Family and Caregiver Schizophrenia Discussion Forum

What to do during a psychotic event

I would like to hear how others handle a psychotic event that does not include suicidal intentions or threats to others.
My 29 year old son who lives with me experienced a psychotic event (hours in the shower, etc.) a couple of weeks ago and I called 911. Since he wasn’t threatening himself or me but I wanted him evaluated I was able to convince the sheriffs to get him transported to our local Behavioral Health Unit. He managed to get himself released with a Writ of Habeas Corpus after 10 days. While there he was diagnosed with schizophrenia. He was non-compliant during his stay and so came home with no meds and only a follow-up Tele-health therapy appointment. He did that one session but I don’t think he’ll do more.
Since he is still displaying symptoms of mental illness I am sure something similar to the previous event will happen again. And since he doesn’t express self harm and isn’t threatening to others I’m reluctant to call 911 again. He is not under any psychiatric care.
I just want to get some suggestions as to how to deal with it. Should I cut the water off? Should I unlock the bathroom door and insist he come out? Or just let it run its course?
Thank you for any suggestions.

I don’t see what the psychotic event is. Hours in the shower, to my mind, doesn’t necessarily qualify. Okay, maybe up to 2-3 hours… Did you knock on the door? Did he respond?

It was over 8 hours until I turned the house water supply off. And yes I did knock several times with no reply from him.

1 Like

When he finally came out he walked into the street and sat down. That’s when I called 911.

1 Like

It is a marathon not a sprint unfortunately - you say he was diagnosed - do as much reading as you can become familiar with the diagnosis as mush as you can - reach out to your mental health society where you live be kind and patient to your self and your love one - work together - journal everything with dates - find a great support group for your love one and your self and breath slowing - all the best :tulip:

3 Likes

Unfortunately, not doing anything, “letting it run its course” can result in more 911 calls, in my recent, bad, experience, with my son who quit all drugs cold turkey.

The key to recovery seems to be, 1) the person realizes they have a mental illness – many don’t, which seems incredible given the delusions and general trouble they must have coping, but unawareness seems to be part of the illness; and (2) agreeing to accept medical treatment. Once on psychiatric drugs, the goal is to work with a psychiatrist to find the minimum dose which is effective at controlling symptoms. The book I Am Not Sick, I Don’t Need Help! How to Help Someone Accept Treatment deals with (1). If trying to reason with the person doesn’t work, the book goes into how to deal with involuntary commitments.

I think the job at the facility your son was in would be to get him started on medical treatment and get him stabilized. Since that didn’t happen, I think it’s a good bet there’s going to be a repeat. I’d try the LEAP technique Amador teaches, but I think you are right – very sadly – that you may have to call 911 again, which is about all you can do to help him. I think he is in danger to himself as 8 hours of mostly hot water is going to damage his skin. The water bill is a financial hardship to you, like destroying property might be.

3 Likes

Thank you for your reply and good information. I have read Dr. Amador’s book and am now reading it again. Since my son is so stuck in denial and barely speaks to me it’s difficult to practice many of the suggestions in the book. And I tried the involuntary admittance to our BHU by calling 911 when he was sitting in the street.

Calling 911 without his being suicidal or threatening to others is not going to get him into the hospital for treatment. His stay last time was not at all helpful since he was non-compliant and was able to get himself out early by filing a Writ of Habeas Corpus.

I guess what I’m really looking for is advice on what to do if a similar event occurs. Would you just back off? Would you badger? Would you wait it out?

@kope. I’m not really sure what to do. My son is currently in a psych unit of a hospital and I talked to him today. His social worker sees that he is delusional and not ready to be released. He is being compliant about his meds, but they don’t seem to be doing much good yet.

If he is released in this state I’ll be in the same situation you are in. I have heard about people being repeatedly released and returned shortly after to a hospital. Amador discusses these cases in his book. The staff call them “frequent fliers”. I suppose eventually they accept treatment and the hospital finds something that works, like a long-acting injectable.

Where I live they don’t have to actively suicidal to be deemed a danger to themselves. If they can be shown to be delusional then they can’t take care of themselves and that is grounds for involuntary commitment.

Thanks for your insight. I’m so sorry to hear that you are in a similar position. I understand the meds take a while to work and that it may take some time to get the best mix. At least he is taking them.
I wish there was a way to get my son into treatment without his having to be a danger to himself or others but unfortunately that’s not the way it works where I live. I guess it’s going to be a long haul of wait and see for both of us. Best to you.

1 Like

Isolation was usually at the core of my son’s episodes. He is unmedicated and doesn’t have suicidal thoughts anymore, but getting him outside was a lifesaver for me, although exhaustive sometimes. He has ADHD so there’s that too. He has to move. COVID has made it even harder to combat that isolation, which I think makes it even harder for many caregivers. I also used to have the lovely habit of wanting to always talk about mental illness, symptoms, cures, meetings, etc. all of the time. I don’t do that anymore. Enough has been said about it between us and so we talk about anything else.

