BIL not leaving the house for 2 years?

[NorthernLass844]

Can anyone advise on how DH can help / advise his mum about a situation with his brother, who seems to be agoraphobic and hasn't been outside in years? Not sure if anyone who works in social services, or mental health might read this but we are at a loss.

Basically, DH's younger brother is 25 and still lives at home with his Mum (my MIL, divorced, has 4 adult children). DH is 10 years older and we live about 6 hours away so they are not particularly close. At 17 BIL dropped out of 6th form and basically has done nothing since then. At first MIL tried to encourage him to get a part time job in retail but he hated it due to social anxiety. He then went on benefit, but that was stopped after he stopped looking for a job. He now, literally spends everyday all day in his bedroom watching things on his laptop. MIL says it's always the same science fiction animation series. She doesn't think he goes online.

Most worryingly, since 2018 he hasn't been out anywhere, and since the end of 2019 he hasn't set foot out of the house even for a walk. He refuses to do so. MIL has tried to encourage it but he went out less and less and now refuses entirely.

BIL barely speaks and when we visited for Xmas he mumbled hi and that was all I heard him say. MIL made him come downstairs and see DH when we arrived but as soon as he could he went back upstairs and stayed in his room.

MIL cooks him dinner every night and he eats it alone in his room. He goes to bed early and gets up early apparently, but just stays in his room. He doesn't drink or do drugs, has no friends and has never had a relationship.

Due to Covid, DH hadn't seen BIL in person for a couple of years and was shocked at how much he had declined - before he used to come across as painfully shy but now he's just like a lost invisible soul.

Over the years DH has tried to talk to MIL about BIL. He encouraged her to take BIL to the GP some years ago and ask for a referral. MIL says BIL is currently on a waiting list for therapy but BIL doesn't want to do it and so much time has passed.

DH has tried talking to MIL but she seems quite blinkered about how bad it is. She likes having BIL at home and feeling needed, thinks DH.

Anyway after seeing poor BIL over Xmas DH and I would like to try and help him but have no idea of the best next step. It's obviously not our place to stick our noses in but at the same time seeing the situation from a distance means that DH can see how bad things are whereas MIL seems to be oblivious. DH is really worried about BIL, his mental health, his physical health and the future for him. Basically MIL wasn't able to go on holiday this year as she was worried about leaving BIL and what he would do if the house burned down - would he stay inside. So she is essentially his full time carer. However when DH raises this she brushes it off or just says BIL is very shy.

Can anyone suggest anything?

Oh gosh, he needs to recover with the help of the community mental health team. His mental health should be taken seriously as it's clearly impacting significantly on his life. They will visit him at home if he can't leave the house. I have worked alongside a handful of clients with similar conditions and treatments can work really well. Sadly, it's not uncommon in young adult men. I would suggest that you find information about social anxiety disorders and depression so that he and his parents recognise this for what it is and acknowledge that it needs therapeutic input. Good luck

Has he been tested for SEN ever ?

Yes he was apparently "on the spectrum" but that's all we've been told. But I work with a number of people with Autism and don't recognise any of this behaviour. MIL seems to think this is the reason behind everything.

Oh this is so sad, he sounds like he needs help and your MiL is so ingrained in his behaviour she can't see it. I'm not sure what else you can do to force the issue. What do his other siblings say?

@Whatabambam thanks- he is currently on a waiting list from GP for therapy. How would we access the support you describe?

@AngelonTopoftheTree

Oh this is so sad, he sounds like he needs help and your MiL is so ingrained in his behaviour she can't see it. I'm not sure what else you can do to force the issue. What do his other siblings say?

To be honest they seem oblivious too. There's a lot of dysfunction and everyone follows MIL's lead. Also my DH is the only one who moved away so he has more of a perspective I think - they are all living close by and spending time at MILs etc. The BIL's situation has been normalised.

