I've run into some people who honestly are such messes that they can't get their lives together enough to realize what it means to have a "mental illness" (yep, I use the word for lack of a better term in this context). Because of their raising, and their chemical or abuse problems or even cognitive problems, they can't handle their psychiatric issues responsibly. I'm not really contradicting myself here; these are folks who just, no matter how hard they try, can't get all the ducks lined up to take responsibility for their actions because the insight, the ability to see consequences, and the ability to handle the stress that comes with responsibility just isn't there and isn't likely to develop. These folks are a little different than the ones that tishie is talking about, but here, I would say that these ARE really sick people with multiple diagnosis, maybe even double trudgers as the AA used to call them. After some thought, I remembered that the folks in a daycare program for people with psychosis problems used to refer to such patients as the above as "those poor guys" or "the really sick ones" even if the speaker was at the moment more floridly psychotic than the person referred to. What was meant was that those folks had much worse chances of functioning on their own than the others. Just a kind of strange aside from the queen of non sequiters. Hugggs all!