December 21, 2013.

For the Mentally Ill, Finding Treatment Grows Harder

And in her practical way she scraped together a small square of dust, and with a twig from a pigeon's nest began drawing a map on the floor.

LEONARDTOWN, Md.----To the outside world, it came across as mood swings and anger. But Regina Cullison would later be told by psychiatrists she struggled with depression and anxiety—and that she needed help. And that is where her trouble began and ended.

IV

Winston looked round the shabby little room above Mr. Charrington's shop. Beside the window the enormous bed was made up, with ragged blankets and a coverless bolster. The old-fashioned clock with the twelve-hour face was ticking away on the mantelpiece. In the corner, on the gateleg table, the glass paperweight which he had bought on his last visit gleamed softly out of the half-darkness.

According to her mother, there were few psychiatrists in the county who took private insurance. When Ms. Cullison lost her job as a dentist's assistant, and with it her insurance, she switched to a nonprofit facility. Doctors came and went, and none stayed long enough to establish a regular pattern of treatment.

In the fender was a battered tin oilstove, a saucepan, and two cups, provided by Mr. Charrington. Winston lit the burner and set a pan of water to boil. He had brought an envelope full of Victory Coffee and some saccharine tablets. The clock's hands said seventeen-twenty; it was nineteen-twenty really. She was coming at nineteen-thirty.

After two years, Ms. Cullison abandoned her search for professional help and tried marijuana. Her mother, Carolyn Cullison, who is the director of a mental-health peer support group, said that helped push away the demons. But in May, while living together, the pair argued. Ms. Cullison apologized, retreated to a bedroom and shot herself. She was 26.