I think my family member with schizophrenia is off her meds. WWYD?

[Decoupage112]

Her condition is managed well with medication when she commits to taking it but a few times per year she will decide to stop and becomes unwell quite quickly.

I have woken up today to multiple rambling texts from her talking about how the royal family (a regular feature in delusions when she's not well) are conspiring with other celebrities to do this and that.

She isn't a conspiracy theorist at all, this only happens when she's on a mental health decline.

I'm concerned as whenever this happens it brings with it alot of stress and anxiety, she will do things such as coming to my home late at night and posting things through the letter box, banging on the door which frightens my small children, constant telephone calls etc.

I would appreciate some advice on how to deal with the situation.

Firstly, would you engage with the texts or not?

Also, if I make contact with her MH services will she know I've done that?

Thank you

Ignore the poll, sorry. I forgot to take it off.

Well, what do you normally do?

I usually notify my mother who is her next of kin and she deals with the situation but she's in v poor health and wouldn't be able to intervene this time.

I'd send her a general text asking if she is OK?
Does she have a social worker? If so I'd ring them... If not I'd ring her GP for advice if you know who it is.. They will either help or point you in right direction...

I sympathise... Getting help for relatives with mental health issues is really hard these days... Especially before they hit crisis point

It used to be that MH services wouldn’t intervene unless she was considered a danger to herself or others, in which case she would be sectioned and forced to take her meds, so I’m not sure whether contacting them would do that much good though it certainly wouldn’t hurt to try and I’m quite sure they wouldn’t disclose to her who informed them of her condition if you asked her not to.
As for engaging with the texts I would perhaps reply to the odd one but probably ignore most of the ramblings for my own sanity.

Thanks happy, I'll do that.

She doesn't have a social worker but I know she's under her local mental health team. My worry is if I contacted them and they told her it was me I would get alot of grief, I don't know who her personal support worker is either.

I could definitely speak to her GP surgery.

Angelina, thank you.

I don't think she's a danger to herself at this point but she does go downhill rapidly. The last time this happened she declined to such an extent that the police and MH services had to forcibly remove her from her flat and take her to hospital

My mother is the one who deals with all of this but she's in poor health and just doesn't have the ability to intervene anymore.

What would happen if you texted her back asking if she is off her meds and stating firmly that she needs to take them because she doesnt sound well?

What do you want to happen long term OP? Are you able/willing to take your mum's place in supporting this relative?

Porcupine, if I were to text her something like that I would then become 'the enemy' in her eyes. I've been on the receiving end of that before and have been completely demonized.

Though that being said, that would be better than the alternative, the alternative being she gets so unwelcome she becomes a danger to herself or somebody else.

Unfortunately I'm not able to provide as much support as my mother did, which included staying with her for a couple of times per week and monitoring her meds most days. I work and I have small children so as much as I love her, they need to be my priority.

So unwell*

Not unwelcome. Type error.

Just contact her MH team and ask them not to divulge that you have done so. What is the point in letting them continue to have a psychotic breakdown? (Even if they knew you'd contacted MH team, they would presumably thank you for it when they are back on anti-psychotics and 'in their right mind').

Have they lost insight? If so contact the MH crisis team who will either deal with them via their Home Treatment team or section them temporarily, if necessary.

I would argue that someone who comes off meds several times a year isn't controlled well at all.
If you know the team she is under give them a call and tell them you suspect she is off her meds. Its likely that due to covid she hasn't been seen as much as usual. They don't need to reveal it was you who has said something.
I've seen people decline (in a professional capacity im an rmn) very quickly and then take months to get on an even keel again.

I commend you for thinking clearly about the support you can give and for prioritising your children. So, whatever you feel you can do 4x a year, do that. This may include alerting someone, ignoring texts, or just accepting demonetisation (contact the police if this results in abuse).

We also support a relative, albeit w totally different problems, and you really do need to know your limits and reinforce your boundaries. Which is hard, if like me, you would be prepared to put in a lot of effort but then expect a permanent fix (cause there generally isnt one).

Thank you all for your replies.

I'm going to give her mental health team a call in a minute and will be clear that I don't want her to know it has come from me.

