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I Need Help for My Brother

My brother is a paranoid schizophrenic with bipolar disorder autism and adhd. His schizophrenia comes with homicidal thoughts. He’s been admitted into a hospital before and was being treated for years. About a year ago now he went off of his meds and it’s been downhill from there. He’s currently in a manic state and has been for months. He refuses to get back on his medications and it’s taking a toll on him and everyone else. He’s violent, combative, and just dangerous. Anyone he sees in his way is a target. He has harmed my mother’s dog. Tried to hurt my toddler (he is no longer around her anymore at all). He’s choked my mom stolen her car, loosened the lugnuts on her tire and when she went to drive away her tire fell off. He’s assaulted a police officer threatened multiple times to kill people. It hasn’t gotten to the point where even my mom had to move out. We’ve called the crisis line, the police, even adult protective services and no one will do anything about it. He’s going to seriously hurt someone or himself and I can’t bear the thought of standing back and watching him drown. He’s destroyed his apartment and belongings. We are at a loss for what to do. We can’t force him to get back on his medications because he is still his power of attorney. We can’t force him to seek treatment at all. Is there anything we can do? He keeps racking up charges for himself and jail is not the place he needs to be. He is a really amazing docile person when he’s medicated, but when he’s not he’s one of the scariest people I’ve ever seen. What can we do?

Desperate times call for desperate measures. If you haven’t tried this already, contact an attorney who specializes in guardianship/power of attorney and explore having your brother declared mentally incompetent. Generally speaking, an individual can be declared incompetent when their mental capacity inhibits their ability to make decisions that are not in their best interest. Each state likely has specific guidelines for what constitutes this type of declaration. An attorney who specializes in these matters should be able to assist you to determining if this is the right move for your brother.

In the meantime, there are several things you can do that may help. One is contacting the Treatment Advocacy Center. On their website, you will find information about the laws and standards regarding involuntary commitment in your state. They also have resources for families who are dealing with situations like yours. There’s also great information on their website about guardianship, emergencies, etc.

Using the aforementioned website, you should be able to determine whether your state uses some form of assisted outpatient treatment (AOT). AOT involves a judge mandating that an individual, who had been previously hospitalized and who is now living in the community, adhere to their treatment plan or be rehospitalized. AOT may be applicable in your situation.

Try to determine if your county has a mental health court via a Google search. Mental health courts are specialty courts for individuals with severe mental illnesses who have violated the law. Generally, they only admit participants who have committed a crime however, they may be able to help your brother since he has a history of being in jail. Given his involvement in the legal system, he may be eligible for mental health court which, if accepted, would mandate treatment compliance or risk going to jail. If that is not a possibility, the people who work for the mental health court may be a good resource for your family.

I would also recommend contacting your local National Alliance on Mental Illness (NAMI) group. NAMI is an advocacy organization that specializes in assisting families who have loved ones with severe mental illnesses. They offer free support groups in local communities. Many of the NAMI members are seasoned veterans who know how to navigate the mental health system. They can provide both peer support and guidance.

It would also be wise to proactively contact your local crisis team. It’s good to make them aware of your situation and concerns. You might do the same with the local police department. These preemptive steps might help everyone be more prepared in the event of an emergency.

It’s important to keep yourself safe. Research indicates that when individuals with severe mental illnesses do engage in violent acts, it is often directed at their family members. Perhaps that is because family members are quite literally in the vicinity, making it easier for them to become targets. When someone is actively symptomatic, they are not behaving as they normally would. They might do something that they wouldn’t otherwise do.

I’m very sorry that this is happening to you. I have worked with families dealing with this very type of situation. I know how difficult it can be. Few truly understand what you’re going through. There are simply not enough resources available for families faced with this situation. I hope that some of my advice has helped, if only a little.

Please don’t hesitate to write again if you have additional questions. Stay safe and please take care.

Dr. Kristina Randle

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