COUPEVILLE — The image is of a middle-aged man with a nice haircut, a neatly trimmed beard and a friendly smile.

The text above and below his photo doesn’t mention how he studied engineering in college after graduating from Mariner High School, or how he worked on bridge projects at one point in his life.

In bold black letters at the top of the poster are the words “MISSING PERSON.”

It can be found on Karen Koschak’s Facebook page where she makes her plea: “Help me find my son.”

Matthew Fitch vanished on Oct. 29, a Monday in the late afternoon. The weekend before, he’d watched his 8-year-old son’s last soccer game of the fall and joined him at an annual Halloween event in town, a kind of pinewood derby but with pumpkins on wheels racing down a street lined with hay bales.

Fitch had been a bit under the weather lately with respiratory problems. He’d received medication from a doctor.

On that Monday afternoon, he took a bath, hoping the hot water would soothe his sore back.

He told his wife, Consuelo, he was going to take a walk while she and their son decorated cookies shaped like ghosts, bats and tombstones. Fitch ventured out through the back yard, which was a little unusual. He normally headed out from the front.

A little after 5:30 p.m., Consuelo texted him, There was no reply.

A half-hour later, she tried calling. No answer, but that was not unusual. He often forgot to recharge his cellphone.

She drove around, but could not find him.

Nearly a month later, after the area near his home was scoured by search and rescue volunteers, search dogs and drones, there have been no signs of him. Family and friends have gone door to door with his photo, combed the woods and walked the beaches.

Island County sheriff’s deputies have followed up on tips, but missing adult cases can be tricky. No one knows with any certainty why Fitch is missing, said detective Ed Wallace. Sometimes adults choose to disappear and there is nothing illegal about it.

Fitch was wearing a gray T-shirt and beige Carhartt pants when he left his central Whidbey Island home on the north lip of Penn Cove. He was not wearing a coat.

He took no money and there have been no debit or credit transactions on his accounts.

Koschak spent four decades in education, beginning as a teacher in Marysville. She worked in the Edmonds School District before becoming a superintendent in Aberdeen, Granite Falls and Coupeville.

Contentedly retired, two years ago she found herself a student again. She’d been thrown into a crash course on mental illness, and the right answers were hard to find.

In 2016, at the age of 43, Fitch began to exhibit paranoid and irrational behaviors. It began with pacing and sleeplessness. Over time, his condition worsened. His delusions became grandiose. He had access to guns and he armed himself against imaginary demons, making threats and becoming a danger to himself and others.

Koschak remembers thinking: “This isn’t my son. We need some help here.”

Eventually, court records show, both Koschak and Fitch’s wife sought protection orders, which he violated.

He was arrested and served time in the Island County Jail with part of his sentence spent at a hospital where he could get mental health treatment.

Months later, after he’d been weaned from medicines and was deemed stable, he was able to reunite with his family. He met with a counselor while on community supervision, which proved to be an important safety net during the transition back to his former life.

“He did have a horrible event two years ago, never before, never after,” Koschak said.

She can’t help but wonder if the medication he was on for his respiratory issues could have played a role in his disappearance, perhaps prompting another psychotic episode. Among the potential side effects of prednisone are trouble sleeping, severe mood swings and personality change.

Fitch had begun pacing again the day before he disappeared, she said.

One thing she is convinced of is that her son dearly loves his wife and son. He’d let the boy help him work on cars and boats and with the apple cider press. They’d often go hiking and crabbing together and Fitch frequently was on the sidelines for whatever sport was in season.

“He wouldn’t have walked out voluntarily and leave his family,” she said.

Koschak remembers a time when she would read stories in the news about people with mental health issues getting in some kind of trouble. She’d think to herself: Why don’t their loved ones get them help?

She has come to learn it is not that easy.

“The brain is an organ just like your heart and your kidneys,” she said. “If you have a problem with your heart or kidneys, you get it fixed. If you have a problem with your brain, it’s shameful. We just have to get past that.”

Koschak tries not to dwell on all the possibilities.

For now, she simply hopes for the best, that he is alive and will come home.

Eric Stevick: 425-339-3446; stevick@heraldnet.com.

Tips can be directed to deputies in Island County at 360-679-9567, or call 911.