Schizophrenia and Delusional Psychosis

Parent Q&A

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  • Hi parents and caregivers, 

    Has anyone used the services of the In Home Outreach Team of Bonita House?

    https://bonitahouse.org/in-home-outreach-team/

    We are looking for help and support with a young adult who is hearing voices and talking/ yelling to the voices, but refuses to get help. 

    Since he refuses to get help we need psychological services to come in, so we can figure out the next steps to get  him help and to find an alternative living situation that would be supportive of his serious mental health issues/condition.

    Please let us know if you have worked with Bonita house or if you have any other recommendations of advice on supportive living situations for psychiatric adults and how to get someone into them, who refuses to admit that he needs help. Please include any recommendations of psychologists or psychiatrists that will come into your home.

    Thank you 

    Sean 

    Hi Sean, This is very tough and you’re not alone, in the least. I could be wrong, but my understanding is that the IHOT teams, whether it be through Bonita House or another CBO, is for Medi-Cal clients/patients or those without insurance, so ensure you have that in place first for your son, if not already. Also it is generally para-professionals that are attempting to engage people into services, and it really depends on who is assigned (I have no recommendations in that case), as most programs, of how diligent they will be in attempting to engage. I’m not sure if you’ve been provided these resources, but the Family Education and Resource Center (FERC) in Oakland and National Association for Mental Illness (NAMI) which has an Alameda Co chapter is available for support to families struggling with getting their family member treatment as well. Good luck.

    As the parent of a child with serious mental health issues I have some experience with similar situations. There is a new mental health team in Berkeley that can help in times of crisis. The Berkeley Specialized Care Team (510) 948-0075.

    However unless he is 5150’d (admitted by emergency to the hospital) for being a danger to himself or othered, he cannot be “forced” to get help. Even then they cannot forcibly medicate him except to calm him initially. I would encourage you not to take this route unless absolutely necessary as it will no doubt cause trauma and impact your relationship going forward. I would seek out the opinions of others who have dealt with these symptoms and those who have associated diagnoses to seek direction. I know this is hard and also finding support for yourself is very important. 

    Hi Sean, the Felton Institute has a program for people who are in the early stages of hearing voices. I think some of their staff have lived experience. It sounded like a great advance in treatment and good outcomes. I don't know the specifics or if they will go to the home but maybe your child would be more willing to talk to someone who has experienced the same thing. Good luck.

    I think National Alliance on Mental Illness aka NAMI has resources.  https://www.nami.org/Home

    I just realized here is the NAMI page fir family and caregivers… 

    https://www.nami.org/Your-Journey/Family-Members-and-Caregivers

    This is such a hard situation. I recommend reaching out Sascha DuBrul, he has a lot of experience working with young people experiencing these issues. He was enormously helpful to our family. If your child isn't willing to speak to someone, he was able to offer us guidance and advice as parents. He has lots of experience working inside and outside the mental health system, and has lived experience of extreme mental states himself as a young man. his website is https://www.saschadubrul.com/ 

  • Hi Parents/Caregivers, 

    We are looking for recommendations, please, for a psychiatrist and/ or psychologist that does home visits to assess, provide treatment/ recommendations  for a 35 year old, who has serious mental health issues. This has been going on for a while, talking to himself, having conversations with people in his head.

    We would be happy to meet with the Psychiatrist/Psychologist prior to a home visit to provide background history. 

    Please let us know if you have any recommendations.

    Thank you very much,

    Sean 

    Hello from a friendly family physician. You need a physician psychiatrist ASAP. I would advise you to either call a major medical system (like Sutter) or call your health plan and ask for help with either an urgent telemed visit (more likely) or home visit (less likely), if you really cannot get to the clinic at first. It’s probable that they will advise you to come to urgent care or the ER to at least do a basic exam and blood work ASAP. But, if you can get a telemed appt, you should know that this evaluation does require a phhsical exam and blood/urine tests soon. Having conversations with people who are not there is a form of psychosis or delerium. The brain is having a problem, and there are a lot of potential causes. Delerium can be from a thyroid disorder, liver failure, or a brain tumor, as examples. Psychosis can also be from a primary mental health disorder, like bipolar disorder, severe depression or schizophrenia.

