A common theme of these questions concerns how to make someone engage in treatment. The reality is that, outside of one being a danger, there is no way to make someone get better.

  • Are they receiving the right treatment/care?
    • That is difficult to tell. The National Alliance on Mental Health (NAMI) offers a guide for families on choosing the right treatment. What may come first is tending to  The Three External Pillars of Recovery, which is salient for a long period of time. Odds are that a fairly effective medication can be found (that’s why there are many different medications for any given mental illness). Regular therapy is very important. Some psychologists and patients “click”, while others don’t. Support of friends and family catalyzes integration into the collective world.
    • The Three Pillars of Internal Recovery are more nebulous, but might be helpful to consider. Developing a healthy mind largely relies on The External Pillars, but also involves actively engaging the world without an significant external stimulus. Body could involve such activities as exercise and diet, while building spirit is highly based on the individual, and has an obscured blueprint.
  • What is the prognosis?
    • Prognosis is a term used to denote the prediction of a mental health professional on how much the disease will affect the mentally ill individual in the future.
  • How can I get them to see the doctor?
    • This is tricky. If you feel that medical advice is greatly needed, yet they insist on not seeing a doctor, it may be prudent to contact your nearest hospital and relay your concerns. They can then tell you whether or not it might be a good idea to bring them to get evaluated. Every state has its own legislation that details under what circumstances hospitalization is necessary. These are called “civil commitment laws”.
    • Generally speaking, when someone has a mental illness that needs treatment, they are a danger to themself and/or others, and they can’t care for themself, hospitalization may be needed.
  • How can I get them to take their meds?
    • Again, when there are legalities involved, the individual may be required to take their medication. Outside of this jurisdiction, no one might be able to make them take their medication.
    • In the case of psychotic disorders, there is a particular resistance from the mentally ill person because antipsychotics can be very hard to tolerate. One of the ways to ensure greater compliance is to have them put on a shot of medication that can last a month or longer. That way, they only need to decide once every several weeks to take their medication, not thirty times per month. Here is elaboration: Injections Versus Pills
  •       What is assisted outpatient treatment, and how can I get that?
  •       How can I get them to stop abusing substances?
    • I’m sounding like a broken record here, but just the same, inpatient treatment is the best way to curtail drug abuse. It’s not 100% effective, though. During one of my hospitalizations someone was caught bringing in recreational drugs for a patient.
    • In order to understand substance abuse, a bit of information on the nature of addiction detailed on another page of this website may be in order: What is Addiction?
    • It is also wise to understand that drug abuse isn’t a synonym for drug addiction. That said, one of the hallmarks of addiction is a disruption in daily life, something that can be greatly compounded if an otherwise mentally ill person abuses drugs.
  •       What can I do to help them?
    • There are a wide host of variables to consider. An important thing to keep in mind that, despite the label and indicated pharmaceutical treatment, each mentally ill individual is a person first. How to go about helping them depends on their disease, and largely, how much they want help. Someone is a lot less likely to accept help if they don’t believe they’re sick.
    • A good place to start is with the mind-state that you can never completely understand, the same way that a white person will never be able to comprehend in full what it’s like to be black in this racist society.
    • Also, empathy rarely goes awry.
    • Inviting them to social gatherings might help re-integrate them, but too much pressure might make them isolate. In this case, it would be prudent to ask their health providers how much to push them.
    • Helping them find constructive means to calm down and vocalize their feelings can help a lot. Please see the Moving Movies section.
  • Where can I find the information I need, and what about services available for them and their family??
    • That is one of the purposes of this site. The National Alliance on Mental Illness (NAMI) is a spectacular resource. It details signs, statistics, research, support, and activism related to mental illness. Mental Health America (MHA) also provides a wide variety of assistance. Both of these organizations offer connection to in-person groups that are tailored toward many different mental illnesses. The National Coalition for Mental Health Recovery also provides valuable information. For knowledge related to a specific person’s unique manifestation of a mental illness, please contact their health providers. They may require a release in order to discuss this person’s treatment with you.
  •   How can I help them gain insight into their condition?
    • Lack of insight is usually associated with psychotic disorders. They have a hard time, or are unable to, know the difference between what is real and what is not.
