“The Voices Aren’t Real!”
When Mental Illness, Homelessness, and a Broken Continuum of Care Collide
There are moments in this work that stay with you.
There are people we meet on the streets who are talking to someone we cannot see. People who are terrified of something that isn't there. People who are convinced someone is following them, poisoning them, watching them, or trying to hurt them. We may know that what they are hearing or seeing isn't real.
But to the person experiencing it, it is very real.
We can tell someone, “The voices aren't real.” But saying those words doesn't make the voices stop.
And too often, neither does the system that is supposed to help them.
The tragic death of 34-year-old Jaquoya Wix in downtown Detroit has left our community heartbroken. Authorities allege that Devon Jason Watson approached Jaquoya while she was on a break from her job and fatally stabbed her. Watson has been charged with first-degree premeditated murder; the case remains pending.
Jaquoya deserves to be at the center of this story. She was a daughter, a sister, a mother and a woman simply going to work that day. Her family described her as loving, funny and resilient—a person who kept getting back up no matter what life put in front of her.
Our hearts at Motor City Mitten Mission are with Jaquoya's family, her daughter, her friends, her coworkers and everyone whose life was changed forever by her death.
But grief also requires us to ask difficult questions.
We Knew Him
Motor City Mitten Mission was familiar with Watson. Our outreach teams had encountered him on the streets.
We never had a violent or threatening interaction with him. At the same time, it was evident to those interacting with him that there were mental-health concerns.
This is where the public needs to understand one of the most difficult realities of street outreach.
Street outreach workers cannot simply force someone into psychiatric treatment because we believe that person is mentally ill. There are legal standards governing involuntary treatment, and when someone does not meet the threshold for emergency intervention, our role is engagement: offering resources, building trust, encouraging treatment, and continuing to come back.
We encounter situations like this all the time.
Some of the people we encounter have schizophrenia, psychosis or other serious mental illnesses. Some hear voices. Some experience paranoia or delusions. Some refuse shelter, treatment, medication or housing because their illness affects their ability to recognize that they need help.
So we engage. And we come back tomorrow.
Sometimes, however, we watch someone deteriorate while knowing that the help they desperately need may not be something we can compel them to accept.
And there is another reality the public doesn't always see:
Some of the people we encounter living homeless aren't homeless because they don't have housing available to them.
They may have a family home. They may have a group home. They may have supportive housing. Yet because of untreated or inadequately treated mental illness, they leave that housing and return to the streets.
Technically, a bed may exist for them.
Functionally, their illness has made that housing inaccessible.
Mental Illness Does Not Care About Your Address
Everyone has mental health, and mental illness can affect anyone. It does not discriminate based on ZIP code, income, career, education, family support, or whether someone has a roof over their head. Any one of us can experience a mental-health crisis, sometimes suddenly and in ways that even the people closest to us never anticipated.
That is important to remember when we talk about what happened to Jaquoya Wix.
What Watson did was horrific. Discussing his mental illness is not meant to excuse his actions or diminish the life that he took. But his actions should not reinforce the stereotype that people experiencing homelessness or serious mental illness are dangerous. Most people living with mental-health conditions will never commit a violent act.
At MCMM, we interact with thousands of people experiencing homelessness. We sit beside them, transport them, bring them food, take them to shelters and hospitals, listen to their stories, help them enter treatment, reconnect with family, and move into housing. The overwhelming majority are not dangerous.
They are mothers and fathers. Sons and daughters. Veterans and grandparents. People who once had careers and homes. People who have experienced trauma, illness, addiction, domestic violence, job loss, or simply one crisis after another.
They are people.
Homelessness can also make an existing mental-health condition much more difficult to manage. Taking medication, keeping appointments, communicating with providers, and following a treatment plan become considerably harder when you don't know where you will sleep, don't have transportation, or don't have a working phone.
Having a home does not make someone immune from mental illness, and experiencing homelessness does not make someone dangerous.
Homelessness is a circumstance. Mental illness is a health condition. Neither defines the entirety of a human being.
Getting Someone Into the Hospital Isn't the End of the Problem
For outreach workers, getting a person experiencing a serious psychiatric crisis into treatment can be extraordinarily difficult.
Sometimes we finally succeed. And then another challenge begins:
Will the facility keep them long enough to stabilize them?
And perhaps more importantly:
What happens when they are discharged?
This is where we repeatedly see the system break down.
Someone experiencing homelessness may spend days or weeks in a psychiatric facility. They may receive medication. They may stabilize enough that they no longer require inpatient hospitalization.
Then they are discharged.
They may leave with medication.
They may leave with a prescription.
They may leave with a piece of paper telling them to call for a follow-up appointment.
But where are they going?
Reporting about Watson's case raises exactly those questions. Publicly reported court records indicate that in July, a medical professional described him as experiencing acute psychosis, and a Wayne County probate judge subsequently ordered mental-health treatment. The order reportedly included assisted outpatient treatment following hospitalization.
Even more troubling, reporting indicates that after his discharge, the probate court was not notified as required that an outpatient treatment plan was in place, leaving the court unable to monitor his progress or intervene if treatment was not occurring. Detroit Wayne Integrated Health Network has said it is reviewing what occurred.
