His disorder may actually be actively convincing him that he doesn’t need help. It may also make him suspicious of the medical community as a whole.
These are unfortunately common to those diagnosed with Schizophrenia and can be compounded by other less obvious symptoms like lack of insight and trouble with memory.
He may believe his delusions are real communication from some legitimate source.
He may believe he is supposed to be rendered disabled and not meant to have control over his thoughts, moods and environment.
He may even believe you and other people closest to him are the cause of his struggles and his stress.
Work toward building trust and providing even-tempered responses to his opinions and his needs.
Establish the angle that you want his quality of life and his independence to improve over time, rather than stay the same or get worse.
Ask him about his quality of life.
Is he content and fulfilled?
Is there anything going wrong, or anything missing?
Does he feel like he has the peace of mind and security to be comfortable at home and also to go out and do the things he wants to do?
Is his day to day generally easy or hard?
He might have nothing to say about all that, or he might have some very strong opinions about it.
If he doesn’t have any input to give, save it for another time when he does feel like talking.
If he has a lot of hurt and despair to convey, be patient, don’t match his level of intensity. Help him explore his feelings and try to conclude that he is not well for a variety of reasons.
His delusions and lack of insight might stop him from understanding that he needs therapy and medication. He may even believe that he needs isolation and self-medication (the worst treatment options for a Sz person).
He won’t get help until he genuinely wants it. And he won’t want it until he gets tired of feeling out of control.
But you can help him to trust you enough to talk to you about what’s going on with him.
It takes a lot of patience and a lot of acceptance that his rationalizations and his actions will be irrational.
Even then, he may refuse treatment. But if you’re going to try to help…
Help him to want your help.