Your family is experiencing a very difficult predicament. My first suggestion is to try to convince your mother to see a mental health professional. This could include a psychiatrist, a therapist, or a case manager at your local community mental health center (CMHC). Most communities have a CMHC. Often their services are based on a sliding scale fee or they can be free, depending on an individual’s income.
If your mother is unwilling to see a mental health professional, then my suggestion would be for you to consult someone at the CMHC. There may be services they can provide to your mother in the home, if she is willing to accept them. They may have specific suggestions about how to handle your particular situation. In addition, they may be able to provide support services for you and your family.
I would also suggest contacting the National Alliance on Mental Illness (NAMI). NAMI is a nonprofit advocacy group designed to assist individuals with mental illnesses and their family members. Most communities have local NAMI support groups specifically designed for family members who have a loved one with a mental illness.
You wrote that you do not fear for your mother’s safety but that she is “spiraling.” I am not certain what you mean by the term spiraling. My interpretation of the term is that she is decompensating (i.e. experiencing a progression in the seriousness of symptoms). Individuals who are decompensating can inadvertently become a danger to themselves. For instance, consider this scenario: an individual would not physically harm themselves, but because of their untreated psychotic symptoms they psychologically deteriorate to the point where they are unable to care for themselves. Due to psychosis, they are unable to walk, talk, bathe, eat, or otherwise function in a healthy way. If not forced into treatment, they could die.
I am familiar with cases in which an individual was psychotic and subsequently began refusing to take their life-sustaining medications. The individuals began refusing their medication because they were convinced that they were being poisoned by their caretakers. By refusing the life-sustaining medications, they inadvertently put themselves at risk of death.
I included the aforementioned cases because even though your mother might not deliberately harm herself, her untreated psychotic symptoms may unintentionally put her in danger. This underscores the importance of consulting with mental health professionals as soon as possible.
Your mother is not well. Intervention is needed. I recognize that you do not want her to live in a state hospital. I fully understand why you would think that to be an undesirable outcome. The alternative, however, may be her living in a continuous state of psychosis, which many have described as being a “living hell.” Services exist in many communities that allow individuals to participate in outpatient treatment, take medication and live in their homes rather than in a state hospital. In fact, the majority of state hospitals across the country are closing. I would urge you to explore what community services are available to your mother and to your family.
If you have difficulty locating a CMHC in your community, then call the local health department and ask what free or low-cost services may be available to you. They should be able to provide referrals to local agencies who can assist you further.
Please do not hesitate to write again if you have additional or follow-up questions. I wish you and your family the best of luck.
Dr. Kristina Randle