Ask the Doctor: What If My Family Member Refuses Help?

A relative of mine clearly needs psychiatric help, but he refuses to see a doctor about this. What should I do?

Unfortunately, this is a very common problem. Sometimes people who are clearly suffering from psychiatric illness don’t themselves recognize that they are having problems, even when this is readily apparent to their families. In other instances, the person may feel ashamed to acknowledge that there is a problem, or feel afraid of what treatment might entail (including fearing possible hospitalization), or feel concerned about being stigmatized because of obtaining mental health treatment. There are many instances when people really know they need help, and may even want it, but can’t or won’t get it without guidance and encouragement from others.

If you have a close relationship with this person, the first thing to do is to try to discuss with him your concerns, gently giving examples of what he has said or done which have made you alarmed. Try to do this in a calm, supportive, and non-accusatory manner, and suggest that he see a psychiatrist or other appropriate mental health professional for an evaluation. Try and convey that you are only suggesting this because you care about him, and be reassuring that the professionals he sees will be knowledgeable and compassionate people genuinely trying to help.

If speaking individually with him doesn’t help the situation, or seems unfeasible, another approach would be to have several close family members or friends meet together with your relative to similarly express their concerns and suggest the need for evaluation and treatment. Sometimes it is helpful to offer to take the person to see a mental health professional, or to accompany him.

If you fear that your relative might be thinking of suicide, or might be violent, clearly there is much more urgency to his getting professional help. In these situations, or whenever serious psychiatric illness is suspected, one option is for you, perhaps accompanied by one or two others, to simply drive the person directly to an emergency room (where psychiatric evaluation is typically available). If you can’t do this, or you fear your relative wouldn’t cooperate, another option is to call the police. In Maryland and many other states, the police are legally obligated to take people with suspected mental illness who seem endangered or dangerous to a nearby emergency room so that a medical and psychiatric evaluation can be performed, and appropriate medical care can be provided.

Another option available in Maryland is to go to a district court and fill out a form called an Emergency Petition. Once this form is filled out, it is given to a judge or magistrate, and a hearing is held in which the judge may ask you some questions about your family member. If the judge/magistrate becomes convinced that your relative might have a mental illness, and might be in danger of immediately impending self-harm or violence, the court official can compel the police to take him to an emergency room for a medical and psychiatric evaluation.

Sometimes, when it seems very hard to know the best way to get help for a family member, it can be extremely helpful to make an appointment with a psychiatrist (without the relative being present), explain the situation, and receive professional guidance about how best to proceed.

Going the extra mile to get a relative needed help is an expression of great concern and love; frequently, at some point the family member realizes this, and ends up feeling extremely grateful.

Posted in Ask the Doctor Q&A.