a young lady with schizoaffective disorder

I first met this patient, K, on Feb. 16, 2023 in North Virginia Mental Hospital, and I have been visiting her for about 4 weeks until she was discharged and sent back to jail.

That day I arrived at the mental hospital at 10:00 am, but I did not meet K until about 11:30 am, because she was still sleeping. Also, a nurse was sitting in a chair at the door of her room to watch her sleeping, since she was not allowed to be left alone without supervision under any circumstances. It is one of the most serious measures used by the hospital for the most unstable patients to prevent them from hurting themselves or other patients.

K is a young Chinese girl, only 25-years-old. She was tall and buxom with straight black hair over her shoulder. She is not obese or overweight, but full-figured, with a prominent breast and butt. Although her figure is not slim enough for the taste of Chinese, it will be considered attractively curvaceous in America. However, her face is somehow big and flat, and her eyes are narrow, and I cannot say that she has a beautiful face. 

I talked to her a little that day. Although she could answer my question well, her response was very slow. Later, another interpreter , who met K before, told me that K did not talk to any person and just looked at the painting on the wall when she first saw her. Therefore, her willingness to talk to me is a remarkable progress. 

The next day when I saw K, she already did not need supervision during sleep. Later, I found that her English is very good, and she has no problem communicating with other patients and the staff as well as taking part in group activities. I only need to explain some medical terms to her. She also mentioned that she did not need an interpreter, but her treatment team thought the presence of an interpreter, who understands her culture background, ameliorate her anxiety and improve her wellbeing, so they still kept requiring interpreting services for her during her stay in the mental hospital.  

The unit she was in is dreadful. Many patients in her unit have hallucination and/or delusion, and displayed significantly disturbing and abnormal behavior. For example, one patient kept talking loudly to himself for hours in his room, and another one kept yelling about no-related issues in group activities. When many irritable and unstable patients are put together, conflict is almost unavoidable, and all kinds of incidents happen all the time. I have witnessed at least two fighting between patients during my visit to the unit. One day, a terrible patient in a wheelchair intentionally pooped in common space, and made the hallways in the unit fetid for a while. In another incident, a patient lay down on the floor in the common room and pretended to lose his conscience for more than an hour, because he did not get the result he wanted from the treatment meeting earlier that day.

 

Since K is the only young woman in this unit, she got many positive as well as negative attention from other patients. I have seen at least one male patient who was frivolous and rude toward her. Also, because of this, she asked to transfer to another unit during the last week of her stay in the mental hospital.

 In spite of some unpleasant patients, most staff treated her well. For example, at least two of the therapists gave her books to read, and she told me more than once that all the staff here are very nice, and she liked Virginia the most among all the states she has been to. 

When I first met her, she was always tired and spent a lot of time sleeping. For at least two weeks, I never saw her up before 11:30 am, and sometimes, she was tired during the afternoon group activity, and went back to her room to sleep. Additionally, her response was slow and did not talk much. She made good progress over the time, and she said the medicine prescribed to her now made her happy. I saw that toward the end of her stay, she was more active, and for the last two days of her stay, we talked all the time of my stay.  Therefore, I have the chance to know many of her life stories. 

She was born in 1998 in Harbin. Her father is from the countryside of Northeast China, and has a college degree. Her mother, only graduating from high school, is from Harbin, whose half older sister and her husband were the founder and owner of a pharmaceutical company in Harbin. Both of her parents worked in this company, but her father worked for more than ten years, whereas her mother only worked for a couple of years. Ke indicated that her parents depended a lot on her aunt for money. 

She lived in Harbin with her parents until she was 8 years old (2006), then her family lived in Beijing for 5 years (2013), and she was enrolled in a private school, because her parents lacked Beijing residency. Then they moved to Shenzhen in 2013, where she went to a private international high school. After graduating from this high school in 2016, when she was only 16-years-old, she was admitted by Oxford University in London to study mathematics. At that time, she already had a much younger brother, and both her parents had not been working for a while. According to K, her father traded Chinese stock every day, and her family mainly lived on the rental income from several investment properties they had in several cities in China.

