Very thoughtful article, Michael. I come from the U.S. but live in Germany now, and a neighbor’s very public psychotic break, which unfolded over the course of nearly a year, was a hard lesson in just how bad mental healthcare can be here also. In the U.S., it’s quite awful. In Germany — given the history of persecution against the mentally ill — things can be so hands-off that the mentally ill are left to spiral deeper and deeper, un-helped, even past the point when it’s quite clear to anyone that they are in urgent need of intervention. The philosophy on the ground in this country is (effectively) that it’s your “right” to be as crazy as you want to be... without anyone acknowledging that being crazy is often a terrifying experience in itself, which nobody genuinely wants at all. Amazing how many cultural variations there are to handling mental illness… and sad how many cultures are failing at this abysmally.

I hope that your friend and your sister find healing, somehow, soon.