costello: I've read the stuff at the Windhorse site, and I'm reading Recovering Sanity right now. I wish I could have such a team for my son, but I don't see it happening. Except for the case manager, the local mhc is hell-bent on medication. My family is negative. They think he's manipulating and/or that he needs to be medicated. I can't afford to hire people outside of the mhc - except for one therapist I'm seeing for myself because he doesn't want psychotherapy. And I can only afford to see her once or twice a month. (She's pretty much anti-medication.)

I don't think anyone could afford the same kind of team Windhorse offers. However, you may be able to find volunteers:

- Friends (Yours or His)
- Family (Not the ones that don't fit well.)
- Other people in the community who have experienced mental illness and are in recovery, or family members of the same
- Students in Psychology or Social Work programs at any local colleges
- Volunteers from local spiritual or religious communities (in keeping with your own beliefs)
- Local professionals who might be willing to cover a three hour shift once a week, or once a month.
- Anyone else you can think of.

You may also be able to fill some of those shifts with activities outside of the home. Time at the pool or a gym; an animal shelter; walking trails, etc.

But he's told me he isn't going to sleep tonight. He says he has nothing to do tomorrow so why sleep? I fear it will only escalate his psychosis. He's been around that block enough times that he must know he's just courting these extreme states of consciousness.

Is he there at home with you because that's where he wants to be as opposed to a hospital setting? If so, can he accept that he has to work to stay out of the hospital too? If he's not going to sleep, can he quietly busy himself reading, watching television, working/playing on the computer?

It sounds as if there's no one there who can spell you off when you need to get some sleep and this is part of the reason you need him to sleep in a pattern similar to your own. Yes?

I was talking to a friend with sz tonight who is very pro-medication. He thinks my son is dangerous, and I should call the police and have him hospitalized tonight. Of course, I could create/escalate a crisis right now, but why? To what end? He wouldn't end up hospitalized tonight because he's not a danger to self or others and he has no intention of going voluntarily.

Sounds like you wouldn't get that sleep you're after either.

Meantime, is your son opposed to making use of sleeping aids such as teas or melatonin? Is he open to channelling any anger or frustration into physical activity such as exercise, dance, etc.

Overall, I think you and your son need to sit down and figure out an arrangement that's going to work. Unfortunately, a great deal of it may be determined by what he's willing and capable of contributing.

Also, what was it about his medications that he was opposed to and was his opposition to all classes? Sometimes people who are opposed to things like long-term use of anti-psychotics are open to things like occasional and short-term use of anti-depressants or anti-anxiety agents. It can be helpful to have a small supply on hand to be used in situations like this. That may be a useful discussion to have... sometime over the next few days.

Something else I suspect it will become very necessary for you to do is to bring some help in for you even if it's just someone who can keep your son company for an hour while you grab a nap or tend to some errands.

If you've not already done so, I would also encourage you to thoroughly scout out resources within the local community. See what kind of support programs there are for you and for him, therapists, free programs, etc.