Helping get through to someone with mental health issues

[1bub1pup]

I need help getting through to someone who is having a mental health crisis and get them to come home. The person going to talk to them is in danger of making the situation worse and I am so far out of my depth.
Is there a service I can talk to who would give me advice on what to say?
I wrote a whole post about the problem then deleted it because I was worried the person would find it and it would blow the whole thing.

I really feel for you. If medical evacuation isn't an option e.g. via travel insurance, and he can't be convinced to go on a bus for a few hours to reach Bangkok or Ho Chi Minh in Vietnam (which is actually quite a bit closer, I just checked the map and it's only 4 hours to Ho Chi Minh by car), and he won't leave the hotel at all, then you or DM will have to ring an ambulance and hope for the best.

I've checked about a dozen places earlier on Google and I couldn't find any "mental health clinics" that deal with anything severe and I can't find any Cambodian hospitals that use western medicine and deal with mental illness at the same time, which is why I haven't posted any. Sorry OP.

@Preppercorn thank you for looking.

The tour company sent a car to take him to hospital but DM hasn't been able to get him downstairs. Apparently a Dr came and gave him some sleeping pills but she couldn't get him to take the full dose.
I'll let her know in the morning what you've said about Thailand/ Vietnam.
We've not been able to find any travel insurance documents either but will keep digging.

I spoke to the consulate again who gave the same advice as you. They sent me a list of English speaking Drs and said I might get more help with the private ones but even then they may not.

I'm sorry I keep posting on here but it feels like the only place people are really listening and I can't keep it all on my head. God I hope DB and family don't find this.
I did get alot of recommendations form an ex-pat group on Facebook. @DucklingSwimmingInstructress that was a good shout. Recommended a couple of drs that would likely help but how we will get him there
I found another expat forum that was very unhelpful and judgemental but I am beginning to build a picture of what it's like out there.

He says he moving to a hotel in Siam Reap but I don't understand how he will get there is he's not with the tour any more. My mum is ready to come home, they've obviously clashed pretty badly. (I should have sent anyone else really but I had my reasons)

He has mentioned moving to Bangkok although I don't know when. From what I have read maybe that would be a better place for him to be? I'm just struggling with the idea that he's both delusional yet seems to be able to travel around.

I'm going to try and give my DD a normal day today and figure out how I am going to explain this to my work.
If I can get the time maybe I'll call 111 mental health services. Maybe they can point me in the right direction for support for my family. They probably won't be able to do anything, but might be good to have something in place when (if) he finally does come home.

OP what a challenging situation! It sounds like he is possibly having psychosis or possibly schizophrenia onset (I say that because an ex BF found himself in a similar situation in a foreign country and it was very stressful).

I wonder if you can find someone - anyone - a friend of a friend or a contact in the expat community that might be willing to take him to hospital? I take the point that SE Asia has a different approach to mental health, but they may at least be able to get him some anti psychotic medications and buy you some time to make your next move.

Good luck.

Is it definitely a mental health crisis (does he have history) or, if this is out of the blue, could he have contracted something which is affecting his brain? In which case he definitely needs to be taken to a hospital - via ambulance if necessary. Your mum needs to do what needs to be done, not pussy foot around if there's no previous mental health history.

Another thought - when travelling India back in the 90's folks talked about the malaria drugs bringing on psychosis - no idea if this might be a factor in how he is behaving/presenting. Either way he really needs to get to a hospital, private if possible?

If I can get the time maybe I'll call 111 mental health services. From experience emphasise to 111 that your brother is normally resident in the UK. They get funny about people who are living elsewhere, even if it's a perfectly sensible medical question.

Thanks for these tips.
@DucklingSwimmingInstructress definitely will do.
@lifesrichpageant thank you. I got a contact for a private hospital and that's where they are trying to get him to. Someone in the expat community linked me to someone that works there and vouchers for them.
@minisoksmakehardwork My gut instinct is that he could have contracted something. Maybe drugs involved, he really despised his drug taking but he could have been spiked. I just feel like it wouldn't have hung on this long. The things that make me think it's something medical - apparently he seems to have a temperature. He also hasn't been sleeping very well if at all. ( I had a seriously bad time Postpartum when not getting enough sleep so I can kind of see how this could be a big factor)
He's usually so introverted but last time he went travelling he started to talk out more on text and social media. So that part was already a little put of character for him but this behaviour is a huge leap. Sometimes he just sounds like he's being a bit thoughtful, looking in at his life and his relationships with others and talking about how we can improve things. Sometimes it's complete madness talking about "codes" and "proof".
I don't know.

