Getting my brother treatment... How???

Hey! I'm new here, searching for support and guidance as to how to help my brother. He was diagnosed with paranoid schizophrenia this past summer. He believes he isn't sick, therefore refuses treatment. We're having trouble locating him and communicating with him. We're pretty much just stuck waiting for him to do something illegal, so the police can take him in and evaluate him. I just hope he gets treatment before he hurts himself or someone else due to his dilusions.

Here's my question...

How does one go about learning that they themselves are sick? How can I help him realize this? Any comments are appreciated.

I think being there for him emotionally would be all you can reasonably hope to do. It is a tough thing to accept these diagnosises, there aren't any magic words, only time. He might get hurt or get arrested, if he is that sick, then those undeniable events could swing him toward treatment. Other than that, it has to be his choice, trying to force him to accepting his illness and invest his time in recovery, I believe would be a waste of your time and could distance you from hum further. I think keeping what lines of comunication you can establish, open for him is the best way to help him. He needs to realize it on his own time. He also needs to know that emotional support from his family is a resource he can count on, unless your safety is an issue. If he is a threat to himself or others than he needs treatment, until he is safe. There isn't a punitive aspect here, this really is a illness with physical causes i.e. biochemistry and biochemical imbalebces in the brain. Avoid treating him like a lepar or an untouchable, he is still your brother .

Good luck!

You might take a look at this post by spiritual_emergency:

http://forums.psychcentral.com/showf...586#Post778234

Keep in mind that Schizophrenia is a serious mental disease. It's really not something you can be talked out of.

It is known that decreased awareness of illness is caused by damage to specific parts of the brain especially portions of the frontal lobe, cingulate, and areas in the right cerebral hemisphere. Thus, some people with Schizophrenia may have complete awareness of their illness, others have partial awareness and some have no awareness.

It may not be possible to convince him he is ill.

Rest assured, It is a very small sub-group of people with Schizophrenia who are dangerous. It is quite possible he will not do anything to violate the law or harm others in any way.

His perception of reality has changed. In his mind everything he says and does makes perfect sense. It is the people outside his mind that are the "crazy" ones.

The best solution is for him to seek treatment on his own. There are anti-psychotics that may help his delusional thinking.

Has he ever shared with you what his delusions are? If you describe them to me I may be able to help you bring him in for treatment.

Unfortunately with Psychosis sometimes the only thing you can do is "play along" with the delusion or hallucination. I obviously am not advocating hurting or kidnapping him but it is okay to play into his reality to get him treatment.

Ultimately if he is not a harm to himself or others no one will force him to get treatment.

I encourage you to read Surviving Schizophrenia by E. Fuller Torrey, M.D. It is a fantastic guide for families, patients and providers to understanding Schizophrenia.

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PsyChris said:

I encourage you to read Surviving Schizophrenia by E. Fuller Torrey, M.D. It is a fantastic guide for families, patients and providers to understanding Schizophrenia.

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E. Fuller Torrey is not universally admired in the mental health community. See his entry in Wikipedia:

http://en.wikipedia.org/wiki/E_Fuller_Torrey

Torrey has proposed that schizophrenia is due to viruses carried by cats. He claims that others are "lacking insight" into themselves.

He is a strong advocate of involuntary treatment. Although I cannot find the reference at the moment, and it was some time in the past, he claimed at one point that the mentally ill were in fact, not just because of stigma, much more dangerous and likely to cause harm to other people than the average person. (I did find some references, in which he says a subset of mental patients is more dangerous. I think it is a matter of what emphasis one places on things. Fuller is not, as I said, universally admired in this respect.)

Here is one reference I found to Torrey and his "Treatment Advocacy Center"; it is not a "friendly" account:

http://www.furiousseasons.com/archiv...dangerous.html

I do not admire E. Fuller Torrey. He's like the polar opposite of Thomas Szasz, who believes that mental illness does not exist. Neither viewpoint is healthy. Torrey does not acknowledge that people are sometimes overmedicated. He does not acknowledge the importance of psychosocial treatments and he does not acknowledge that some people have been abused by the mental health system. He describes psychiatric survivors by using quotation marks! How condescending is that??!!

My viewpoint is that every person and every situation is different. Sure, some people might be so severely ill that they may need to be "pushed" into treatment but even in these cases, the patient needs to be treated like a human being and have someone listen to his or her thoughts on treatment. Psychiatrists like Torrey treat patients as collections of physical symptoms instead of listening to them as real people.

Forced treatment is a complex issue. Back in the old days they could lock up women for being "promiscuous" or they could lock a person up for being "odd." But then again, you also have people like Cho Seung Hui, who probably wouldn't have murdered all of those people at Virginia Tech if someone had forced him into treatment. There's no clear cut solution.

I'm not quite willing to endorse his idea of Toxoplasma Gondi as the cause of schizophrenia but it does seem entirely possible that Schizophrenia could be caused by immunoinfectious disease.

You need only to look to HIV or Creutzfeldt Jakob Disease ("Human Variant of Mad Cow") to know that there is plenty of evidence for animal-human crossover in virology. His theory is contained in Infections and Immune Theories...along with many other theories for the causes of Schizophrenia. I believe it is up to the reader to decide which theory they would like to support. Just for the record he also discusses Genetic Theories, Neurochemical, Developmental, Nutritional, Endocrine, Stress in the same section. He does however put Thomas Szas in the "obsolete" category.

I agree that forced treatment is a complex issue. We have a long history of abuse getting involved even when it is the best of intentions. To his credit he does mention this early in the book. He gives the example of the Soviets attempt to label political dissenters with Schizophrenia as a legitimate excuse to commit them to psychiatric wards.

