How to Involuntarily Commit a Psychotic Person

How is your sister able to finance an office visit with her pdoc? Were she to get SSI, she would then automatically get full Medicaid.

If the pdoc prescribes a med for he/she, as he surely will, your mom could ask to see the bottle of pills. There is no good way to ascertain if she takes the meds as prescribed. From what I've read, a lot of people who are put on Abilify end up being non-compliant. I'm not sure why that is. Comliance is hard to monitor. It's not that hard to learn how to appear to swallow a pill and then regurgitate it.

I see above that you say your sister is currently drinking. Is she content to sit at home drinking, or is she out finding drinking companions. How is she financing the drinking?

Since your sister is age 30 and you are a year younger. I take it that your mother is not 85 y.o. or even 65 y.o. You mom is in the prime of her life, at a point where her own mental faculties are at their peak. Deciding what to do about your sister is really more up to her than it is up to you. You describe your mom as "passive." It sounds to me like she enables your sister's bad behavior by being too tolerant. A lot of what's going on here is between the two of them. There may actually be very little that you can do to affect what is going on in that household.

At some point, if your sister comes to the attention of a court, as a person in need of a legal guardian, your mother (or you) may not be the person best suited to take on that role. If a guardian is needed to consent to treatment that your sister doesn't want, I think it's wiser to let a party outside the family perform that function. Why set things up that will only lead to your sister being mad at your mother? At one point my brother asked if I would be willing to be his legal guardian because he believed I would never consent to anything he didn't want. Since that was his expectation, I resolved that I would absolutely never agree to be his guardian. Why should I have him mad at me?

Being mentally ill is one of your sister's problems. She has other problems. She is a substance abuser. She is prone to hostility. She is dishonest. She keeps company with unsavory characters. This all points to her being a person who, at age 30, is already permanently damaged. She is damaged emotionally, and she is damaged in her character. She will be the bane of your mother's existence for as long as she lives in your mother's house. The sister you used to know is not coming back.

Your mother might want to consider putting a secure lock on her own bedroom door. This would give her a safe place to retreat to, if your sister became threatening.

I also think your mom might want to make a report to Adult Protection Services. A social worker from that agency might help her to more clearly see what options/resources there are for getting your sister help and how to access them. You want to get started on establishing a paper trail raising the concern that your sister is mentally disturbed.

The people they pick up and take home, the strangers/random people, I am guessing this psychotic person has found (in their thinking) something magical about them.

Being drawn to people for strange reasons, having ideas about them, could be either a personality trait in psychotic people, or it just comes from psychotic thinking. A vision quest.

They could appear special, meaningful, an omen, taking them home could have some magical effect on the house.

Why do they choose the people they choose, and get so excited about them, but the happiness/mood elation about these strangers could have no basis in reality, but rather, some other reality?

These are positive symptoms of psychosis, negative ones, are not so pleasant.

A lot has already been written in reply to this topic, I can't bring myself to read all of it. Bringing home strangers like a treasure hunt, or like pets carry home dead animals to impress their owners, it's cute. There's something so adorable about that.

update:

so this has been going on for the past year. we have rode out the waves of psychosis/mania that my sister endures.

it all came to a head yesterday morning. my sister punched my mom and said she is going to cut her up with the kitchen knives. my mom went straight to the magistrate. this is what we have been waiting for- a statement that is worthy of her being involuntarily committed. the police came and took my sister to the emergency department. my mom said that she admitted she said the statement about the knives, but only said it because she was mad and didn't really mean it. regardless, she admitted to saying it, which is good.

she's been in the emergency department since yesterday morning. she had a teleconference with a psychiatrist in a neighboring city. i texted my mom for an update a few minutes ago. she said they have made a decision, and she is waiting for the call to say whether my sister will be admitted or not.

this is bittersweet. this was my worst fear: that she would try to hurt my mom. yet, it is good, in a way, because now she can finally get help.

the problems i see are these:

1. my sister will not be admitted and will go back to my mom's house full of angry feelings over this whole ordeal. i fear for my mom's safety intensely over this situation occurring.

2. my sister will be admitted, take the meds in the psych hospital, get better, get discharged, then chuck her meds out and go back to this insane cycle. in this case, we are going to be back at square 1.