  • A young man I'm acquainted with seems to have signs of schizophrenia (paranoid delusions, hearing voices). Was wondering if anyone has had experience with the meds offered for it. He's alienated from his family (not uncommon). He recently checked into a hospital at the urging of a friend and was put on Haloperidol, I believe. I was going to reach out and offer some support/advice, since he's fairly alone in this. Obviously he needs to also continue with professional help, but in the meantime I'd like to become better informed about people's experience with medications and treatment. Incidentally, I should mention that this kid smoked a lot of pot i his teens, and there's been a recent study connecting teenage pot usage to increased incidence of schizophrenia, sadly. Thanks.

    Hi. In Alameda County, check out prepwellness.org. Other counties in the Bay Area have PREP programs as well. 

    I've had to learn a lot about psychosis and schizophrenia over the years because of a close family member and think this organization is doing great work. 

    Yes, this happened to a friend of mine! A young man, 29, who had smoked a lot of strong pot. All of a sudden he started spouting conspiracy theories -- it sounds funny now, but he literally thought the French were planning an attack on San Francisco! (I told him that a) the French are too xenophobic to bother wih us , and b) if they did come, the food would get better. By the time he got to his mother's house for Mothers Day he was hearing voices. I had called ahead and warned her that he was going down and needed serious help.

    His family immediately sprung into action and had him (involuntarily!) hospitalized. He was given anti-psychotic medication and miraculously returned to his old self. There are many that work well, but it's a bit trial and error.

    The challenge is to get the person to KEEP taking the meds. If they don't, they go off the rails.

    It's fantastic that we live in a day and age where these people can be helped. You're a good person to want to be involved, and I encourage you to continue. These people are a suicide risk if they don't get the meds they need.

    My friend, alas, stopped taking the meds and ended up homeless for a time. But things are better now.

    Haldol is a very old drug that works but has lots and lots of side effects.  There are better ones now and obviously it's not a one-size-fits-all situation.  That is, Haldol may not work for him. Hopefully, he has some kind of insurance that will cover his treatment.  It's a medical condition like any other and needs good care from a specialist trained in psychiatric disorders. Best of luck to him.  It's a terrible disease.

    Oh, and btw, I haven't read the studies but it's possible that the link between teen pot usage and schizophrenia is more a case of self-medicating against the early symptoms, and not a cause of the disease.

    There is an organization called Prep (prevention and recovery in early psychosis) which may be helpful to you in your efforts to learn more about this issue. (https://www.askprep.org/about-us). If there is appropriate intervention when young people first start to show signs of psychosis, there is much greater chance of better outcomes. 

    This particular organization is just for alameda county but if this young man lives outside of Alameda County, they could probably direct you to similar organizations in other counties. 

    It's really kind of you to reach out to support him. Good luck to both of you, 

    My brother had a delusional psychotic episode a few years ago that was very like schizophrenia, but he was in his early 50s. He was a small-time pot grower and a heavy user since his teens. He became convinced that members of a worldwide drug conspiracy were trying to kill him, and were following him on black motorcycles. He was so distraught that he abandoned his home in central California and came to stay with me here in Bay Area, but he left abruptly after only two days because they were following him here, too.  He then went to live on the UC Santa Cruz campus, sleeping under a tree. After a few weeks of alerting UCSC police every time he saw a black motorcycle, he was hospitalized involuntarily. He felt very safe in the hospital, although when he was released a few weeks later he asked us to rent a helicopter to pick him up from the roof since motorcycles were circling the hospital waiting for him. It sounds funny, but he really was terrified.

    The doctor at the hospital told me that they regularly see patients who are heavy pot smokers suffering from schizophrenia-like symptoms (my brother had given me permission to talk to his docs, otherwise I wouldn't have known about this.) I then did some research on my own and found studies that showed that some percentage of the population is susceptible to psychotic episodes from marijuana use. I remembered from my own pot-smoking days how some of my friends would say that pot made them "paranoid" so they didn't smoke, and I stopped smoking pot myself in my late 20's after having what I now realize were panic attacks while I was high. So I knew that getting high is not trouble-free relaxation for everybody, but I really did not know it could cause psychosis in some cases.  By that time I had already raised two teens thinking that pot was far less harmful than alcohol, and looking the other way when they went out back to smoke.  My brother served as a powerful counter-example to our previous beliefs.

    Fortunately, my brother stopped smoking pot. He was on anti-anxiety meds for a year, which calmed his fears enough to be able to live with us, and for a year we watched over him and tried to get him back on his feet.  Eventually he was able to resume an independent life, although there are certain areas of conversation that we avoid, because he still believes the drug mafia was after him back then, but for some reason they have now lost interest in him.  His doctor told me she didn't know if he would get better, but he did.  So maybe that means that if your friend's son's psychosis is caused by marijuana, it can get better by stopping marijuana.  I hope so.