I'm not sure where I stand on this issue. We have acknowledged that society can intervene if you are acting homicidal or suicidal. It seems to me that if that disease can be treated; then it is inhumane to leave people who can not care for themselves physically or mentally, alone.

I did not get the impression from this book that he was trying to lead the reader into capturing Schizophrenic people or Cat Genocide.

It sometimes becomes difficult to validate theories. Especially if they are steeped in things like Virology. It would be nice to know everything but most of us have to pick a field and learn.

I'm not a virologist and don't have any specific training that would lead me to say yes he's right or no he is wrong about his cat theory. For that reason I can not endorse this theory until there is substantially more evidence.

We all know that Psyschology is a relatively new field compared to the other sciences. As such there is constant criticism and debate. I think that is GOOD and ultimately will lead to better results. There are many examples of scientists having far-fetched theories that turned out to be true. The encountered the same kind of criticism Fuller does. That doesn't make him right, but it shouldn't make him wrong either.

I don't think the purpose of this book is to indoctrinate or for someone to take an academic view. It's purpose is for Patients, Families and Providers to understand Schizophrenia. If he paints a more positive view of Schizophrenia..I prefer that to Thomas Szasz view for families trying to understand Schizophrenia.

Thanks for both book suggestions and your oppinions. The only book I've read on schizophrenia was "Coping with Schizphrenia" by ???.

My brothers current dilusions involve serial killers that the FBI are aware of but let go. It also involves President Bush and has many political threads in it, but I haven't heard these directly from him. (I just got into town and hope to see him soon). Just trying to prepare a little before seeing him.

I think I feel at peace with my plan of just being supportive and listening. Trying to empathize with him. I"m just not sure what to say when he directly asks "Do you believe me?". Because I"m sure he'll ask this. Before, I would say "Well, it's very complex and it's hard to believe, but I"m sure it's scary for you?".

You seem to be headed down the right path.

The important thing is that you do listen to him. What he says to you may make perfect sense or it may make no sense at all. You might have trouble following his line of thought but as long as you look engaged in what he is saying and responsive you should be able to convince him to seek treatment.

Delusions are not the same as hallucinations. Delusions usually have some basis in fact. You can try to find that basis so you don't have to lie to him.

Just remember with delusions it's important to let him know "It's possible" but it is also not possible. He most likely will not agree with the latter. Sometimes it's best to stay very abstract about that ideal.

I don't like to suggest this in light of recent conversation about forced commitment but if you have any reason to believe he may act on any of his delusions in a violent way you need to call the police. The last thing anyone wants to see is your brother getting hurt doing something he would not normally do.

These type of Delusions involving the FBI and the President are very common. You need to look for any type of plan he may have, logical or unlogical to act on his intentions. I have talked to Schizophrenic people that wanted to harm others, specific. Until you have reason to believe otherwise consider any threats he makes to be legitimate.

I'm not suggesting fear, I'm suggesting safety until you both know each other intentions.

I know this is a lot to bear right now and I do suggest that his ultimate treatment be in the hands of Mental Health Professionals. Let us know how it turns out!

> There's no clear cut solution.

For sure.

Okay, so I'm meeting my brother tomorrow and will be presenting the idea of us going together to a group meeting. We hope this could be the first step in getting treatment; making some friends dealing with the same/similar illness, meeting the Dr. in a casual setting.

I'm having trouble deciding how to approach him with this idea. He doesn't think he's sick, so he's not going to want to go.

I'm considering asking him to go with me just this once to see what it's like, downplaying it a little, just to meet some people.

Not sure what my other options are. Any ideas?

Also, after wandering the State investigating his theories, he's returned to my parents house, quit his job and refuses to go to his apartment. My parents feel that they've exhausted their options and are about to resort to saying "You can't live here unless you take your meds." Does anyone have any experience with this "tough love" technique? What are the odds of this really working?

Thanks for the input.

No one can really say. That's why specialized treatment from a Mental Health Provider will help a lot.

I think you are doing a great job with him. Down-playing it sounds like a good plan. If he is more in the mind-set that you are all going as a group to get up with your collective problem's he won't feel so cornered and alone.

I agree. Sounds as though you are doing a good job in difficult circumstances, Sis.

Met with him a few days ago. Unfortunatly, he's not opening up to me like I had hoped. And he gets REALLY upset with me when I mention going to a couselor or other appts. So, I'm just not going to mention it for a long time. Now i"m just going to focus on doing fun things together.

I have learned that when I do approach him next time, it needs to be shortly before the appt. He can only handle one thing at a time, so talking to him about several things is only going to confuse him.

On the bright side, my dad DID get him to go to his MHMR TRAG update meeting. Does anyone know what they do at a TRAG update?

> MHMR TRAG

What does that stand for?

Mental Health & Mental Retardation clinic (MHMR)

Texas Recommended Assessment Guidlines (TRAG) update

a person learns that they are *sick* as u said when the person goes to the doctor and gets a diagnosis and then accepts or believes resonably without a doubt the doctor was telling the truth some people hide from the diagnosis dont believe it becuase they dont want to have a [ label ] for instance i am getting ready to take alot of ( TEST'S ) becuase i actually think i have alot wrong with me but i am not sure so i need the doctors experience to help me find the truth now all you can do for your brother if communication is not possible is pray for him and hope he will soon come in touch with evry1 again and seek help on his own

I think you are doing a great job with your brother.

The fact that his family is still involved will help him a great deal and give him at least one tether to reality.