What help can be given when a young person 'disengages'

[Lightuptheroom]

24 year old, attempted suicide over 18 months ago. Had a total of 4 appointments with a community mental health nurse, recommended self help, 30 mg citalopram.
Then completely disengaged, doesn't take the medication, GP doesn't seem to follow up at all. Lives in a bedroom which involves crawling over feet deep of rubbish to get in and out, threatens suicide and walks out the door every time asked to do any clearing up of any kind, threatens suicide if we offer to clear the room up. The room stinks as does the person. We keep being told they are an adult by every organisation we've made contact with to try and find assistance. He's supposed to have some kind of talking therapy but won't go to the appointments, won't go outside other than in the early hours of the morning (1am for instance) However, will go out and do niche hobby with friends (gaming based) often for days or weeks at a time, be up all night and then sleep constantly when back at home. Is reliant on universal credit, we can't see how he could access accomodation of his own or even be able to live on his own. If we don't provie food, he eats pot noodles and drinks energy drinks. He leaves his washing on the kitchen floor. Cutlery and crockery come down every so often as far as the sink. There is the ever present threat of commuting suicide if hes asked to do anything - how do we get past this fear?
It seems so sad that at 24 all he feels able to do is sleep. Who can we ask for assistance. Not allowed to attend GP appointments with him as he won't give permission.

That sounds really tough for you. Not sure what to say except there are lots of families having to deal with young adults with mental health problems, walking on eggshells.

In the end, they have to want to change, and we can't do it for them. we've a DC living away from home but in a similar state. Just hoping that time and maturity eventually kick in and they access the help they need.

Thank you x

Hi,

I just posted a long message about my son who is also disengaged. I have no real answers, but it does seem to be a problem a considerable number of families are facing.

My thoughts are with you, it is such a tough situation that many families face. Unfortunately if the person doesn’t want to access services then it’s a real dilemma. In some places there are outreach services but they are far between and tend to be when someone is experiencing psychotic type illnesses.
My suggestion would be to ask for a careers assessment for yourself, and see what local support is available to you. Good luck.

Thanks x it just seems that they fall into a gap of 'being adult' whilst still having their family supposed to look after them. The crisis team told us we would have to take h to A&E not sure how you're supposed to do that with someone over 6 foot tall!!

Why doesnt he want to get better?

If it comes to it, you could call an ambulance, due to the threat of suicide. Then at least he would get to A&E and see someone from a mental health liaison team. However ultimately unless the threat of suicide is serious, he would not be sectioned.

Personally I would be tempted to let him eat pot noodles and not bother with his washing, but I realise your instinct is to try to look after him. It's an impossible situation.

Oh that sounds so hard. Can you get some help for you? I think I'd have to insist on every room in my house being clean and tidy and if that initiated a crisis that led to a hospital admission I think that would be a positive.

He is a adult and you are treating him as a child giving him food. Etc. If he living in your house you can hand him over to adult ss care to find him a semi supported housing...
As pp suggested stop tiptoeing round and if it triggers crisis call 999. Nothing will change if you carry on as you are...

He has realised that threatening suicide gets you to leave him alone. He can emotionally blackmail you with this now.

Is he a clever person?

How serious was his attempt?

Did he do it where he would be found or was he trying to do it where nobody would find him so was serious and he was just lucky he was found in time?

I’d be tempted to switch off the broadband to spoil his gaming fun and get him told to clean his room and it will be switched back on. Next day his task will be to do his own washing. Next day to shower. And so on. “If you don’t like it you can move out”

If he threatens suicide phone an ambulance immediately. At least that will be recorded and be more evidence for the services to try and help him more?

Nightmare situation. But he does sound manipulative, sitting in his room getting everything handed on a plate to him knowing he can threaten you with committing suicide to bend you to his will.

Sorry if I’ve misunderstood the situation. I’ve had two exes threaten suicide many years ago a decade apart if I left them. I left. They are still alive. Although one made a pathetic attempt with knife marks up his own arm to prove it. So my experience has perhaps made me look at your situation differently. I appreciate when it’s your child it could be different. But youve tried things your way and it’s not worked so it could be time to try something else.

Elieza, you've summed it up perfectly. I can't give detail as too outing, but he didn't make a serious attempt. He's not my child. The manipulation manifests itself towards his dad, who feels guilty about some life events, including the boys mum dying unexpectedly when he was at uni. Which triggered the first attempt, which then followed the same pattern we've seen this time. He's a clever lad, bright, articulate, but literally acts like functioning on a day to day basis is beyond him, seems to be sleep walking most of the time. He wouldn't qualify for supported housing (we've asked) I've suggested switching off the broadband etc and making him do x, y , z each day. His dad will speak to him about it, things will improve for a few hours maximum, then he claims he's hurt his back, hurt his hands, headache etc and disappears into his room again for days at a time. We have got to a point where his dad is recognising that he is enabling the behaviour, then his dad becomes scared and backs off. There is a review coming up of his benefits, so that could see a change anyway, as they are unlikely to leave him as not able or required to look for work for much longer

Poor you. You can't get someone to re-engage if they don't want to.
I think it has to come from his Dad. The 'enough is enough' speech and insistence of going to the GP together (Dad and son) for new AD's?

