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New Contributor

When to intervene for a family member who has delusions

Hi carers,

I'm wondering how to ensure that my sister receives proper treatment, especially psychotropic medication, when she continues to resist and deny the existence of her mental health illness. I do not wish to wait until a crisis occurs. 

- She suffers from symptoms of an undiagnosed schizoaffective disorder (erotomanic delusions, paranoia, and visua hallucinations, not sure about auditory).

- She has received formal diagnoses of PTSD and Bipolar Disorder in recent years.

- She is 'high functionig' with university qualifications and strong work record.

- She is not at acute risk of self-harm or suicide and no history of either.

- She is resistant to any medical or psychological interventions, although she has seen a clinical psychologist a few times but seems to have been unhelpful. No history of psychotroic medications.

- She views almost all events in her life as a theatrical play orchestrated by a Higher Power for the sole purpose of matching her with the man that she is attracted to (this has been going on for around 3 years). I am in communication with this man.

- He has an AVO against her (for stalking and intimidation: she gives him gifts, attends his workplace, and visits him; despite being explicity told not to). She is not physically aggressive, but can be verbally aggressive.

- She has breached the AVO by visiting or giving him gifts to him again. She views the arrest and court proceedings as part of this theatrical play. Therefore, she resists all legal support. She has no prior criminal record.


I've tried many strategies ranging from motivational interviewing, CBT, DBT, attentive listening (active, reflective, empathic), casual brother-sister talks, attachment, conditioning histories, etc etc etc. The usual response to any style or approach that I use is that she is self-sufficient, can self-manage, that she knows what she's doing, etc.


When is the right time to get her involuntarily admitted into a mental health facility? Have events been prolonged for too long or do I wait until a non-family member (i.e., the court) requires her to be involuntarily assessed and then admitted into a mental health unit? Is it worth rupturing family rapport (i.e., trust and comfort; but then repairing it later) in order to stabilise her mental health condition (and therefore keep the man and his family away from my sister's ongoing nuisance behaviours)?

I am leaning more towards gathering family members to be assertive towards her about this issue and for her to see a GP/psychologist, or otherwise rupturing rapport by having the local mental health acute team contact her or otherwise calling the ambulance. I think that being assertive (and benefitting her mental health) but then becoming the enemy is the better choice than being passive (and not benefitting her mental health) but staying as friends.

Thanks all, I really appreciate the feedback.


Senior Contributor

Re: When to intervene for a family member who has delusions


Each state has a mental health act that sets out when and how a patient can be involuntarily admitted. You can find this information readily on the internet.

Here is a short 15 min talk gives 4 good strategies to help when MI enters family.

I have been recommended a book by Xavier Amador "I am Not Sick, I Do Not Need Help"
His focus is how to get a patient to accept help when they cannot see or accept they have a mental health problem.

I have not read the book but have watched his lectures on YouTube and others might find his approach helpful.

Part 1:

Part 2:

This is a coping method that the Qld mental health resources for carers website suggests.
New Contributor

Re: When to intervene for a family member who has delusions

Thank you, I will check these out. I really appreciate your response.
Casual Contributor

Re: When to intervene for a family member who has delusions

I have read Amodovar's book and found it very useful. When I follow his process to the letter it actually works when my bipoloar son is psychotic and needs help. I do have to re read it every time my son has an episode because they are quite far apart. But more than once a coversation with my delusional son has ended up with him making a sensible suggestion such as "i think I could take some antipsychotics" . Well worth the time spent learning his method of talking to someone who is in psychosis.


Re: When to intervene for a family member who has delusions

@Ytsrik @YJacob @Darcy thank you for these posts. They give me ideas for dealing with my situation too.