Family and Caregiver Schizophrenia Discussion Forum

How do you deal with family member having psychosis/delusions in public?

I am wondering how others deal with their family member experiencing psychosis in public. I think one of the most mentally difficult things for me with being with my sz mom is when she begins talking to herself or talking to other people about her delusions at the grocery store or any other public place we go to. If it’s really bad, there have been times she will really raise her voice and attract a lot of attention. Sometimes I feel kind of shallow being embarrassed by people staring and possibly judging, like I should be more concerned about my mom’s wellbeing over public appearances. She wants me to go with her to do errands, go window shopping, etc. but I always have anxiety about her being triggered by something.

As someone with SZA, when you have symptoms of psychosis you have these options:

1.). Stay home. Don’t go out in public.
2.). Go out alone. Cope as best you can.
3.). Go out with a partner. Hope they can share the burden.

When you make the decision on whether to brave the world, if you have insight, it’s similar to a decision everyone makes when they leave the house: what’s the weather today? I am I appropriately dressed to meet the world and can I handle any possible changes?

I’d consider changing your mindset to focus less about how silly you might look in your rain gear, but how good an umbrella you can be for your family member. Helping her cope will lift all boats and perhaps model coping mechanisms so she can better function on her own.

While you need to take care to avoid infantilizing your charge, it’s not unlike tactics parents use to deal with misbehaving children in public. Distractions or substitutions help. Calming words or other pacifications help. Bargaining or delaying tactics help. Reminders about social norms and raising awareness that she’s in public and needs to behave differently can help. Asking how she feels and what might be upsetting her and helping to problem solve may work. Hurrying her, or interjecting that you need to go or keep on schedule or on task can bring her back from distractions.

As for public embarrassment, your options are similar: avoid/ignore her (act like you don’t know her, until things run their course), avoid or ignore public reactions (don’t care what people think and do what you need to do), engage the public nonverbally (exasperated looks and such) or apologize, explain, de-escalate and engage sympathetic accomplices or officials.

I’m sure you’ve seen parents use all these tricks and more in dealing with childrens’ behavior in public. These situations aren’t much different. Over time and with practice, you’ll eventually find some tactics that work better than others. As bad as it may seem at times, you need to remind yourself that your presence is making the situation better than the alternatives: being a shut-in, or going it alone and possibly getting into serious trouble.

@throwaway_heal Better that they do it with you rather than alone. My son was just picked up by the police standing on the sidewalk, probably gesturing and talking. A homeowner spotted him and called 911. He was sent to an ER and from there to a psych ward for 7 days.

My plan for the next few weeks (or until he recovers from his psychosis) is to go with him outside the house – that is, if he can be persuaded to leave the house. He’s afraid, understandably I think, of being apprehended again!