Archived Q&A and Reviews


Questions

Bad living situation for husband's schizophrenic sibling

Sept 2010

Hi, To make a very complicated story short-- one of my spouse's siblings is schizophrenic. Over the past few years, the sibling has lived with various family members, and has various degrees of success with each. The sibling was recently living with one family member, when another family member who didn't like how he was being treated, went behind his guardian's back and somehow got guardianship. While his previous guardianship situation was not good, it was better than this. He does not have his own room, they are convicts that sell drugs out of their Section-8 home that they share with two children, and a prostitute. He has no room, and they use lots of drugs. They dabble in all kinds of fraud. I am appalled at the situation, for both him, and the children. No one in my spouse's family wants to get involved because no one is a position to to take her children or to have the schizophrenic sibling live with them.

My soul is deeply troubled, however. I am constantly reading articles about schizophrenic people who have meaningful lives, when they have the proper treatment and environment. I want so much better for him (and of course for the children.) Evidently, my brother-in-law only gets about $700 from the state, which is not enough for him to live off of. What resources are available? Who can I call to report the situation ANONYMOUSLY?

I have discussed this matter with my spouse many times; my spouse agrees that the matter is deeply troubling, but since we can't have him come live with us (we have two young kids in a small two bedroom apt) he doesn't want to rock the boat, and NO one wants to deal with his guardians-- they are a special kind of evil. Does anyone have any helpful suggestions on what can be done? Can't let this go on...


Please call Child Protective Services immediately on behalf of your sibling's children. I had a schizophrenic mother and grew up much like the children you describe- in the process experiencing sexual abuse from strangers who we lived with, terrifying situations dealing with my mother's mental illness, and struggling with no one feeding me, bathing me, getting me to school, etc. Even though my mother's sibs, neighbors, etc. were aware of what I was being exposed to, no one ever intervened to get me out of her care. Finally at 10, social services intervened on their own and placed me in foster care, but by that time I had experienced so much trauma and instability that it has taken me years just to feel functional. I will be forever angry and sad that none of the adults involved cared enough to stand up for me as a child- that the concern was for her as an adult and not making waves. As a grown up who is aware you have an obligation to stand up for those children who can not take care of themselves and GET THEM HELP! Schizophrenia is devastating, and yes it's an illness, but children deserve to have a childhood and to be safe and stable. You can make an anonymous CPS call- and keep making those calls until the kids are safe. CPS will also refer your sib to other services that may be helpful (but given the nature of schizophrenia may not be either). I'm all for mental health patients having rights and freedoms, but not at the expense of ruining innocent children's lives. I've been there


You can call adult protective services and report anonymously. You can also call police non-emergency number and explain the situation and they should be able to help. If there is a court case, it can be re-opened by the previous guardian with this new evidence. anon


Sounds awful! It is clear that the new guardians only took guardianship (and how that happened without the former guardian being involved, I wonder about the legality) for the $700.

I have two suggestions: Adult Protective Services; I believe you can make anonymous calls, and they may be able to help if your BIL's schizophrenia is making him unable to care for himself, as it sounds as if it does

NAMI (National Alliance for Mental Illness); they are an organization for family members of mental health consumers; NAMI-CA or each county has its own chapter

And yes, many schizophrenics live full and productive lives with the proper medication and/or support. anon


Call Adult Protective Services, also known as APS (577-1900). They are the people who will take reports of concern about any elder or disabled person who is being abused or neglected (physically, emotionally, financially). You do not have to give your name, though it may help to let them know you are a member of his extended family. You can give them all the details and it sounds like a situation they would likely follow up on.

My guess is at that level of income he may be on SSI and may indeed qualify for a spot in a Board and Care home (RCF, residential care facility) that accepts residents with SSI income. They would take most of his income for rent and food but leave him a little bit for discretionary spending. They can tell you more and may be key in making that happen. Best of luck. Kate


You could contact his county's Adult Protective Services; contact NAMI and/or Family Caregiver Alliance for advice. You could also consult an attorney to see what might be required to challenge the guardianship (financially and legally).

And, you could also call the cops. I know that seems draconian. But if there is drug use, it's not a safe situation for the children. Evidence like could get the guardianship dissolved very quickly, and could force the parents into rehab. Doing this could cause a lot of discord in the family, and things could go differently than you expect, so think carefully before you go this route and ask yourself what's best for the most vulnerable parties.