    • A good place to start might be by yourself reading up on the illness. This includes, but isn’t limited to, what the symptoms are, how it affects daily life, how stigmatized it is, and its biological basis. Of course, you aren’t a mental health official, but that doesn’t mean you can’t learn about the disease.
    • Additionally, if at all possible, make sure they take their medication as recommended by a doctor. This is crucial, the exact amount, even if the doctor is open to changing it. In doing so, the mentally ill person widens their receptivity of other opinions. If I had abided by this rule from the beginning, I would be less ill than I am now, which is the same with countless others.
  •   How do I know I’ve found the right psychiatrist?
    • In my life, I’ve been assigned to ten different psychiatrists for an appreciable amount of time, and several more I’ve seen a couple times. My opinion is based on experiences with these individuals, and on my academic and independent research.
    • Odds are that there will never be a perfect match, especially in the beginning. That said, a good psychiatrist is like a good parent: they are authoritative. They are at once warm and receptive, but have clear rules. A good psychiatrist takes the whole individual and their lifestyle into account. They run blood-tests to test for vitamin levels. They discuss activities that can improve mental health. They note body language. They ask the patient what worked in the past, but offer prescriptions that ultimately are in the patient’s best interest before what the patient asks for.
  •   What kind of counselor is best? A psychologist? Drug counselor? Social worker?
    • In general, a therapist is not as meticulous as a clinical psychologist. Therapists are more geared toward accepting the patient as they are and making them feel that they’re all right. Psychologists probe deeper to unearth hidden, complex problems that perpetuate the mental illness. They have a lot more training.
    • If drug abuse is a concern, someone who specializes in drug counseling might be a valuable asset. Using recreational drugs doesn’t help, and frequently leads to poorer health.
    • A life-coach is another option.
  •   Is a family intervention a good idea?
    • In certain cases, absolutely. They are usually more effective when the health providers of the mentally ill individual think it would be beneficial. The person they see can offer advice on how to more effectively conduct the procedure. Staging an intervention should be done with the utmost care, or the person meant to be helped might retreat or lash out due to fear. The shock of being forced to look at oneself can be very painful. The American Psychological Association offers a lot of information on Family Interventions.
  •   How do I know the diagnosis is right?
    • You don’t. Even years after I first became mentally ill, doctors still disagree on my diagnosis. Mental illness furthermore usually doesn’t remain absolutely stagnant, it morphs, even slightly, as time goes by. The diagnosis doesn’t matter as much as it would seem. What really matters is that the mentally ill are able to exist meaningfully in the world without significant symptoms compromising their life.
    • The diagnosis serves as a sort of rough marker. It guides such actions as prescribing medications that have a high probability of helping (and keeping away from those that don’t); providing a prognosis; and determining useful topics of talk therapy. But what really matters is simply whatever helps most.
  •    They don’t want me to visit them in the hospital. Should I go anyway?
    • I’ll start with an anecdote. I did this. I had come to the realization that my life was horrible. It was one of the first times since i became sick that I looked out for my greater well-being. I took steps to ensure that I would be in the hospital for a significant amount of time. I wanted to do this alone, to break free from my unhealthy dependence on my mother, to become a decent adult. That’s why I put her on the list of people I didn’t want to see. She came anyway, but instead of being upset, I think she thought that what I did was right, as did the excellent Dr. Colin Dauria.
    • My opinion is that it depends. If they’re angry at you, visiting them in the hospital might provoke an outburst, which staff take very seriously. If they otherwise simply prefer to be alone, it might be a good idea to respect that.
  •   The neighbors know there was big commotion with police and an ambulance. What do I tell them?
    • That is up to you. My code is to tell the truth whenever possible. I try to be honest so that I don’t haunt myself with guilt. It does sound over-simplified, though. Such a circumstance can cause a lot of embarrassment. Revealing that someone living with you has a mental illness can furthermore feel shameful, but that is not because it is. It is because society has largely not yet made room for treating the mentally ill as humans, and with empathy. Don’t fret, though. Some people do “get” the validity of mental illness. Others develop it over time. An unfortunate few will not understand.