Rose, you said my mom is being too tolerant of all this. i totally agree. this is how my mom is and has been my whole life. she was this way with me when i was acting out as a teenager and using hardcore drugs all the time. she let me live there and do as a i please, stealing her money and medication, sleeping til 5pm, staying out til 7am.

this is not new behavior. this is the type of parent we grew up with. my father died when we were young. my mom became the passive door-mat, never really speaking up on the struggles we had... just kind of silently observing them. my mom is not dumb, she notices A LOT more than she allows herself to comment on.

our family dynamic is pretty messed up. i won't deny that.

i want to tell my mom to give my sister an ultimatum. my mom could say that she has to watch my sister take her pills every day, or something like that.

the problem is with my mom following thru with the 'or else' part, which would basically mean my sister becomes homeless.

i know its easy to read all this and say, just give the ultimatum. but please try to put yourself in our shoes... think of this being one of your loved family members, and try to understand how difficult it would be to do that. regardless, i think it is the best option if this all fails.

thanks for reading, any support is welcome.

I'm glad your sister has been hospitalized; it sounds like the hospital is the best place for her in all regards. I assume you're in the UK? -a good thing, because here in the U.S. it is very, very hard to get someone involuntarily hospitalized unless the person makes a direct threat against the police.

I wish I had some advice or suggestions for you; the position you're in is an extremely difficult one.

I am in the US. They commit people for homicidal and/or suicidal statements...not just towards the police. We have been trying to get her committed for a year now

I think you are absolutely correct in the way you see this hospitalization playing out, with the first and second outcomes you've outlined above. Even if she's admitted, as you foresee, that will be only a stop-gap measure and not a guarantee of any permanent solution. They will only keep her there for so long. Then she will come out, resume her typical pattern or cycle of behavior, including non-compliance with treatment, and you, your mom and sister will all re-live this yet again. The only difference - and it's an important one - is that she now has a much better paper trail of documentation of her condition. Once a person has been admitted, it will be easier to get admitted the next time. There will be a next time. And there will be a next time after that. Being an inpatient will allow staff to sbegin getting to really know her. The physicians' and nurses' notes in her hospital chart will much better reflect the seriousness of her level of mental disturbance than notes made by a pdoc after a 45 minute interview. So, as you say, this is a good thing. But, as you also say - and I agree - it's not the beginning of the kind of comprehensive solution one would wish for.

I'll be the last person to say there is anything easy about your family predicament. (I have a brother much like your sister.) Even if your mother took your advice and "gave the ultimatum," your mother is not going to follow through with a firm, consistent approach. And you already know that, yourself. A lot of this is beyond your capacity to influence, no matter how sensible your insights and recommendations may be.

Do you live in this household yourself? Are you living with your mother?

I can totally grasp that this is heartbreaking with no easy solution. My brother goes in and out of homelessness, in and out of jail, in and out of substance abuse rehab programs, and in and out of psych in-patient facilities. He used to move in and out of my parents' home. Now they're deceased. He has lived sporatically with either my sister or myself. Trust me! I am more than a little familiar with what you are trying to cope with.

I do think it may be even worse with a female who is mentally disturbed because of the greater potential for her to be targeted on the street by men who will sexually exploit her and physically abuse her. This is why, in most communities, it is generally easier for single women to access shelters than it is for single men. Just about any homeless 30 year old woman can find a man who will take her in, which is usually not a good thing. Men who pick up homeless women are not the nicest guys in the world. She's apt to end up raped and beaten. I'm sorry to paint such a grim picture. I know the realities, so don't think I underestimate the awful quandary you are in. You can't solve this. And there is no government, social or medical entity that is going to step up and take over with a good solution.

You can advise your mother all you like. I don't doubt that you give her sensible advise. In the end, your mother is probably going to let your sister move in and out of where your mother is living - without applying any firm, consistent expectations that she will expect your sister to conform to. And - you know - that's your mother's right . . . whether you approve or not.

I hate to be pessimistic about your sister's future, but I am. And you are right to worry about your mother's safety. On one occasion, after not getting drug/booze money from my mother, who was home alone, my brother picked up a broom and ran around the ouside of the house smashing windows.

Years later, I financed my brother moving to where I had relocated . . . a region that has a lower cost of living. I helped him in every way humanly possible. I assisted him to connect with every form of social support available in my community. It so happens that there is a more help in my city than in a lot of places . . . and I happen to know more than the average person about that help because of my years working here in healthcare. For awhile, it seemed like this was greatly benefitting my brother. Then it fell apart. He was in and out of jail. Then my brother wasn't speaking to me. Now I don't even know where he is. For all I know, he may be living inside a warm apartment 2 miles down the road from me. When driving around town, I look at homeless men on the street to see if one of them might be him. I hope he is alright . . . or, at least, has a bed to sleep in at night.

