DB sectioned and blaming family / aggressive

[goteam]

Would love advice from anyone who has experienced similar. DB sectioned in March. Has bipolar and severe addictions (hard drugs and drinks excessively) Is late 20's and has never held down job for longer than a few weeks, left school at 15 and can't maintain own accommodation so lived with our elderly parent but trashed house, had drug binges there with others. Was aggressive and behaving unpredictably, hence section but DB is being very aggressive towards his family. We have all helped as much as we can in the past but with children of my own now I'm actually sick of it. DB is manipulative and only calls for money. He had a sad childhood, we all did though.

How do others deal with this? I have tried to emotionally detach as my priority is my kids (1 and 3) and I have a demanding job. Toddler says she is scared of DB. Im sympathetic to him but I just don't think you can let childhood experiences take over and need to let go. DB dwells but isn't interested in therapy. Just wants to be able to live rent free with parent, fed etc free of responsibility and for family to give him money when benefits spent. No desire for work or any kind of positive future. Very angry at us all for not allowing this to continue. Any advice welcome. Parent has enabled in the past which I have always tried to stop but now handouts are expected.

A fortnight not a week.

goteam,

re your comment:-
"I think I will stick to a weekly call to the ward which he can respond to if he likes and transfer my attention to caring for parent and communicating with hospital staff about care plan etc".

I think this would be an excellent idea but with the proviso that you only talk to the staff. Your brother still does not want to know and is in blame everyone else mode.

Is your dad already in communication with them?. What does he make of all this now?.

It took me far less time to detach from BIL and his myriad of issues but it was easier for me as an outsider looking in. DH wanted to keep trying with his brother for very understandable reasons so he did (and I did not stop him because I could not, also he had to properly see it for his own self) but after one particular snub at a family event even DH realised that he could do no more for him. DH had to be emotionally hurt though in order for that to happen and that still makes me feel sad and angry some years later.

tsonlyme I'm so sorry to hear about your own experiences with your DD. I have tried to tell DB that we didn't get him sectioned but doctors did based on his behaviour but he won't have his behaviour challenged.

Thanks kitty you are right. I think he does believe what he is saying.

Attila DF in similar limited contact with staff. Calls around twice a week and goes to hospital weekly with bits of food etc which DB snatches and then tells DF to go. Journey is an hour and a half for DF who doesn't drive and has physical health problems. DF angry with DB but loves him so keeps trying.

Sorry that you DH was so hurt by his brother. DB refused to come to DF 70th a few years ago. Said he had better things to do.

"It's not families that make the decision to have someone sectioned it's doctors"

That is indeed correct but my BILs parents objected (oh the scandal of having BIL carted off for all the street to see, that is exactly what they thought) so he was not sectioned. Parents do have the right to object and they exercised it. He would never have willingly gone into a psychiatric unit for a month also because he thinks there is nothing really wrong with him.

goteam - it is also because of his MH problems that you must detach from him. What you have tried as a family has simply not worked and ultimately you can only help your own self.

Helping is doing something for someone that he is not capable of doing himself.

Enabling is doing for someone things that he could and should be doing himself.

An enabler is a person who recognizes that a negative circumstance is occurring on a regular basis and yet continues to enable the person with the problem to persist with his detrimental behaviours. Simply, enabling creates an atmosphere in which our adult children can comfortably continue their unacceptable behaviour.

When we continue to allow these behaviours to occur, we are setting a pattern of behaviour in our children that will be hard to change. We are enabling their repeated inappropriate behaviour. Then we repeat the enabling pattern with the result of instilling bad habits and accepting what should be unacceptable behaviour for so many years that it eventually becomes as natural to many of us as breathing. Yet all the while, a nagging feeling deep in our heart and soul tells us something is very wrong.

Years of my ILs emotional enabling and excusing crippled him and they are partly responsible for how he is now as well. Their helping hurt, they did not act out of love and they were completely out of their depth particularly when he hit teenage years. They enabled their adult child to avoid his own responsibilities—to escape the consequences of his actions. Rather than help your child grow into a productive and responsible adult, they have made it easier for him to get worse.

