Nelson Duarte knows “health comes first” and the importance of staying on his medications. He recites his frustrated refrain as he navigates the challenges of community clinics and the disability insurance application process. He struggles with bipolar disorder and schizophrenia, as well as diabetes and high blood pressure.

Nelson first had hallucinations at age thirteen, and he soon found himself caught in the criminal justice system’s revolving door. Prison, however, actually provided Nelson with effective medications for managing his mental illness.

“A lot of people do stupid stuff to afford medication,” he says grimly, “I’m not the only one who’s stressing because they can’t afford their health care.”

Now released and a free man, he cannot get the medically necessary brand-name medications needed to treat his schizophrenia. Instead, because he lacks Medicaid or other insurance, he can only get generic medications that are far less effective at managing his symptoms. And because he struggles to manage his symptoms, finding employment that accommodates his medical conditions has been challenging—hence the disability application, a process that can take several years to resolve.

In the meantime, Nelson wrestles with severe mental illness, struggling to survive, regularly selling his plasma in order to buy medications. “A lot of people do stupid stuff to afford medication,” he says grimly, “I’m not the only one who’s stressing because they can’t afford their health care.”