    • If you tell your neighbors an overview of the situation, that may be a wise compromise. Perhaps some of them are competent to understand the story in more detail, and might prove useful supports for you and your loved one. In my experience, these people can be felt out.
  •    They stopped taking their meds, what warning signs should I be looking for?
    • It depends on the illness, but one of the first, and largely universal, markers of mental illness, is isolation.
    • If they’re showing symptoms that are similar to those displayed before they were treated with medication, it may be indicative of such.
    • Stopping medication without a doctor’s recommendation is a warning sign in-and-of itself. While it may take a while for symptoms to re-appear, chances are that they will. Even if the individual appears normal days after stopping medication, that may not mean much. For instance, the antipsychotic medication Abilify (aripiprazole) taken as a tablet may not leave one’s system for over three weeks.
    • Please refer to the Warning Signs of Mental Illness section for greater elaboration.
  •   What does it feel like to have schizophrenia?
    • A decent starting point may be a quote by Dr. Rosen, a psychiatrist, in the movie A Beautiful Mind, on schizophrenics: “Imagine if you suddenly learned that the people, the places, the moments most important to you were not gone, not dead, but worse, had never been. What kind of hell would that be?” Granted, this is in reference to a more advanced form of the disease. Research is gaining ground on catching it much more early.
    • I think it feels different in different contexts. At this point, I only have my own experience to relate. Firstly, when I wasn’t receiving mental health services but was using drugs, I was at once hyper-vigilant, deeply confused, and constantly fearful in most (even mildly) social situations. I had this mask on. I did not trust anyone with what I felt.
    • When I was not medicated or under-medicated, and wasn’t seeing a therapist or psychologist, it felt like the world was very cruel, that is was bearing down on me, that I was so different and completely alone, not able to genuinely connect with another human being, that in fact, I wasn’t human. The aforementioned fear was present, but I was more sad than angry.
    • When I was medicated but abusing substances, I had a large arrogant chip on my shoulder (drug abusers tend to be narcissistic). My social filter was primitive. I escaped into drugs so that I could delude myself into thinking that I had control over my life. I was more approachable than when I wasn’t medicated, but deep down the drugs made me angry.
    • When I take my medication and don’t abuse drugs, there is a feeling of hardship present, along with cravings. It was quite powerful for about nine months after I stopped using. It only really went away after implementing structure into my life. Nowadays, the burden is much more light, and cravings are few and far between. I like to think that I can differentiate between what thoughts and feelings are the product of my illness and drug cravings, and what are heavily rooted in reality. I’ve begun to cultivate social relationships on an advanced level. I have a good idea of what is acceptable to express to different people. I’m much better at troubleshooting negativity in an objective sense. Today, I am in more control over myself, more hardworking, care about others more, and am able to work out minor setbacks in a productive manner. I never thought this possible. It takes medication, abstinence, therapy, and many varieties of hard work.
  •    They leave a path of mess behind them. They used to be so neat and helpful around the house. Are they capable of cleaning up after themself? Should I demand that they do?
    • Back to the authoritative parenting style, it would do them well to understand that their emotions are valid and valuable, but that there are limits on their behavior. Some people have to be hospitalized before they accept that there are things they must do. What this entails varies on the individual.
    • It can be very difficult to know just how much a mentally ill person should be pushed. On the one hand, we want them to live as independently as possible, to grow on their own. On the other, chances are that they’re more sensitive to stress. We don’t want to make them worse off. As stated before, their mental health providers can offer an opinion as to how much responsibility is healthy for them to carry in their daily life.
    • That said, cleaning up a mess that they’ve created seems like a very basic, doable rule to me. We don’t want them to fall under the impression that someone else will make them better, a hard rule I had to learn.
    • Lack of hygiene may be an indicator that they aren’t being sufficiently treated.
  •   Is it okay to leave them alone if they’re an adult? I’m afraid they’ll destroy the house if I do.
    • If such a fear is well-founded, they probably shouldn’t be in your house. Please relay this concern, again, to the people that are providing them treatment, as well as why you feel that way. Adults can be just as irresponsible as children.

Sources: Surviving Schizophrenia, 6th Edition: A Family Manual, Dr. Colin Dauria, Barlow, Abnormal Psychology: An Integrative Approach, Dr. Howard Feinstein