You can ask the GP to refer him or make a self referral directly. You should be able to find most information that you need from the website of the NHS primary care trust in his area. Have a look at the Mind or Rethink websites too as they have some useful factsheets. An assessment with a mental health professional should then follow with a plan for treatment. You might need to be his advocate if you feel that he is not being offered enough support. There is definitely less parity between mental health and physical health but if you consider the enormous impact of his condition on his lifestyle then you could almost equate it to him having such poor mobility that he can't leave the house. Use this measurement to help you understand just how much help he should be entitled to if he was housebound due to a physical disablement where he would quite possibly be seeing orthopaedic surgeons, neurologists, OT and physiotherapy. He deserves the same care from the mental health team (I know that in reality the mental health service is under resourced and this does not happen in practice but it's the logic behind it that is useful to hold on to).

Look up Hikikomori Syndrome

Your BIL's and MIL's behaviours have have carried on for so long and become so entrenched, that they can't see what's wrong.

They've completely normalised it and convinced those closest to them that it's OK.

Your MIL is enabling your BIL, almost as if she were a feeder and he was one of those 600lb patients that Dr. Nowzaradan treats in his clinic.

They both need help.

He needs professional support, my neighbour had intensive intervention to get her to leave the house then into volunteering, finally into paid (admittedly part time) work - took 3 years in total. Is mil willing to basically call the gp

You also need a painfully honest conversation about what happens when she dies / cannot look after BiL. If she’s expecting you to step into the breech and you cannot or will not then she needs to come up with a plan:

This needs to be sorted before the MIL dies or is unable to look after him.
Such a sad situation for him.

Bloody hell.

In the first instance, I'd be considering how his physical health is. He must be deficient in vitamin D. And, who knows what else.

Secondly, I think your DH needs to get his siblings on board. They have to know what the situation is.

As for his mental health, I suspect this is going to be the most difficult thing, because his mother is enabling it, even co-dependent?

What a sorry situation. I hope he gets the help he needs

I suffer from GAD which at its worse meant I couldn't go out the house.

I personally think part of your problem is going to be covid. First of all spending 2 plus years on the waiting list to be seen when you are not suicidal is the norm.

For me when the government announced the first lockdown, my brain went click and all I had was see I was right, you shouldn't go out.

Before then I was doing really well and I think for the first 3 months of lockdown I didn't go out and got worse, which made my depression so much worse.

I think your best bet is to see what private help you can get for him, also trying to get him to apply for benefits, like PIP and ESA (don't think its called that now.) The forms are a real shit to fill in but they do really highlight what you can and can't do, so that might help putting it into perspective for your mil

But, ultimately he is an adult and can tell you to fuck off

Nothing will improve until MIL changes her behaviour somehow. It's not her fault but she is definitely enabling him.

It's illegal but I know a couple of people like this and they started microdosing...not sure if it was LSD or truffles.

They're both changed men now, they're working, have relationships, social lives, confidence etc.

Sounds like my Autistic BIL.

One obvious question. His benefits stopped when he stopped looking for work? So who is actually funding him? I'm guessing the mother is having to pay his way for him?

@MirthlessChuckle

Nothing will improve until MIL changes her behaviour somehow. It's not her fault but she is definitely enabling him.

This. And it's so ingrained I have a feeling you might find she undermines any attempts to help. Obviously he's not providing for himself so she will have played a large part in his predicament and might not want to let go.

@NorthernLass844 My advice is to do something different to his regular routine inside the home first. Change will be hard, so taking it slowly step by step is key.

As an example: If he spends all his time gaming, could you get him a lego set to complete?

Oh my god this is so sad he can’t be happy . First of all I agree something needs to be done he can’t just stay in his room indefinitely he needs help . Your mil is brushing this off which is just not healthy perhaps encouraging her to get some help for him as this isn’t caring for him it’s making him worse .

