Marty and Candy Larsen were in their pajamas, getting ready to watch a movie in the living room, when they heard their 27-year-old daughter scream.

“I need help!” Julia cried.

They could see her standing just a few feet away, her long blond hair unkempt, her blue-gray eyes at once alert and vacant. She’d looked like this in other moments when fear overtook her and reality slipped away. But a new sight jolted them upright: their daughter’s fingers, wrapped around a pink handgun.

Julia pounded the weapon against a wall, then squeezed its trigger, sending a bullet down an empty hallway. “Help me!” she shrieked.

The parents scrambled in different directions. Candy was on with 911 while Marty reached toward his daughter. “Julia, stand down,” he said. “How can we help you if you don’t stand down?”

But Julia fired again, repeating her plea like a mantra.

“Help me!” she cried. “Help me!”

The need had been building for almost six years, since she returned home from a stint as a Navy firefighter aboard a warship in the Persian Gulf. She was tormented by the rippling trauma of an on-duty sexual assault and grappling with symptoms that led her to be diagnosed with a psychotic disorder.

She was dependent on the Department of Veterans Affairs for care. Just that morning, when her latest crisis began, a nurse at the local VA clinic in Chico, California, had told her mother to bring her in. When they arrived, a telehealth provider was too busy to see Julia. A social worker asked questions to gauge her risk of suicide or violence; even though Julia refused to answer, she was sent out into the world and told to return for the next available appointment, in 11 days.