BIL in a bad way. How can we help. Feel out of my depth.

[Spidermama]

BIL is in his 40s. Two years ago he had some kind of breakdown and became delusional. He thought people were poisoning him and ganging up having secret meetings to try to fit him up and get him arrested. Really wild delusions.

He was very fearful of his neighbour so he moved out of his rented flat and moved in with his dad and his dad's wife. They thought it was just 'til he found another flat so they looked after him, got him talking to the mental health team, tried to help him find a flat.

Anyway after several months it became obvious he had no intention of moving out so the wife had to make him leave.

He then moved back in with his mum and has been there over a year. The thing is she really doesn't want him there. He's 45, probably alcoholic (has been for years) and really hard to live with. He drinks black coffee and irons shirts at 3 in the morning for example.

Long story short -- they've had a row and he's gone off to stay in a hotel for a bit. She doesn't want him to come back and has asked dh to help make sure he gets a flat and pisses off out of her house.

She's in her 60s and looks after an ill relative. She shouldn't have to have her 45 year old son at home.

He manages to keep down a job so though he has been and probably still is delusional, he's not totally incapacitated by it.

Anyway dh is trying to help get him a flat, but people have been trying to get him a flat for 2 years now and he has obstructed all the way.

I wonder where it will all end and would love some advice. He seems to have managed to shake off his mental health team and this is causing so much stress in all the family.

It sounds like your BIL had some kind of psychotic illness as he was out of touch with reality. The thing is it is always difficulte when people with mental health problems self medicate with alcohol because this just makes the whole thing worse.

If he holds down a job, can he not get a private rent flat or bedsit (he only needs 1 bedroom doesn't he. Don't know where you live but I think the rents are quite high wherever. If he is on a low wage, I think he could claim housing benefit, but they are changing all the benefits sytem at the moment so not sure.

Mind the thing is he is being obstructive to anyone helping him isn't he. Sounds harsh but maybe you just have to leave him in the hotel. He will though in all probabability go back to his mother and she will have to be strong enough to refuse to have him back.

Sorry this isn't much help as I am just telling you what you already know. Could your DH contact the mental health team onhis behalf in the hope that they can engage with him again.

Maybe someone will be along with better advice.

Thanks NanaNina. His wages are OK. He's an IT trainer so does earn enough to rent himself a flat.

It's a shame he's back on the booze with a vengeance. He was off it for years but used to buy and drink around 20 bottles of alcohol free beer every night.

I think you're right about MIL having to be strong and just say 'no'. I understand why it's hard for her as she worries her boy might end up on the streets. In a way, though, he's holding her hostage because he knows that if push came to shove the safety net of going back to mum is there so perhaps it doesn't do him any favours and he can't get motivated.

Maybe we should all just let him slip through and see if it jolts him into action. BIL and DH have said his psychotic behaviour ebbs and flows when it needs to. That sounds harsh to me but there you go.

Hi- I both work with MH patients, and lived with a man with MH issues (bipolar). The issues are complex. What your BIL was/is experiencing seems like a psychotic episode. The longer this goes on (chronic, i.e. lasts over 3 months, or chronic recurrent, i.e. happens again and again),the more likely it is he has Schizophrenia. The longer the psychosis goes untreated, the harder it becomes to treat, and the more likely that it won't go away.
Psychosis/ Schizophrenia not only means they loose their grip on reality/ have delusions, but also comes with various "soft" and "negative" symptoms, like loss of drive, loss of social interaction/social withdrawal, increasing lack of self care etc.
And always, always with lack of insight- that means, that the sufferer DOES NOT KNOW THEY ARE ILL. They don't. Everybody else is wrong, and they are right. So WHY would he want to get involved with the MH team? they keep telling him he is mad, and are just out to get him!
If he has been involved with the MH team previously, they will have documented "next of kin". Next of kin can refer to MH services- no need for GP, if patient known (don't let them tell you otherwise!NOK can even sign section papers!)Local community MH team, or even crisis team.

