When someone struggles with mental health issues and refuses to get help, it might seem as though they become a danger to themselves or somebody else. It becomes even harder to determine how you can help them. People tend to have a better experience in the hospital if they choose to go by themselves. The hospital team may respond differently to voluntary admittees, and the procedure is more difficult for a forced commitment. Your loved one may come out of treatment feeling like you do not respect their decisions, which can hinder their recovery. Whenever possible, it’s best to allow them to make treatment choices. Just because they declined in the past does not mean that they will not change their mind.
The best option is to get them to go voluntarily.
Keep asking questions and listening to them help them to feel better. Stay connected to them and engage them with statements like, “I am concerned about you. I am thinking we should go to the doctor to see what is going on.” Comfort them that you will stay with them and help them through the process. Watch for their signals that they might be more okay with the idea than they were before.
Patients who are officially committed to a hospital can be released on the condition that they are compliant with medication. Failure to comply can result in discharge from the hospital. In most situations, the hospital director has the authority to do this first seeking permission from the courts. Forty states have laws approving conditional release. In the past, this form of assisted treatment was used for both civil and criminal cases. Later on, New Hampshire was the foremost state using conditional statements for civilly committed patients. In 1997, 26 percent of patients released from the state hospital were placed on conditional release.
Things to ponder when someone refuses mental health treatment
You cannot force anybody under the age of eighteen into treatment unless they pose a danger to themselves or others or show signs of depression or psychiatric illness.
Pay close attention to your loved one, watching for telltale changes in their behavior which differ from their normal state. When you notice these changes in their behavior, avoid using a judgmental tone with them and reassure them you want what is best for them, that you are there to help. Some major areas of concern are:
- Changes in behavior
- Decrease in level of energy
- Lack of interest in people and other activities
- Change in appetite or sleep
- Negative thoughts they bring up in conversation
Reinforce your concern and emphasize you are there for them. Try to provide clear and consistent information on treatment for mental health illnesses. Offer to help with the logistics, which can feel overwhelming to a person facing admission to a mental health treatment center.
What if things get worse, and they still won’t go?
It is sometimes necessary and appropriate to hospitalize a person against their will. A person can be unknowingly committed to a hospital if:
They pose a risk of harm to themselves or others;
They are gravely disabled;
They have stated they are planning to harm themselves or others or if they have explicitly stated that they have both the means and intent to do so.
Someone who is having a psychotic break may not express an intent to harm anyone, but they may still meet the standards for disability and involuntary hospitalization. A similar standard applies to someone who is suffering a drug overdose and requires treatment for mental health issues or substance abuse.
People tend to have a healthy experience in the hospital if they make their own choice to seek treatment. Hospital staff may respond differently to voluntary admittees, and the procedure is more difficult for an involuntary commitment. Your loved one may come out of the experience feeling as though you do not respect their decisions, which may negatively impact their recovery. Whenever possible, it’s best to make treatment choices together. Just because they declined in the past does not mean that they will not change their mind.