"Way Station" (Reflections, September) reminded me of a similar experience I had while working as a public health nurse. The police called me about a young man they found sleeping in a parking lot. He was only 17 years old, but had been through drug rehabilitation and boarding schools before being turned out by his adoptive mother, who felt she just couldn't handle him anymore. I'd intended to treat him as an adult welfare case (an emancipated minor), but while I was discussing this approach with social services, he sliced his wrist in the hallway outside my office. As he recovered, I helped to place him in a juvenile psychiatric unit, even though I had to threaten to go to the media if he wasn't admitted. One doctor in particular didn't want to take him; she thought he was "fine" and believed it sufficient to give him her business card, in case he felt self-destructive again while living on the street.

I visited this boy twice before he turned 18 and was released to a family friend. His case broke my heart, and I've often wondered what happened to him. I'm pretty sure there was not a good ending, based on his history, conversations with his mother, and one phone call I received from him after his release.

This was a very sad experience, and one that taught me a lot about life and being a patient advocate. Soon after, I spoke at a county emergency-planning meeting about the lack of mental health services for adolescents in our area, based on the difficulty I had in finding help for this young man.

Christine Contillo, RN-BC

Haworth, NJ