Family and Caregiver Schizophrenia Discussion Forum

As sz son's primary caregiver...initiating mandatory medication/commitment action...thoughts?


#1

If any of you have executed a court action for mandatory medication, or a commitment hearing, can you tell me how you prepared your loved one for this? How you weathered what has the potential to be a trust and relationship killer?

I am my son’s lifeline and support, he lives with me, has little insight into his illness, and he has been non-compliant with medication since a hospitalization in July. I have guardianship as of this week, but it is so strange to me that whether I admit him (which is very likely), or he stays in my home…even with guardianship, I have to have to be the bad guy…to be the person that requests that the County Attorney takes this action and helps the atty prove the need for mandatory meds or commitment.

I am not unclear about his medication need…but I am deeply concerned about me being the heavy, the one that initiates this action. I might be surprised, but I welcome your thoughts.


#2

I would exercise all other options, like going to the outpatient pdoc first. If non compliance is an issue, it could be due to the horrific side effects some of these meds have.

In my state, it takes 3 people, not just you.


#3

It is a non compliance issue…no insight as well. I am in MT and it is essentially the same procedure as a commitment hearing.

I was able to get him to a pdoc, but only because we insisted he see the doc or he moves out (he has no where to go, no money and with -20 degree weather homelessness was not looking good). This included a mandatory medication requirement if he goes and the doctor orders meds, but he has been non-compliant. With the guardianship I received on Wednesday, I have collected his records from the current pdoc, talked to him, and he suggests we move swiftly on a mandatory medication action. I am in the process of collecting all of his records from prior hospitalizations, visits (typically because he was placed in a 72-hour police initiated ‘gravely disabled’ hold and subsequent hospitalization in another state.)

Because we are 1.5 hours away from an ER, it is not an easy trip for emergent moments. Often he settles down before we get there. We have made the trip a few times, in all cases, he talked himself out of a hospitalization. This was before guardianship. In the case of us needing police intervention to initiate that course of assistance, we live in a county that is 5500 sq. miles. It often takes a deputy more than an hour to get to us, sometimes longer,…and even then, the deputy is not CIT trained. I have talked with the sheriff, we know him, they know us…and now they know my son. So at least if it is a county deputy, I know that they will at least proceed when they arrive knowing who my son is. Sometimes because a state trooper is closer, they will dispatch one of them. We have been close, but have not done that yet.

He needs treatment…is at times out of hand…and we are headed toward a really bad place. I believe I have everything I need to display a medication need, I am just really struggling being the one that has to execute it with what it will do to his level of trust of me.


#4

I have been there too. Sometimes you just have to do what’s best for their health at the moment, the rest will come later. He will forgive you eventually once he sees that you were only trying to help him.


#5

You make it sound like he’s breaking the law. I’ll tell you a story of what happened to me.

I was traveling far from home and became increasingly psychotic. I tried to get home, I didn’t make it.

I stopped to buy gas and eat breakfast, and my debit card was shutoff at the bank. The bank was closed, small bank. I called them. Since my debit card wouldn’t work, the store / restaurant called the Sherriff. I babled some nonsense to the Sherriff, and the next thing I knew I landed in a commitment hearing, then in a hospital for 6 weeks, possibly 8 weeks can’t recall for sure.

I was never charged with stealing my $7.95 breakfast. I did land in the hospital where I needed to be.

You mentioned the Sherriff in your post. They do know what to do if the psychotic person has broken the law.


#6

Dear jmarie, I was in a similar situation to you, except with no clear path towards mandatory treatment.

Months ago, I did call the crisis social workers on my family member, who had not committed a crime. Family member left home and returned having calmed down. I then chose not to receive “courtesy transport” to Emergency Department from police. Family member became more and more ill over a few days. The day I finally decided to commit, it was too late. With zero history of crime or violence, family member committed felony assault during the episode and has been in jail for months.

I knew he was very ill and did not wish to force things because 1.) where we live, I could not guarantee that he would receive treatment even if the police dragged him from our home (again) to the Emergency Room for assessment and 2.) The last thing I wanted to do was call social workers on him again if there would not be long-term help and he would stop trusting me.

We went through a year and a half of difficult relating after his first hospitalization brought about by a police hold two years ago. Police were called by the social workers I called. Family member was enraged with me. It took so long to restore our relationship.

