Do you ever walk past a person on the streets exhibiting mental health issues and wonder what happened to their family? I have a brother—or at least, I used to. I worry about where he is and hope he is safe. He hasn’t taken my call since 2014.

James and his brother as young children playing together before his brother became sick. James is on the right and his brother is on the left.

When I was 13, I had a very bad day. I was in the back of the car, and what I remember most was the world-crushing sound violently panging off every surface: he was pounding his fists into the steering wheel, and I worried it would break apart. He was screaming at me and my mother, and I remember the web of saliva and tears hanging over his mouth. His eyes were red, and I knew this day would change everything between us. My brother was sick.

Nearly 20 years later, I still have trouble thinking about him. By the time we realized he was mentally ill, he was no longer a minor. The police brought him to a facility for the standard 72-hour hold, where he was diagnosed with paranoid delusional schizophrenia. Concluding he was not a danger to himself or others, they released him.

There was only one problem: at 18, my brother told the facility he was not related to us and that we were imposters. When they let him out, he refused to come home.

My parents sought help and even arranged for medication, but he didn’t take it. Before long, he disappeared.

My brother’s decline and disappearance had nothing to do with the common narratives about drug use or criminal behavior. He was sick. By the time my family discovered his condition, he was already 18 and legally independent from our custody.

The last time he let me visit, I asked about his bed. I remember seeing his dirty mattress on the floor beside broken glass and garbage. I also asked about the laptop my parents had gifted him just a year earlier. He needed the money, he said—and he had maxed out my parents’ credit card.

In secret from my parents, I gave him all the cash I had saved. I just wanted him to be alright.

My parents and I tried texting and calling him; there was no response except the occasional text every few weeks. But weeks turned into months.

Before long, I was graduating from high school. I begged him to come. When I looked in the bleachers, he was nowhere to be seen. I couldn’t help but wonder what I had done wrong.

The last time I heard from him was over the phone in 2014. I tried to tell him about our parents and how much we all missed him. I asked him to be my brother again, but he cut me off, saying he was never my brother. After a pause, he admitted we could be friends. Making the toughest call of my life, I told him he was my brother—and if he ever remembers that, I’ll be there, ready for him to come back.

I’m now 32 years old. I often wonder how different our lives would have been if he had been diagnosed as a minor and received appropriate care. The laws in place do not help families in my situation.

My brother has no social media, and we suspect he traded his phone several years ago. My family has hired private investigators over the years, who have also worked with local police to try to track him down.

One private investigator’s report indicated an artist befriended my brother many years ago. When my mother tried contacting the artist, they said whatever happened between them was best left in the past and declined to respond. My mom had wanted to wish my brother a happy 30th birthday.

My brother grew up in a safe, middle-class home with two parents. He had no history of drug use or criminal record. He loved collecting vintage basketball cards, eating mint chocolate chip ice cream, and listening to Motown music. To my parents, there was no smoking gun indicating he needed help before it was too late.

The next time you think about a person screaming outside on the street, picture their families. We need policies and services that allow families to locate and support their loved ones living with mental illness, and stronger protections to ensure that individuals leaving facilities can transition into stable care. Current laws, including age-based consent rules, the limits of 72-hour holds, and the lack of step-down or supported housing options, leave too many families without resources when a serious diagnosis occurs.

Governments and lawmakers need to do better for people like my brother. As someone who thinks about him every day, I can tell you the burden is too heavy to carry alone.

James Finney-Conlon is a concerned brother and mental health advocate. He can be reached at [email protected].