Going to Oxford was a great achievement for a Chinese girl like her, however, she only studied there for one and half years. When I asked about the reason why she failed at Oxford, she said she did not focus on studying then because she was with a boyfriend. After failing at college, she became a stripper and danced at an adult club. She said that since she had not been 18-year-old yet, she used a fake ID, which was caught by English Police. Then one of her colleagues told her America is better than England, so she applied for a visiting visa using her own passport and came to the USA in 2018. Thus, she only worked in England for half a year.

The first city she lived in America was New York City. She was just 18 years old, and an exotic dancer living in ChinaTown. There she met a guy named John, who is a US marshal. She had been with John for 2-3 years, but they never talked about marriage. John said marrying an undocumented immigrant will cost his job as US marshal and he loved his job, so he could not marry K. But I thought this was just an excuse.  

Shortly after breaking up with John, she got another boyfriend, Richard. Then she was 21-years-old, but Richard, a court clerk and her neighbor, was already 42 years old. K said after she and Richard had been together for about 1 year, she took him to meet her aunt (her mother’s rich older sister) in Seattle. K said at that time, her parents and her brother already moved to Hong Kong in order for her brother to be educated there instead of in Mainland China. Also, according to K, her parents may not have legal status in Hong Kong. Since her parents could not come to the USA, and her aunt who has already immigrated to Canada and lived in Ottawa, came to Seattle to meet Richard.

 The meeting was not conciliating. Although her aunt did not openly oppose their marriage, she seemed not like Richard. It was understandable, because this man was so much older than her niece. She gave K $5000 for her dental treatment (she needed to retract her wisdom teeth then), and asked to meet Richard’s family. Somehow, this no-unreasonable-request led to the breakup between K and Richard.

K said she became upset and sad because of this breakup, so she went to Hawaii to relax. In Hawaii, she found a job other than being a stripper. She worked as an assistant for an old female architect, where she met her next boyfriend, Peter. Peter, only one year older than K, also traveled to Hawaii for pleasure, and he worked for the same architect for a month. After they fell in love, Peter took K back to Idaho, where he worked as a lab technician in a small chemical company. She got pregnant there, but had abortion at 6 weeks.

She got abortion because she had not decided to marry Peter. Peter was a laid-back guy, and had no clear plan with his life and career. His salary at that time was $14/hour equaling about $28,000/ year, which was not enough to support their life. Because of concerns for finance and  future life, she had the abortion. But after the abortion, she became depressed, and it was 2021 and she was 23.

She said because of her depression, she turned to a psychic and tried to find out about her future, who took $58000 from her, and gave her no answer. Now, she realized she was swindled and thought about suing this psychic, but it is almost impossible to get her money back.

Somehow, around that time, she had a one night stand with a guy from California. Afterwards, she felt she was in love with this guy, and followed him to San Francisco in the hope of developing a relationship with this guy. But this guy was not interested, and she had an incident of attempted suicide, which she denies now. She said she just turned on the gas in the kitchen, and somehow the flame was distinguished, and it was not her intention to commit suicide. It looked like her neighbor called the police, and the police sent her to a mental hospital, where she stayed for one week. This was Jan. 2022. 

In March, 2022, she was hospitalized in a mental institution for the second time in Hawaii. She bought a small ice store on her first visit to Hawaii, and hired some local staff to take care of this business. She always said that this business had good profit, but she said since she was no longer in Hawaii, her staff stole money from her. Therefore, she went back to Hawaii to deal with it. Somehow, she felt depressed in Hawaii, and checked herself in a local mental facility, stayed for one week, and checked herself out.

In Hawaii, she had another scheme to get her legal status. She said she paid $2,000 to a guy named Kevin to marry her, so that she could get legal status through her fake marriage. Kevin is in his thirties, and a mixture of Hawaii aboriginal people, Chinese, and Ireland. He was a waiter, and only reported $26,000/year in his tax return. Later, she broke up with Kevin and filed for marriage annihilation, but she got a learner’s permit in Hawaii, which was her first legal ID in the US.           

