Does financially supporting a schizophrenic doing more harm than good?Is it hindering them from realising they need help?

My friend has been financially supporting a woman with schizophrenia for the past few years. They initially met when she was homeless and my friend helped her get off the streets. She now has a part-time job and my friend supports her financially so she can have her own flat.

The issue is that she does not acknowledge that she has schizophrenia (despite being hospitalised at one point) and her delusions are still strong. The closest she came to acknowledging she was ill was when she lived on the streets. Could the financial aid be hindering her from ā€œhitting rock bottomā€ and acknowleding that she needs help?

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My opinion is no, as long as the support is conditioned on remaining stable and viewed as supplemental or temporary. Itā€™s a good sign that she is able to work part-time. I was able to work part-time while unmedicated with supplemental support from my parents, and eventually came to realize I needed medication. My chief motivation was I was concerned Iā€™d lose my job if I didnā€™t. Eventually my mother started charging me rent and I eventually moved out, and I started supporting myself and now own my own home. Although mine is an unusual and atypical case, my brother who has bipolar disorder and accompanying substance abuse problems did not follow this pathā€” largely I think because too much help and enabling was given by my parents with little consequences.

This person knows what itā€™s like to be homeless, but anasognosia (lack of insight) is a feature of the disease, so itā€™s cruel to force someone back to homelessness thinking somehow this is akin to alcoholic ā€˜denialā€™ to get them to hit rock bottom. The disease doesnā€™t work that way. By the same token too much help can be detrimental too, as it was in my brotherā€™s case. The only time I think this is appropriate is if the sufferer is abusive and/or violent and getting him/her to submit to treatment is not possible. In this case forcing a situation where the person is jailed or put into court required treatment (likely with injectable drugs) can be helpful.

I suggest also you and your friend look into the LEAP method as a different approach to address anosognosia. Hereā€™s a video TED talk that describes how and why it might help. Good luck to you all.

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This has been a concern for me as well, although from the perspective of a family member. Years ago, mental health staff berated me for sending $ to seriously ill daughter. The claim was that I was propping her up and delaying the rock bottom that would cause them to swoop in and save her. I was afraid that rock bottom would = dead in a dumpster, and I was not willing to take that risk. I find that working through the worst possible consequence, and deciding if you could live with that, is a good exercise

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At least in the US this flies in the face of practical limitations of the legalities of forced commitment. They simply canā€™t ā€˜swoop in and save herā€™ without endangering herself and others.

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This has also been my concern fully financially supporting my son , am i enabling him not to work ? i asked his therapist that exact question and she said he is clearly psychotic and not to bug him about work for the next 3 months and we will discuss further . My son laughs to himself quite often, so obviously responding to some sort of stimuli . Having said that he does drive himself to the groceries and he does deal with his lawsuit against one of his doctors . Im afraid when i wonā€™t be around in life , how will he manage alone ? How do i prepare him to look after himself ? Tough one .

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I resented it so badly when my daughterā€™s illness began and I had to change my life totally to support her. She had NO idea she was mentally ill, and without me, she would have ended up homeless. Slowly, through NAMI education, the book ā€œIā€™m not Sick, I Donā€™t Need Helpā€, and very smart compassionate people on this site, I overcame my anger and accepted my new role as her caregiver. It is 4 years now, the past 1.5 years she has been successfully medicated.

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Iā€™m not sure I understand your comment. Here, an involuntary committal requires a possibility of ā€˜substantial deteriorationā€™ in some area of life. It could be physical, monetary, losing a job or facing eviction. It does not require a threat of physical harm to self or others.

While the details vary from state to state, in the US the threshold for commitment to a hospital for a 72 hour psychiatric hold is being a threat to self and/or others. Thereā€™s usually a provision for lack of self-care, but itā€™s an extension of threat to self by incompetence or neglect. This is often referred to as ā€˜Baker-actingā€™ or a 5150 by the colloquial names of commitment laws in Florida and California respectively. After the evaluation period a hearing determines whether treatment is warranted and whether the subject can be held and treated involuntarily for up to 6 months.

A loophole to this is putting the person in a situation where a person might break some law which in some states can lead to court-appointed treatment. Either way, it puts the person and others in jeopardy.

