Help / Ideas for Helping Person's Brother?

Someone emailed this to me - perhaps people can contribute their ideas for assistance to this person’s brother:

Here is the situation:

I have a 35+ year old brother.
He very clearly has Schizophrenia as he meet all the guidelines and symptoms.
He lives his life as a hermit. He used to have a very good job, but he lost it 8 months ago and hasn’t had one since. He hears voices 24/7 of his old coworkers telling him he is worthless and crap, telling him lies about his family, etc. He says it is constant and doesn’t know how they are doing this. He truly believes that these voices are real. It makes me fear that he will do something to them or himself . The police were called and he was evaluated many months back but they let him go stating nothing was wrong. My sister has called the Mental Service place near him in North Dakota but they said my brother has rights and nothing can be done.
I live on another continent and my sister lives across the state. He is all alone and we don’t know what to do at this point.
He no longer has insurance. He is a drug user as well.

Any advice or help greatly appreciated on what I can do to help him.

Tell him to get on this site and quit using drugs.

http://www2.nami.org/MSTemplate.cfm?Site=NAMI_North_Dakota

I’ve been rereading this and it feels like because he is alone, he’s falling through the cracks of the system. He has no immediate advocate.

I hope the sister can maybe talk this poor man into maybe having him move closer? Or go to him for a little while to help set up a visiting nurse with DHS or put a CARE or ACT team in place so he can have a wellness check?

ND Health and Human Services | Health and Human Services North Dakota - mental health services of N.D.

ND Health and Human Services | Health and Human Services North Dakota - comorbid conditions and help in N.D.

It’s hard to set this sort of routine up being so far away. I have a sinking feeling that as long as he’s alone, no one will take the time to help him.

As I do understand he was let go the first time he was assessed, but if he’s gotten worse, then maybe another trip?

If he could be officially diagnosed by a psychiatrist, he might then be eligible for SSI. That would also open the doors to a case worker as well. He would also need a Rep Payee so he could have his finances looked after since he is alone.

Being alone is the red flag that stands out to me. I do hope that somehow his sister can spend some time or help him relocate so he does have someone near by.

I am sorry your family is in this situation and I hope this man gets the help he needs.

Thank you for letting me post.

Thank you for your advice and direction. My sister who is stateside has openly told my brother to come live with her and she would come help him move, sell his house, etc, but for all this time he has been saying that he is getting the house ready for sale. He just doesn’t have the motivation or ability at this point to do such a thing as he spends his days trying to figure out how these people (voices) are talking all the time when he can’t see them :worried: I did tell my sister that she needs to get there and try and take care of things. He says for her not to come… I will forward the website and other information that has been suggested. Thanks again!

Lack of motivation - Avolition is a symptom of this illness. It can really make it hard for people to follow through no matter how hard they try.

If he tells her not to come to take care of the house sale, maybe have her say that she misses him and would just like to see him?

I hope it works out for all of you very soon. I’m glad he’ll get to live closer to family.

There’s information on my weblog that may be of benefit to the family of the ill man. Despite the distance, his family can still advocate for him by helping him with smaller tasks that can lead to future self-advocacy such as creating an emergency plan: http://cbdpush.com/emergency_plan/ or assisting him with his warning signs: http://cbdpush.com/warning_signs/
If he is a danger to himself or others, then Mental Health Services has an obligation to have him hospitalized, but you certainly cannot force him in just because he is sz. My best advice is to start with having a plan in place for the unexpected. Unfortunately, in my experience, something usually ‘sets off,’ the hospitalization-- a psychotic episode in public,a suicide attempt, an arrest… the chances of these occurring increase with illicit drugs in the picture.
Again, please visit the weblog, it was created to help individuals and families equip themselves with knowledge, experience, and hope.

Can I tell him I think he is Schizophrenic? Because he obviously says he’s not “crazy”(his words). Maybe if he gets on here and sees that other people are going through the exact same things, it would help him. Or does his brain not even work in that way at this point?

http://www.leapinstitute.org/ - under resources are free videos on using LEAP
LEAP is a way of communicating to build trust. Listen-Empathize-Agree-Partner.

http://dramador.com/ - Dr. Xavier Amador is a clinical psychologist whose brother had schizophrenia. He is the founder of the LEAP Institute. Wrote the book: I’m Not Sick I Don’t Need Help! Can buy from his website.

Search Xavier Amador on YouTube for more videos

http://ourhealthyminds.com/family-handbook/communication/Building-a-collaborative-relationship-leap.html
Building A Collaborative Relationship “LEAP”

Treatment Advocacy Center - under problems you will see anosognosia
Anosognosia looks like denial but is different.