Any update OP? Been thinking about your brother today.

They are now in Bangkok, staying near the airport. I'm piecing together what's going on from bits and bobs of messages. As I should have realized, mum going out there was not welcome and at least initially made things worse. It's going to take alot to repair. They do seem to be getting on "better" now.
He did see a Dr in Phnom Pehn. They've prescribed medication but we have no way of insuring he takes them.
That said I think he has been taking them and he does seem to be making more sense overall. Still doesn't want to come home.
We are just holding our breaths for what will happen this morning

Thank you for keeping him in your thoughts

OP I went to Vietnam a few years ago and there was a vaccination you could have against an illness that could make you delusional/appear to have a mental health episode. I remember looking into it at the time as it was an optional jab for people travelling to rural areas (which we weren't). Did he have all his jabs do you know? I think it was Japanese Encephalitis having reviewed the current list. I recall reading about it at the time and there was a case study about someone who was not initially diagnosed with the condition and was treated incorrectly as they just presented with severe mental health symptoms. Annoyingly I can't find it now, but it sprung to mind when I read your thread. If he's not been vaccinated and has been to rural areas may be worth thinking about requesting a test.

Whatever is going on I hope your brother is OK. Best of luck. Must be terrifying.

Just reread your post and saw he has a temperature. I would definitely push for the Japanese Encephalitis test if it were my family member.

@1bub1pup Glad he has made it to a country that's much better equipped with medical facilities. Bangkok is a much better place to be. @CrazyAndSagittarius 's suggestion about getting him checked for Japanese Encephalitis is a very good shout, too. If you can speak to him on the phone or Facetime, you could go with the angle that he's had a temperature for a while so should go to a general practitioner to get checked for it, rather than anyone "challenging" his delusions head on.

Mum has had to come home without him as the situation between them had become unbearable. He doesn't answer the phone to me but he messages and is messaging alot of other people. The more I think about the Japanese Encephalitis the more I think it could be it. But I just cannot figure out how I am going to best communicate that to him. It seems like he's trying to have a great time now and won't want to go to hospital.
To add to everything I have come down with Mastitis and spent the last day in bed. So I barely know what day it is without the time difference!

Oh no! Mastitis is rubbish. I hope you've got some antibiotics for it and the opportunity to rest lots.

I'd approach it with him as, "how's your temperature doing?" and then maybe something like, "that's been going on a while, maybe it's time to go and get some antibiotics from the doctor" and get him to go for a very simple reason, then when he gets there they can check him properly and take it from there. That way you won't alienate him and he'll know you're coming from a place of kindness, and be more likely to keep the lines of communication open. But at the end of the day you can't force him to see a doctor (as crap as that is). If it is JE, it will get to a point where he will end up in hospital anyway.

Here's the NHS page for JE, in case you haven't got a handy list of symptoms. The headache sounds pretty debilitating, maybe ask him if he has that? https://www.nhs.uk/conditions/japanese-encephalitis/

Well he's finally home. Still no idea what to do. DM is an absolute mess over it DB not really talking to her. DF is supporting him but really in a way pretending like nothing happened.
I just can't seem to find the words to say to DB anymore. I messaged him most days but it's all small talk. I'm so worried about all of them.
I tried subtly convincing him to go to hospital whilst he was in Thailand but he really doesn't believe anything's wrong ( Or so he says).
I'm scared to keep pushing it and have any of them seeing me as the enemy, But it feels like it's going to go that way.

That must be a relief he's home, did they ever find out what caused it, how is he now.

The area I live in has a 'crisis team' you can call and they will give advice on the best steps and also sign post you to other services that might help, if needed they will visit the person and get involved

Oh Christ sorry just seen he's in Cambodia. You need to get him home if you can

He's home

Oh what a relief. How is he doing? Can you get him some professional support now?
Could he have taken some hallucinogenic drugs? Hopefully whatever it was he'll recover soon. Well done getting him back to safety and familiarity