To ask what you do if someone won't accept their disability

[mannerhouse2]

I am asking for a relative, they have serious mental health problems but think they are fine.

Is there anything that can be done in these Cases?

It's a danger for every homeless person in this weather. But the danger refers to self harm, refusing to take medication that is really needed, violence and aggression etc against themselves or others.

No sorry then in that case it isn't attention seeking. . It's really difficult when people won't acknowledge they are ill or need treatment. It can happen in the case of physical illness too.

Yes, but there are not enough shelter places for people desperate to take them and willing to comply with shelter rules (eg no drink/drugs, no aggression towards other residents). Someone who is sleeping rough can be offered help and a bed for the night but they cannot be forced to accept that help. People who work with rough sleepers and homeless are already struggling to help those who ask for assistance: they do not have the resources to pursue someone who rebuffs any offer of help.

This was sort of me, well I knew I was unwell, but not aware of how unwell. Unfortunately at the time I was also being very badly bullied - because the "responsible person" who should have dealt with the bullying, knew I was unwell, they deemed it to be my perception of things (my perception was still pretty spot on).

Bullying progressed to threats, which progressed to a death threat and being stalked, I eventually became quite unwell and this was then used in defence to not deal with the bullying / abuse. I have now, two years on, been believed - only because the bully did something similar to someone else. It was horrific.

I'm only saying this because please make sure that there's no abuse going on before you tackle them accepting their own mental health problem - they may be aware of additional stressor you are not.

A relative of mine who was homeless wouldn't be homeless for long. z-bed, lounge, etc.

This is a really difficult one. DH suffers from episodes of psychosis but it took 10 years of frequent crisis team input and me asking the GPs for help before he got a diagnosis and any formal support and that was only because his delusions became bizarre and he was unable to rationalise his voice hearing. When DH is unwell he loses insight and completely believes the delusions.

I'm no expert but from what I've gathered over the years there is a huge gap in the system where people are not unwell enough to be sectioned but too unwell to realise that they need help. I've even been told by police officers that my husband is one of the many people who fall through this gap in the system and end up homeless, unemployed, in prison etc.

Personally I think that part of the problem is interpretation of the law as a way to keep caseload under control. Certainly crisis team have always been very content to take a "no thanks I'm fine, I don't need your help " at face value. I even once had a series of conversations with crisis team where I explained DHs bizarre delusions but was told "yes we agree that he sounds very unwell, but there's nothing we can do unless he wants us to get involved " at the time I had no comeback to that but now I do. The Mental Health Act only allows someone to be detained if they are considered to be at risk to themselves or others. (Although my husband being seen twice in one day due to being firstly suicidal and secondly having made a suicide attempt immediately after they discharged him didn't apparently constitute enough risk to even trigger a follow up appointment!) The Mental capacity act requires someone to be able to weigh up information including risks in order to make an informed decision. So this is now my go to when my husband lacks insight into how unwell he is. If his doesn't have insight then he can't possibly have the mental capacity to make an informed choice about his treatment. Unfortunately this only works if the professionals a)agree that he is unwell at the time and b)agree that he lacks capacity and these points now tend to be my battleground. Our last interaction with crisis team ended with me put in a very risky situation because they wouldn't listen to me on these points.

From a practical viewpoint your relative's nearest relative (a legal term not the same as NoK see rethink website for more details) can request a mental health act assessment without your relative's consent if you feel that he is seriously unwell. Make sure you use that exact phrase or you may get fobbed off (I did) (again there is more info on the rethink website).

I've also just read a really good book called "I'm not sick I don't need help " by Xavier Amador, which looks at insight in serious mental illness and at how to improve communication and help people who lack insight engage with treatment.

@falsepriest Have you ever housed a homeless relative with severe and enduring mental health difficulties who didn't accept they either had the difficulties in the first place, or that they needed help?

I was so lucky things were broken to be gently - because had they come out and said my diagnosis on day 1, I would have honestly told them to all f**k off and walked out of there, i now have full acceptance of my diagnosis, can talk about it and know how it affects me, but I was not an "easy" person to be with during the bad times when I didn't know. I don't think I would have offered myself a bed, I was all over the place.

