Please help, need advice desperately!

[wanna B an RN]

My family and I are very confused and don't know what to think or do. My cousin has been complaining for a couple of months now that "people" are out to get him. At first it was an enemy, now we don't know who it is.

Within the last few weeks, he has been saying that he hears voices & they're telling him things. We didn't believe him at first, until an old friend of his, pulled his sister aside & confided in her that he needed help because he caught him "talking" to the voices telling them ,"Be quiet before they hear you." Now my cousin has always had a problem with drugs, so we thought that he was on drugs again. There have been many arguements and fights because "nobody believes him". He continuously tells my grandparents (the only ones he really talks to) that he's not lying & he's not doing drugs & has even broke down crying because none of us believe him.

My grandfather went over to check on him a couple of days ago. My cousin has been saying he was leaving to Texas (we're in California) where the voices wouldn't find him. He found he had all his clothing packed & ready to go. He wouldn't give him the car keys & there was a huge fight. Anyways, they've been trying to get him to go to Mental Health, so when this all happened, my grandfather went himself to try and get him some help. It was awful, they went to his house & after evaluating him, my grandfather had to commit him because he wouldn't go willingly. The couselor that spoke with him told my grandfather he was a VERY sick man. This last episode happend on Sunday? Well, my cousin called this morning asked if we could go pick him up because they we're releasing him! He told the doctor he was lying about the voices. I don't believe it, & I'm really scared they he will try to leave now. We don't really know what to do.

We signed some papers, in case he has another episode, we just call them & they'll come get him. He will not have any choice in going to Mental Health once that happens. As for now, I think we're all on pins & needles because we're scared he may do something crazy, and it's up to him to go for help. What should we be doing, or are we over reacting?

[MollyJ]

It is hard to know what to tell you to do because we aren't there. But! Someone (probably your grandfather) needs to see if he is indeed dismissed and, if he is, what the discharge plan is and what needs to happen if you cousin becomes non-compliant with the discharge plan.

He most likely will be discharged to follow with the local mental health center. With a little luck, he may be assigned a case manager. (This is far from foregone since he's been "in the system" for such a short time). But I would insist on a discharge plan and a back up plan for if he doesn't follow with it. Also the admitting doc needs to know how your cousin was doing with work, acitivities of daily living (like bathing, cleaning, and eating) and handling money. If these things are not going well, that is a clue to over-all disfunctionality.

The saddest part of this is that people who are delusional/hallucinating are really pretty frightened and we would never think of letting a physically ill person manifest so much fear and not help them with their fear or anxiety. If things don't go well for your family member _keep ringing the system's doorbell until they answer_.

[ADN 2002]

Hi,

I don't think your family is overreacting. That's scary stuff to deal with and there have been too many cases (that I've heard, anyway) of people running to get away from the voices and their families never see them again (not saying this to scare you, but I think it's something you should know). I would definitely keep a close eye on your cousin and if he starts talking about leaving again, I would get him back into inpatient care. Glad to hear you have papers signed in case something starts happening, but you might also want to look for another doctor, if you don't believe what this one told you.

Let us know how you all are doing...

[PammieRN]

Dear Wanna B,

2 things struck me...and by the way, I'm not a psychiatrist. I not only am a nurse but have a daughter who is bi-polar and have dealt with depression personally for 15 years.

Having said that...

#1...this person seems to be self medicating with drugs or alcohol. Very common.

#2...manipulative....very common with bi-polar and schizophrenic people. Usually highly intelligent.

Research the laws in your state, as they vary. However, it usually requires a 48 hour evaluation when someone is committed, then they just don't get out, they're evaluated first.

Most importantly though, do you feel that you or your family are in danger from this person? No matter how much love your family may have for this person, it won't do the job that a good psychotropic can do.

There will be times that you feel like you can't cope another minute. Reframe your situation minute by minute by asking yourself "Is there anything that I can do in the next 10 minutes (12 hours, 2 days...)to make things better? If not, take those 10 minutes (12 hours, 2 days...) to relax and take care of your basic needs.

Protect and take care of yourself, that is the only way you can protect him or your family.

Take care, really. It can be a long hard haul.

Pammie

[wanna B an RN]

I thought the same thing about the drugs, but I wasn't sure. We've never dealt with with this before, and we're so unsure about everything. The sad thing, is that my grandparents have always been the ones to help him & check on him, and now they're just fed up. They're not giving up on him, but it's frustrating.

He did get released yesterday, and we are all very confused about that. The doctor that released him told my grandfather there was nothing wrong with him. My cousin told them he lied about the voices & wasn't leaving anywhere. I don't believe him. He obviously said whatever it took to get out of there. When we put him in there, they said he would be in there for 3 days, yet they released him in 1 day. I feel like the system is failing us! How could they make that decison in less than 24 hours? On the drive home from the hospital, my cousin got upset again because he told my grandfather, "You don't believe me about the voices?" My grandfather confronted him about what the doctors told him & threatened to take him back, but got no response from my cousin. I'm just scared that if he is going through all of this, he will start hiding it from us too.