There are efforts to relax the threshold of these laws, but since this is the present tough reality for most caregivers in the US, LEAP has more of a following. I still think any notion of people having to hit rock bottom to ā€˜acceptā€™ treatment is nearly as futile as it is here given the prevalence of anosognosia. Your hospitals still probably have revolving doors, even if those doors are easier to push.

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I agee.

If a person has a capacity to see reality as it is, then perhaps the ā€œhitting rock bottomā€ idea would work. But psychosis takes away a personā€™s ability to reason things out, as they canā€™t see the world (or themselves) as things really are. Discipline, especially hard discipline, does not defeat anosognosia at all. It just breeds resentment in my opinion.

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Thank you all for your insight. Iā€™ve passed them onto my friend and he would love to talk over the phone with anyone who would be willing to discuss in more detail. If anyone would be open to this, please email me at: martina@tangolaw.com.

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2565855097 is my cell, talk or text

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I donā€™t know about supporting a friend, but I think supporting a family member with sz is not only ok, itā€™s necessary for their wellbeing.

Iā€™m not a fan of the ā€œpull yourself up by your bootstrapsā€ philosophy. Many sz cannot work, and providing them w some income can help eliminate some stress and live on their own outside the family home.

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Personally, I believe that simply (said lightly, as nothing is simple or easy in these casesā€¦) there is something to be said for the ā€˜simpleā€™ consistency of having the same person, with the same expectations, the same love, the same familiarity, the same dedication, that is important for those that we love, who are suffering MI, to be able to see and be able to find when they come ā€˜homeā€™. At any phase.
But thatā€™s from my selfish ā€˜family/caregiverā€™ position that I chose to be in with my sz partner. On the other hand, what do I need to do for myself to be healthy and strong and does it ever benefit both of us to hurt myself more to know I canā€™t do anything much or more to help? Probably notā€¦

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I agree. When you have symptoms of SZ, your ability to filter thoughts and sensations are often seriously impaired even when medicated. Itā€™s important to keep a stable controlled environment to avoid overstimulation and eventual relapse. Thereā€™s a natural tendency toward agoraphobia and reclusiveness in sufferers which isnā€™t good either. Regular caring contact with consistent, calm and stable people eases suffering, minimizes relapse and can serve as a bridge to recovery. And short of that itā€™s supportive care that improves and extends their lives.

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My 2 cents

You canā€™t get someone who canā€™t handle a semi or nearly normal life without help to not need help by not giving them help

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Well said! I had to read it twice, but yes, exactly, @three

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I have been thinking about this very thing for the past few months. I pretty much support my son and everything. I have had to buy things over and over for him because he loses them or lets them deteriorate, or even breaks things himself. He calls me up a lot , Also my sister. He says some pretty horrible things to us on voicemail messages. His father doesnā€™t do a whole lot but, gives me $200 a month that I split with myself for groceries every week for Chris. His father just told me today that he is had enough of this BS and that he is no longer going to give me the $200 to help support the food. It makes me start to wonder if I have been doing too much over these 25+ years. My son is is extremely verbally abusive when he is unmedicated. He is drinking a lot! Honestly, I am so ready to hang things up because this is become so hard over the years to deal with. I guess my question is ;Should I just stop drop dropping off his groceries for him every Saturday, or just leave him money? He will probably use it for liquor if I do that. Iā€™m pretty sure he has had a dual diagnosis for many years. Any feedback would be great thank you so much.
I would also just like to say that he lies tremendously and I never know what to believe from him anymore. He will sound totally coherent when he wants something, and 10 minutes later sounds like heā€™s off.

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He recently told Me that he was sick of the way his life is, and that he was sick of pretending that he had schizophrenia.

My experience is my alcoholic brother with bipolar disorder can go from completely rational to an obnoxious delusional jerk in about half a beer. Iā€™ve watched him do it. No telling what his residual alcohol level is at any time.

I primarily do gift cards and physical items to avoid conversion to alcohol if I can help it.

I have tried that but it doesnā€™t seem to make a differenceā€¦I take groceries to him every Saturday morning but his verbal abuse is something I can no longer handle.
Canā€™t seem to find a way to do this without putting myself through this anymore. Iā€™m afraid I am all out of answers after all this timeā€¦:persevere:
Thank you for responding