Arizona promised secure treatment for its sickest psychiatric patients. Seven years later, it still doesn’t exist.

AZCIR by Jasmine Demers, August, 2026

Larry Bootsma was 23 years old when he experienced psychosis for the first time.

His parents still remember the phone call from his apartment. He was panicking, saying bugs were crawling out of the vents. He was later diagnosed with schizophrenia.

Larry exhausted nearly every level of Arizona’s behavioral health system over the next 25 years, including its most intensive public services for people with serious mental illness, or SMI. He was ordered by a judge to receive treatment, assigned to work with a specialized team of psychiatrists, nurses and case managers, and eventually given a court-appointed public guardian.

Despite those interventions, Larry never found lasting stability. He lived on the streets and cycled in and out of hospitals and treatment centers, occasionally landing in jail as his illness worsened. And then, on the morning of Sept. 24, 2025, the 47-year-old, known to his family as “Larry Bear,” was found dead at a bus stop in Phoenix, just outside of the mental health clinic where he received treatment.

The medical examiner said he died of a drug overdose.

“All this didn’t have to end like this. That’s the hard part for me,” said Helen Bootsma, Larry’s mom. “He could have gotten better.”

The cycle of failed treatment that preceded Larry’s death reflects a gap that Arizona has recognized for years: The state has no appropriate treatment options for people with mental illnesses too severe to be managed in the community but who don’t qualify for long-term hospitalization.

Advocates estimate that up to 3% of the roughly 63,000 Arizonans with serious mental illness—nearly 2,000 people—could fall into that gap.

Read more at AZCIR.