There are things that can be done if they are diagnosed with a judgement impairing illness ie schizophrenia, bi polar, but even then it is often only when they come to the attention of the police or MH services because of their behaviour. I work for a MH team and we have had families ask for help with relatives who refuse treatment or input. At times we have had to wait for the person to deteriorate further before they can be legally detained which is hard for all involved especially the family.

What SGB said. Awful situation, but there isn't a lot that can be done about it if they rebuff help.

It's more they aren't well enough to get it and delusional. I just feel bad. Like something awful will happen and it will be my fault.

A relative of mine who was homeless wouldn't be homeless for long. z-bed, lounge, etc.

If only it was that simple! On one occasion when DH was very ill he was convinced that people including me were trying to kill him so wouldn't accept help from anyone and ended up on the streets in a strange city having disapeared within 24hrs of being discharged from hospital. Crisis team didn't seem bothered and made no attempt to intervene as it was his choice not to engage. Yeah right whilst suffering these delusions he was in a great place to make an informed choice about his treatment and demonstrated this by choosing to sleep rough in winter. I was basically told to wait for a "blue light " situation and that it didn't sound like it would take long for this to happen "one way or another " my personal view is that professionals are hiding behind misinterpretations of the law to excuse negligence in these types of situation.

Also have you ever tried living with someone who is seriously mentally unwell and not engaging in services. DH and I ended up separating whilst he was really ill and if we had had DC at the time that point would have come a lot sooner.

It's more they aren't well enough to get it and delusional. I just feel bad. Like something awful will happen and it will be my fault.

Can you give examples of the delusions. You might have a case for going down the nearest relative and mental health act assessment route.

Also whatever happens will not be your fault, you are doing your best by the sounds of it. DH is often suicidal and has many attempts behind him. I used to feel this was my responsibility to prevent this I've come to realise that whilst I can support him the best I can I have no more control over his mental health than I do over his physical health and no more control over him attempting suicide than I do over him having a heart attack.

Another thing, in my experience the best people to call in a mental health crisis are the police not the mental health services, they are far more helpful and most of what I have learned about navigating the mental health system has been from the police.

I understand that it’s very painful to watch someone you love live such a terrible life.

But the sad reality is that most people who are rough sleeping have some form of metal illness as well as addictions. Even when health and other care is offered to them they will often not accept it.

I know it’s very distressing. It’s also hard for people who work with those who suffer from these issues.

NoLonger Thanks for that book recommendation.

Op, I have no advice, only sympathy. We are in a similar situation with my brother in the US and it's so hard to accep that there's nothing you can do to help. We even had a lawyer look into ways of getting him sectioned, so that he could get help, but were told there was nothing they could do, as he's not an imminent danger to himself or others. It's very hard. I'm so sorry you're going through it too. Xx

False I have tried but have very young babies and it proves impossible.

Thank you so much for your advice I really appreciate it.

It won't be your fault if something bad happens to your relative, OP. It really won't. You cannot cure someone of a mental illness with love and kindness and good intentions. And you are not obliged to take someone who has a mental illness (and whose behaviour is therefore likely to be unpredictable, to say the least) into your home, especially if you have DC to consider.

Someone who has a mental illness (and whose behaviour is therefore likely to be unpredictable, to say the least)

...gets the award for the most offensive Mumsnet comment of the day.

A relative of mine who was homeless wouldn't be homeless for long

You hero! Lived with a lot of people with severe mental health difficulties have you? My db will likely be homeless within the next couple of years. He won't be in my spare room because he's a drug addict with mental health issues, is intensely paranoid and can be extremely aggressive when not supplied with money for drugs (which he "needs" to help avoid facing his mental health issues). He won't engage with anyone , doesn't even have a GP (thrown out of the last practise for aggression). Won't sign on. Every time he's set up in independent accomodation he gets thrown out for not paying the rent/following the rules/being vile to the neighbours.

But if you'd like to save him, be my guest. Just pm me your details and I'll pass them on.

Quite.

Well said, Barbarian