I would say that if you want to be involved in improving the life of this schizophrenic relative, be sure first you have the stomach and the commitment to stick it out. Managing someone with a chronic mental illness is a long road. Been There


How to set up a legal guardian for adult schizophrenic sister

April 2008

My Mom is old and can not continue to be the payee for my schizophrenic sister. She needs to be placed in a facility but my mom does not know how to do this and neither do I. She wants to hire an attorney to do the leg work, paperwork, etc. for her.


While I can't recommend anyone specifically, you may want to research an organization called NAMI: National Alliance for Mental Health. The statewide office Web site is www.namicalifornia.org. On that site, you can find links and phone numbers to each County's own NAMI. I know that the Bay Area has at least one, and possibly several. They should be able to point you/your mom in the right direction.

There is also American Mental Health Alliance (www.americanmentalhealth.com), and California Institute for Mental Health (www.cimh.org). Either of those may also be able to offer some resources for finding an attorney. Best of luck. anon


I believe my friend has schizophrenia

Feb 2008

I am looking for advice on getting treatment or help for a friend who, I believe, is in the early stages of schizophrenia. She is estranged from her family, is not married, and does not have children. She has been seeing a psychiatrist for several years, but I am beginning to question whether he has been optimally managing her situation. The main problem is that she does not believe that she has a problem and wants people to stay out of her business and leave her alone. One thought that I had was to find a great doctor who I could speak with in order to get information for myself in learning how to deal with her and the situation, and then at some point down the road try to convince her to talk to someone other than her previous doctor. Does anyone have a recommendation for an excellent psychiatrist who deals with schizophrenia and bipolar disorders, or has personal recommendations or experience with such a situation. -at a loss for what to do


Kaiser has a group for friends and family of those with mental illnesses. It might be a good place to start and educate yourself as well as find resources for you and your friend. Good luck. Anon.


It sounds like your friend thinks she is dealing with her problem, if she's seeing a psychiatrist and doesn't want help from other people. You can certainly try to find her a different doctor, but you should be clear about what you can expect from a psychiatrist in terms of ''managing her situation.'' They specialize in tinkering with medications and can only work with what she is willing to give them in terms of information. I'm not sure if a psychiatrist will talk with you about her situation because it's hard for them to recommend anything without meeting her.

All that being said, I can suggest a psychiatrist that has been helpful to me, Donald Stanford in Berkeley at 540-6235. He did an excellent job of analyzing my situation and getting me onto the right medications for bipolar disorder. I just wonder how easy it will be for any psychiatrist to do that secondhand. anon


Husband bi-polar, fear schizophrenia

June 2007

My husband was diagnosed with bi-polar disorder a few years ago after he had a severe manic episode that required hospitalization. Since then he has been diligent about taking his medications – lithium and geodone – but I still don’t feel that he has fully recovered. He is still distracted, giggling to himself, unable to focus. I’m wondering if anyone has any experience with bi-polar disorder, these medications or the best way to get a thorough psychological analysis to assess other issues (I sometimes fear schizophrenia). Thank you anonymous


Schizophrenia is a completely different disorder than bi-polar disorder and it's highly unlikely that your husband has both. What it sounds like is that your his medication aren't working sufficiently and he's still experiencing bi-polar symptoms. Maybe they're not the best meds for him and/or not being given at the best dosages. There are many different drugs these days, prescribing them is as much an art as a science, and most people need their meds tweaked from time to time anyway. Everyone is different, and there's absolutely no way for anyone other than a skilled and experienced psychiatrist to say anything meaningful about your husband's medications.

You might try calling either Langley-Porter Institute at UCSF, or Stanford Medical School- they both have top notch Mood Disorder Clinics, and offer evaluation and treatment. anon


I'd recommend going to the NAMI website (www.nami.org) and/or attending some NAMI meetings for family members of people with mental illnesses. They have services and a wealth of information for both people with illnesses and their loved ones.

It can be very difficult to find the right medication combination for bipolar disorder; and medicines may have to be adjusted throughout a person's lifetime. Further, while some people experience full relief from symptoms from medications, others have only a partial response. ____Bipolar Mom___


It seems like a thorough psychological/medical evaluation would clarify your husband's diagnosis and ensure that he is being prescribed the medications/getting the treatment that would be of most benefit to him. Andrea M


Mental illness is an ever evolving science and unfortunately there are never any straight answers. One thing is certain. You will need a lot of support and much patience. My sister is also bi-polar with hints of schizophrenia and was diagnosed almost 30 years ago. Everyone's situation is different but you should be prepared for a bit of a roller coaster ride with visits in and out hospitals. Fortunately, there are organizations out there to lend support and get you the assistance that you are going to need. One such organization is NAMI - the National Alliance for the Mentally Ill. It's a great starting point and you should immediately contact / join them. Although my sister still suffers from the illness, she is able to live on her own and hold a part-time job. She is able to do so because the help she received through NAMI. Good luck and know that you are not alone. anon


Would you hire a highly recommended but diagnosed schizophrenic caregiver?

