Need help for friends' daughter

[sgtanthony]

We have friends of the family whose 40 something daughter has severe schizophrenia and is bi-polar.  She was not always this way.  They told us it started coming about 5 or so years ago.  She has completely lost touch with reality, is refusing to eat most of the time because she says the good is contaminated because her parents touched it and is losing weight rapidly becuase this.  She is paranoid and hallucinates.  She has been held on a 5150 two times, after her parents were force to call the police due to her behavior, but the mental health facility she was at had to release her, because she refused to submit to blood work.  They said they need to do blood work to prove she is not taking drugs, but to also test her for any condition that may be making her ill, i.e. brain tumor, stroke, etc., in case there is something physical causing her mental health problems.  They said because she refuses this, they have to let her go after the three days.  They have no choice but to let her come back because they don't want her out roaming the streets.  They've just resigned to the fact that they are stuck and will probably watch her die, since no one is willing to help them.  I don't understand this, as I have never heard of having to have a mentally ill person's permission to run blood work on them.  When someone is critically ill or injured in the hospital, they don't wait for their permission to run it.  Does anyone have any suggestions on what they can do to force her to get help or force the mental health facility to hold her past the three days?  They agree that she is very sick, but say they legally cannot hold her.  She is in major denial that she is sick.  They live in California.  Thanks.

[sgtanthony]

The thing is, (and I don't know the whole story), but they had to call the police on her because she was so out of control.  The police actually were forced to do an investigation on her, because they suspected she had committed elder abuse on her parents (don't know if she did or not).  She is verbally abusive, tells them how much she hates them, how they are making up lies about her and refuses to go outside because she might infect someone with a non-existent infection she is Claims she has, even though every doctor she sees about it tells her it's just an allergies.  Her family is not putting labels on her.  They are simply going by what the doctors have told them.  The thing is, I know you can have someone committed if they are a danger to themselves or othersm so why doesn't she qualify?

[lori314]

Maybe also because the police were called she scared to do blood work. Speical sence she is having the problems you mentioned. I had to.call ambulance for a friend that passed out her they couldn't  figure out what to do for him. Then the police man asked me if he did amy drugs.  He said not to get him in trouble they needed to know. I didn't  know for sure. I said its possible. They knew what to do then. And he was awake in seconds. But he was close to death. His friends said to ambulance and police he didn't  do nothing. But i think he did not here with me but before he got here. I didnt know for sure. So maybe she is worried about the blood test. And the police.

[lori314]

I was thinking maybe she could contiue to go to doctor and go to day hospital.  Not over night. And she'd home at night a friend of mine whent to day hospital. And maybe they won't  let her unless she takes her meds and they feel.she is stable. She needs to trust someone. And that maybe know they just want her to.feel better and be well. Be kind to.her. but she could still see her doctor and get her meds. I think its what the doctor says I guess.

[lori314]

I have heard they can refuse meds. And if she sign her self in she can sign herself out. If she has family they cn go to i think a judge and have her i say put in hospital  . My frien did that to get her son whose over 40yrs old to get help because he was on drugs.it has to be family member. Husband wife can i guess mother dad bro sister. Daughter Son maybe i am not sure

[thatquietgirl]

I would imagine something like that would be a clear reason to make a case for keeping her under hold for further observation.  That's a lot of weight to lose so quickly and just eating as a reaction is certainly not proof of "recovery," if you will.  Granted, I'm certainly not someone studied up in the nuances of this.  I've never had need to as I've been of the mind that seeking help when needed is better than letting it get so bad I can't function.

And no, you can't force a person to take medication if they refuse.  Medication refusal is actually quite typical of many mental illnesses.  These medications feel awful at first, speaking from experience, and it takes a person who's determined to see change to stick with them beyond the first few days to see the side effects subside.  Besides that, if you're on a manic high, it is very difficult to deal with suddenly feeling like a zombie.

You also can't force a person to seek help, and even if you push the person repeatedly to the point they're finally like, "FINE!" and go, no real change will happen.  Your friend's daughter will have to reach the point that she feels she needs help before any real change is elicited.  

Something to consider: I would evaluate language you use around this person when trying to convince her to seek help.  

"Can you force them to tske medication if they refuse to?"

Seems like she's going from a person to a statistic/stereotype/something negative in the language shift there.

A person is not their illness and clumping people living with mental illness into this big lump sum of "them" makes it sound like this line of distinction, like somehow better than the person living with the mental illness.  All it is a brain chemical imbalance.  If your friends or you use such language nuances around their daughter, it's typically not missed by someone who is currently not in a good place (or even if the person is in an ok place, it can bring them down or trigger).  Being treated as though something is wrong or they are different can also be triggering to a person living with mental illness.  A simple, "I'm here if you need me," goes a lot further than constantly having it brought up.  

I don't know if this is the case, but it's something to keep in mind.

[sgtanthony]

Well the first time they had her taken in, she wasn't eating at all and got down to less than 90 lbs.  after they told her they had grounds to keep her there unless she startrd to eat, she finally started eating.  Unfortunately she has stopped eating agsin except for crackers and she weighs less now than before.  The doctors tell her parents Thst they can clearly see that she is mentally ill, but without the blood test cannot hold her.  If they can see she is clearly mentally ill, isn't that grounds enough for keeping her longer?  Can you force them to tske medication if they refuse to?

[thatquietgirl]

72 hour hold for 5150 is standard unless the patient needs more. However, I would think 72 hours is enough to disprove drug use.  A lot of drugs get out of the system within that time frame.   She must not appear a danger to herself or others at the end of the 72 hour hold for them to have grounds to hold her longer.

As to the bloodwork: A mentally ill person can be in need of a 5150 hold yet still aware enough to make calls regarding their health, so they have to provide permission, where as a critically ill/injured person may not.  If someone has blacked out, for instance, there's implied consent while they are unconscious but if they wake up and are able to prove they have control of their facilities (name, date, president, etc.), then they must make further calls themselves.

Unfortunately, until she either makes it undeniably obvious she is a huge danger to herself or others or decides to get help, there's little you can do to my knowledge.