The speaker describes living with what sounds like a severe mental illness, and the poem puts us inside the experience. At twenty, old childhood nightmares come back. Ordinary details start to feel loaded with hidden meaning, voices whisper on the street, and a running news report in the speaker's head tracks every move. Figures break into the bedroom to tease and torment, then vanish.
When the speaker tells a doctor, the help on offer feels like punishment. Shoelaces are taken away, cigarettes are rationed, and pills make the speaker "forget I exist." The poem never says outright that this is a hospital, but the details strongly suggest one.
The mood is frightened, numb, and lonely. As the body feels distant and memories fade into shadows, only "the echo of a soul screaming out / for deliverance" remains. The title fits: a cry that no one seems to answer, fading but still there.