That was nothing, nothing compared to him being incarcerated. 90% of people with schizophrenia will never harm themselves or others. Our family got the bad draw. Incarceration is worse than a nightmare; it is torture for someone in acute psychosis. If I could go back, I would have dragged him to the Emergency Department when I knew he was terribly symptomatic during acute psychosis. If I could go back even further, I don’t know what I would do because it took so long for us to be close again after the police hold two years ago.

That said, I don’t know what is best for your son and you. I really don’t. He might be among the vast majority of people with schizophrenia who will never get into legal trouble.

The jail where my family member is being housed just filled up when the weather dropped to freezing and the snow and ice-rain came. People commit crimes to get warmth and food. There are medical wards in the jail for people with medical illness and many inmates seem to be homeless with severe mental illness. It’s heartbreaking beyond belief.

Hindsight being 20/20, I did the wrong thing for my family member and for me.


#7

True, my fiancé was in JDC as a kid. If his mom had pushed further treatment and gotten more help, I think we wouldn’t be where we are today and he wouldn’t have done down on the life path that he did. Until I was with him he never had been medicated except for depression and it had caused him to have a seizure, so he never continued to get treated.


#8

No, my son is not breaking the law…but he is unable to construct a sentence some days without being distracted by the activity, conversations, or thoughts competing for his attention in his mind. Sometimes he is completely absent, can’t hear anyone…and other times, he will pace or spin in circles out of the mental anguish and a throbbing anxiety in his head. The rest of the time, he is like a man in a foreign country where he can’t speak or understand the language of everyone around him…and he simply is angry, as he feels like he is trying to negotiate a purchase in a market where he is sure someone is ripping him off. During his less anxious days, he refuses to leave his bed. I discovered him peeing out the second story window yesterday…just so he wouldn’t have to leave his room. My son is completely disabled by this illness.

He has made a valiant effort to try to tackle this without medication, and we have provided him with safety while we begged, pleaded, bargained, and attempted to coerce him to choose otherwise. He has attempted to negotiate an alternative path for himself…but the progression of his illness is something we simply struggle to allow to continue. It wasn’t until Wednesday that I was even able to get a hold of the records of what I know to be his first visit with a school psychologist in CO…when he still had some awareness of his illness. He confirmed in his visit with her that some of these feelings began his senior year of HS and it sounds like his first psychotic bread was his freshman year in college. We were completely unaware. Like many of the stories you all have shared, he kept his secret until his sense of reality was fractured. He told us about it in November (last year). He had an academic suspension in May, and in the hospital in July with his first admission into a psychiatric facility.

So no, not breaking the law…but he has been so close on a number of occasions to qualifying as the more common “danger to self”…“danger to others”. He is a gentle person by nature, but according to his psychiatrist he saw in November, who I spoke with for the first time on Wednesday (thank you, guardianship!!!)…“he is far advanced in his illness…and we must move swiftly.” So that is where I am at today…taking our next steps.

I struggle terribly with violating his trust, as I have very little of it in the first place with his paranoia.

Thank you, all of you for listening and replying.


#9

Anytime, we are here for your. I understand that. I’m familiar with the behaviors that you have described as well. And he may not be violent now, but you never know if one day he’ll want to kill himself or someone because of a delusional belief. One of my uncle’s with schizophrenia committed suicide and my fiancé family told me that he threatened to kill them, but he denies this and has no recollection of this or other things he has done in the past.


#10

I thought I might have to do what you’re thinking about recently. Luckily, my son, when he gets really, really sick, wants someone to listen to him other us - and that has gotten him to a place where someone else would put an involuntary hold on him on two occasions and I didn’t have to be the one to do it.

My biggest fear would be that I would lose him - either his trust, or lose him physically if he decided it’s better to leave than face hospitalization in the future.

However, I finally decided that if it came down to it, I’d be strong enough to do what I thought was needed to save him and the consequences be d*mned. After all, I was losing him anyway - and he had definitely lost himself. At some point, not doing it would be practically the same thing as killing him myself.


#11

He has come close on two occasions to being horribly violent, Doctor…and I don’t doubt that he contemplates suicide, although he represents otherwise. We are truly at a tipping point which is why we are in the position we are in. That is why I mentioned my call to the sheriff, NiceHat.