I apologise I should have realised that he wouldn't accept that it wasn't his family who 'had him sectioned' by the very fact that he is, showing that he doesn't currently have mental capacity. It's a very tough place to be and I don't envy you. I suppose sending him to rehab on release from the psych ward is a pointless task if he's not not interested in changing his addictive behaviour and I doubt they would spend money in that direction if they're not convinced that he's motivated.

I think the weekly phone calls (to the staff) is a good idea too and to support your dad.

Attila, was he under 18 at the time? I'm not disputing what you say but I would be surprised if the decision to section had been made it wouldn't be in the parents power to overturn that for an adult. A patient has to be very very unwell to be sectioned against their will.

Hi Op.
I have been in a similar situation. My DB has drug induced paranoid schizophrenia and has now been sectioned 3 times.
It's incredibly difficult. We're not a close family, but the first signs were weird phone calls etc often in the middle of the night. My DB was also violent, and his first section coincided with an arrest. He has also required detaining in a secure unit.
I have found it very difficult. My DPs (esp DM) have expected me to "sort it out" which meant a bail out of 6K which I was not prepared to do (I know it sounds harsh but I don't believe in funding more drugs or temporarily bailing out someone who is never going to be in control of their finances.
I also didn't invite him to my wedding. I didn't want him there. It caused a degree of stress with my DM but I think she understood in the end.
I have managed it by detaching. He is abusive, not interested in changing his lifestyle, not interested in a functional relationship with us, and has pretty much no insight.
I have however always been involved in helping out during his various crises. My parents are elderly and it has involved me taking time off work at short notice hiring various vans and clearing out his flats (in abject squalor) and storing his possessions when he was evicted/sectioned so I feel I have done my bit (and of course will continue to do so for the rest of his life)
It's so tough. You can tear your hair out trying to help them - often when they don't want it.
For me, I have detached over the years but will always be there in the background should he need help.
I really wish you all the best OP.
It's tough.

The only method I have found that has worked goteam has been to detach on emotional and physical levels. I think the process is called detaching with love. I also now have higher and firmer boundaries re his family anyway which I maintain.

I have also found that other relations who have seen below his plausible surface have actually done the same i.e. withdraw from him. I would not worry about the reactions and judgments of others to your brother if you do decide to completely walk away, that is your right and they have not walked a day in your shoes. Those that mind do not matter, those that matter do not mind.

I certainly do not think he should take up a rehab place on discharge because the will to do that has to come from him. He clearly is still not accepting of any responsibility here for his actions.

Have the staff tried to discourage your father from actually visiting his son?. I can see why your father is still trying and still looking for the right answers/magic buttons but really he is only hurting himself in the process and what he is doing is simply not working.

I really feel for your family. It's not uncommon for people with MH problems to self medicate with drugs. I have a son who used drugs, to help him cope with his problems. His addiction became a big problem, and we hade to make him homeless, at the age of 18.
I'd spent so much time dedicating my time to helping/enabling my son, I spent less time with my younger sons. The definition of insanity is repeating the same behaviour, and expecting a different result.

I discovered Families Anonymous, they have an on-line forum, litrature...Tough Love is a great booklet for your circumstances, and they have meetings all over the UK, and abroad. My life has changed for the better, a lot of our members, have similar problems to your family
My son, ended up living in supported housing for young people, where he received counselling, help with budgeting etc. they gave us our son back. He now is a student and our relationship has improved 100%.
I hope your family manage some serenity in this terrible situation

No, he was in his mid 40s but he was also living under their roof as well. His mother in particular welcomed him back with open arms.

I feel that sectioning him would not have done any good anyway although doing that would have removed him from their home for 28 days (only to return to the family home because he had nowhere else to go).

BIL is now in his 50s with no job and lives with surviving parent (FIL died some time ago).

This is also the problem. His parents too were never united enough to act in anyone's interests (even their own son's) other than their own, that is how selfish they were and they refuse to accept their part in the responsibility for how their son is now.

Hugh I'm so sorry that you have been through similar. I have done all of this things, paid deposits on flats that have been trashed. Unlike you though I think DF has tried to protect me from some of it. It must be so hard and it ISN'T your responsibility. I need to detach like you and make it clear that I'm there when needed (not for money though)

Attila your advice is invaluable and I agree with what you're saying about enabling. DB has been prevented from having to focus on things like paying bills, budgeting, maintaining a flat etc which has allowed the addictions to flourish and mental health to worsen. DF is beginning to see this but I think feels guilty about things that happened in childhood (bitter divorce, family estrangement, multiple moves etc). I am talking to him about stopping visits and just calling but I think he has sort of come to rely on this caring role since retiring even though it has been destructive. There is a bit of mutual dependency there.

