Advice for People Who Have a Mentally Ill Family Member Who Refuses Treatment

I've spent the last few days giving support to a dear friend whose brother has been behaving erratically. He has fits of rage that go on for hours and happen quite frequently. He also exhibits other unnatural behavior, and for the sake of the family's privacy I will not go into them. Although I'm not a mental health professional, I've dealt with a mentally ill member of my own family and strongly believe that her brother is exhibiting symptoms of a bipolar illness or perhaps an age-related degenerative brain disorder. He refuses to see a doctor for an evaluation. As I've learned from my own family experience, getting help for a mentally unbalanced family member can be extremely difficult if the person doesn't want to seek help.

Until only a few generations ago, psychotic individuals (those who have lost all touch with reality) were often put in the back ward of mental health facilities and basically forgotten by the family and society. We now know that many forms of brain disorder are caused by a chemical imbalance in the brain that can be treated with prescription medications. Just as a patient doesn't choose to have diabetes or cancer, the patient with a brain disorder doesn't choose to be mentally ill.

Telling a depressed person to "cheer up" or "get over it" doesn't work because their body chemistry just won't allow them to! A person who is psychotic is even harder to deal with than one who is merely suffering from depression. Their altered reality is their reality: they don't even recognize that they have a brain disorder. No amount of reasoning will convince them that they do, because their ability to reason is also skewed.

I sought information from my son, who has experience as an inpatient therapist at a mental health facility, about what could be done to get help for my friend's brother. His answer was, "Not much, unfortunately." If a mentally imbalanced person does not want to seek help, he/she cannot be involuntarily admitted to a mental health facility unless he/she attempts or threatens to attempt suicide or homicide. In such a case, you may call a police officer to have the person taken involuntarily to a mental health facility for evaluation. It is then up to the facility to determine whether the person can safely be returned to society as an outpatient, or whether they need to remain hospitalized for further treatment.

Some involuntarily admitted patients may be able to convince the medical professionals who evaluate them that they are emotionally well balanced. In truth, they may be dangerously ill. Not all persons who have a brain disorder become violent, but symptoms may be mild at the onset and become more severe over time if the patient doesn't get treatment. Antidepressant and anti-psychotic drugs may produce some unpleasant side-effects, and the patient may discontinue their medication without his/her doctor's knowledge or approval.

Dealing with a friend or family member with a brain disorder can be stressful, especially when you are untrained and uninformed about mental illness. You may need to resort to an intervention to convince your loved one to get the help they need, but please contact a trained professional to help you with this. Patients who accept treatment and take their medications as prescribed will still need help from friends and family to address lifestyle issues that may need to be changed, and given emotional support and encouragement. The entire family may need to learn to deal with the stigma of brain disorder. Fortunately, since we now understand brain disorders better the stigma is lifting. There are many excellent resources and support groups online that can help you and your family cope with the many issues that mental illness raises. Your family physician should also be able to direct you to the appropriate resources.

You may need to consult with a lawyer if your mentally ill family member is in a position of legal authority (such as the executor/trustee of an estate or holds power of attorney over another person) if you don't believe they are capable of making good decisions because of their illness. He/she will likely be seriously offended by this action, but you must protect your family's welfare if the person refuses to recognize they have a problem or won't seek the help they need.

And above all, if this person threatens to kill him/herself or others, call the police immediately to deliver the person to an inpatient mental health facility if they won't go with you willingly. Too many prison inmates are incarcerated because they are mentally ill and did not, or would not, get the help they needed on the outside. Your loved one may resent you for your interference, but you must do it for their own safety or that of anyone who they may have threatened.

I was only a baby when my mother had my father involuntarily committed, and she told me that he hated her for it at the time. But once he was well he was able to live a full life as a productive member of society and raise his family. Although he did struggle with depression and had to be re-hospitalized on a few occasions over the years to have adjustments made in his medications, he was a great dad who was devoted to his children, taught us good moral values, and set an excellent example of what a parent should be. I could not have asked for a better father.

So if you are dealing with this situation, please don't give up hope. There are alternatives to living in chaos and fear. Arrange an intervention, if necessary. Join support groups. Any problem is easier to deal with when you know others are going through the same thing. If your loved one turns away from you for having him/her taken away in a squad car, reassure yourself that you have done what you had to do to give him/her a chance for recovery and a normal life.

Once they are well, they will be grateful that you were strong enough to do such a difficult thing. In prison, they won't get the help they need. You may be offering them their only chance to remain free and healthy.