I would argue that someone who comes off meds several times a year isn't controlled well at all

You are right yes. When I say it is well controlled I'm referring to when she is med compliant, as in, the medication does significantly help the delusions and paranoia.

Sadly she just won't comply for long enough to be stable for any significant period of time and without my mother's ongoing intensive support this is likely to become even more regular an occurrence than it has been.

Why do folk alway want to contact authorities before confronting people? It's a kind of snitching mentality that I just can't get with?

OP could you contact her to say you're concerned about her health and is she currently medicated? If she has a negative reaction, then that's the cue you need to contact medical services?

I just don't see how doing it the other way and contacting them first, does anything other than cause issues in future where you might find she won't text you at all and you lose the warning signs you just had, because she thinks you're a snitch?

Have they lost insight?

It certainly appears that way based on the context of the messages, this is what I've received this morning.

"Firstly Danny dyer Is taking some time to talk royal He is not alone there are people placed around England doing the same
The fellow of the Harold the conquest days he Godwin is the cruelty type And there is the Windsor's royal family ours
Just lastly the atmosphere reaks of the tower of London just basically stated here"

So, word salad and strong indications that she has become delusional.

Which is hard, if like me, you would be prepared to put in a lot of effort but then expect a permanent fix (cause there generally isnt one)

Yes absolutely. If I knew I could stop this happening again I would try my hardest to make myself more available, however hard that would be (and it would)

Unfortunately this happens often and I just don't have the time, emotional bandwidth or facilities to handle it.

@JuniperFather

Why do folk alway want to contact authorities before confronting people? It's a kind of snitching mentality that I just can't get with?

OP could you contact her to say you're concerned about her health and is she currently medicated? If she has a negative reaction, then that's the cue you need to contact medical services?

I just don't see how doing it the other way and contacting them first, does anything other than cause issues in future where you might find she won't text you at all and you lose the warning signs you just had, because she thinks you're a snitch?

I do see your point.

My reluctance to address it with her stems from a past experience when I've encouraged her to take her medication and I've become a target for hostility.

I have responded to her messages and asked whether she's ok and asked what is making her think those things, I'm yet to receive a reply.

I can't get through to her MH team either.

JuniperFather horrible of you to refer to someone who is worried about, and is seeking help for their severely mentally ill family member as a snitch. Family often suffer enough guilt without this.

Trouble is, when they are in the grip of an episode they are not going to think 'oh she's right, I'll just take my meds' so I think contacting her team is the only thing you can do. Must be a mixture of frustration and sorrow for you OP, you have my sympathy.

I've just checked and she has read my message but hasn't replied.

Knowing her as I do, the fact that I've even questioned the delusions will now mean I'm 'part of the problem' or against her.

Frustration and sorrow absolutely.

It hurts my heart to know she's going through something so frightening but then there's another part of me who is just so frustrated about the fact she keeps stopping the medication.

When medicated she's extremely insightful. She is an intelligent woman and she knows what happens when she stops complying.

It's quite common for people to come off of their meds, the issue is that once they do, they often won't go back on to them voluntarily as the medication becomes part of the conspiracy; ie they want me to take these as a way of tracking me, or to try and hide the truth etc. After being sectioned 3 times, we got a court order for my sister to have hers administered by injection monthly at home, it wasn't easy though, and not all meds are suitable, it was also a last resort. In this case you are correct, you run the risk of being part of the enemy in her eyes and she will likely disengage from you. You know her behaviour and when it's slipping back, it doesn't make you a snitch to contact her MH team. They also will have an understanding of her and be able to advise you on what is the most appropriate course of action. It could be that they can send a support worker out as she is 'on the books', or they might deem something else more appropriate. But please call them, it's really ignorant for someone to say you're snitching, and to suggest talking them directly about it.

@Angelina82

JuniperFather horrible of you to refer to someone who is worried about, and is seeking help for their severely mentally ill family member as a snitch. Family often suffer enough guilt without this.

Apologies for the poor choice of words. I have experience with mental health in my family also.

OP @Decoupage112 geniune apologies for poor choice of words here. Thanks for your considered reply.

If you can't get through to the MH team, is there a public number you can try? Here there's one on the trust's website, and they can direct as appropriate.