When someone needs help but is not willing to get help

It is not uncommon for a person with a mental illness to deny they are ill or that they need help. This is particularly true for people with a psychotic illness or Bipolar Disorder. This may be due to their lack of insight or awareness due to the illness. They may refuse to seek help for their illness and believe that it will fix itself or that it doesn’t exist.

How you speak to the person and approach the subject may be a critical factor in convincing them to seek the help they need. Be aware of how the person is behaving and any changes that may be of concern.

Some signs and symptoms that someone may be mentally unwell includes if they:

are overly suspicious of others
see or hear things which are not real
have thoughts which are not in tune with reality
have serious disturbance of thought
behave significantly differently
are considered a danger to themselves and/or others
talk about wanting to harm self and/or suicide
talk about feeling very down and nothing can help
are often tearful or overly sensitive
are overly anxious, scared and fearful about situations or objects
lose interest in day to day activities
have trouble sleeping at night or needs very little sleep
stop reaching out to family and friends and has isolated themselves
may have started using an excessive amount of alcohol or other drugs

How can you help someone who may be mentally unwell?

It can be difficult to support someone who you feel may need help especially if the person may not be willing to access support. If a person is legally an adult then ultimately it is up to them to seek treatment and accept help unless they fit criteria under the Mental Health Act to be scheduled into hospital as an involuntary patient.

There are some ways you can offer support to a person who may be experiencing a mental illness or mental disorder to encourage them to seek support and treatment.

Ways to help someone who may have a mental illness:

Find a suitable time to discuss your concerns with the person and let them know you are on their side
Talk sensitively to the person about the change in behaviours you have noticed (try to avoid blaming and accusing the person)
Try to be as understanding as possible regarding how the person may have a range of emotions regarding accessing support
Offer to go to a GP with the person as a starting point to access help
Educate yourself about mental illness and the type of professionals who can help
Develop a plan on how you would respond if the person’s behaviour escalates to the point where they are a danger to themselves or someone else

Who can help?

Professionals
General Practitioner (GP)—a GP is always a good starting point for locating support and further referrals to more specialist professionals.
Psychologist— A health professional who prescribes therapy or counselling as treatment for mental health problems.
Psychiatrist—A Medical Practitioner with specialist training in psychiatry who is able to prescribe medication for medical conditions.
Social Worker—A Social Worker is a health professional that provides support to people and their families going through a crisis point. The social worker is able to provide practical support, counselling, information and emotional support.
Counsellor—a counsellor is a health professional that provides supportive listening and emotional support to individuals dealing with difficulties of varied nature as well as support given to families.
Mental Health Nurse— A specialised type of nurse who cares for people with mental illness. The term ‘psychiatric nurse’ is also used.
Mental Health Team—community mental health teams comprise of multi-disciplinary professionals and provide comprehensive mental health services to people experiencing mental illness.
NSW Mental Health Line: 1800 011 511 (24/7 to get in touch with local mental health service)
Hospitals

Hospitals often have acute mental health wards to help people experiencing acute mental health symptoms.

Family and Friends

Family and friends can be of great support to someone experiencing a mental illness and help link to support services in the community.

Religious leaders

Religious leaders can provide guidance, counselling and help link people to further support services in the community.

Support Group Coordinator

A person who has specialised knowledge in a specific area of mental health and organises a group of consumers to meet together and gain social and emotional support with their illness.

Why would someone not want treatment?

There are many reasons why someone may not be receptive to getting treatment. Often a person is concerned about how others around them will react to having a mental illness or sometimes the individual may not recognize the scope of impairment that the mental illness has on their life.

Possible reasons someone decides not seek help may include the person:

not having insight into the problem
being scared to seek treatment and is afraid of the unknown and what would happen in hospital
feeling overwhelmed with the process of seeking help and not know where to start in terms of asking for help
having had a negative experience with seeking help before and does not want it to occur again
being scared what will happen if they admit they have a mental illness (e.g. lose custody of a child)
feeling embarrassed about asking for help
worrying about the stigma attached to mental illness
coming from a cultural background where it would bring shame on the family to have a mental illness
having asked for help before and no one was able to help or no one validated their mental health concerns
being disadvantaged in receiving access to health care (e.g. Indigenous background, distance from services)
fearing financial costs of receiving mental health care