Mainly, I concentrate on living my own life. I asked if you if you were living with your mother. If you are, then you will be a direct observer of all that goes on between your mother and your sister. A lot of it will be dysfunctional and stressful for you to witness. It might be healthy for you to not be living in that house. If you do have an apartment of your own, you might have to distance yourself a bit, mentally, from a situation that may never respond much to your best efforts to be a good influence.

i dont live with them. i live an hour and a half away from them.

You're fortunate. I had a room-mate who was mentally ill, a drug abuser, violent, and made direct threats on my life to me. I pleaded for help from the police many a time, but they would never hospitalize him. As soon as they showed up he'd sweet-talk the cops, lie, and they'd blow me off. When I showed them property he had damaged they told me they had no way of proving he'd done it. The only way, in California, the cops will arrest someone is if the person leaves marks on someone else. The only way to 5150 someone is if s/he tell the cops s/he is suicidal, homicidal, or is unable to feed themselves...and that's only if a person is in the 'right' neighborhood.

I finally left the situation (the room-mate), and in doing so lost most of my possessions. That was my only, and I mean only, option.

The laws in Calif can be very odd.

Rose's post is spot on, in my experience.

I'm glad that you have emancipated yourself and have your own place. That way you can create for yourself the environment that you want to be in. Of course you're going to be deeply concerned about your sister and your mother. It sounds like you try to be a sensible influence on what's going on in that home. I hear your frustration. Unfortunately, this situation is probably going to get worse before it gets better. And it may never get much better.

Your sister's problems sound to me like the type that are progressive . . . like my brother's. With time, her problems will compound with interest, so to speak. Mental illness isn't a sign of bad character. And it's not a cause of bad character, IMHO. But character affects a person's ability to manage their psychiatric problems . . . just like character can affect how one manages any challenge. Your sister has serious character deficits, along with mental illness. That greatly reduces the likelihood that she is ever going to cooperate with any program to manage her mental health problems and achieve some psychological stability.

I've seen individuals with very serious mental illness learn to manage their illness and live reasonably well. What seemed to make a difference was that they did have a strong moral core. Somewhere along the way, growing up, they learned to care about the difference between right and wrong and felt accountable. Also, they were capable of being in a mutually giving relationship. I worked in a non-profit facility that provided daily monitored medication administration. Individuals came in every morning to self-administer their medication in the presence of a nurse who kept track of their supply of meds. I met some of the nicest people within this population. They had serious mental illness, but they had good attitudes. For me to have hope for someone, I've got to see that.

I am really quite uncomfortable with the idea that meds are the solution to anything. They may be a partial help, but I think pushing them so much is part of the dysfunction of the mental health system itself. Maybe your sister actually realizes this herself on some level, which might be why she would quit the meds, feeling that the system is actually cheating her.

not to change the subject, i'm posting to say i was a person with mental illness and still am. i learned i have to take meds to stay stable. i used to refuse for years but in 2008 was hospitalised and was soo bad i agreed with everyone that i was really ill. since then i've been on meds to stablise myself. God forbid if i shouldn't take them anymore, i would probably die. i love feeling stable and sober so much, i wouldn't give it up for the world.

When she took her meds she was fine. I know some people do not like meds. Meds saved my life from my debilitating psychosis. My sister took her meds and had a job, went to school, had many friends, lived on her own. When she stopped taking then she lost all of that and is basically a toddler. A 30 year old woman. Is basically a toddler.

Without.meds, what then do you suggest for severe psychosis? ????

This is very hard, but -- someone actually listening to her on an extended basis. Good luck in finding someone who can.



Also, I did not say without meds entirely.

i think my sister would benefit greatly from therapy. she is so resistant to it though. she wont tell my mom or me whats going on in her mind. i was the same way... until i was basically forced to do therapy. it saved me. therapy and medication saved me. i want the same for my sister. we have been through so much, especially as children. i feel i have a better chance of talking to her than my mom does. she holds alot of anger towards my mom. i am trying to see if they will let me come visit my sister in the hospital. i miss my sister. i do not recognize the person she is anymore.

im sorry if i overreacted