Family and Caregiver Schizophrenia Discussion Forum

New schizophrenia diagnosis for out of state sister in law - where do we begin?

My husband and I live in Texas. My mother in law is in MO and is bi-polar. My sister in law lives in another state. Over the holidays we were made aware of abnormal activities, to the extent that my husband flew out to her, and drove her to MO. They were able to get her under involuntary care for about 48 hours, and that is how the diagnosis was received. She refuses to take medication, and believes that everyone is involved in a conspiracy against her. This is new to both of us, and being that we are out of state, we don’t know where to begin or what to do. How do you get someone that doesn’t believe that they are sick to visit a doctor or take medications? The stress of the situation has also impacted my mother in law, who has recently stopped taking her own medications. We are at a loss on how to handle all of this and I came upon this site today. Can anyone provide any insight on where we should begin? My sister is homeless and we found that she hadn’t been taking care of herself at all, though she put up such a good front that we thought she was being followed. She is living with my mother in law for now, but between the two of them, they are both unemployed and living on a limited income. We’ve been told that we need guardianship, but if that won’t force her to take meds, then what benefits come with guardianship?

Sorry if this sounds like I am panicking, but in a way, we are. We have no idea what to do. Any help would be appreciated.

Thank you

Dear thecourt99, I would be panicking too.

It’s true that guardianship does not allow the guardian to force their ward to take medication. Only the court can do that. The benefits are being able to talk with her doctors and providers, schedule appointments, find out how things are going, get prescriptions filled, and possibly become or help designate a representative payee if any government support is available, also can help apply for services or supports or housing if you are guardian. Depending on which state she lives in, a guardian can go to court and request a court order for medication, but this is not possible in every state.

The book often recommended here is “I’m Not Sick I Don’t Need Help” by Dr. Xavier Amadour. Most of us have family members who do not believe they are ill and experience lots of difficulty, debility/ disability, and suffering due to the illness.

The book has communication strategies, but the main goal is not a strategy at all: just staying as close as possible to a person you love who is having a very hard time and doesn’t know how to feel better.

Do lots of research on supports and services where your SIL lives for when she does accept treatment. Be there in whatever ways you can. Reach out often in truly friendly ways; if she is managing, don’t talk about her diagnosis or illness unless she brings it up. Maybe bring it up every ten or fifteen times you talk. As in, 90% of interactions with her are not about her illness as long as she is anywhere near not meeting the standards for involuntary commitment. Listen to her really openly.

If she becomes more ill or more vulnerable, it seems like the thing to do is try for involuntary commitment.

Find a social worker or counselor you can talk to who is 100% familiar with people who truly have serious mental illness, not the “worried well,” and ask every question you can think of. Also, there is NAMI for education and emotional support.

My advice is to just take a break from panicking whenever you can…

Best to you.


Here and here gave excellent advice. Hopefully she will get the help she needs. You can do a lot with your support. Even if it’s over the phone. I’m reminded every day what patience and prayer can accomplish. Hang in there and take care of yourselves too.

I would add to hereandthere excellent suggestions to call the NAMI in the Missouri area if she’s still there. The local chapter will have some valuable information on who to contact for possible help with housing as well as where to call in case of a emergency mental health crisis. My state has a team of people who will go out to see the person and evaluate their mental health and sometimes can recommend involuntary treatment at a local hospital.

Also joining your local NAMI may be very helpful as there are other loved ones going through similar crisis. NAMI also offers classes about mental illness - what it is and how its treated. Good luck to you and your husband. You sound like a very caring sister in law, Also it helps tremendously to have online support such as

Thank you so much for your thoughtful responses. It feels great to be able to ask these questions and get some feedback. To be honest, much of our conversations are centered around whether or not she is taking her meds, and as a result, we are now part of this conspiracy and are reading from a script. It is sad and disheartening, especially since my mother in law has now stopped taking her meds, and she is supposed to help watch my sister in law. We will most definitely reach out to NAMI ASAP.

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