How to Encourage a Reluctant Family Member to Seek Mental Health Care

A family member is suspected to have a mental health disorder but refuses to seek medical attention?

Hello, my father-in-law often complains about the following symptoms: 1.
Numbness or tingling sensations in his body 2.
Feeling of heat in the body 3.
Weakness and soreness in his limbs, difficulty standing 4.
Dizziness 5.
Rapid heartbeat and discomfort in the heart 6.
Shortness of breath 7.
Chest tightness 8.
Persistent burning sensation in the stomach despite not eating anything spoiled 9.
Sweating (not due to heat) 10.
Discussing end-of-life arrangements, among other symptoms.
These symptoms fluctuate; he often feels unbearable pain one moment and then feels slightly better the next.
However, he has undergone thorough examinations, and all results have come back normal, indicating good health.
A month and a half ago, he underwent surgery for a herniated cervical disc, which was successful according to the doctor.
Yet, he has since felt that there are issues with his esophagus or stomach, experiencing burning and pain.
Last week, he visited your hospital's gastroenterology department, where the doctor assessed his gastrointestinal health and suggested he see a psychiatrist, believing he might be overly concerned about the surgical outcome, leading to excessive worry and anxiety.
Following the doctor's advice, he made an appointment with your hospital's psychiatry department, where the psychiatrist prescribed him some medication.
He mentioned that after taking the medication, he felt very sleepy but was unable to sleep due to his physical discomfort and pain, so he stopped taking it.
A few days ago, he went to Taipei for a gastroscopy and an ultrasound of the liver, gallbladder, and gastrointestinal tract, all of which indicated good health.
His family continues to hope he will return to your hospital's psychiatry department for further treatment, but he refuses to go.
May I ask what methods we can use to help him recognize that he may have some mental health issues that need to be addressed? Please advise us.
Thank you.

joline, 40~49 year old female. Ask Date: 2009/07/10

Dr. Dai Wanxiang reply Psychiatry

Hello! Generally, when elderly individuals have physical complaints, the possibility of a physical illness is prioritized.
If relevant medical examinations do not reveal the cause of their discomfort, then considerations for psychosomatic disorders, somatization, or other mental illnesses may follow.
It can indeed be challenging to have such cases accept psychiatric treatment.
Typically, we start by empathizing with the patient's physical discomfort, acknowledging that they genuinely feel unwell, even if the medical tests show no significant issues.
Their discomfort is real, and the referral to psychiatry (psychosomatic medicine) is aimed at a more comprehensive evaluation and management of the distressing issues they face, rather than dismissing their physical complaints.
In short, it is essential to understand the severity and complexity of the patient's problems, necessitating a more thorough assessment and intervention; psychosomatic medicine is just one part of the multidisciplinary consultation.
Additionally, physical ailments can inevitably affect a patient's mood and sleep, and psychosomatic medicine has more expertise and experience in addressing these associated issues.
If they can come to psychiatry (psychosomatic medicine) for treatment, it represents a valuable first step.
The subsequent process depends on how the physician establishes a trusting therapeutic relationship with the patient, encouraging them to return for follow-up.
If the assessment indicates that the primary issue is indeed psychiatric, a strong therapeutic relationship can facilitate a focus on psychiatric management, reducing unnecessary medical examinations.
Thank you.

Reply Date: 2009/07/10

More Info

Encouraging a reluctant family member to seek mental health care can be a challenging yet crucial task, especially when they are experiencing a range of physical symptoms that may have psychological underpinnings. In your case, it seems that your father-in-law is dealing with a complex interplay of physical health issues and potential anxiety or stress related to his recent surgery and overall health concerns. Here are some strategies that may help you approach this sensitive situation:
1. Open Communication: Start by fostering an open and non-judgmental dialogue. Express your concerns about his well-being without labeling his feelings or symptoms as "just anxiety" or "just stress." Use "I" statements, such as "I feel worried when I see you in discomfort," to convey your empathy and concern. This approach can help him feel understood rather than criticized.

2. Normalize Mental Health Care: It’s important to normalize the idea of seeking mental health care. You can share stories of others who have benefited from therapy or medication, emphasizing that mental health is just as important as physical health. Highlight that many people experience anxiety or stress, especially after significant health events like surgery, and that seeking help is a sign of strength, not weakness.

3. Educate About the Mind-Body Connection: Help him understand the connection between mental and physical health. Explain that anxiety and stress can manifest as physical symptoms, such as those he is experiencing. You might say something like, "Sometimes our minds can affect our bodies in ways we don’t fully understand, and it’s okay to seek help for that."
4. Suggest a Different Approach to Medication: If he had a negative experience with the medication prescribed by the psychiatrist, suggest discussing this with the doctor. There are various medications available, and sometimes it takes a few tries to find the right one that works without unwanted side effects. Encourage him to communicate openly with the psychiatrist about his experiences.

5. Offer Support in Seeking Help: Sometimes, the idea of going to a mental health professional can be daunting. Offer to accompany him to the appointment or help him find a therapist he feels comfortable with. You could also suggest starting with a consultation rather than committing to ongoing treatment, which might feel less intimidating.

6. Focus on Small Steps: Encourage him to take small steps toward seeking help. This could be as simple as reading about mental health, attending a support group, or even talking to a trusted friend or family member about his feelings. The goal is to reduce the pressure and make the process feel more manageable.

7. Address His Concerns: If he has specific fears or misconceptions about mental health treatment, address those directly. For example, if he fears being labeled as "crazy," reassure him that mental health care is about support and coping strategies, not labels.

8. Be Patient and Persistent: Change often takes time, especially when it comes to mental health. Be patient and continue to express your support and concern. Let him know that you are there for him, regardless of his decision about seeking help.

9. Involve Other Family Members: If appropriate, involve other family members in the conversation. Sometimes hearing similar concerns from multiple loved ones can help reinforce the message that seeking help is important.

10. Professional Guidance: If he remains resistant, consider seeking advice from a mental health professional on how to approach the situation. They may provide additional strategies tailored to his specific circumstances.

In conclusion, the journey toward mental health care can be complex, especially for someone who is experiencing significant physical symptoms alongside emotional distress. By fostering open communication, normalizing mental health care, and providing support, you can help your father-in-law recognize the importance of addressing his mental health needs. Remember, your ongoing support and understanding can make a significant difference in his willingness to seek help.

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