It can be hard to see someone struggle with mental health issues and refuse to accept help. If it seems like they might become a danger to themselves or someone else, it becomes even more difficult—how can you help someone who needs to go the hospital, but won’t go?
This question comes up the most if a person presents a danger to themselves or to someone else, or if they are having a psychotic break. A psychotic break can be the result of drug use, or a symptom of a mental illness such as schizophrenia or bipolar disorder.
It’s best if you can get them to go voluntarily.
People tend to have better experiences in the hospital if they make the choice to go themselves. Hospital staff may treat them or you differently, and the process is more difficult for an involuntary commitment. Your loved one may come out of the experience feeling like you don’t respect their decisions, which can set them back in their recovery. Whenever possible, it’s best to make treatment decisions together.
Just because they refused once, doesn’t mean they won’t come around. Keep trying, asking questions, listening, and reflecting. Help them feel heard and ask again. Continue to say things like, “I’m really worried about you. I’m thinking we should just go get checked out by a doctor to see what’s going on.” Reassure them that you’ll stay with them and help them through the process. Watch for signals that they may be more okay with the idea than they were before. Once that happens, tell them something like, “Okay. I’m going to help you find help. I’m going to take you and be with you in this process.”
What if things get worse and they still won’t go?
Still, there’s a time and a place for taking someone to the hospital against their will.
A person can be involuntarily committed to a hospital if they are a danger to themselves, a danger to others, or gravely disabled. They are considered a danger to themselves if they have stated that they are planning to harm themselves. Likewise, they present a danger to others if they have stated that they intend to harm someone else. Grave disability is when someone is sick and can't make decisions for themselves. Someone who is having a psychotic break may not verbalize intent to harm anyone, but they likely meet the criteria for grave disability. The same goes for someone who is experiencing a drug overdose.
Getting them to the hospital
A mobile crisis team is a group of health professionals that respond to mental health crises in people’s homes. The team may include nurses, social workers, psychiatrists, or peer specialists. Mobile crisis teams sometimes work together with police departments. If your city has a mobile crisis team, you can call them and they will come to your house to do an assessment. They will ask you a lot of questions, and then help you get your family member to the hospital as needed.
Sometimes there is no one available to help, and you have to take them to the hospital yourself or call the police. Remember that police aren’t trained in mental health, and seeing them can scare people. Whenever possible, it’s best to rely on support systems that include people with mental health backgrounds. A mobile crisis team is the best option for this.
If you have the choice to go to a inpatient mental health hospital it is also best for you to visit there first for admission rather than going to the ER. Emergency rooms are designed for physical health emergencies and are not well equipped to handle psychiatric emergencies.
If your family member needs some kind of bed and respite but doesn't meet criteria, some communities also offer peer run respites as alternatives to hospitalization.
At the hospital
When you admit your family member to a hospital, tell the staff what is going on—for example, that you think they are having a psychotic break. Explain to them whether this is the first time this has happened, or how long it’s been going on and what symptoms you’ve seen. The hospital will want to make sure your loved one has not used drugs. They’ll need to be off drugs for 72 hours before a hospital can clearly diagnose any type of mental illness, like psychosis.
Once they’re admitted, your loved one will be monitored, kept safe, and possibly given medications.
After their stay
You’ll probably feel relieved once your loved one is stable, but for them this may be just the beginning. Especially if this is their first time, be there for them as they come to terms with their mental illness. Be patient as they go through the process of grieving this change in their life. And most of all, be supportive of their own recovery process. Make sure that they have a role in managing their own illness. It’s tempting to try and take control—but that’s disempowering for them, and it will make it harder for everyone moving forward.
Paying for a hospital stay
Hospital visits can be very expensive. On average it can cost anywhere from $1,200 to $1,500 a night—sometimes more. If you have health insurance, make sure you know beforehand how much will be covered. If not, the hospital will have someone you can talk to about getting your loved one on Medicaid. Hospitals also have financial assistance programs for people who don’t have health insurance and can’t afford to pay out of pocket. You may have to fill out an application and show proof of income. If the person you’re taking to the hospital isn’t a family member who can be covered by your insurance, offer to help them figure out how to pay for their stay.