When a Loved One With Schizophrenia Refuses Treatment

When a loved one with schizophrenia refuses treatment, even when their symptoms are getting worse, it could be time to look for additional assistance. If they don’t have a conservator, it could be very challenging making them do something they don’t want to do.

The initial steps to getting a loved one with schizophrenia help is convincing them that they need it. Many people who have the illness are unable or go in and out of thinking rationally. They might not realize they need to receive treatment if they aren’t aware they are ill, as about half of the diagnosed population have anosognosia—the definition when someone doesn’t realize they have a serious mental illness.

People who have schizophrenia often have symptoms of hallucinations or delusions, which may “tell” them what to do. It is a mistake to argue with a loved one with schizophrenia by saying “that doesn’t exist” or “that’s not the truth.” Try supporting them calmly and without judgment.

Take a step back of offering too many suggestions and focus on a specific challenge which is a secondary symptom to mental illness such as being tired, or not feeling physically well. Additionally, they may be more willing to go see a doctor if they feel in control of the situation. Give them a choice of doctors, perhaps different geographic areas, or a choice of who might go with them.

These approaches can be a way to get your loved one to see their doctor.

Developing an easy to follow treatment plan and helping your loved one with schizophrenia stick to it works only when they are willing to participate. If they have been diagnosed and are working with the appropriate healthcare professionals, an individual guide to their treatment is necessary. Part of the plan should be that they take their medication when it’s prescribed. Creating a visual reminder chart can help. Helping with appointments with gentle reminders or going with them will create consistency.

You can discuss with your loved ones what their immediate and short-term goals are, which can assist in plan development, and help them feel that they are more in charge of their life. If they still meet with resistance to going to appointments or taking medication, remind yourself that this is a process of recovery, it won’t happen at once.

Learn everything you can about the illness, different methods of treatment, and attend support groups. A terrific resource for information on mental illness can be found through The National Alliance on Mental Illness (NAMI.) NAMI offers family free family courses for caregivers of people who have mental illnesses.

Reach out to treatment centers in your area who have a structure for treating primary mental illness for possible help options, resources, and information.

When your loved one has entered treatment, a team of family and friends can design a plan for support. This can help those around them to not “burn out” as they provide care. The support team, (whether it’s 2 or 10) can be on the lookout for signs of relapse. Schizophrenic patients often exhibit symptoms when they have stopped taking medication. Signs can include:

• Disorganized thoughts
• Hallucinations
• Delusions
• Suicidal ideation
• Withdrawal and isolation
• Difficulty with communicating
• Bizarre actions

When your loved one is receiving treatment, offer support while not trying to “fix” everything. Allow them to be able to do small steps for themselves, which will create self-empowerment and be the beginning of independence.

Offer to do things they like with them, such as exercising, music, art, or going to a movie with them.

• Create time to be able to talk without distractions with your loved one: turn your phone off, don’t multi-task, don’t overwhelm them by having too many people around, or noises.
• Allow for silence. If they are not talking, try not to chatter just to keep the conversation going.
• Ask open ended questions such as “what makes you afraid of taking your medication?” rather than “are you taking your medication?”
• Stay emotionally stable and calm. Try not to exhibit strong emotions, as it can trigger someone to feel unsafe.
• Apply active listening skills. By repeating in your own words (not parroting) what they say, your loved one will feel heard.