Family and Caregiver Schizophrenia Discussion Forum

Need help dealing with friends first episode


#1

I have a close friend (27 yr old) who had gone missing last week but was found a few days later in a mental hospital about 2 hours from home in Palm Beach County, Florida. He was diagnosed as bipolar, but we know there is SO much more to it. He is extremely delusional.

He ran off in his girlfriends car with no wallet or phone. The week prior, he kept telling us about million dollar deals he was making, but in actuality hasn’t a dime to his name. We found transaction history of 9 times he tried to use Venmo to gift $250,000 to Christ Fellowship. He thinks he owns EIGHT Gold’s Gyms. He even thinks he OWNS the mental hospital and the nurses WORK for him and that is why they released him. Since being released he has lashed out and literally foamed at the mouth at everyone who cares about him and is trying to help because they “don’t have his back or believe in him.” He has even tried to jump from moving vehicles when he’s told something he doesn’t like. Now he continues to write $6000-$18,000 checks to himself while his account is severely overdrawn and racking up late fees.

His family came to help and he refused treatment and they left defeated. He lives with the girlfriend of only a few months (who has a preteen female child in the house) and the police cannot do anything. He has not threatened anyone, but is so delusional that the idea of him on his motorcycle is terrifying. She does NOT feel safe with him there, but cannot make him leave because he has received mail there.

We have contacted local mental facilities and they tell us he needs to be baker acted, but the police won’t take him in again. She is documenting every time he says/does anything and keeps her phone/wallet/keys on her at all times because he will try to take them.

So…how do we get him the help he needs? What can she do to remove him from the house? Do we try to explain reality or go along with the delusions? Do we just let him run free??? Any help/suggestions would be VERY much appreciated. We are all so lost, worried and frustrated.


#2

I can only imagine and am so sorry. I would file an mental inquest warrant and they should hold him longer.


#3

It sounds to me that someone, anyone, needs to call 911 at the very first opportunity, and report that this “is a psychiatric emergency” so the police are prepared. If there is ANY threat or action of violence to self or others, someone should get themselves to a safe spot and SECRETLY make the call, so he doesn’t run away. Don’t bother with making threats to call, just do it. To me, attempting to jump out of a moving car would’ve warranted a 911 call, as a “danger to self”. Just be very clear to the 911 dispatcher that it’s a psychiatric emergency.

It also sounds like your friend is so psychotic that there is absolutely no point in trying to interact with him when he’s expressing his beliefs (delusions), especially since it just escalates his angry behavior even more. Just stay away from him if he starts to rant. Maybe he’ll start destroying property, to get your attention, but that’ll give someone a reason to call 911.

The child needs to be out of the picture. Can someone take her until he’s hospitalized? I think the girlfriend should not be alone with him in the apartment. Maybe a friend or one of his family members needs to stay with them. Better yet, maybe friends or family can take over for the girlfriend and get him out of her apartment by quickly setting him up in temporary housing elsewhere.


#4

Thank you both for taking to the time to respond…we’re working on your suggestions. Unfortunately, the police have not been much help AT ALL.


#5

So sorry you are going through this buts it’s also great you want to help your friend. Day by Day’s previous message seems pretty spot on to me. Our family has been through similar experiences and I know how terrifying it can feel and also how powerless the family can feel.
To add to day to days comments, if you do call the police for an emergency commitment ask them if they have any CIT trained officers/deputies on their force. CIT training prepares the police for physc emergency’s using deescalation techniques.
One thing that has worked for us is telling the ER docs that the patient is suicidal and has a plan. Often episodes like this continue to escalate until an emergency commitment takes place it’s sort of inevitable. Talking with your friend and trying to make sense is probably not going to work until he is hospitalized and stabilized.


#6

Today I thought I’d try proving to him that there’s no money and no million dollar deals. Although everyone showed him the facts, he now says the money will be there tomorrow. He continues to do online shopping, but nothing is being approved. He’s currently trying to buy health insurance over the phone for EVERYONE. He is telling them that he made $300000 last year. He is insisting I take him to a dealership so he can buy a car. That way he can sign up as uber driver. He also started having chills today, on his motorcycle in the Florida heat, with a sweatshirt on. Not sure what I can do at this point


#7

Maybe you can use the “chills” to strongly suggest a trip to the ER? Say you’re concerned he may have a bug of some sort and he can just get checked out. Do you think he’d buy it?

Once he gets to a triage nurse, they’ll know. HIPPA doesn’t prevent you from talking to clinicians about him. It just prevents them from sharing info with you.


#8

It’s possible he would. I will give that a try. Thank you!


#9

Trying to jump out of a moving vehicle is a danger to one’s life…report him as “as danger to himself”. Use those words.
If the police are still not inclined to assist ask them for guidance on the areas mental health crisis teams and how to get an involuntary admit. Do this through the regular dispatch phone line, not 911. I am not against using 911 in dire situations, but sometimes you get dismissed. I have found the staff more willing to help because they are not under the same guidelines as 911 operators.
And above all else, do NOT challenge his delusions. Not challenging is not the same as agreeing. This applies to both a psychotic break as well as day to day. It is hard because you sometimes want to yell at them about their unreasonableness. What helps me is keeping in mind, irrational or not, a belief ANYONE holds is theirs to hold. And consider this—he may well believe YOU are the one with delusions. Take care.


#10

No matter what you show or tell them, you can’t talk someone out of a delusion. They will use confabulation constantly to make their delusion work.

Good example of confabulation at work:

You show him there is no money, He tells you it will be there tomorrow. If you show him he was wrong the next day, his brain will just make something else up that he will believe. The more you argue with someone who has delusions and attempt to prove them wrong, you become a part of the delusion and lose trust.

Have you called for a CIT - crisis intervention team or a mental health city/county officer yet? Does your area have such a thing?


#11

I was just given that information this morning. I will be have Mobile Crisis come out to my house this evening. Praying this works!


#12

Don’t give up. Here are some resources:

First Aid for Psychosis:

http://www.schizophrenia.com/sznews/archives/005561.html

and - try to get him here for help (identify some things that are bothing him that he can agree to - e.g. feeling anxious, or depressed, etc.