I have a very close online friend who has been suffering from depression and the like for many years now. He's disabled and housebound, usually spending most of his time in bed as sitting, standing, or walking leads to a great deal of pain. He is married to a woman he hates, living in backwoods Appalachia with limited access to resources, and is so convinced that the vast majority of humanity is merely looking for a way to exploit one another that he refuses to even call a crisis line.

The way he's been talking lately, I fear he may do himself harm. He describes himself as feeling empty, emotionless, like a ghost who has already died and lingering around. He feels his situation is completely hopeless, and that anything I could do -- namely getting him out of his current living situation and somewhere he won't have to ride two hours in a car to see a doctor -- wouldn't improve his mood or health in the slightest.

He needs help. I have found therapists in the area that he could see but refuses to call any of them. As I said, he has even refused to call crisis centers or visit message boards like these, if only as a favor to me to help ease my own mind. I am considering approaching his wife for help in this, but I don't know her very well and have no idea if she's aware of the extent of her husband's suffering, or even if he'd listen to her any more than he'd listen to me as he loathes her so.

I don't know what else I could possibly do to help convince him to get help. Might anyone have any suggestions or advice?