Lost Patients

A look ahead at the final episode of Lost Patients, coming next week on April 23. We'll explore what recovery looks like for people with serious mental illness — and what it might look like for our fractured system of psychiatric care itself.

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After 10 months at Washington State's largest psychiatric hospital, Adam Aurand is discharged onto the streets of downtown Seattle — ejected into a world shaped by decades of deinstitutionalization and failure to build community-based mental health care. His mother rushes to save him before he gets pulled back into the "churn." A Seattle Times reporter tries to pinpoint where the discharge process failed — and the investigation leads her to new conclusions about the limitations of psychiatric care in the U.S.

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In the middle of the last century, a movement to free patients from state-run psychiatric hospitals swept the U.S. This movement — deinstitutionalization — is widely blamed for seriously mentally ill people ending up on the streets. The real story goes much deeper than a loss of psychiatric hospital beds. It's about how incentives and decisions half a century created the dysfunction many people with serious mental illness are lost in today.

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After Carrie Davidson learned that her great-grandmother died in a psychiatric hospital, she spent years tracking down details of her life there. Was the asylum a refuge? Or a prison? This earlier era hangs like a shadow over our approach to care today. We peer into horror and nostalgia that surrounds our societal memories of these mental institutions — and try to sort out which narrative is true.

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Across the U.S., efforts are underway to make it easier to involuntarily commit people to psychiatric hospitals. It's a reaction to the sight of seriously mentally ill people on the streets and the cries of families who say it's too hard to get a loved one help when they're in crisis. But this gets at one of the most delicate questions our society has faced: When does our belief about what's best for someone override someone's right to decide for themselves?

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Heidi Aurand has watched her son Adam spiral from one psychiatric crisis to the next for about eight years, bouncing between emergency rooms, jails, and homelessness. Now, after treatment at the state's largest psychiatric hospital, Adam was just released back onto the streets of downtown Seattle. A mother asks: How could her son pass through so many institutions and none are able to stop his decline?

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Imagine a sprawling house in which every room, doorway, and hall passage was designed by a different architect. Doorways don't connect. Staircases lead to nowhere. Rooms are cut off from each other. That's how reporter Will James describes our complicated system for treating people with severe mental illness – a system that, almost by design, loses patients with psychosis to an endless loop between the streets, jail, clinics, courts and a shrinking number of hospital beds. Lost Patients is a deeply-reported, six-part docuseries examining the difficulties of treating serious mental illness through the lens of one city's past, present and future. With real-life testimonials from patients, families, and professionals on the front lines, Lost Patients provides a real, solutions-oriented look at how we got stuck here...and what we might do to break free.

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