I recently met a distant relative at a funeral who is diagnosed with bi-polar. He could not sit still at his own mothers funeral. He was her only child. He was disheveled, had no one there who he could call to give him a ride to his own mothers funeral!. He told me he took 3 buses to get there, 5 hour ride. He had become so isolated. He is on disability. He had graduated from law school, only to be unable to take his boards due to his exacerbations. When you are isolated, you rely on psych case managers, social workers to see that you can get rides to your appointments and pick up you medications, buy food and clothes ect. Where he lives, ano one would want to be. He would be the type to frequent an emergency room. I fell sorry for nurses who would turn themselves so hard to be unable to see the crisis in front of them. I am sure you see some abuse, but these are people who once they leave your E.R., go back to living in their own hell on earth.