In the 15 years since her daughter Tanya was diagnosed with a schizophrenia spectrum disorder, Monmouth Junction resident Grace Hu Travinsky has had to convince her daughter more than once to continue the therapy and medication she needs to limit her symptoms.

"My goal for her is to be independent because I know I won't be around forever for her," Travinsky said.

Tanya, now 38 years old, would always come around and listen to the advice of her mother. Compassionate doctors made the process easier.

Right now, according to Travinsky, Tanya's seeing the best doctor she's ever had.

"He's more like a father than a clinician to Tanya," Travinsky said. "We travel all the way to the Bronx, but he's worth it, and Tanya is worth it, too."

Even with the proper care, Tanya's struggle with a mental illness is "never smooth," Travinsky noted.

But at least Tanya accepts treatment with a little nudge. The journey could be an onerous one for parents, siblings or caregivers if an individual with a mental health condition refuses to seek help or refuses to admit there's a problem.

"The outcomes from treatment are much better if a person agrees to accept treatment," said Phil Lubitz, associate director of NAMI (National Alliance on Mental Illness) New Jersey.

While certain individuals can be forced by the legal system into treatment — particularly when they present a danger to themselves or others — Lubitz said the preferable scenario is one in which an individual ultimately reaches that decision themselves, typically with the help of loved ones.

"I think you want to try in any way you possibly can to convince a person it's in their best interest," Lubitz said.

That conversation, he said, would include listing the benefits that could be realized by the individual — benefits as simple as a better night's sleep, for example.

If these attempts fail, and there's a real concern about the safety of the mentally ill individual and/or others, New Jersey is one of the many states with an outpatient commitment law in which in a judge is permitted to order treatment in certain situations.

"You can take a person to one of the designated psychiatric screening centers that every county in New Jersey has, and meet with a psychiatric screener, and they'll determine if the person meets the criteria," Lubitz explained.

If treatment is ordered by a judge, an outpatient-based plan would be developed and the individual would be assigned to a mental health professional who'd be tasked with ensuring the individual is accessing all services necessary to carry out the plan.

If the individual is non-compliant, Lubitz said, it's up the mental health professional to inform the judge and screening center.

"That differs a little bit from what had been the case in New Jersey ... Frequently a family was told, 'Well, he's an adult, he can do what he wants,'" he said. "The mental health professional's and the family's hands were really tied."

The state operates four psychiatric hospitals to handle the most extreme cases. According to the Treatment Advocacy Center, New Jersey in 2016 provided 17.2 psychiatric beds per 100,000 people — below the recommended rate of 50 (a shortfall registered by every state in the nation).

There's no cure for mental illness, but the treatment available has done wonders for plenty of sufferers — even those with extreme conditions. On day five of our series, we'll speak with a couple New Jersey residents who've come a long way from a deep, dark place.

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