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