Bayes for Schizophrenics: Reasoning in Delusional Disorders - LessWrong - helped my understand delusions

(May 26, 2010) Professor Robert Sapolsky finishes his lecture on language and then dives into his discussion about schizophrenia. He discusses environmental factors as well as genetic characteristics that could apply to people who are affected. He describes schizophrenia as a disease of thought disorder and inappropriate emotional attributes.

Find a way to get anti-psychotic medication into him. Maybe you can talk him into going into the hospital.

You know - I don’t think that would be helpful or positive. I recommend you just focus on the symptoms or issues that bother him (e.g. lack of a job) and try to get him help.

It probably won’t help to tell him that he has schizophrenia at this point (and maybe never).

Here are some ideas that might help too:

http://www.schizophrenia.com/sznews/archives/005561.html

and here:

Your sister may need to go help him. With substance abuse things could get sticky. He may end up in the ER if he gets into trouble. Drugs just make the situation worse.
Tough one.
Your sister is going to need help with this. It is pretty hard to tell someone they are delusional. Maybe talk to the police in that area, tell them the situation, and your sister could meet up with them so they can take him to him in to the hospital. You may just have to wait it out. She can also call social services and see what they advise. Good luck

He needs to call the mental health office again. My son has Schizophrenia and when he was living with us, we had to call the police several times, along with Crisis. Yes, to him, the voices are very real. Nobody can convince they are not. It may be a lot harder if he lives alone. Who pays his rent? If he lives with someone, they need to call Crisis if they feel he is in danger to himself or others. NAMI is another organization that has helped me any many others. She should look them on online and find a support group in her city. But, if she can convince him to see a dr. again, that may get the ball rolling to get him the help he needs. Drugs don’t help but those that have SZ self medicate to get rid of the voices. He needs meds to help with that.

It’s good to make absolutely sure he has schizophrenia. I would suggest taking a trip out there. He needs family support. First call him if he has a phone and let him know you are there for him and your willing to make a trip even with sis, to get him the help he needs. Call some doctors nearby his location, do some research on schizophrenia, before heading out there. Try getting appointments set up for him before going out, so you can make decisions on committing him, hospitalization, or him getting treatment nearby. He needs a guardian or guardians. He needs a home, he needs family support, he needs treatment. You might have to get him on disability, so he has money and insurance. He needs support he is sick, he has an illness. Once you get him set up, if he lives by himself get him a caregiver. Get some legal counsel on being his guardian and getting him the care he deserves.
Contact Nami.org
Contact a lawyer
Contact the state where he resides for treatment, institutions, hospital for inpatient or outpatient care
Get him diagnosed and treated immediately
Contact Social security for disability and insurance
Think about caregivers to assist him with independent living

Send him over to Illinois, I’ll get him a mechanic job and perhaps a good apt with some strings pulled.

Thank you. He pays his own rent. Our parents died a few years back and left some money. I think he’ll keep living on that until it runs out. My sister called the mental health services in his area and they have him in the system because of the 1 time he was evaluated but nothing since then. She said she strongly suggests he go voluntarily… Not going to happen! My sister told my brother she would come help, even try to help with “the voices who keep bullying him”, he said no way he would let her come. If she shows up, or cops come, it may not be good… A small part of my sis thinks she’d be betraying him if the cops were involved, or something like that because he says he just wants to stay there, do drugs, and he can deal with the voices. Our biggest issue is how to do it initially. The details, selling house, finding treatment, SSI, are not even a concern, when the biggest hurdle is how to get him out of the house (paranoia keeps him inside), and agree to get help…

I can relate to this. My son has schizophrenia and was medicated and living a highly functional life. This past November he stopped taking his medications. And he cut himself off from the family. We try to visit once a week to monitor his decompensation. And he is decompensating. Under the law, as you know, we can’t do anything until/unless he becomes a danger to himself or others. That’s a terrible thing to wait for. My questions for you: 1. Is there Assisted Outpatient Treatment in your brother’s state? 2. Is there a crisis interention unit in his city who can make house visits and check on him? I know this isn’t much, but it’s a start.

Being concern about his welfare is crucial. A loving supported family is a priority to recovery. I really hope he gets the help he needs. A mental illness doesn’t have to be a stigma, it’s not an infection that’s contagious or an epidemic. Schizophrenia is an illness and a disability. Maybe an advocate can help.

I don’t know the answer to those questions. We finally have a contact at the mental health clinic there, so I will find out. Thanks for the advice!