Op

I don't have experience but I really would do nothing at all with him.

No money, no nothing.

I think he needs to hit rock bottom.

By blaming his behaviour on external events demonstrates to me that he is not taking responsibility for himself. Some of that is due to the assistance you have all given him over the years.

I truly believe if you all withdraw this assistance he will have no alternative but to sort himself out and grow up or he might spiral into addiction.

You can't change his perspective on his drug taking and life. It needs to come from within.

serene so glad you have your son back. You did the right thing. If someone is so destructive it can affect those around them and you had to focus on other kids. I began to get postnatal depression with my first as I was overwhelmed by demands from DB and along with the sleeplessness meant I couldn't focus on baby and then felt guilty. The ill person doesn't know or care how far reaching their behaviour is. I sorted myself out before it got bad though. Very good at self preservation! I have to be.

I will look into Families Anonymous. I thinknDB will also move into supported housing. He is early 30s though. Still time to build a life if he wants to. Glad your son is doing so well now.

I also think you need to find some emotional detachment for yours and your families sake. I don't have any relatives with serious MH problems but have seen many families become burnt out and overburdened in my job as a MH nurse over many years. I think 10 years of trying would be enough for anyone. I would concentrate on supporting your elderly father who is obviously going to find it harder to detach.

In your brothers case, unless he accepts the support when out of hospital he is just going to lurch from crisis to crisis, unfortunately some people do exist this way. You cannot force someone to turn up for appointments and engage in the process of therapy and treatment, there are community treatment orders but they still rely on some co-operation from patients to turn up. Usually the threat of going back to hospital is what makes some people take their injection for example. But as someone up thread said we cannot put someone under a CTO for poor lifestyle choices if they are deemed to have capacity to make those choices.

Sorry Op this is very very hard for all of you.

Quite sorry. I didn't mean to rubbish the opinions of those without experience it's just the first two replies were nasty and judgmental. You have empathy which is just as good and I agree with you and apart from our few offerings we have done that. Certainly withdrew the previous level of support. That's why he hates us right now though.

Great to have a professional view mrscain and I can see his life continuing in this way.

As others have said although family can legally request a mental health act assessment only the Drs and social worker can actually 'section' him. The nearest relative, which will be your father, can object to the section and ask for discharge but this rarely happens and would usually be opposed by the Drs if it did.

Have MH problems and a drug addiction is quite common and is known as 'dual diagnosis'. A person in this situation should get both mental health and addiction services support. There is a legal requirement (under S117 MHA) to provide aftercare for someone who has been detained under S3 (but not S2). There are also national policy requirements to provide follow up within 7 days after discharge because it is a known high risk period.

Please don't worry about your brother being angry and saying things about you. This is part of mania and staff hear it every day and won't take any of it to heart. Other patients might but you will have to just let that go.

Also remember that staff can only speak to you about him if he has given permission and if he withdraws that they may not be able to give you any update because of confidentiality.

Sometimes when people are very unwell we may advise family not to visit for a while ( I work on an inpatient MH unit) because it can upset both the family member and the patient.Its good for your brother to know that you are there for him but actually not good for his long term recovery to rely on others. He is an adult and he needs to face the consequences of his actions ie spend all your money on drugs = go hungry or he will not have any motivation to change. Sometimes by trying to help family members make things worse long term if they enable dysfunctional behaviours.

Your parents don't have to have him back home. They can refuse and then MH services will try to find another place. He might get a place at MH supported accommodation but to be honest these are scarce. Or the council will be obliged to house him. If your parents are elderly and frail they may be at risk from his violent behaviour. If he lives with them they would be entitled to a carers assessment but tbh I would advise that they try to detach a bit and put up boundaries eg you can't live with us (ever not even if you have nowhere else), we won't give you money (again ever, for any reason), we won't answer calls or visits at night, we won't let your friends in our house.

Im sympathetic to him but I just don't think you can let childhood experiences take over and need to let go. DB dwells but isn't interested in therapy

Even in the depths of profound mental ill health at some point there is the choice to take responsibility for your own self.

