In Their Own Voice: Skyrocketing Expenses and Reduced Income for SMI Caregivers

The Preparedness Project, an initiative founded by financial advisor Paul Peeler, has made it their mission to provide specialized financial planning support for Serious Mental Illness (SMI) caregivers and their families.

As part of that mission, Peeler has produced a variety of articles and other educational resources for caregivers and has recently started a series called “In Their Own Voice” where he interviews parents and caregivers of an adult child with a mental illness. Through these interviews, he helps to share their journey and identify themes and lessons that can help other families in similar situations.
Heather Hawthorne is a single mom and a marketing professional. In 2022, she made the gutsy decision to leave her employer to find a position that advanced her career goals. Little did she know at the time that her son would soon go into crisis and throw her job transition plans into disarray. The Preparedness Project interviewed Heather about the challenges of managing career transition while navigating a family mental health crisis. This conversation has been condensed for clarity and brevity.


Paul: Your son went into crisis about the time you left your former employer, correct?

Heather: Yes. Literally the day after it was announced to the organization that I was leaving, he was admitted to an acute treatment facility. He was experiencing psychosis, voices, agitation, manic episodes, dilated pupils… Going back to school seems to have been the trigger for him and we were able to get him admitted for treatment voluntarily.

In hindsight I guess I could have postponed leaving, but at the time I had no idea what I was getting into.

Paul: How is your job search going right now?

Heather: Going into the job search, I thought for sure I’d have a job offer by now. My former employer extended my employment to the end of the year, but the situation with my son has delayed things. Because I hadn’t been in the job market for a while, I wanted to work with a career coach to translate my experience into marketable skills. But honestly, I just didn’t have the bandwidth to engage in the process. Each month has brought a different version of crisis.

And dealing with crisis, you are so drained that it makes it difficult to even function. It’s not that you’re procrastinating; you just don’t have the reserves to move forward. And that as added stress to the holidays on top of the crisis with my son.

I have applied for a few positions and am really attracted to a couple of opportunities. In the meantime, I have been able to default back to some freelance work with clients from my previous life. That’s not ideal, but it provides some income. My former employer was more than generous with severance, but that is coming to an end.

I view my full-time job right now as finding residential treatment for my son, and the freelance projects give me the flexibility I need for that. But I also need the stability and benefits of full-time employment. So, each has its pros and cons.

Paul: What kind of support have you received?

Heather: Support is essential to survival. My friends have been amazing. My ex-husband and I attended a NAMI support group early in the process, and the connections we made through that have been invaluable. The individuals there recommended doctors, books, and legal strategies we should be considering. And the sharing and understanding make you feel that you’re not the only one to have this problem.

One day I’d like to be a support to others in a similar situation, but I realize I need to get through this initial wave first.

It also helps that my ex-husband and I have gotten on the same page. I think he may have been in a bit of denial at first, but in all fairness, he wasn’t seeing our son day-to-day like I was.

Paul: You mentioned the recommendations you got. What are some that stand out?

Heather: We were pointed toward a book: I’m Not Sick, I Don’t Need Help. That was very illuminating.

And someone told us to double-check and make sure any treatment or facilities we were considering were covered by insurance. We have rung up thousands in out-of-pocket costs, and frankly, my ex is bearing 100% of the payments right now.

It gets scary when someone on the phone asks you, “Can you pay $1,000 today?” But you just do what you can.

Paul: Anything else you’d like to add?

Heather: Let me just add this: At the beginning of the year, I made the decision to stop drinking. I didn’t like my relationship with alcohol; I felt like it was a huge limiting factor in my personal growth. Sobriety has given me the radical clarity I need to manage this situation.

Paul: Thank you for sharing, Heather.


In the time elapsed between this interview and publishing, Heather received and accepted an offer for a position in her field. Nonetheless, her situation echoes themes that we often see with caregivers in her situations.

Heather and her ex-husband saw skyrocketing expenses, even with employer-provided health coverage. Heather certainly experienced a compression of emotional bandwidth – which certainly impacted her job search. We also discovered in an offline conversation that she and her ex-husband were planning on consulting a special needs planning attorney, reflecting an increased legal and estate complexity.

Amid all this, The Preparedness Project applauds Heather and her ex-husband for fully collaborating in the care of their child.

If you are finding yourself grappling with similar issues, don’t go it alone. Reach out to The Preparedness Project today for additional support.