My loved one doesn't want medication or therapy/won't leave the house - How can I get them the help they need?

While you may care for someone’s well-being and believe you know what’s best for them, adults maintain the legal right to make decisions about their treatment.

There could be many reasons why a person decides not to engage in treatment or rely on only some treatment options. Some people decide not to take psychiatric medication because of unpleasant side effects, or they decide to manage their symptoms on their own. Some people don’t think therapy helps. What’s important is that the person is living a life that brings them satisfaction and happiness.

However, without treatment some people aren’t able to achieve the type of life they’d like to have. In this case, a relationship built on trust will put you in a better position to discuss the benefits of participating in treatment and how it may help them achieve their life goals. 

Lack of Awareness – How to Communicate with Your Loved One

Often an individual living with a mental health diagnosis – particularly one that involves a serious mental health condition (or one complicated by substance use disorder) – may experience Anosognosia [Ann-knows-egg-NOSE-yuh], a neurological condition that can accompany serious mental illness. Anosognosia affects an individual’s ability to recognize that they have a mental illness. This is especially troubling for families and friends who are often responsible for providing their loved one’s care.

To learn techniques for communicating with your loved one, and to help them agree to partner in their recovery, we would recommend reading I’m Not Sick, I Don’t Need Help!, a book by Dr. Xavier Amador. Dr. Amador is a psychologist who encountered the challenges of anosognosia in his own family. In his book, Dr. Amador discusses the condition of anosognosia and outlines strategies for communicating with a loved one to help them work toward recovery. The strategies include an approach called the LEAP method that family members can use to partner with their loved one, strengthen the relationship, and encourage their loved one to participate in recovery. Portions of the book are accessible to the public on our website here; the book is available in English and Spanish for purchase at online booksellers.

A broader discussion of the strategies of Dr. Amador’s LEAP method, including videos on how to apply the method, are available for public access here.

My Loved One Won't Leave the House to be Evaluated – What Are My Options?

An alternative option to consider: a Mobile Crisis Unit (MCU) or, Mobile Crisis Rapid Response Team, is an emergency mental health service offered by many (but not all) counties across the nation to provide on-scene evaluation, treatment, and crisis intervention in the community. MCU teams specialize in providing these services to individuals who are experiencing a mental health emergency and who need, but are unwilling or unable to seek, mental health treatment.

While the goal of the MCU is to enlist the individual’s cooperation and develop the least restrictive treatment options, the MCU is authorized to recommend and facilitate involuntary hospitalization and treatment when necessary.

The criteria for requesting an MCU varies depending upon the county or city mental health agency.  However, a person experiencing a mental health crisis that presents a danger of harm to self or others — and is unwilling or unable to accept emergency services — would qualify for mobile crisis services. If you are unsure about the availability of mobile crisis services in your area or when it’s appropriate to call, ask about emergency mental health services in your county by dialing 2-1-1.

If you believe your loved one is or will soon be experiencing a mental health crisis, you can also contact the 988 Suicide & Crisis Lifeline. Trained crisis counselors at 988 can connect you with local services in your community, including MCUs if they are available and appropriate for your loved one’s situation.

To reach the 988 Suicide & Crisis Lifeline for Veterans, select "1"
To reach Nacional de Prevención del Suicidio (Spanish) select "2"
Lifeline Options for Deaf + Hard of Hearing for TTY Users: use your preferred relay service or dial 711 then 988. You may also text 988, or chat function is available here at 988Lifeline.org.

Being Prepared for a Mental Health Crisis

Being prepared for a mental health crisis by learning about resources and support services allows you to act fast and make good decisions. You may find the information in NAMI’s publication, “Navigating a Mental Health Crisis" helpful. We would also urge you to read through the information on our webpage, “Being Prepared for a Crisis.” There, you will learn about developing a wellness recovery action plan (WRAP), which can be very helpful in planning your loved one’s overall care and how to avoid a crisis. 

Taking Care of Yourself

Often, when trying to care for a loved one, we forget to take care of ourselves. You may find the information under the “Family Members and Caregivers" section of our website useful.  There, among other topics, you will learn about supporting recovery, and taking care of yourself.

You might also consider reaching out to your local NAMI affiliate and participating in NAMI programs for family members and caregivers of people living with mental illness. There you will connect with other families facing similar challenges and learn about what has helped them navigate this circumstance with their loved one.

NAMI Family-to-Family Classes are for families, significant others and friends of people with mental health conditions. Designated as an evidence-based program by SAMHSA, this program facilitates a better understanding of mental health conditions, increases coping skills and empowers participants to become advocates for their family members. Also available in Spanish, De Familia a Familia de NAMI. Find a Family-to-Family course class near you via yourlocal NAMI Affiliate. 
NAMI Family Support Groupis a support group for family members, significant others and friends of people with mental health conditions. Groups meet weekly, every other week or monthly, depending on location. Find a NAMI Family Support Group near you at yourlocal NAMI Affiliate.

Hours of operation Monday-Friday, 10 a.m. – 10 p.m. EST

Call: 800-950-NAMI (6264)

Text: 62640

Webchat: www.nami.org/help

Email: helpline@nami.org