to make decisions for someone who can’t.

She discovered more harsh truths:

Conservatorship is not free.
It is not fast.
And it is not designed for low-income families.

Legal fees can run into thousands of dollars.
Court evaluations take months.
Public guardian offices are overwhelmed.
Judges want extensive documentation — and even then, approval is far from guaranteed.

Francine couldn’t afford legal help.
Jim couldn’t afford anything.
The system didn’t offer alternatives.

Despite all the rhetoric, conservatorship is often a tool available only to families with resources.

What makes Francine’s story even more heartbreaking is the human truth at its center: Jim had suffered silently for decades because he didn’t know where to go or how to ask for help.

When he finally reached the point of saying, “I need a psych ward”, he meant it.

But the system wasn’t ready for him.

The system never is.

While agencies argue jurisdiction, while hospitals run out of beds, while staff shortages stretch every service thin — families like Francine’s have no choice but to become the frontline mental health workers of America.

They sit up at night monitoring their loved ones.
They plan emergency drives.
They negotiate with someone whose mind is slipping away.

They become both
Caregiver &
Crisis responder.

It’s unpaid, untrained labor that no one acknowledges — until something goes wrong.

Francine kept showing up, even as the system kept failing to.

She researched.
She drove him places.
She begged relatives to help.
She held conversations with him during his moments of clarity and moments of fear.
She quietly braced herself for the day he might refuse help again.

She knew something that professionals rarely say out loud:

Mental illness does not kill in one moment–it kills in a thousand small moments of delay.

And families are the only thing standing between those delays and disaster.

Francine’s experience is not isolated. It is the norm.

Across the nation:

• People in crisis wait weeks for psychiatric appointments.
  
• ERs become makeshift psych wards.
  
• Police are used as de facto mental-health responders.
  
• Veterans face long wait times even within the VA system.
  
• Families are told to “monitor the situation” because services are unavailable.
  
• Low-income households are left without legal options.
  
• People fall through cracks so wide they look like open floors.

Mental illness is not rare.
Support for it is.

And while Jim’s story is deeply personal, it mirrors the reality facing thousands of families in Imperial County and millions across the country.

It is a story of suffering — but also of a daughter standing where the system should have been.

Francine once believed her father’s behavior was who he was.

Now she knows it was the untreated, unseen illness he carried like a shadow.

But the system that could have helped him carried its own shadows too — shortages, delays, denials, loopholes, and structural failures built over generations.

Her story forces us to confront a difficult truth:

If a man clearly in crisis, asking for help, and accompanied by a willing family member cannot get timely care — what hope is there for those who cannot speak for themselves?

It is a question with no easy answer…

but it is one a
Community cannot
afford to Ignore.