How to Encourage a Family Member with Mental Health Issues to Seek Help?

Q: How to Encourage a Family Member with Mental Health Issues to Seek Help?

Hello, A-mei： Undoubtedly, your brother is currently a "severely ill patient" (at risk of self-harm or harm to others) and urgently needs treatment. <br>The hospital is a medical institution, not a legal one, and psychiatric hospitalization is generally considered a form of "rest

How can I help my family member with a mental health issue seek medical treatment?

Dear Dr.
Chen,
My brother has been exhibiting a series of erratic behaviors in recent years due to significant workplace stress.
He feels that he is being conspired against, which led to him losing his job.
Even after finding new employment, he continues to encounter strange people and situations that undermine his confidence, resulting in him quitting jobs within a month.
He often expresses unbelievable and illogical thoughts, such as believing that his former boss intentionally sabotaged him, that online acquaintances know his secrets, and that he is involved in various international terrorist activities and political events related to elections.
These symptoms have persisted for nearly two years.
Initially, our family thought that minimizing pressure on him would alleviate his symptoms, but his condition has not improved.
We have taken him to see doctors at two different hospitals, but he always refuses to continue treatment after the initial consultation, so he has not received any real medical care.
Additionally, as a 31-year-old adult male, he lives with only elderly parents and a few sisters who do not reside with them, leaving no one to compel him to do anything against his will.
We feel helpless; we advise him to stay home, but he has exhibited violent behaviors such as breaking dishes, shattering windows, and damaging furniture.
My parents have reached their breaking point and feel their safety is threatened.
Now, he does not even trust his family and believes that our parents are sent to bully him.
Recently, we considered contacting the local health department to utilize community mental health resources to compel him to seek treatment.
However, my mother is worried that he may not be able to handle the psychological shock and might resent the family for life.
She is also concerned that, according to the health department nurse, the hospital can only admit him for a maximum of two months, after which we would face the same difficult situation again.
Therefore, I would like to ask the doctor if there are better ways to help my brother receive the treatment he needs.
Thank you for taking the time to consider our family's issue.
If you are willing to respond, it would be our greatest blessing.
Thank you...
We are grateful!

Amei, 20~29 year old female. Ask Date: 2005/03/01

Dr. Chen Wenyu reply Psychiatry

Hello, A-mei: Undoubtedly, your brother is currently a "severely ill patient" (at risk of self-harm or harm to others) and urgently needs treatment.
The hospital is a medical institution, not a legal one, and psychiatric hospitalization is generally considered a form of "restriction of freedom." Without legal authority, one cannot unilaterally restrict another's freedom.
In your brother's case, it is advisable to notify the public health nurse at the health center for an evaluation.
If necessary, the health center can directly contact law enforcement to assist with involuntary hospitalization.

Generally, individuals with mental illness often lack insight into their condition (anosognosia) and refuse treatment.
However, if they can be encouraged to accept treatment (whether voluntarily or involuntarily) for a period of time, they may eventually recognize their illness and take their medication willingly (gain insight).
News reports frequently cover incidents of individuals with mental illness harming others or committing suicide, and these cases often involve patients who are either non-compliant or have not received treatment at all.
In reality, if patients can be engaged in treatment, such tragedies would occur much less frequently.
In today's industrial society, individuals with mental illness who are not hospitalized often live with elderly parents or young children (with grandparents helping to care for the children), and these individuals are frequently the ones most at risk of harm when the patient experiences a crisis (most media reports focus on these cases).
After involuntary hospitalization, patients can change their status (to major illness or health insurance) and continue receiving treatment.

In fact, patients often feel persecuted and live in fear.
If someone can help them escape the disturbances of hallucinations and alleviate their fears, why would they continue to harbor resentment? Clinically, many patients who threaten their families before hospitalization express gratitude to their families for facilitating their treatment after discharge.
Thank you for your letter!

Reply Date: 2005/03/01

More Info

Encouraging a family member with mental health issues to seek help can be a challenging and delicate process, especially when the individual is resistant to treatment. In your brother's case, it seems that he is experiencing significant distress and exhibiting behaviors that are concerning not only for him but also for the safety and well-being of your family. Here are some strategies that may help you and your family navigate this difficult situation.

Understanding the Situation
First, it’s essential to recognize that mental health issues, particularly those involving paranoia or delusional thinking, can create a barrier to seeking help. Your brother may genuinely believe that he is being targeted or harmed, which can lead to distrust of family members and professionals. This is a common symptom in various mental health disorders, including schizophrenia and severe anxiety disorders. Understanding this can help you approach him with empathy rather than frustration.

Open Communication
1. Create a Safe Space for Dialogue: Try to engage your brother in conversations when he seems calm. Express your concerns without judgment. Use "I" statements to communicate how his behavior affects you and the family, such as, "I feel worried when I see you upset," rather than "You need to stop acting this way."
2. Listen Actively: Allow him to express his feelings and thoughts without interruption. Sometimes, just feeling heard can reduce defensiveness and open the door to further discussions about seeking help.

Encourage Professional Help
3. Normalize Seeking Help: Frame therapy as a common and beneficial resource rather than a sign of weakness. You might say, "Many people see therapists to help them cope with stress and anxiety. It could be a good way for you to talk about what you’re feeling."
4. Suggest a Check-Up: If he is resistant to seeing a mental health professional, consider suggesting a general health check-up. This can sometimes be a less threatening way to get him into a healthcare setting where mental health can be addressed.

5. Involve Trusted Individuals: If there are people in his life whom he trusts (friends, relatives, or colleagues), consider enlisting their help. Sometimes, hearing encouragement from someone other than family can make a difference.

Professional Intervention
6. Explore Community Resources: Since you mentioned contacting local health services, it may be beneficial to work with mental health professionals who can provide guidance on how to approach your brother. They may offer strategies tailored to his specific situation.

7. Consider Involuntary Treatment as a Last Resort: If your brother poses a danger to himself or others, it may be necessary to consider involuntary treatment. This is a difficult decision and should be approached with caution. It’s crucial to consult with mental health professionals about the implications and processes involved.

Family Support
8. Educate Yourself and Your Family: Understanding mental health issues can empower your family to provide better support. There are many resources available, including books, online courses, and support groups for families dealing with mental illness.

9. Take Care of Yourselves: Supporting someone with mental health issues can be draining. Ensure that you and your family members are also taking care of your mental health. Consider seeking support for yourselves, whether through therapy or support groups.

Conclusion
Ultimately, the goal is to help your brother feel safe and supported while encouraging him to seek the help he needs. It may take time, patience, and multiple attempts to get him to agree to treatment. Remember, you are not alone in this; many families face similar challenges, and there are resources available to assist you. Your concern and love for your brother are evident, and that foundation can be a powerful motivator for change.

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