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The question was submitted 01/06/2008

Subject: Concerned Friend

Hi,
For once this isn't entirely about me, but I would like some advice if possible.
One of my best friends has been seeing a guy for the past 12 months. When they first got together, he told her that she would be mad to be with him, but she just brushed that off as a joke.
As the months went on we all began to notice some disturbing behaviour - he began to live off only yogurt and pepsi max (which he still does), he would walk around in circles everytime he'd enter a new room, and he would belittle and harass my friend, not trusting her. These are only a few examples.
My girlfriend tried to help him with his problems (eg: getting him to see a doctor/counsellor, and helping him financially) but he said he had no problems. She asked both advice from myself and other friends and we all basically said the same thing - he needs help. His response to that was that that we were the sick ones and that "when the world ends in seven years, (he) will be the one who gets lifted up to heaven for his suffering and (we) will all go to hell".
It all became too much for her and she ended the relationship about 3 weeks ago. She still talks to him and he throws it back in her face to hurt her, saying that he is sleeping with women she knows when he obviously is not, and the latest thing to happen was that he was evicted from his home 4 days ago, and has no where to go.
She wants to still help him, and I want to help her to help him, but I don't know what I can do except to listen to her. I worry that he will try to hurt himself. I worry that she will become depressed herself (I can see she is not the same person she once was). I want to help but I don't know what I can do.
Can you please give me some guidance with what I can do to help. How can we show him that he does need some kind of help?

Thankyou for your time. This website saved my life in the past and I hope you can help with this now.

Rebecca

Answer from DepNet

Hi Rebecca,

I think we’d all agree that “he needs some help” but I’m afraid that the law in most States now recognizes the right of the individual to refuse treatment unless his condition poses a serious (and often imminent) threat to his life or the lives of others. Add this to the lack of enthusiasm (dare I say “backbone”) regarding mental illness issues displayed by most legal systems plus under-resourced treatment facilities and you have the current very unsatisfactory situation in many areas. All this means that he probably won’t get help until (a) he asks for it or (b) there is some kind of “incident”. Simply being psychotic (if that is what he is) is not enough to get him detained in many places. Please don’t misunderstand me I am not defending this clearly unsatisfactory state of affairs – I’m just expressing my view of current reality.

Part of the definition of a psychosis is that the psychotic person can not be persuaded by logic or reason that their ideas are unrealistic. They tend to cling to them no matter what and if pushed usually say that they are right and everybody else is wrong. That is the thing that is so difficult in this area – the sick person denies they are sick and almost always refuses treatment. The wise men that make the laws seem incapable of observing this fact and claim they are right, and the rights of the individual are more important than the fact that the individual might be psychotic and unable to exercise proper judgment. You have probably gathered by now that you are not alone in your frustration with this situation and if I continue along this line I risk being accused of having a problem….so, moving on….. What can you and your friend do?

You can not show him he needs help (see above plus review your experience to date).

Given this fact your friend can tell his family of her concerns if she wants to and if he has a potentially concerned family. They (as next of kin) can then pursue legal processes re treatment if they wish. This is their responsibility not hers/yours. Your friend should not be involved in ongoing support of his family.

Your friend has terminated the relationship so should now walk away. She has tried to help over an extended period and been refused. Her obligation is now terminated. The reason I take this heartless stand is that ongoing contact is a waste of time and is obviously very stressful and definitely not in the best interests of her health. You have noted the changes in her to date.

You can love and support your friend through this very difficult time. She will be grieving the loss of all the good bits of the relationship plus her hopes for the future and wrestling with her ongoing (mistaken) feelings of responsibility and concern for his future. She should focus this energy on her own survival.

I have to be honest – he could hurt himself in some way or be involved in some type of incident that brings him to the attention of the Legal System. If that occurs it will hopefully trigger the System to detain him, do an assessment and start treatment if deemed appropriate. As stated above I believe it is scandalous that this has to happen before a sick person can receive treatment. The incidence of suicide in the severely mentally ill is an inditement upon the values of our Society. Hopefully this will not be the outcome in his case. Civil Libertarians reading this should save themselves the trouble of e-mailing me hate-mail.

The bottom line is that our responsibility to ourselves should be stronger than our responsibility to others (with the exception of our children). I sincerely hope this sorry situation does not end in tragedy and your friend has the courage to put her own needs first. She is lucky to have people such as you around her.

The answer was published on DepNet 04/06/2008