He seems to be functioning on a reasonably ok level (working, self care),he will by default try to live somewhere "catered", though. Own flat means, people out to get him can "get to him" (dangerous), but also means effort. Ability to handle money is usually quite compromised, as well, so he may well stay in Hotel , even though can't really afford to IYKWIM.
Get MH team involved again, only real option, I think. Once the way home is cut off, he may accept advice from a support worker re housing.
Very difficult and frustrating, and never an easy answer. Doubly frustrating, as the ill person does not engage, blocks all attempts to help, gets very annoyed, and generally does not appreciate outside input!
Best of luck.

I'm thinking he should be left to live in the hotel, not sure how mentally ill he is if he holds down a good job. can you be selective about how and when you are ill? Can't imagine how stressful it is for mil worrying about her boy but if he is obstructive its not fair for him to drag you all down with him. I don't think you should be turning your back on him but he must be made to understand that you won't be enablers to his problems. that unless he is open to your help that you can give that you can do no more. Can you re engage with his mental health workers on his behalf?

Anushka - that was a really helpful and informative post that I am sure will help the OP. Learned a few things myself as well! I do not have a psychotic illness, but am still struggling to recover from a severe episode of depression (3 months on psych ward) a year ago - have many ups and downs, more ups than downs but have not fully recovered and often wonder if I ever will. Am on 200mg imipramine - psych says the setbacks sometimes go away and sometimes not. I am seeing an NHS psychologist soon. The thing is about depression is that it "tells" us things about ourselves that aren't true and we believe it - like "it would be better for everyone if I wasn't here" and that we should be able to do something to stop feeling so awful etc etc.

Sorry only meant to say how helpful you had been but as you seem so well informed on mental health I thought I would ask your advice. Hope you don't mind.

Nana ... I'm glad you're having more ups than downs. Must be tough climbing back when you've got so low you doubt your worth so much.

Thanks Anushka. Great post. That's spot on. You describe his behaviour really well. In fact now he has been given time off work and instead of flat hunting he's gone off somewhere, disappeared and failing to return family calls and texts - probably the cottage in Wales.

He's also terrible with money. He keeps all sorts of stuff, scores of old computers and cameras for example, in a lock up costing him £135 per month! I doubt he can afford the hotel. He JUST manages to hold onto the job and his boss is very understanding.

He's in denial. Family getting increasingly frustrated. FIL has been talkking to his mental health team but you are right that he really thinks he's right with all his conspiracies.

He thinks I and others try to poison him when we cook for him.

So will the MH team intervene and contact him? I don't want him to slip further into psychosis. The family don't seem able to help him and there is more than an element of enabling going on here.

Sorry for delay in response.
My Ex-P's uncle has Schizophrenia. He does the hoarding thing, as well- usually because he is convinced these things are very valuable/ worth millions

BIL is not in "denial", he truly does not know he is ill. Your whole life you have learned to trust your senses, your eyes and ears. Suddenly, they play tricks on you- how would you know everybody else is right and you are ill? Does not make sense to them.
The poisoning rings bells,too.
Yes, the MH team should contact him if there are reports that he is actively psychotic. It may take various forceful attempts to get them to, though!Make sure you point out he is known to MH service, best go back to original team.
His GP may help, home visit request with one of you present. Sometimes A+E can be helpful, but not often, in my experience.
If he is missing/ out of contact, do not hesitate to call police and report missing- he is classed as vulnerable once has diagnosed Psychotic Illness, and if found in public area behaving strangely, police can detain under section 134 and take to place of safety (usually A+E).
Will check back here intermittently.
Nana, sorry to ignore you for now, will get back on later, I hope.

Thanks again Anushka.

Anyone else who fancies contributing? I'd be very grateful. I feel I'm keeping Anushka a bit busy here.

I fear he's becoming more and more entrenched in psychosis but I'm not even sure if he has a diagnosis despite being properly delusional for over two years now. He's a master at appearing normal to get people off his back.

DH and FIL want to continue reasoning with him but it's not working and hasn't been working all this time.

When I raise the posibility of looking into forced intervention from his MH team, DH says it would destroy BIL's life because he'd never be able to work again. He fears he'd lose his job and be unable to get another because no-one will employ someone with mental health issues.

He hasn't got another plan though apart from the same old.