Any ideas for relapsed anosognosic DD?

OK, maybe all I am doing is venting here, but just maybe someone will have something useful for me.

I am dealing with not only DD, but her BF, both of whom have schizophrenia. They are living in the townhouse we bought so they would have a decent home in a market where the rent would normally be more than their total combined disability benefits. We live several hours away, and rely on reports from sympathetic neighbors, only visiting when necessary. Following several years of relative stability, I just discovered that neither of them have taken meds or received any treatment since late last year. Predictably, things have totally gone off the rails. He appears to have returned to a life of petty crime, and possibly meth use. She has returned to her delusion that we are evil, evil people who want to do her serious harm. Concerned neighbors report that he returns home in the wee hours, slams doors, and yells at DD. She seldom leaves the house, and is rarely seen and never heard.

We visited last weekend, she knew we were coming and expressed no concerns. On arrival, we were shocked to see the condition of the home—absolute filth and squalor, and our DD, also unkempt. BF, typically friendly and happy to see us, was nowhere to be seen. We made arrangements to come back and take her out for a meal. When we arrived, she said she had ordered in, and proceeded to remove the piles of junk from the table, and tried to find unbroken chairs. Again, no BF. We tried to have a conversation about BF disturbing the neighbors, who are also concerned for her welfare. She vigorously defended him, and denied there were complaints, blaming me for making it all up. DH made the mistake of asking if she was afraid of BF—which totally set her off. We left.

I visited the Mental Health office the next day. DD had been on extended leave, and was required to show up for injectable meds. Apparently, late last year, she stopped showing up. Rather than having her returned to hospital, they failed to renew the order, and closed her file. Of course, no one informed me, because ‘privacy.’ The best they could offer at this point, was to show up at her door, lay eyes on her and ask if she was OK. Done, over to me.

I have limited options. Yes, I can probably get a judicial order for involuntary commitment. This would leave BF alone, off meds and out of control. Thus far, he has kept some of his activity away, but with her not there, who knows? I could evict him, which would leave him literally on the street. Also, he is a B and E expert, changing the locks won’t make sure he stays away. I am really sad that he is in this condition, as we have known him to be a wonderful man, and have been happy to have him in our family. Doing nothing, and waiting for the next thing to happen? He has a case working it’s way through the court system. In a perfect world, the result will be to send him to hospital. Back to DD, who is severely anosognosic, and as mentioned does not trust us (or anyone afaik). Her last hospitalization was after she had been on the street, banned from soup kitchens and homeless shelters and literally begging to survive. This time, she is invisible, possibly agoraphobic, and thus it is extremely unlikely that she will come to anyones attention to be forced into treatment.

I have encouraged the neighbors to call police anytime there is a disturbance. Also to report their evidence of his illegal activity, mostly theft. They have been reluctant, partly because they are afraid of the very large and angry man.

Everything is complicated by being several hours away, and coming up to winter with bad driving conditions. And I hate to admit it, but weighing heavily on me is that one way or another it will be up to me to clean up the physical mess of her home.

So, yeah, looking for any suggestions, or maybe ideas about possible outcomes of any particular action. And if you got this far, thanks for listening.

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I am so sorry to read of your situation. So many of us have either been there, or know we could be there at some point in the future.

Personally, I would try to get some kind of intervention and hospitalization for your daughter.

Can you make contact with law enforcement in their neighborhood and ask about them doing wellness checks? Perhaps the neighbors could, instead of contacting the police themselves, contact you, and then you could contact the police to do a wellness check. This was sometimes the route I took. You can ask for CIT trained officers, explain the situation, and make it clear that it is a wellness check, not a complaint.

One of the “best” parts of my son’s hospitalizations when he was very ill was the chance to get into whatever his current living quarters were and clean up. It was always so sad to see the increasing squalor when he was sick.

Hi Spu,

I am sad to read you are going through this, after doing all you could do to provide not only your daughter but also her boyfriend with a home. You are a great mom or dad!

I wish that I could provide some useful information, but I have been going through a similar issue for nine years now with my husband, who went off his medication not long after we started dating, has anogosnosia and has only been getting worse and worse. I was the provider and caretaker for all that time but he was verbally abusive and I had to leave the state to take care of a relative. My husband is also, like the boyfriend, committing petty crimes and using drugs and drinking as well. We have been separated for a year and a half and he is homeless in another state, not wanting to seek help at all, only wanting me to be around to provide shelter and pay for his lifestyle (OK, probably for my company as well, but sometimes it feels that all he wants is money).

It is so simple for us to look at it: You are providing a good, dependable home with no anxiety or stress. That should be the very best option for people with serious mental illness to be able to survive and thrive in the world. But that still isn’t enough sometimes.

Perhaps the best thing to do would be, as you say, to get a judicial order for involuntary commitment for your daughter. What about the boyfriend, though? Does he have any family nearby? I hope that your daughter will be treated and eventually be able to move back to the home you have created for her. Or you might have to look into a managed/halfway home until you can be sure she will stick with the meds.

Best wishes and my thoughts are with you. :two_hearts:

A Wellness Check was all that was offered by Mental Health workers, and included police. It is completely useless, as all they do is confirm that she is alive and not requesting assistance. I already know that!
I will most likely have to have a judge order committal, and hope that they will keep her long enough to help. In the past, they deemed her not ‘sick enough,’ and she has been released to deteriorate further. Timing is critical. I know, it is ridiculous.

I don’t know too much of BF’s history, only having known him in recent years. He has family (not in his community) and afaik they are only connected through Facebook and perhaps phone calls. I am certain that he put them through a lot, and I do not fault them at all for distancing themselves. We do not all have the resources to cope. I did try to contact his Mom, but did not receive a reply.
Thanks for the supportive words. Sadly, I know that there are so many others in difficult situations as well. I wish you the best on your journey as well.

I think documentation of frequent wellness checks could assist you if you need to pursue hospitalization later. The CIT officers were also great about noting down what they see in the environment when they make a visit.

I believe circumstances would have to change before they will do another check. They did actually refuse to go earlier this summer, as they had closed her file and were not willing to get involved again unless she requested assistance. Not gonna happen.

Maybe things are different where you live. In the city where my son lives, I can always request a wellness check by police officers. The trained officers do a good job of assessing the situation and doing some basic intervention.

On a couple of occasions they kind of “held down the fort” to give me time to get there and assess the situation myself, and they have provided support when the decision was to take him for psych hospital admission - they followed closely behind to make sure we got there okay.