If life is tough enough that you do develop mental ill health, even severe mental ill health, you do still have that choice. Ime people who try (even erratically, even failing often) to take responsibility for their own actions have a much better chance of recovering to the point of having a stable and hopefully reasonable-quality life.

As you know, you cannot do that for him. The pain that leads him to make choices that are destructive can be intense, though I can't help also feeling that the choice to drink too much / take drugs is often self-indulgent too. No one can magic that pain away.

Also (and I know what I speak of here!!!) dwelling on the past too much is destructive. Even worse if you start blaming everyone else for your woes.

I think you are right, you have to concentrate on your own family and to protect your children (your poor toddler, she is afraid of him :( ).

Phone calls seem reasonable. But not more. He is a vulnerable (and from the sound of it incredibly selfish) adult but you cannot be dragged down by him. Until he is willing to face his own self-pity and anger and entitlement, he's not going to get anywhere. Hopefully one day he will.

I don't think he wants a normal life meerka~ he thinks we're square and borng for wanting normality, 9-5s, family, holidays etc and has always been drawn to nihilistic pop culture and thinks he is some sort of visionary (posts what he thinks is profound thoughts on Facebook but is just mis-spelt twaddle). I think he sees his life as bring quite 'rock and roll'. The rest of us see it as being very sad.

I know. Poor toddler. She is a tough cookie, afraid of nothing but him. Even when he is 'well' he talks erratically and frantically and calls us stupid 'you wouldn't get it' sort of thing 'you don't know anything'. I have a Masters. DB thinks he is the oracle and belittles rest of family's intelligence. Not a nice person, mental health aside. Love him but don't really like him. Not someone I would choose t be friends with.

Thanks mamadoc he is on S3 so good to know about aftercare end thanks for reassurance about ignoring anger etc.

Also if he is detained under section he has an absolute, legal right to an advocate (an IMHA). They have to provide this service by law.

If he is not detained now then advocacy will come from an outside organisation eg MIND. Advocates aren't employed by the hospital (or they would not be independent) but it would be very poor practice for patients not to have access to an advocate.

It sounds like your dad could really do with support to manage how he reacts to all this. Possibly Age UK or one of the charities for family members of addicts eg AlAnon could help.

There legally has to be a S117 discharge planning meeting held before someone detained on S3 leaves hospital and that would be really good if you and your dad could attend that (with your bother's permission) as you could then know what services DB can access and make it clear what support you, as a family, will and will not provide.

I would absolutely not send him any more money either. All you really need money for in hospital are cigarettes and maybe some snacks, magazines, toiletries, phone credit. Although it should not be possible to get drugs it can happen if other patients who are not detained or visitors smuggle some in. People having a lot of cash in hospital is just a major headache because it can get stolen too.

Obviously I would never criticise his writing to him. Just venting on here!

Thanks mamadoc. I'll ask about an advocate as I asked DB who said no. I guess he wouldn't want one though. Thanks for detailed info on section. That's really useful.

The money was for items mentioned and I sent it as he is getting used to reduced benefits although they were all spent on drugs before section so he should be loaded. I won't give him any more.

You know the 'visionary' ramblings and superior attitude might all be due to illness. Symptoms of mania include grandiose ideas and disordered thoughts.

If he has not had a sustained period of treatment and has been out of it on drugs a lot you might not have seen him really well for a long time. Was he like this when he was young, before he was ill?

I say this because sometimes being detained can be something that people look back in retrospect on as a positive. It can be the 1st chance for a sustained period of treatment. It would usually take 1-2 months of treatment to get well and maybe longer if the 1st meds aren't right. Obviously the hope is that when he is well and thinking clearly he realises there is another way and wants to accept support and rebuild his life.

Self preservation first! This is important.

Talk to Social Services about any concerns you have about the welfare of your DB or your parents.

Keep your DB away from your young family. Never under any circumstances let anyone who takes hard drugs and drinks excessively near your family, whether they have MH problems or not.

Don't under any circumstances give him any more money.

Make up your mind what you can and cannot do. If you feel okay about phoning him once a month or once a week then do so. If however, you feel the only way you can cope is by detaching yourself completely, then do so. Your MH is important too, so you mustn't feel guilty. Do what you can but put yourself first.