2 Likes

I am not sure if my experience helps and I hope there is something in there you could take away with. When my daughter was released from hospital 2 weeks ago, her symptoms were still pretty strong. Given that she is med compliant and is aware of her illness, it is agreed that home is a better place for her to recover. My daughter suggested “not bursting the bubble” which has been working for us. It is something like this. She knows she has paranoia and it is hard for her to tell what is real. So she will try to suppress them. At the same time, I learn what aggravates her and will try to prevent them. For my daughter it is sensitivity to light, sound, heat and most of all, her frustration at not achieving her aspiration so anything that insinuates will trigger it. As long as we can maintain that bubble, she will feel safe. At this point, her condition has improved and the symptoms, e.g. long showers have dissipated.

Hope the best for you.

2 Likes

Thank you! I appreciate your input. May I ask how your daughter came to be hospitalized?

My my son has schizophrenia. He is non-compliant with his meds. I believe he’s having a psychotic episode and I’m not sure what to do. He has been wearing the same clothes everyday that smells like urine. My brother went to his apartment when my son wasn’t home the door was unlocked and the the apartment was deplorable. There was trash everywhere, old food in the kitchen, and urine on the floor.
My son recently purchased a car and has wrecked the car in less than a month.
Does anyone have any advice on what I should do?

1 Like

@Believing I think you should check into the laws where you live for an involuntary commitment for a psychiatric evaluation.

1 Like

At his age, the only option would be to get temporary conservatorship. Find a residential place where he can live (you can do that without a T-con.). He should be in a structured living environment with medication monitoring.
Contact your county, ask if they have an AOT program. Assisted Outpatient Treatment program.
Call the head of your county mental health program. Get yourself and your son known.
It is important to get him on the right meds for a consistent time (doctors say 5 years)
At 27, he should and can be more independent.
It took 5 years of hell (and me being a constant pain to everyone) before my son was placed in a top notch facility to get him stable.
Good luck

2 Likes

Hi @kope. I have so much sympathy for what you’re going through with your son. My brother has schizoaffective disorder. While I personally have never had to call 911 for him, I remember my parents having to wait until he was “ill enough” to warrant 911 sending a crisis team to evaluate him.

I think you followed the correct course of action.

As an outsider reading your story, I can imagine the sheriff not being convinced that your son was ill enough to be committed if all he was doing was sitting in the shower for hours, but you turning the water source off forced your son to do something else that provided more evidence that he was unwell. I think sitting in the middle of the street would be proof enough, and it was, that your son needed professional help at that point.
My suggestion to you would be to follow your gut as you did this last time. It may be, unfortunately, that your son may need some interference from you in order to demonstrate that he is unwell enough to need professional involvement. With my brother, it took three hospitalizations for him to put two and two together–that avoiding being handcuffed and taken to the hospital meant compliance with his medications. Each time our loved ones fall off the wagon and need help is torturous, but it also begins a paper trail of their condition which opens doorways to them getting the help they so desperately need and deserve.
Sending you strength and hope.

4 Likes

It’s so hard. The only thing I can say from my experience is that the only way my SO finally agreed to treatment was to get so loud and aggressive that he went to jail. Even then, he refused transfer to the psychiatric unit. He got out on bail and then was re-arrested and I think that is when he saw that he needed help and went into crisis, with the help of the arresting officer and many months of me pleading with DHHS and local crisis services to help him (several wellness checks, etc). Having a diagnosis really helps when you need to call. If possible, maybe join a peer to peer family support group through your local NAMI chapter to talk with others in your state and share their solutions, and I agree turning off water is not worst idea. It may trigger other behavior but that is not necessarily bad as others have pointed out. Honestly, the system is so reliant on consent, we are all forced into watching our loved ones who lack insight to decompensate until they have no choices. It’s why jail is becoming the largest mental health facility in the US. My loved one was obsessed with bathing during his last break; I think it is grounding. See that your son is trying to help himself, and maybe look back and see if any thing else helps? I know for mine, driving was also a tool…,but it got very dangerous so I recommend trying to keep your son out of a vehicle.

3 Likes

The laws in CA require grave danger to oneself or others. It is pretty strictly defined as someone who is suicidal or threatening to hurt others or not able to care for themselves. Also if you are sent in to a mental hold non-voluntarily you can file a Writ of Habeas Corpus to be released. My son is very intelligent and when he was admitted to a hospital Behavioral unit he was able to get himself released just by saying he wasn’t in danger to himself or others. The court representative allowed the hospital to release him. He was sent home like a zombie in almost worse shape than when he went in. One month later and he is back in the hospital. I’m hoping this time he isn’t allowed to leave until he is in much better shape and hopefully willing to comply with drs.

2 Likes

My heart goes out to all who are living this nightmare with their kids. It is the most difficult and heartbreaking thing I have ever done. Thank you for your personal insight. I am reading every bit of information offered here and am so grateful.

3 Likes

@Gennyg134
You wrote:

See that your son is trying to help himself, and maybe look back and see if any thing else helps?

Yes, what motivates the person? Behavior modification psychology isn’t much in vogue these days, but it might be the perfect thing for helping someone who is psychotic and only capable of responding to reinforcements. I.e. they are operating on a more primitive level.

Maybe make a list of everything that’s positive the family member does and try to reward it. Ignore negative things, if one can, since the attention might be reinforcing.

3 Likes