Stepson & breakdown

[Capripants]

My husband's eldest ds (21) appears to have had some form of breakdown. He is at uni & dh had so go collect him yesterday morning having gotten a 5am phone call from security in his accommodation as he was refusing to go back to his apartment as he maintained people were talking to him through the walls.
Dh is alone with him now in a house he maintains in the town where his other 3 dc live with their dm.
Due to covid he could only speak to a doctor who told him to get ds to sleep & to make a gp appointment on Monday but to take him to A&E in the meantime if he deteriorated. So far all he's done is sleep as apparently he had been awake for 72 hours when dh collected him.
His ds has always been a bit introverted & has a history of mild situational depression but nothing in his history to predict this current crisis.
The thing is that before he fell asleep yesterday afternoon he told dh he would not go to a gp & would in no way go back to a therapist (he saw one for 6 weeks when he was 18). Dh is now massively worried that he will refuse to go to any gp's appointment that he makes & as he's 21 he can't make him. The ds seems to think he can just come home from uni and everyone is to leave him alone. He denies taking drugs, ate a massive meal yesterday before going to sleep but kept saying to dh that his phones were tapped & he could trust no one.
Has anyone experienced anything of this sort with a 'child' this age & if so how on earth do you get them to the doctor if they won't go?
Dh is beside himself with worry.
Thanks in advance.

We have a ds who began to have psychotic episodes 3yrs ago. If they refuse to see a GP you can't force them - it has to get worse before you get help was our experience - by keeping him calm and safe we were actually not helping him access the help he needed and the strain on us was immense.

We took ours to A&E in the middle of an episode - only then could he be assessed. It was a long wait, but after that he was put under a crisis team who came daily, then the Early Intervention Team. He refused meds and was sectioned as a danger to himself. I didn't think he had been taking drugs but I was naive- he had dabbled in all sorts 😡. When he's taking his meds he really is almost his old self.

Forget the GP, you need to get expert involvement ASAP - Check your local health authority for a mental health line - ours has a 24hr one - they will point you in the right direction. NEVER minimise what is happening, be honest about the full extent of the psychosis, early intervention is crucial.

Good luck i- it's a horrible thing to have to deal with.

All the GP will be able to do is contact the "crisis" team or equivalent on your behalf. There is no point waiting for that. I would request an out of hours GP appointment today or consider ED attendance if that's easier to arrange. He needs an urgent assessment if these are his first psychotic episodes. I would say 90% of young people experiencing this at this age for the first time is secondary to drug use (usually cannabis) and the prognosis can be ok but he needs to be seen by a psychiatrist sooner rather than later.

If he has been awake 72 hrs is it possible that some of his hallucinations were caused by that? In which case, sleep should alleviate that. I suppose it depends what caused the 72 hrs awake, whether it was some kind of drug or something else.

Thank you all so much for the replies. I myself think it is most likely coming from drug use but both dh & exw seem determined to believe him when he says he hasn't been using. I also think this could be why he doesn't want to see a doctor or therapist.
I will try and advocate taking him to ED today but being the stepparent I don't have much weight.
Dh says he's a bit better after sleep but that's all I've heard today.
Again thank you so much & @ohyesiknowwhatyoumean I hope things are easier now with your ds.

Honestly @Capripants no - we've had some really good patches of time, but he keeps coming off the meds when things are going well. It's a total rollercoaster.

Please do contact the mental health team in your area - there are ringfenced funds for early intervention in psychosis - we really didn't get in there fast enough IMO, he'd been with a partner who was also drug using so we now think there were signs well before that we just didn't see. Hindsight is a wonderful thing ☹️