This is a challenging situation. Since he is an adult, he is able to make decisions for himself despite the fact that he is currently experiencing what seems to be psychosis.
When people are psychotic, they are not thinking clearly. He is convinced that he is being followed and it is probably making him very frightened and thus he’s reacting accordingly. Currently, in most states, people who are actively psychotic are legally able to make decisions about their care, except in cases where they have been declared incompetent by a judge or pose a danger to themselves or to others.
It’s very common for people with schizophrenia not to believe that they have the illness. It is thought to be the result of anosognosia, a neurological condition that prevents people from knowing that they are ill. It’s so common that it’s actually a symptom of schizophrenia. Approximately half of the people with schizophrenia don’t think they are ill. If an individual does not think they are ill, then they are unlikely to accept treatment. Without treatment, psychosis typically worsens.
Treatment works but when an individual does not engage in the treatment, they don’t get better. This can be very difficult for family members who are caring for a loved one with a psychotic illness. In this way, schizophrenia is a family illness. Family members often feel helpless when a loved one, who is clearly ill, refuses to participate in treatment. It’s difficult on everyone.
You should encourage him to seek treatment. You can also report your concerns to his doctors. Privacy laws prevent them from contacting you (unless he gives them permission) but you can contact them to provide them with information. It’s also best to avoiding arguing with him about his belief that he’s being followed. As you learned first-hand, it only makes the situation worse. In his mind, his being followed is very real to him. Evidence to the contrary will have no effect upon the psychotic mind. By definition, psychosis is a break with reality. It can be a very frightening experience.
One of the best books written about dealing with a psychotic family member, who is refusing treatment, is I’m Not Sick I Don’t Need Help by Xavier Amador. It’s a useful resource and can provide you with good suggestions for how to handle this problem. Please take care.
Dr. Kristina Randle