Schizophrenia

I live in California and my brother has had schizophrenia for about 25 years. He has seems go go off his meds about every year or so and ends up in the hospital to get stabelized. He has also been off and on conservatorship. Currently, he is not on a conservatorship so no one is monitoring him or seeing him for his illness. He is currently off his meds. He is very ill; hearing voices, dilusional, paranoid, poor hygiene, etc. He has voluntarily gone to Psych Emergency twice in the last 2 weeks (which is huge, he hates the hospital and never wants to go), but he has been very scared by the voices. He won't talk about what he hears, but it is bad and scares him. Psych Emerg. releases him the next morning before he gets a chance to see a doctor because they say he is not harmfull to himself or others. He also tells the staff he is going to ask the doctor to lower his meds and that he is feeling better so they think what is the point. All our mental hospitals in our area are closed or closing due to cut backs. He is very ill and not in touch with reality right now. How can we get him help BEFORE he hurts himself or others? What can the family do to get him admitted so he can get stablilized on meds. He won't do it, but something has to be done soon! Once he gets stabelized then he is typically okay for about a year or so. Then we start all over again. Thanks!

I see no one has replied to your question. Is there any way you can get your brother into group housing or some sort of living situation where his med-taking is monitored? It sounds like he needs some help with that -- maybe he would stop relapsing once a year. Can you go with him to the hospital and explain to them what the problem is, and convince them to let your brother see a doctor for med management? Can he see a psychiatrist regularly? That positive reinforcement might help. I agree -- you don't want to wait until it is too late. I did much better living at home with my parents, but that is not an option for everyone.

Carolyn

Hello VE,

It sounds like your brother has been in denial that he has an illness, possibly anosognosia, a symptom of the schizophrenia. Especially if he tries to convince the staff he doesn't needs the meds or is doing well. It's a classic tactic that someone who lacks awareness of his illness employs. After, if you didn't think you were sick and wanted to get out of the hospital, you'd say anything to convince the doctors you were doing better, and then once you were released, you'd stop taking your meds.

At this stage (25 years) I would say that you need to get him into a group home or supportive living, as Carolyn stated.

I recommend to others in your situation that they read the book I Am Not Sick, I Don't Need Help by Dr. Xavier Amador, who coaches family members and friends how to couch what they say to convince a loved one to accept treatment.

This has been going on for awhile with your brother, however, see if the book has some ideas you can use. And in the immediate term, look into a halfway house or group home.

Best,
Chris