@CAAR2016 your journey with your son is ahead of mine, as my son is hospitalized and on meds for the first time since his diagnosis last July. My son has never been willing to take meds until he was required to last month. My son has no insight and all he wants at this time is to be out of the hospital, and to be away from his familly. He is both angry and certain that we are part of his problem. After oral Paliperidone and the Invega shots to get him to a level, he still has no insight. In fact, he told me on Friday that they gave him another "illegal injection". His deluded beliefs are fixed and he pulled the court order page for medication from his pocket and read it.....and said, "see", I can choose "involuntarily" to take meds. I know he knew what that word meant prior to this illness....but there was no reasoning with him, so I instead encouraged him to talk with the disability rights advocate. Although the state hospital is not the best place in our case (like your son's hospital environment), I have refused to discuss a discharge plan that includes him returning home in hopes that it creates a treatment direction that will improve his insight or his ability to be successful upon discharge for them. Ultimately, he will be back with us, and ultimately it might be that we are his plan, but I have decided to listen to the experience in this forum, and with other wise counsel (a family therapist, others that have experienced this here in our state).
Where we live, and because there is only one hospital in the entire state for mental health, they are quick to take advantage of the bed space with the parent that is willing to house their family member, and sometimes that is at the risk of creating a less than desirable clinical outcome, or not pursuing other possibilities. I think it also happens in more population dense areas due to bed availability. In order to get an order for medication with outpatient treatment, we have to petition the court for yet another hearing. The hospital can do that and will likely do that if they discharge him somewhere else.
As much as I would prefer to take my son home from the environment he is in, my son would likely go AWOL./homeless if he was discharged to me for fear of another hospitalization....especially now, as prior to the medication, he could not have executed any plan. The Invega has helped him some in that area. We can only hope that it causes them to consider treatment/medication alternatives if there is no change in the coming weeks related to his insight.
Truly, I do not know the answers....and we each do what we think might be best for our loved ones. What I don't like is that I feel like my own decision making is like throwing a dart at a dartboard blindfolded.
I wish you the best of outcomes with your son, and all of us a week of peace, answers, and clarity in our decision making.