In Psychiatric Illness, Families Must Be Our First Responders

The plight of families that recognize a member is becoming mentally ill, and at risk to harm themselves or someone else, can be truly agonizing. Their loved one often will not accede to their entreaties to go for evaluation or treatment. Sometimes this is because the illness is so serious that it interferes with the persons ability to recognize they are ill — often denying any difficulty and blaming others for their fears or anger. Sometimes it is hopelessness that erodes a persons capacity to take action on their own behalf, amplified by feeling unworthy and not wanting to be a burden; guilt and shame add to their psychic state; or they have had bad experiences with mental health care, or fear it. These are powerful forces to contend with, but families need help to manage them successfully.

Even when these families do reach out to professionals medical, mental health, police, etc., their calls are often rebuffed. They are told that professionals cannot speak with them because of HIPAA federal privacy regulations, or that no action can be taken to hospitalize a person with a mental illness unless they demonstrate “imminent” dangerousness, which is to say at that very moment a moment in which many an ill person will manage to put on a good face for the doctor and promise to go to an outpatient appointment – -though they have steadfastly refused for months. This has been termed “dying with your rights on.”

Family alarm calls often occur months before what become difficult to reverse setbacks in school or work accumulate. Their calls come at a time when early intervention could prevent crisis and the need for involuntary treatment or the assistance of police. Their calls come when there is greater likelihood of success and greater opportunity to avert disability and potential catastrophe. [The author] meets these families all the time. [He sees] their demoralization and outrage about how handcuffed they feel in trying to get help for their loved one.

via In Psychiatric Illness, Families Must Be Our First Responders – Lloyd Sederer – The Atlantic.