Involuntary Hospitalisation under the Mental Health Act 2007

Sometimes people may not want to get treatment for a mental illness but they may need to be scheduled or involuntarily hospitalised under the Mental Health Act, in order to ensure their own safety and/or the safety of others. To be admitted involuntarily under the Act the person must exhibit behaviours which clearly show that they have a mental illness (a long term condition) or that they are currently mentally disordered (short term). According to the Mental Health Act (2007, Section 4) mental illness means “a condition that seriously impairs, either temporarily or permanently, the mental functioning of a person and is characterised by the presence in the person of any one or more of the following symptoms:

Delusions (beliefs that are contrary to reality),
Hallucinations (distorted perceptions of reality)
Serious disorder of thought form
A severe disturbance of mood
Sustained or repeated irrational behaviour

Also their condition must be severe enough to believe that treatment or control is necessary for protection of harm to the person or someone else.

How to help someone who meets criteria under the Mental Health Act

If you are aware of the person’s GP and/or psychiatrist then try to get in touch with the doctor(s) about your concerns. Unless the person who is unwell has given you permission to speak with their health professional then the doctor will not be able to disclose any information to you due to privacy laws, however, you have the right express your concerns about the person’s mental health. When speaking to the GP and/or psychiatrist try to be very specific about the particular behaviours which are of concern and how you feel that the person is at risk of harming themselves and/or others.

GPs and psychiatrists are qualified health professionals who can conduct an assessment and fill out the appropriate forms to have someone scheduled as an involuntary patient in hospital under the Mental Health Act.

If you are not able to get in touch with the treating doctor(s) or the person is not currently under the care of a health professional then you can contact the nearest mental health team. In NSW there is a 24/7 mental health triage which links people to their local mental health service. The triage assesses someone’s level of risk to determine the most appropriate course of action and whether they fit the criteria to be scheduled under the Mental Health Act. It is important to also be clear about the person’s behaviour and how you feel they are at risk of harming themselves or someone else and thus should be hospitalised.

NSW Mental Health Line: 1800 011 511 (24/7)

If the mental health team is not able to intervene at this stage and you are still concerned about the person’s safety and the person of concern is willing to get help then you can try to take the person to the closest hospital emergency room. At the hospital the person can be assessed and sent to the nearest inpatient unit if they require hospitalisation to a psychiatric ward.

If the person is not willing to get help, or the mental health team is not willing to get involved at this point, and/or you feel the person is violent or at risk of being violent, then you can call the police. It is advised to inform the police about your concerns of the person’s safety and also their mental health; you can request a Mental Health Intervention Team if possible to respond to the situation.

Responding to a crisis situation or emergency

It is important to plan ahead and know how to respond to a mental health crisis situation. Decide how you would respond if the person’s behaviour escalates to a point where they are considered an immediate danger to themselves or someone else. If you feel that someone is a high risk to their own safety and others then you can contact your local mental health crisis team or phone 000 for the police or an ambulance.

Taking care of yourself

The emotional toll of caring for someone with a mental illness can be difficult and draining. It is important to remember to also take care of yourself.

Unfortunately there is only so much you can do to provide support for someone with a mental illness. It is ultimately up to a person to seek further support and treatment for their illness unless they do fit criteria to be scheduled under the Mental Health Act for treatment. Therefore it is vital to take the time to care for yourself and seek help to maintain your own emotional wellbeing and mental health.

Often the main source of support for a person dealing with mental illness comes from family members and close friends. There are many activities you can take part in to strengthen you own mental health.
Some examples to help yourself include:

Consider seeing a health professional for counselling to deal with the range of feelings experienced caring for someone with a mental illness
Pursue some new hobbies and activities
Make time to do things you enjoy
Go for a walk or some other type of physical activity
Try to eat healthily and avoid large quantities of alcohol
Talk to trusted family members and friends for support
Join a support group for carers of someone with a mental illness

Support services

There are a variety of support services available to help relatives and friends of the mentally ill to cope with the demands and difficulties of caring for someone with a mental illness.

Counselling services and psychological support—some people might find it helpful to talk with someone such as a counsellor and/or psychologist to work through various feelings regarding caring for someone with a mental illness.

24 hour counselling services—24 hour counselling services are available to speak with someone about the various feelings associated with trying to help someone with a mental illness and also talking through about how to care for your own mental health.

Disclaimer

This information is for educational purposes. As neither brochures nor websites can diagnose people it is always important to obtain professional advice and/or help when needed.

This information may be reproduced with an acknowledgement to WayAhead – Mental Health Association. The Association encourages feedback and welcomes comments about the information provided.

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