Tonight I find myself wide awake while the cats prowl the house, restless and alert. It mirrors my own mind — scattered, heavy, hopeful, and tired all at once. I wanted to write earlier, but life, as it often does, pulled me in other directions. Still, these thoughts keep circling, and they need somewhere to land.

This is not a neat essay. It’s a reflection from someone who has lived too close to the cracks in our mental health system — as a parent, as a volunteer, and as a witness to the quiet suffering of people who are unwell and unsupported.

The Fear Only Loved Ones Know

There is a particular kind of helplessness that comes when someone you care about is mentally unwell and you cannot fix it. It is a grief that doesn’t end, because the person is still here, still loved, still fighting — but trapped in a system that cannot hold them.

Psychotic episodes are terrifying for everyone involved, especially the person experiencing them. Hallucinations, sleeplessness, distorted thinking — it is a storm inside the brain. And the fastest way the system knows how to respond is to section someone for their own safety or the safety of others.

In those moments, sedation and stabilisation become the priority. But stabilisation is not the same as understanding.

The Loophole No One Talks About

A 28‑day section is designed to calm the crisis, not to diagnose the cause. And this is where the system fails so many.

People are discharged without ever being assessed for:

• Autism
• ADHD
• Bipolar disorder
• Trauma-related conditions
• Personality disorders
• Developmental differences

The assumption is that the episode was the whole story. But often, it is only the surface.

Many people who experience psychosis have underlying conditions that were never identified. Once the crisis passes, they are sent home with no deeper understanding of why it happened.

This is the loophole.
This is where lives unravel.

Without accurate diagnosis, people drift into isolation, addiction, homelessness, or despair. Families burn out. Friendships collapse. The person becomes “difficult,” “chaotic,” or “lost,” when in reality they were never properly understood.

A&E Is Not a Mental Health Ward

A friend recently took her baby to A&E in the early hours. The child was struggling to breathe. They waited for hours. Around them were people in distress — a man urinating outside, another passed out across seats, a woman screaming at staff. The waiting room was full of individuals clearly in mental crisis.

Her baby had tonsillitis and a dangerously high temperature. She should have been prioritised. But the mental health emergency unit that once existed at that hospital had been closed. Everything — every crisis, every trauma, every breakdown — now funnels into A&E.

It is unsafe for the public.
It is unsafe for the vulnerable.
It is unsafe for the staff.

We need dedicated mental health emergency wards. Not as an afterthought, but as a core part of the NHS.

The Cruelty of Judgement from Those Who Have Never Lived It

One of the hardest parts of loving someone with severe mental illness is not just the illness itself — it’s the judgement from people who have never stood where you stand.

There is a particular kind of scorn that comes from the comfortable, the untested, the ones who have never had to drag a loved one through the darkest corners of the mind. They look at the chaos from the outside and assume it is the result of poor parenting, weak boundaries, laziness, or moral failure. They speak with confidence about situations they have never survived.

Until you have lived through the chaos of a loved one’s mental collapse, you cannot understand the toll it takes. Families are thrust into situations they are not trained for — moments that can become unpredictable, overwhelming, and at times genuinely dangerous. And tragically, many people who are mentally unwell turn their fear and confusion into blame, directing it at the very people trying to keep them safe. In the midst of illness, they often have no comprehension of the heartbreak their behaviour causes, nor the emotional devastation left behind.

Families in crisis do not need criticism.
They need compassion.
They need support.
They need a system that works.
And they need the world to stop assuming that suffering is a choice.

The Human Cost of Neglect

We talk about “down and outs” as if they are strangers to someone. But many of them were once loved, once stable, once hopeful. They are not all addicts or drifters by choice. Some are undiagnosed autistic adults. Some are traumatised. Some are bipolar. Some are simply lost.

And behind every one of them is a family — exhausted, frightened, grieving, and often judged.

People say “Why don’t their families help?”
But sometimes the illness becomes bigger than the family.
Sometimes the person becomes hostile, unpredictable, or unreachable.
Sometimes love is not enough.

We Need a Different Approach

We need:

• Proper diagnostic pathways for people who experience psychosis
• Separate emergency wards for mental health crises
• More trained staff
• Faster intervention
• Support networks for families
• Spaces where neurodivergent people can meet others like them
• A cultural shift in how we view the brain

Mental illness is not a moral failing.
It is not laziness.
It is not weakness.

It is a malfunction of the most complex organ we have — and when the brain falters, the consequences can be catastrophic.

Before It’s Too Late

The world is becoming louder, harsher, more isolating. Suicide rates are rising. Violence is rising. Addiction is rising. And the vulnerable are absorbing the impact.

We cannot keep sweeping this under the carpet.
We cannot keep pretending the system is working.
We cannot keep leaving families to cope alone.

Most of us know someone who needs help.
Most of us love someone who is struggling.
Most of us have felt the fear of watching a mind slip away.

It’s time to rebuild the system — not patch it.

Because lives depend on it.
Because families depend on it.
Because one day, it might be someone you love.

🤍 A Final Word

If you’ve read this far, perhaps you’ve walked some of this road yourself — or you love someone who has. Maybe you’ve felt the same fear, the same exhaustion, the same desperate hope that the system will finally catch the people it keeps dropping.

My intention in sharing this isn’t to point fingers, but to open a window into a reality that too many families endure in silence. Mental illness affects entire circles, not just individuals. And until we speak honestly about the gaps, nothing will change.

If this resonates with you, you’re not alone.
If it hurts to read, it’s because it’s real.
And if you’re carrying someone through the dark right now, I see you.

We deserve a system that sees you too.

🤍 Tiffy Belle 🤍