Where we live, the deputies have only 16 hours of training…for all things…and they essentially are on the road and serving the public. Truly, we are in a county that has a little more than 8K people in 5500 square miles. That is an area that is two-thirds the size of the state of New Jersey, and they might only have 2 deputies on during busy holidays/weekends. Most of the time, only one. It could take them an hour or two to get to us depending on where they are when they get a call. The pay is meager to begin with. The deputies are often raised in rural communities here in Montana, few with a 2 year college degree, many with no degree at all. Regardless…it is their life experience and judgement that guide their decision making. Certainly we have some mature deputies, but the young man that serves the area nearest to us most of the time is 25. I know he understands the law…but I did not (and still don’t) trust his depth of experiences in his life, his absence of CIT training, and more specifically…his absence of training or exposure in general to understand the severe moments my son (or anyone with mental illness) has when he is paranoid, afraid, or perhaps acting violent out of some delusion. My son returning to us in a discharge plan and living here in this rural area required a call to the sheriff to prepare for what is ahead if we have a crisis because of our distance to any services. We are literally 3 hours from an inpatient facility that could serve someone’s mental health needs, which is where his pdoc is. The closest ER is 88 miles one way. I wanted to be proactive and let them know he is here, find out what their training was, and I asked to have the young deputy meet my son so my son could know who he is if the deputy ever had to come to our home. I still shake my head in disbelief that I even had to have a conversation like that in the first place…but I am grateful that I did, as it allowed for a foundation, and some sense of comfort in case there is ever a crisis for us.

Again, many thanks to all of you. You truly are a place of respite for me. I am grateful to know there is someone “nearby” in this internet place…


#12

This is so true…and so sad, slw. It pains me for all of us, but you are right. Thank you for replying.


#13

Since his doctor is on board, and encouraging compulsory treatment, you can in good conscience shift some of the responsibility. A mutual, shared decision with the doctor seems responsible and maybe your son will understand one day.


#14

I understand, and of course, we will always be here. hugs :slight_smile:


#15

We actually did the involuntary and guardianship but we haven’t done the mandatory medicine yet I’m very close and have considered it but we haven’t done it yet. I know you are going through hell and I’m sorry. Our son was so sick when he finally was committed last year that his attorney interviewed him in the hospital.

I actually think that if I did the mandatory medicine my son would flee but you know your son. I hope it all turns out for he best with you.


#16

We had a very bad experience the first emergency and my son has ptsd because if it. I tried to stop in and talk to the sheriff as well. No CIT officers but we’ve had some really calm ones show up when called. God has always protected him during these times. I prefer to drive him in one hour away to the mental health emergency room.


#17

Mom2, I think mine might flee too. It is such a balancing act…and I know we all weigh each aspect, each decision…and yes, A LOT of prayer.

The place I am stuck at this time is that I have an ability to admit him now with guardianship, but there is nothing that can mandate he takes medication at this point if he refuses. Even with the complete psych evaluation he just had. The pdoc stated he needs meds, but he refused. Even if he was in the hospital through my admission as guardian, I still have to take the action through the County Attorney to get him to take meds. I have a call with the County Attorney to talk with him about it next week. I am hoping to get clear on all of this at that time.


#18

This was good for me to hear. Thank you.

I am so grateful for all of you!


#19

e County Attorney to get him to take meds. I have a call with the County Attorney to talk with him about it next week

Jmarie1067, what did the county attorney tell you? Our county attorney said that even though we are guardians we can’t force them to take their meds. He indicated he was guardian to a gentleman and knew what it was like.


#20

Mom2,

We have to have an additional hearing to mandate medication. It is essentially a commitment hearing. It can be a CTO or out patient community treatment order or an inpatient program.

God willing he stays steady through Christmas, our goal is to wait until after Christmas if possible. We found a mental health stabilization home/crisis center and we are going to ask him to voluntarily admit, or we are filing a petition with the county atty. he will have a choice.

My sons issues are mostly severe negative symptoms…or at least that is what we see most. He has had some psychosis that has been scary…but his day-to-day is mostly behavior that qualifies him as gravely disabled. Although he has some odd fixed beliefs and he denies hallucinations, we believe he has auditory hallucinations all of the time.

What I am struggling with now is mandating medication when everything I read is that it often doesn’t improve the negative symptoms. We simply pray a further commitment will help him engage in discovering if treatment will help him. He has yet to be compliant with any medication.

Wishing all of you peace through the holidays.