Philadelphia Community Mental Health System. Anna took a bus from PSH to center city Philadelphia, went to an adult services agency, gave a false name and was referred to a centralized intake unit (CIU) for medication. She spent the night at a shelter, calling her mother the next day. A local mental health center agreed to help Anna achieve her dream of living outside of a locked hospital setting, but the system was fragmented and unprepared to deal with someone as traumatized and institutionalized as she had become. For 39 days she struggled to stay in the community. During this period she was shifted from one setting to another a total of 41 times. In addition to adult services, shelter, intake unit, and various social service and legal agencies, she experienced 2 community mental health centers (CMHC), 1 community rehabilitation residence (CRR), 2 day programs, intensive case management, 6 crisis specialists, 2 mobile emergency teams (MET), 2 mental health court hearings, 1 specialized crisis facility (SCF), 36 transports by police, ambulance and agency vans, and involuntary commitment to 4 psychiatric emergency rooms and 3 acute hospital wards. None of these services saw or responded to her as a person suffering from trauma. She was told she was "chronic" and should be sent back to the state hospital from which she had fled. She was raped and beaten on the street outside a crisis facility. Her report of the assault was not believed. Strapped down in four-point restraints at a psychiatric emergency service, Anna screamed over and over again, "I'm just a sex object, I'm nothing but a sex object". She told her therapist of the "voices" inside her and what they were saying. "I'm a very young person", said the "young one", "I want you to help me." The "Mark" voice said, "go screw, do it, do it." Others said "We want blood". When asked by her therapist "whose toes are moving", Anna replied "the baby's", and "the baby is crying". Her therapist's attempts to find someone within the crisis system who could understand and help Anna, were unsuccessful.