There are few things worse than watching a loved one’s mental health steadily decline because he is too sick to recognize he has a problem.  The feeling is even worse when the loved one lives halfway across the country: you know he’s in trouble, but can’t be there to help and have no idea of who on the local scene can.

On a single day last week I took calls from two different family members concerned about a loved one in crisis.  Both calls were about grown men with serious mental illness who refuse to be treated, despite showing signs of obvious distress. This is a difficult but all too common dilemma for many families with a loved one affected by mental illness.  The fact that the callers lived in different states from the persons in crisis made it that much harder to solve the problem.

The high burden of proof in most state’s civil commitment laws makes it difficult, but not impossible, to get a resistant family member the help he needs.  The basic standard of proof in most states is whether the person is an immediate and substantial danger to self or others.  In the face of such laws, clinicians who recognize the desperate need for treatment in some individuals are often powerless to intervene.  Journalist Pete Early describes in his family mental illness memoir Crazy: A Father’s Search Through America’s Mental Health Madness how a hospital staffer let him know that the way to ensure his severely psychotic son would be treated, would be to invent a story that he had threatened to kill him.

The irony is that so many of those who refuse treatment during the height of illness, are actually grateful for a forced intervention once they return to a former state of normalcy.  Family members are right to be strong advocates for their loved ones with mental illness.  In many cases, if a member of the family does not step forward to advocate for safe, effective and humane treatment for an incapacitated loved one, nobody will.  The problem facing many families is how to be an effective advocate for someone who lives hundreds of miles away and does not want their help.

When someone calls RtoR.org asking how to get help for a loved one in another state, the first thing our Resources Specialists do is to listen and empathize.  Sometimes it helps just to know that you are not alone with a problem you are having.  Of course, most callers are looking for something more than that: an answer to the question, who can help?

Here are four things our Resource Specialists do when someone calls asking about help for a loved in crisis:

1. Explain about crisis intervention services.  It is surprising how many people do not know about the availability of these services in most communities.  Crisis intervention services offer intensive, short-term help for the purpose of stabilizing or preventing a mental health crisis. Many communities have a mobile “Crisis Team” that performs screening, triage, assessment, and counselling in the community and can authorize short-term involuntary hospitalization for evaluation purposes.
2. Send information from the website.  For callers who provide an email address, we send follow-up information from the site on mental health Crisis and Recognition, What to Do in a Crisis, 8 Tips for Using Mental Health Crisis Services, and  2-1-1 – An Underused Resource.
3. Research local service options. For callers seeking services in New York, New Jersey, Connecticut and Massachusetts, our Resource Specialists will work with families to identify appropriate providers and assist with referrals and follow-up care.  For callers outside of our service region, Resources Specialists will provide information about crisis, emergency, and state 2-1-1 referral services within their communities.
4. Offer to follow-up.  At the end of a call or email exchange our Resource Specialists leave an open door to check back in a few days to see how it went and ask if any more help or assistance is required.

Dealing with a mental health crisis in a loved one can be an incredibly stressful and bewildering experience – especially if you live hundreds of miles away from the person needing help.  There is no easy way to get through such experiences.  But knowing that there are resources you can turn to for support in nearly every community of the United States can be of enormous help.

Jay Boll, Editor in Chief

Throughout the month of May, RtoR.org will release a daily Post
of the Day in observance of Mental Health Awareness Month

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Jay Boll, Editor in Chief www.rtor.org

Jay Boll, LMSW, writes about mental health from dual perspectives: as a professional with more than thirty-five years of experience working with homeless youth and adults with mental illness, and as a family member who has witnessed the impact of mental illness up close and personal.
 
There are many sides to mental health recovery. Jay’s blog takes The Family Side.

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