Managing money for the mentally ill

Hello all, it’s my first post here…

My nephew, almost 30, was diagnosed one year ago as schizophreniform. He has lived with me for that year, and I have supported him 100% and then some. He has worked about 20% of the time, at a variety of minimum wage jobs, and always runs out of money.

Last week I caught him injecting something - meth, it turns out. I’m sober, and have required him to be sober to live with me. I’ve caught him with booze on his breath numerous times, and believe he spent his excess cash (non-phone/bank fee) on drugs and alcohol. He’s been addicted to heroin and meth.

So I told him that, if he wants to continue staying with me, he’ll need to turn over his earnings, so that he can’t buy drugs. I’ll keep it in an account, it will earn interest, and he’ll help me pay the rent and groceries (according to clear rules, percents, which we’ll agree to), and eventually he can buy that car he’s always wanted… in a few years.

Today, I started looking for bank accounts for people to manage the money of SMI relatives (severely mentally ill) - guardianships, POA, dual-signature, joint accounts. Nothing really matched exactly - is there anything else?

What would you recommend for my situation? Thanks, and I attend NAMI meetings at SF Gen, so I’m in a community of folks who help their SMI relatives. But that’s been closed for two months thanks to Covid-19.

Cheers,
Kevin

My two cents, you may be over complicating things. If you are looking to completely control his finances, that may be a pipe dream. He could work under the table or sell possessions to covert them to cash, bitcoin, etc, etc. Generally drugs are bought with cash, Silk Road dark web transactions not withstanding. Monitoring his account with him being fully aware of the monitoring is likely enough. You will not and cannot completely control his drug use this way, and if you try you will likely cause more hassle that it is worth. My family opted for a containment strategy.

My family does a three account approach for my brother, but one of them is a trust account. The trust owns his house, so taxes and any maintenance goes there.

My parents have a joint account, and any income he gets goes through into that account. There’s also a joint account with my sister and my brother’s name on it, which is effectively his living expense account. Money is periodically transferred from my parents account to this account, and my sister watches it with text alerts and emails for each transaction. She took over the monitoring function from my parents as they aged. I have account access via a shared password, but I rarely use it.

We’ve found that often times he gets into trouble less from drug and alcohol use, but other spending issues which he goes to great lengths to conceal— e.g. bidding on stuff on eBay. And then the added stress of this burden leads him to use. Monitoring has allowed us to intervene earlier, before things become a problem.

Edit: we do this all remotely. My sister and I live in a different state from my parents and brother.

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Can you get him into drug rehab?
My first thought is that he will lose his job if he is using as you mentioned and you won’t have a money situation.

What has worked for me. 1 account that only I control. 1 joint account. I make regular transfers from my account to the joint account, conditioned on my son staying med compliant. I can see to some extent what his expenditures are in the joint account.

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Thank you for your candid and helpful replies, people.

I’ve asked my nephew, and he’s agreed, to email me his bank account statement daily. That’ll give me a way to spot likely meth purchases going forward.

We had a talk about his meth use, why he uses -it reduces/eliminates nightmares and out-of-control anxiety. At the same time, from what I’ve read it’s gonna harm his nervous system and shorten his life.

Apparently his psychiatrist has given verbal consent to continued meth use (“just use it safely and conscientiously”?!) which blew my mind, and has to be dealt with.

I get that ppl with psychosis want to self-medicate, to reduce the feelings that come from being psychotic and schizophrenic. During my own time in alcoholism recovery, I’ve met many folks (in AA) with SMI who self-medicated with H and M, mostly leading to further stints with inpatient recovery programs.

The current psychiatrist says to just increase the seroquel to reduce anxiety. My nephew’s at 500 mg seroquel (increased from 300 mg), 2 mg risperdal, 20 mg lexapro -nightly. His nightmares are reduced, but he’s craving stimulants badly.

Not sure what to do, but at least I got some ideas on the banking side -much appreciated.

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@SaneInsanFran Best wishes and stay strong in Keeping up with YOUR sobriety.
Don’t go down with this ship.

“So I told him that, if he wants to continue staying with me, he’ll need to turn over his earnings, so that he can’t buy drugs.“

I would caution against making statements that you are unable or unwilling to follow through with. What actions by him will trigger you to require him to leave? How many chances does he get? I understand what you are trying to do, but I think you will find it is impossible and probably not desirable to have complete control over his finances.

Thanks @Mojoclay. Two feelings come up, annoyance that he is breaking our deal by using, and loss/sadness to watch his life go this way. I have intact boundaries, his life isn’t my life, but I am involved daily, so I feel about it.

Tonight, we will attend a dual diagnosis meeting via Zoom. Neither of us have been to one before. I am hopeful that we’ll learn of / meet other schizophrenics who have gotten help and learned how to have some type of a life without having to take narcotics or alcohol daily.

Hi @Spu, yes you are right, I have backed off on intervening financially.

Last night my nephew came home with liquor on his breath. I asked if he’d been drinking, and he immediately denied. I brought it up again later, he denied again. He’s not stupid, he knows he can push the line.

He’ll probably do the same with meth. My other line of reason with him is the health outcomes of tweakers. Possibly his drinking last night was to counter his cravings, which he mentioned earlier in the day, his hands shaking so much he dropped his phone several times.

I have no idea what his inner experience is like, other than what he’s told me. As a young neurotic, feeling persecuted by schoolmates and family, I felt out of control and that feeling stayed with me into adulthood, leading to my drinking heavily -until I got help.

For a schizophrenic, can those feelings be reduced via therapy and pharmaceuticals? My impression from NAMI meetings is it’s a lifelong battle.

I want to see him have a life of some reasonable type. His preferred form of medication is a judicious balance of alcohol and meth, which led to him being kicked out of his parents house and living on the street, after getting a DUI for same.