Family and Caregiver Schizophrenia Discussion Forum

His meds stopped working and he's also been arrested -please help

#1

My brother (25 years) was diagnosed 7 years ago, had relative remission of symptoms beginning about 6.5 years ago with ability to function- hold a job pretty reliably, take college courses.

Was continuing to have substance abuse - alcohol, marijuana, acid, cocaine, mushrooms, probably more. Substance use increased last fall and this spring, followed whether causatively or not by return of his symptoms, which have now been present constantly for the past 3-4 months. He lost his job at the end of June when he reached the point of dysfunctionality beyond the ability to interact with others. Symptoms include:

  • He can’t focus, gets distracted between someone saying their side of a conversation and his response so that we have to repeat a given question/statement several times
  • Believes voices are real people
  • Little to no short-term memory
  • Erratic behavior - quickly arrives and quickly leaves with no response
  • Can’t do tasks of daily living including feeding his dog, turning off burners on the stove, eating, taking meds without reminders, or setting up systems for managing these things for himself
  • Generally odd decision making (getting in fights with trees, getting 4 blocks of cream cheese and two jars of salsa for groceries)
  • Threatened my dad with a glass bottle when he told him he shouldn’t drink alcohol

He’s also committing crimes. He was arrested last week for trying to enter a stranger’s house (was knocking on door incessantly and trying to open the knob) - turns out he wanted to ask for a glass of water. He’s also been shoplifting and trespassing, and was at one point going around trying the doors of cars in our neighborhood (to get change/steal cash apparently). We assume that a lot of this centers around trying to get money for cigarettes, but we are buying him cigarettes and he’s still doing these things.

We took him to a crisis center after his arrest and he was admitted involuntarily but discharged after 48 hours. He was slightly more calm but his symptoms had not improved from when they judged him unstable enough to be admitted. They have a short-term residential treatment center there but the doctor did not refer him to that treatment and after we received notice of discharge from the facility, they said the doctor would not reconsider the paperwork. His doctor was stunned that he was released but they did not appear to have contacted/consulted her.

His doctor who he has seen for 6 years has increased his dose of Latuda and added Rexulti but his symptoms continue at the same or progressing degrees. She recommended that he should stay at a residential treatment facility because he is living alone and he needs regular monitoring in order to find the right medication combination in addition to dealing with his substance use issues, but he will not agree to that and we do not have the ability to pay (no insurance).

We are looking for options.

If anyone can make recommendations, please do:

  • Options for sliding scale treatment / alternatives to insurance
  • Ways to speed up things like disability applications
  • Would obtaining guardianship allow us to get him into treatment longer than 72 hrs without his will?
  • Experience with dealing with medication stopping working and how that went?
  • Experience convincing someone that they are not supposed to drink or use drugs with sz/sz meds
  • What kinds of residential/inpatient treatment options are there?
  • Because of his arrest, he will be going through mental health court. Does anyone know how decisions are made about what treatments to prescribe by the court? Will they consider his current doctor’s recommendations? Do we need to get a lawyer to advocate for a specific treatment plan or how does this work?
  • Are there ways to work with a crisis center to press them to hold him longer or transfer to an intensive outpatient or short-term residential center?
  • Any resources to help identify the quality of psychiatric inpatient facilities? Google reviews and the Florida AHCA’s inspection and fine records are what I have located so far

Thank you very much. We are trying but sometimes it feels impossible to make this any better

#2

Dear yellowbelly,

I’m sorry your family is going through this. I don’t know what Mental Health Court is like in Florida, but there might be an evaluation with review of all previous medical records. This would be the time that hopefully his doctor will release records speak to the MHC treatment team.

All of your questions are questions I have too. Your brother should have a point person or team with Mental Health Court.

Try to get all of your bullet points (both your concerns and your questions) in this excellent, thorough post to that person or team, if possible. They will likely have resources for fast tracked disability applications and housing. There could also be a substance abuse treatment component of the court ordered treatment.

Best to you and your family.

#3

Hi,

Very sorry to hear about your brother’s situation. You have a lot of questions - understandably. Here are some ideas and responses, and hopefully others will add their own thoughts here in response to your questions:

First of all - regarding legal issues and options with your brother - I recommend you contact the Treatment Advocacy Center - they have lawyers that focus on legal issues as they relate to mental illness and can usually answer specific questions you have:

http://treatmentadvocacycenter.org/

200 N. Glebe Road, Suite 801, Arlington, VA 22203
703-294-6001 (phone)

Medications do stop working or become less effective over time - that is not that uncommon. All you can do is try other medications.

Substance abuse is sadly common with schizophrenia. What you need to try to do is get the person to understand the negative impact on their lives of the abuse - and to seek professional help. You’re not going to be able to just persuade them to stop - I think it would be best done by an expert - perhaps a therapist or another social worker or person experienced in helping get people off illegal drugs.

Residential / inpatient treatment options in your area are best discovered with the help of your local NAMI (the nonprofit National Alliance for the Mentally Ill)- contact the local office from their web site: http://www.nami.org

Yes - there is a way to get the crisis center to hold them longer - call them and send them letters to document exactly the issues and behaviors and history (up to the current time) of your brother and the exact nature of his problems. Document them and make sure they understand the full nature of the problems - and his need for help and treatment. if you need to - get serious with them and threaten them with legal responsibility. Here is more information on how to get the best treatment for your family member:

http://www.schizophrenia.com/family/bettercare.html

and

http://schizophrenia.com/family/FAQgen.htm#law

and

http://schizophrenia.com/family/FAQgen.htm#bettercare

and

http://schizophrenia.com/family/FAQgen.htm#medcompliance

#4

Thank you so much!!!

#5

Thank you so much!!!

#6

Great information!! Thank you so much for your time and effort into writing this!!

#7

Thanks for sharing such a great information. This would be really beneficial. Lawyers like in Treatment Advocacy Center or Bechara Tarabay also provides counseling. They also help us by telling the pros and cons of the action we would take. Hope you would not be facing any more major trouble after hiring a lawyer.