This isn't about suggesting that everyone living with mental illness is dangerous. They are not. Millions of people live with mental-health conditions and never harm another person. We do tremendous damage when we equate mental illness with violence.
It is also not about excusing criminal conduct because someone has a mental illness. The criminal justice system will determine responsibility in this case.
It is about asking whether we are doing everything we reasonably can before someone reaches the point of crisis.
A Prescription Is Not a Discharge Plan
Imagine being discharged from psychiatric hospitalization while experiencing homelessness.
You may leave with medication, a prescription, and instructions for a follow-up appointment. But where will you sleep? Where will you keep your medication? How will you get to the pharmacy? Do you have identification, insurance, transportation, or a working phone?
And if your illness includes paranoia, hallucinations, or disorganized thinking, are we really expecting you to independently navigate multiple agencies and appointments immediately after discharge?
Imagine trying to manage paranoia while sleeping somewhere that you genuinely do have to worry about being robbed, assaulted, or having your belongings stolen. When some of the things you fear actually can happen where you are sleeping, distinguishing between what is real and what is part of your illness can become even more difficult.
Then, if you don't show up for that appointment—who comes looking for you?
Too often, the answer is nobody.
A piece of paper is not case management.
A prescription is not housing.
A phone number is not a warm handoff.
And discharging someone experiencing serious mental illness back into homelessness is not continuity of care.
We Know How to Build a Bridge. We've Done It Before.
There is an important comparison to substance-use recovery.
Someone completing residential substance-use treatment may have access to recovery housing, peer recovery coaches and other continuing supports. The system recognizes something fundamental: completing inpatient treatment does not mean recovery is finished.
We need to apply that same principle much more consistently to serious mental illness.
A psychiatric hospitalization should not end at the hospital door.
For a person experiencing homelessness and serious mental illness, discharge planning should begin before discharge and include an actual destination—not simply an address for another appointment.
We need stronger systems that can provide intensive transitional case management, peer support, medication coordination, transportation, benefits assistance, supportive housing or appropriate residential placement, and persistent follow-up.
We need warm handoffs, where one human being transfers care to another human being—not referrals that depend on someone in psychiatric crisis navigating the system alone.
And when someone misses an appointment, the response shouldn't simply be “noncompliant.”
The question should be:
Where are they, what happened, and how do we re-engage them?
This Cannot Be Normal
We have to create something between “Would you like help?” and “Call 911.”
At Motor City Mitten Mission, our teams will continue doing what we have always done: meeting people where they are, offering food and necessities, encouraging treatment, transporting people when they agree to receive help, connecting them with services, and returning again when they say no.
But street outreach cannot substitute for a functioning mental-health continuum of care.
Homeless shelters cannot substitute for psychiatric treatment.
Police cannot be expected to become the mental-health system.
Emergency rooms cannot be the beginning and end of psychiatric care.
And people with severe mental illness should not have to deteriorate on the street until they finally become dangerous enough—to themselves or someone else—for the system to intervene.
Jaquoya Wix Deserved to Go Home That Day
Jaquoya was not a statistic or simply part of a story about homelessness and mental illness. She was the victim. She was a mother, daughter, sister, friend, and coworker whose life mattered. She went to work that day expecting to return home to the people who loved her, and she never got that opportunity.
Her family is now living with a loss that can never be undone. A child is growing up without her mother. Her loved ones are left trying to understand how something so horrific could happen.
Nothing about Watson's mental illness excuses what happened to Jaquoya. Talking about failures within our mental-health system does not change that, nor is it intended to minimize what happened to her.
But I also believe we have a responsibility to ask difficult questions when something this tragic happens.
Were there opportunities for intervention before Jaquoya was killed? Were there gaps in treatment, discharge planning, follow-up care, or accountability? What happens when someone with severe mental illness is discharged from a psychiatric facility into homelessness?
And what can we change so another family does not have to experience what Jaquoya's family is experiencing today?
Those questions aren't about excusing Devon Watson. They are about preventing another Jaquoya Wix.
We cannot bring Jaquoya back.
But we can say her name.
We can remember that she is the reason we are having this conversation.
And we can examine where systems failed or broke down and work toward a mental-health system that intervenes earlier, follows people after hospitalization, and provides meaningful support rather than waiting until another crisis ends in tragedy.
We cannot know with certainty whether a different intervention would have prevented what happened to Jaquoya. But we can learn from what happened without stigmatizing an entire population of people experiencing homelessness or living with mental illness.
Because the voices may not be real.
But the person hearing them is.
Their fear is real.
Their illness is real.
Their need for treatment is real.
Their need for housing is real.
Their humanity is real.
And Jaquoya's life was real.
Her family's grief is real.
Her absence is real.
And the responsibility we have to learn from what happened is real.
Jaquoya deserved better. Her family deserved better. And as a community, we have a responsibility to do better.
We have to do better.
— Gail A. Marlow
Executive Director & Co-Founder
Motor City Mitten Mission
“It’s Easy to Be Kind.”
WXYZ Channel 7 Detroit
September 23, 2026
By: Brett Kast
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