What is a realistic aim?

[Lightuptheroom]

My step son is 30 this year. Due to mental health difficulties (mainly social anxiety) he hasn't worked for 8 years. He is medicated with Mirazapine but it's not regularly reviewed (he states that he doesn't sleep at night but doesn't return to the gp) He has 'used up' all the counselling etc the NHS can offer and is in the 'limited capacity for work or work related activity' for universal credit, meaning that nobody expects him to even try to look for work.
This means that he's still living at home. Nothing improves things and we worry how he's going to function going forward, he can't afford to rent his own place. He sleeps all day, doesn't wash, doesn't do anything in the house, yet nobody follows anything up. Is this how life is going to be? His dad doesn't know any other information and professionals won't discuss it with us. It's causing problems as when he wants to, he goes out with his mates playing Dungeons and Dragons until 1am in the morning. We have no idea what to do.

There may be nothing you can do to change his situation. His mental health sounds very poor, and he’s been assessed as unable to work atm.
Is he in touch with mental health services?

@WaitingForMojo no, he gets referred, then doesn't attend appointments, so they sign him off as not engaging. It just feels like going in circles without anyone overseeing what's going on

I knew a woman who had to move 200 miles away from her adult daughter so that the young woman, who had mental health issues, would be placed in sheltered accommodation through adult social services. It was a few years ago. I don't know if those facilities are still available but it might work for you. The mother's aim was to ensure her dd had support after the mother died, and wasn't left confused and unsupported in the long term.

Is he in touch with Mind, maybe a peer supporter? He really needs a community psychiatric nurse but I think they're thin on the ground. He needs help to move forward, to set some achievable goals and get to them. Far too many people are stuck like this.

That is incredibly difficult and frustrating, mental health services are in such a state, it’s awful that he is being discharged because he isn’t well enough to engage. Will he allow anyone to go to an appointment with him?

If he lives in your house don't allow him to stay in bed all day and not shower. Tell him he must get up by 9am and shower every day. You say professionals are not following him up but you are literally in the same house as him and allow him not to shower and stay in bed all day. If he never showers I'm surprised he has friends to go out with. He needs to get out in the fresh air every day even if only for half an hour. I'd be telling him to do job searches every day too. There must be something he can do. Could he WFH? What are his qualifications and skills?

Mental health services have extremely limited funding and it tends to be spent either on people who are clearly a danger to themselves or others or below that level on people who are prepared to engage with it.

Basically they don't want to waste money they don't have hassling people who don't want to be there.

In practice what this means is that for late teens and early twenties people with anxiety it's down to the parents to sort it out.

There are multiple drugs that help with anxiety so he could try others.

I speak from experience.

I would either make him leave or leave myself, frankly. No way am I living with a 30 yr old ss who doesn't work or shower.

I also know a woman who had to sell up and move in order to extricate herself from her grown-up son who still lived with her and refused all help.

She was on her knees and there was no other option for her to cut the apron strings and live whatever life she had left without him.

The final straw for her was when he briefly had a girlfriend who dumped him very quickly at which point he threatened to kill himself, saying he was on a bridge over the Thames.

He was actually in his bedroom, doors closed, lights off, creating havoc from his phone. He was 31.

I’m so sorry @Lightuptheroom - it sounds so difficult. Does your Step son talk about how he feels ever? Does he have worse times than others? On days he can game can he function in other ways? Has he had a diagnosis other than social anxiety? Sorry to say this but does he ever talk about ending his life and have you asked him if it’s something he thinks about?
I'm not a MH expert at all. I’ve had just family experience of it. When you have a fear of something the way to over come is exposure.
I’m sure you know more than most how much MH can improve from routine, purpose, contributing to the home, feeling clean.
taking that first step is the hardest thing but results happen quite quickly. I reckon you need advice on whether his condition is such that tougher love (saying he has to shower, cook, help in house in order to live there) could cause him irreparable harm or to end his life through distress . If you don’t think it will or this is how he’s feeling - then I feel out of love for him, this is what should be done. Even if they’re small goals - eg this week he’s up by 10am, showering and doing a small workout. Otherwise you’re both enabling him and giving up on him. I also wouldn’t think you can’t treat him a certain way because of his age - as he’s not behaving like a 30 yo, he’s really like a 15 yo - so could be pushed accordingly.
This book (hope link works) was recommended to me by a top psychiatrist for another young person struggling… it may be useful for you?
really wishing you lots of luck x
(It’s called Brain Lock)
https://amzn.eu/d/aDO1uhH

He's repeatedly threatened to harm himself, this results in very short term multiple appointments, then they say he's 'fine'
I'm not sure how I make a 30 yr old get out of bed and wash? I've told him numerous times but get ignored. His dad won't push it because he threatens to hurt himself. He won't allow anyone at appointments and we rarely know what appointments he's been given as he's not given permission to be discussed. Supported living in our area isn't available as he's not deemed to be in sufficient need (he can be very convincing to professionals and talks about applying for apprenticeships etc and then doesn't do anything) Do universal credit review his status or just leave him in that group for ever?

He's been through the local Mind services, he has been told that he's exhausted their offer, as he does the course, seems to improve, gets a certificate and a day later starts the old ways again.

You really appear to have tried everything.

He sounds Autistic, and he's in the right universal credit group for his difficulties. Not sure what else you can do realistically.

He won't change until he has to.

If his dad won't push it there isn't a lot you can do.

Eventually his dad will get sick of it (or you will) and either you will leave or his dad will make him do stuff.

The answer to how to make a 30 year old make do stuff is to nag and generally be annoying until it's easier to do the stuff than listen to you any more.

It's very wearing to do though.

As a stepmother to a 32 year old woman in a similar situation, I think some of the responses here are appalling. You can't make a 30+ year old do anything, and you can't abandon them either.

How cruel to say he has to leave if he doesn't shower. If he has been assessed as limited capacity by the DWP, then he isn't going to get a job and is likely to be unable find accommodation and live independently.

He has a social life. He is living his life his way. He has a disability and so many people are encouraging the OP to kick him out into a system that is really shit for 30 year olds with careers, let alone those who need massive amounts of support which just isn't available.

We batch cook for my DSD who has a fridge and microwave so she eats what and when she wants. She has her laptop, phone and TV, like the OP's DSS and she's happy. She does her own washing. So she doesn't shower every day, but she does wash and won't go out unless she's had a shower.

We know she's safe and will always have a roof over her head. Some PPs seem to think it's OK to abandon your children. Some of us prefer to support them.

I wouldnt abandon my children. But I would find it hard to live with a stepson whom I couldn't effectively nag.

He definitely isn't autistic. I can sometimes get him to do things, he'll do it once and then not come out of his room for a number of weeks. Last week, he decided he was going to the gym with friends, he was chatty, upbeat, laughing, everything was bright and shiny. He went twice... rang his dad saying his anxiety was very bad and went in his room. He's been like a zombie since but still going out with his mates.

I know I will be flamed but if he can go out with his mates, he can do chores around the house.

Well, that's your style. I find you get better results with honey than vinegar.

I would definitely not use honey on any family member who did no chores but went out with friends. Child, stepchild, husband, anyone.

Yes, he sounds autistic. It's very difficult to engage with others when you know you're different and lack the means to understand why. Just knowing can be a tremendous relief. He's likely at least found some of his own tribe through D&D

Sorry just seen you say he's definitely not autistic, OP. What makes you so sure?

What's the long term plan?

There's a difference between not washing at all and not washing every day tho. My dc don't shower every day..but they do keep themselves clean.