April 2003

Would any of you use someone who is a diagnosed schizophrenic (I don't even know if I am spelling that right!) to take care of your kid? She comes highly recommended and is on meds which are controlling her symptoms. Also, she would be in the house with me almost all of the time. I feel very comfortable with this woman and she is an excellent caregiver. I would be interested in your thoughts. anon


I can easily say that I would never leave my child alone with someone who has an untreated serious mental illness. But your situation is obviously different. If this woman is committed to taking her medication and has not had a psychotic episode in quite a long time (years), I think it is probably fine for her to take care of your child when you are at home. However, at the risk of sounding discriminatory towards people with mental illness, I would not leave my child alone with a woman with schizophrenia, even if it were well-treated. Given the extreme danger a child might be put in if a caregiver were to become psychotic, it is just too much of a risk in my mind. a clinical psychologist


If you feel comfortable with this woman, why not give it a try? The stereotypes about people with schizophrenia are way more negative than the reality. There are many people with schizophrenia who have families and fulfilling jobs and whose symptoms are well-controlled with medication. If you are going to be there most of the time, you can get a sense of her stabliity by working directly with her. Anonymous


I would and have used a schizophrenic to care for my child. As always, it depends upon the person. I'm surprised that you even know about her diagnosis. It's a shame that mental illness brings such a social stigma. In reality, schizophrenia strikes 1-2% of the population, comes in different degrees and can be controlled. Do what you are comfortable with, but it sounds like you've found a great caregiver; she's - excellent, highly recommended, and you're very comfortable w/ her. Anon.


The issue here is really her history of compliance with her prescribed medical treatment & the consistency of the control that meds provide her. Many psychiatric disorders can be treated and/or controlled with meds- at this point in medicine, schizophrenia cannot be cured but can be very well controlled for some patients. With all disorders there are some patients who think that they are well and can stop taking their meds now, others are very responsible and grateful to have a normal life. She sounds like she is responsible- she is honest & she is providing for herself. But I think that you need to get her permission to talk with her doctor and review her history for your own peace of mind. I feel very strongly that responsible people with psychiatric disorders should not be discriminated against. It takes a lot of courage and shows a strong character for a person to seek treatment & to stay with it- these are very desirable traits in a caregiver. The excellent recommendations & your comfort with her are very important evidence of her basic goodness & abilities. Get more information, trust your instincts, & examine your own prejudices. anon


I think it's great that you're considering employing someone with this type of disorder and I really encourage you to not let her diagnosis stop you. But if you are worried about it affecting her ability to care for your child I encourage you to talk to her about it. Ask her what her medication does for her, what she's like when she doesn't take it, if she ever decides not to take it and why, how long she's been taking this medication, etc... Of course she may not be entirely comfortable with this type of questioning, but if you let her know that you are just interested in what it is, your only concern being that it doesn't effect her care of your child, maybe she would be ok with it. Or maybe you could ask these questions to the people who recommended her. Either way, finding out about the disorder and how it affects her in particular will help you to make an informed decision.

That being said, people with mental disorders are too often stigmatized and labeled as being ''crazy'' or whatnot. People often don't realize that these disorders are (simply put) chemical imbalances and can often be treated with medication just like any physical disorder. For instance, I have narcolepsy (sudden sleep attacks) and have to take medicine to stay awake. I've been diagnosed for about 5 years and have never been turned down for a job because of it. As far as I know no one has ever even considered not hiring me because of it (most people didn't even ask me about it, despite the fact that I wrote it on all my applications). And when you think about it, what's the difference? As long as the person is taking the medication they need to be ''normal'' there isn't a problem. So as long as you are confident that she takes her meds as prescribed and regurlarly sees her doctor to make sure they continue to work, (and you are comfortable with her in all other areas) then there is no reason not to give her the chance. The fact that she told you about it up front says a lot too. And besides, you'll be there most of the time to make sure everything is ok! Good luck in your decision! Sarah


I am not a medical expert but I am the younger sister of a schizophrenic and I would NEVER leave my child in the care of someone with this illness. One of the sad realities of this disease is that you never know when the person will have a pyschotic break. anon