In December 2022, she moved to Virginia, which was arranged by her aunt. Her aunt is a Christian, and she has a Christian friend living in Virginia near DC, who has an extra room in her house. Her aunt paid two-week-rent for her, and she flew out of Hawaii, and lived with her aunt’s friend for three weeks. Three weeks later, she moved to a free shelter for human traffic victims, because she could not afford the rent. She stayed in the shelter for two weeks, and was forced to leave because she was bullied by other residents in the shelter. 

With no place to go, she knocked on the door of her previous residency, her aunt’s friend’s house. But the owner never let her in, and told her she was no longer welcome here, and they called the police. Police came, and warned her that she needed to leave, and cannot go near this house. However, she still came back to the house after a while, and this time she was arrested for trespassing after being forbidden, although she had never entered the house.

She was put to jail for two weeks, and then transferred to the mental hospital because of her abnormal behavior. When she first came to the hospital, she looked deeply depressed as I described before. She made good progress in the hospital, and was discharged about 4 weeks later. So she was transferred back to jail a few days before her court day.  

I attended one of her treatment meetings in the hospital, and found out she was with Schizoaffective Disorder, which means schizophrenia combined with bipolar disorder. She also recalled in this meeting that she had taken multiple Psychedelic Drugs, including LSD, ketamine and magic mushrooms. But she insisted that she has never been addicted to any drugs, and she also reported that her current medicine made her happy.  

Because she was charged with trespassing and needed to attend the court, she was required by the court to take part in a competent group meeting, where social workers taught about the court systems, defendant’s rights et al. Only when the patients with mental diseases pass the competent interview, they can be tried. K attended all the competent sections, and passed the competent interview smoothly. In this interview, the attending psychiatrist told her that since her only charge was trespassing, and she already stayed in the jail and the hospital for several weeks, even if the judge ruled her guilty, her stay in the jail and hospital should have already covered her possible sentence. Thus, she would be released at her court day. 

However, I think her situation and future are still very gloomy. First, nobody can take care of her in the USA. When I asked her if she could ask anybody to give her a ride when she was released from the jail, she said no. Her treatment teams said they could arrange a phone call with her mother in Hong Kong for her. But she had never gotten this phone call until she was discharged from the hospital. Although she made great progress, her mental status is still very fragile and she desperately needed a stable and safe environment to recuperate. Since this is already her third hospitalization in mental institutes, it is unrealistic to expect a complete recovery without recurrence in a short time.

I think the best way for her is to go back to her parents if they are willing and able to take care of her. However, she said she talked to her parents about going back to China before, but they wanted her to get legal status in the US first. But, I am sure if they have fully recognized her situation, then they should know this expectation is not practical.

I can see this goal about legal status gave her a lot of stress. In the hospital, she talked a lot about how to get legal status, including claiming she is a human traffic victim or applying for asylum. She even called her first boyfriend, John, in the hospital. Because he answered her phone calls twice, she was very excited, and thought he was still in love with her and they could be together again even though he was married and has a son. However, later John stopped picking up her phone.

She also called Kevin, and found out that he had not signed and sent out the annihilation document, so they were still married. She said Kevin still wanted to help her to get the legal status, however, his income is not enough to sponsor a wife to get a green card. To solve this problem, she said she would like to pay somebody to be her sponsor, so that she can get legal status through this fake marriage. However, she doesn't love Kevin, and will not live with him. She said that she wanted to go back to New York City and resume her career as a stripper.

She also mentioned she has not been sleeping alone since she was 18 years old, and she is not used to sleeping alone, so she wanted to get another boyfriend as soon as she was released. I felt she was in an extremely vulnerable mental situation, and was easily taken advantage of, it was almost impossible to find a beneficial relationship in her situation. An unscrupulous relationship now will only hurt her later.  

All in all, although K will be released soon, I am worried that without any supporting system, her mental status will deteriorate sometime after her release. It is very sad to see this young, smart girl ruining her life like this. Although her current desperate situation was mainly caused by her several bad decisions, her parents should share the responsibility because they sent their teenage girl to a foreign country without any supporting system, and pushed their already very stressed and lonely daughter to fulfill an onerous task of obtaining legal status in America.  

I feel sorry for her. May God help her.