Undertreating Mental Illness

In the shadow of her own family history of schizophrenia, Mac McClelland investigates the neglect of mental health treatment across the US, “where the three largest de facto psychiatric facilities are jails.” In San Francisco’s impoverished Tenderloin neighborhood:

The majority of [community center director Cindy] Gyori’s clients are suffering afflictions like PTSD, anxiety, depression, and the associated addiction issues. That is: With treatment, they’re theoretically capable of recovery and (nonsubsidized) functioning. But Gyori’s staff is short, underpaid. New clients can’t be seen for initial risk assessment for a month. The city’s public-housing shortage is so severe that it closed the list to new applicants. “This society is set up to create Tenderloins,” she says.

“We’re dealing with the most stigmatized and misunderstood population. You can scream outside my window,” she says, turning her face in the direction of the guy screaming outside her window—something about “dinner”—”and I’m not gonna make assumptions that it’s your fault. As long as a person is disabled, and income is limited, you have to help them. Destigmatization is a big part of it.”


When I leave the clinic, it is admittedly difficult not to judge the strung-out-looking fellow lunging through the crosswalk hollering a song about monkeys, the refrain of which is a monkey call, or the parties responsible for the two piles of human shit I sidestep in as many blocks. Though an estimated 1 in 5 families contains someone with a mental illness, even families of the mentally ill aren’t always sympathetic. “We have families who aren’t willing to work with us or do anything,” says my Aunt Terri’s caseworker, Eleanor. “Your family was so willing; everybody was there to do whatever.” But she’s certainly not talking about my great-grandmother, who pronounced Terri lazy, and not even so much my grandfather, who thought his daughter was a spoiled brat who just wanted attention. And she wasn’t talking about me, whose total uselessness in Terri’s transportation and other needs earned me the resentment of at least one cousin.