When There’s Nowhere for Your Children to Be Safe

These mothers keep their phones on silent because their nerves are fried. Every time they hear a ring, they know it could be awful news, and their minds and bodies tense up — over and over again for years.

Their adult children have serious mental health issues or ongoing substance abuse issues or both. One woman, whose son has severe mental illness and has been showing signs of emotional dysregulation since he was a small child, said that sometimes the phone would ring and “I didn’t know if it was a nurse calling to let me know she had to give him Tylenol or if they were calling to let me know that the sheriff’s office was there and they had to pull out the Tasers. I never knew.” Another woman, whose daughter struggles with mental health issues, said, “Anytime I hear that ring in a movie or anything, I have a dramatic reaction to it.”

I heard these stories when I sat in on several support groups run by Judith Smith, a psychotherapist and the author of “Difficult: Mothering Challenging Adult Children Through Conflict and Change.” I agreed to allow these women to remain anonymous so that they could speak candidly about their children’s struggles without further risking alienation or estrangement from them. (The groups I visited are for mothers, but many fathers manage the care of their mentally ill adult children as well.)

I interviewed Smith about “Difficult” in 2022, and since then, the problems experienced by families of difficult adult children really haven’t improved.

While there was variation in these families’ histories, the women I heard from hit similar bleak notes. A common story went something like this: An adult child had severe mental illness but wasn’t medication compliant because he or she hated the side effects or suffered from anosognosia, an inability to recognize one’s own illness.

Several women reported that even if their children consented to proper treatment and allowed their parents into the process, the treatment they sought could be nearly impossible to obtain. Sometimes insurance wouldn’t cover long-term care, or the availability of care was illusory: On paper, for example, there might be 10 psychiatrists in a given state who saw schizophrenic patients. But in reality, none of them were taking new patients, or they didn’t accept Medicaid, or they practiced hundreds of miles away. The women talked of countless hours spent looking into disparate health care options and coming up empty.