We've tried that, he won't make an appointment, so we then end up with his dad making the appointment, taking him to the gp, then he will tell gp he doesn't want anyone in the appointment. Last time gp decided to increase the AD's , he 'lost' the prescription at a mates house. We can't end up giving them to him every day because to me that buys into his actions of being much younger. Currently he says he's hurt his back so badly that he can't possibly move a bag out of the way of the sink, yet won't take painkillers or see the gp. I'm now getting angry as his dad just shrugged and said 'leave it there and I'll do it later' somehow the enabling behaviour has got up stop too

Leave it to his dad then. Take yourself off somewhere else for a few weeks

Currently not possible due to work commitments, his dad is my DH, wouldn't really class myself as 'step mum' as he's an adult

I think this sounds really really tough and more complex than we can imagine.

One thing for sure though is that by facilitating this depressed lifestyle free from normal routine and responsibilities is enabling him to continue.

He needs to face up to life and the only way to get him to do that is get him up and out.

Is he still at university? Could anyone there help? Does he have friends?

Maybe think about making a list of two or three small things he's to complete in a day, like taking washing down, dishes, whatever...something easily achieved that will make him feel a sense of accomplishment. Doing anything at all when you're that low is mentally like climbing a mountain.

The suicide threats, when he mentions them do you clam up or ask him about it?
The advice is to get them to talk about it, don't make it the elephant in the room.

Sometimes medication doesn't help, its situational. If he's grieving after the shock loss of his mum he may need grief counselling before he can try and deal with his depression.

CallmeRachel - thanks, it all feels way too complex for us, we struggle to know how to put a basic routine in place when he appears to fight against it, as an example we said food rubbish had to come out of his room once a week (not tidying up, cola bottles etc) he did this twice then refused to do it.
His mum died 4 years ago, he dropped out of uni at that point after his first suicide attempt. They tried to support and up to just about 18 months ago were willing to take him back for the final year. He flatly refused to meet with the uni (local to home so he wasn't going away or anything) and eventually they stopped asking /suggesting things. He has friends within the hobby and gaming, no friends outside of that.
The community mental health nurse suggested the few small things a day, he won't go outside unless he decides to and it's always at really strange times (very early hours of the morning ) which in turn makes us worry for his personal safety as he's not at all worldly wise (went for a walk at 2am and then panicked when a large group of drunk guys walked past him) We've literally only just got to the point where he might actually walk somewhere, previously he stands at the front door looking mournfully at his dad until his dad offers a lift. Yet, he gets on a train or a bus when he wants to.
We talk.about it, he can only see that he needs to get away, it's honestly like having a caged animal walking round. The crisis line state that he's an adult, unless he harms himself then they wouldn't send anyone and he wouldn't voluntarily go to A&E so like I suspect many families we have this strange catch 22. He's been offered grief counseling and all sorts of other talking therapy but their terms are that he has to make the appointment himself and he just won't.

Are there drugs involved? Without going into detail this is very familiar and it turned out that drugs were a root cause. No solutions unfortunately - we are still trying to figure that out

He needs sunlight and exercise. Your DH needs to step up! I think just lay down the law. He needs to leave the house once a day in daylight hours, otherwise no broadband. I know it's infantalising, but you have to start somewhere. If he doesn't like it, then he needs to propose a better plan.

I mean, it's okay to love people and insist that they are well.

hotcrossbun - that I'm not sure of, i've suspected something before only for his dad to tell me that his son would never even contemplate something like that.

I made DH take him to visit a relative today. Just them. He will now probably sleep until the end of the week

He sounds incredibly manipulative, sorry.

Life's just great for him, waited on hand and foot, and living a life of gaming.

What a waste of a life.

That's how I view it, though I've come to view it as manipulative through depression

It sounds a very sad life for you all. Depression can make you manipulative.

My ds2 has had anxiety and depression for the last 4 years, he is almost 18. It has been an awful time and he missed most schooling from about 14. He threatened suicide at points and has self harmed.

He also struggles to go out by himself and at his worst times spent most of his time in bed sleeping. He doesn't sleep until early hours and gets up around lunchtime as he doesn't have any reason to. He tried to go to college but it was too much for him and made him worst.

I've done the remove internet etc but it didn't work he just stayed in bed.
He is on medication but it doesn't really seem to help.
He does gaming online and has made some friends but if you ask if he is happy he will say no. He doesn't see the point to his life and thinks he is worthless.

I wish I could give you a magic answer as to how to help him but sadly i just don't know. Spending time watching tv or playing board games helps but so far we haven't figured out how he can change his mental state.

Be patient and just keep trying little steps. It is really exhausting having depression and trying to help someone cope with it. Sending you best wishes.

Thank you x since living with this, we hear of so many young people with anxiety, depression, other illnesses. Thinking about the gaming side, it's almost like they can cope in an unreal world. He has people asking his advice and applauding him online for every little thing, in real life he doesn't do anything. Perhaps these techno savvy youngsters should design an app where they can only progress with a game if they manage to do real life tasks! The mental health system seems stretched beyond measure, and in many ways because their world is so virtual I wonder if it contributes to being unable to deal with real life when it bites.