Its good you want to help him though I agree with your MIL, as a mother of an asd child, That sounds very much like autistic behaviour when very anxious with it and it will not be your MIL causing it, I very much doubt she wants him like this, sounds like she is doing what she can to look after him but he must now have extreme anxiety, may have been lockdowns triggered if asd. Very common for asd not to work and if he is almost mute unlikely he will engage with professionals, you could try. If you can afford it and he will engage a private asd assessment would at least confirm asds suspicions or rule them out. And the methods for social anxiety and autism are not that different as autism causes anxiety so not sure it is vital to get, what is important is you work with MIL and I would not get into is he asd or not debates just a plan to improve things. If he wont see professionals it maybe you and MIL could see one and work out a way forward, realistically may well need to go private otherwise wait 2 years or so.

I would try to tackle one thing at a time, tackling everything at once will be too much. Use like a cbt approach of exposure gradually to fears. I would start by trying to get him to go out, you might start this by as little as week 1 get dressed every day, week 2 stand outside, week 3 walk to end of road or go in car for a drive and return, week 4 say go to a shop buy 1 item or go for a drive, get out for a minute and build up.

Speak to him and ask questions as you would normally, try not to answer for him but do not react if he speaks or does not speak as that will make him more anxious as its pressure to speak. Try and work with your MIL as she needs to be onboard, maybe phone autism charity for their advice, and work out a plan together. Whether its autism or a mental health issue like social anxiety the methods are similar. For getting out if its autism special interests help so if loves animals a zoo. Progress will be slow as its taken 2 years to regress, it may take that long to fully recover, hopefully not but just be realistic. Lockdowns wont have helped. My son is a bit similar but younger and it was the lockdowns that led to his decline, being asd he took the rules very seriously. He will not speak to any professionals, we have got him going out again, and he is speaking a little, he met up with a friend for first time recently, he goes to school everyday so does go out to that. Its very difficult, the professionals say its autism with extreme anxiety. Its good you want to help him, it may even be worth going straight to do you want to come out to x with us to him initially and see if he says yes, if not the steps.

Thanks for all the suggestions. Looking into everything that has been suggested. It's really tough with the MIL though as she is the link and without her onboard we don't know what we can do. BIL won't see a GP and MIL downplayed it all to her GP.

Fellow agoraphobe here (secondary to ocd for me)

Unfortunately waiting "on the list" is pointless!

He and mil need to show local services they WANT the help and push for it! Otherwise they will be ignored as these services are SO overstretched at the moment!

Gp should have AT LEAST put him on anti anxiety/anti depression meds as a start to get him starting to get better before therapy begins.

Therapy can be done remotely (phone/video call) or by home visits

There are also helplines and online forums

How is mil and he doing financially? Is she having to use savings to support him?

Even if things are fine he IS eligible for disability benefits inc pip which I get. Mental illness is JUST as valid a disability as any other.

If a more full dx re asd can be achieved that will help too

I would urge you - from the other side - to address this as soon as possible as the longer it goes on the harder it is to overcome

Does bil have a phone? Could your dh call him weekly as sounds like he hasn't much contact. Or do a Zoom catch up/ game together online while they chat. This might help him develop some social skills.
Going privately for help is very difficult as everytime you need another professional it's more money while you get into the public system you can access all areas. It's a shame he has been waiting so long but maybe the family need to start creating a stink contacting MPs or whatever. His GP should be fighting for him.
I presume he is getting a disability allowance.

My SIL also dropped out of college and has no GCSEs but she is able to go out of the house and travel. She is 23. She does eat with us and talk to us. But what worries me and DH is that she doesn't have a job or an inclination to get one (she feels she is working as she writes online and earns a few hundred from that plus claims UC). She also doesn't interact with anyone who isn't family. Her mum doesn't see this as a problem.

OP I have no advice but following this thread in case anyone has any advice. My SIL used to refuse to eat with us too and would often stomp out of the room after 5 minutes cos someone said something that angered her. I find that what helps is treats. If he likes anything, offer to take him out on a treat. DH's sister is so happy when we buy her favourite food, her mum usually can't justify the cost so she really opens up. Also give him things that are 'his', my SIL was territorial about food. I know it's not good to encourage it but I tried to buy her specific items she liked and she felt more included and liked.