Getting Mental Help for Someone Who Doesn’t Want It

Mental Health Laws and Regulations for Involuntary Commitment 

• Florida: The Florida Baker Act is a law that permits doctors, mental health professionals, judges, and law enforcement officers in Florida to commit an individual to a mental health rehabilitation facility for up to 72 hours. This action can be taken if the person exhibits certain violent or suicidal behaviors. For instance, if someone with a mental health disorder is at risk of harming themselves or others, they can be placed in a mental health facility for their safety and the safety of those around them. The purpose of the Baker Act is to provide immediate care and assessment for individuals in crisis. During the 72-hour period, mental health professionals can evaluate the person's condition and determine the best course of action for their treatment. This may include further hospitalization, outpatient therapy, or other forms of support. The Baker Act is an important tool for ensuring that individuals who are experiencing severe mental health crises receive the help they need promptly. It aims to prevent harm and provide a pathway to recovery for those in need. 

• California: The Lanterman-Petris-Short (LPS) Act is California’s standards and expectations surrounding involuntary commitment. It was developed to end people with mental illnesses’ indefinite, inappropriate, and involuntary commitment. Once enacted in 1967, many people were released from state hospitals. The LPS Act requires that individuals be evaluated by a mental health professional within 72 hours of being detained. If the evaluation determines that the individual poses a danger to themselves or others, or is gravely disabled, they may be held for up to 14 days for further treatment. During this time, the individual has the right to a hearing to contest their detention. If further treatment is deemed necessary, the individual may be held for additional periods of time, but each extension requires a new evaluation and hearing. 

• Massachusetts: In Massachusetts, Section 12 of Chapter 123 of the Massachusetts General Laws governs the admission of individuals to general or psychiatric hospitals for psychiatric evaluation and possible treatment. Section 12(a) allows individuals to be brought to a hospital against their will for evaluation, while Section 12(b) permits involuntary admission to a psychiatric unit for up to three business days. If involuntarily committed, discharge options are limited. Judicial review is available under Section 9(a), allowing appeals within 10 days of the initial decision based on legal errors during the commitment process. Alternatively, Section 9(b) enables discharge upon petition to a superior court, necessitating a hearing within seven days of application. Legal representation is provided as necessary, with discharge contingent upon demonstrating that the commitment criteria are not met, often requiring expert evaluation and testimony. 

• New York: In New York, emergency medical professionals and law enforcement officers have the authority to involuntarily commit an individual who is believed to be struggling with a mental illness. If an assessment is conducted during the holding period, this involuntary evaluation can be beneficial when seeking court-ordered treatment. The process commences with the individual being taken to a hospital for evaluation. Should the assessment determine that the individual poses a risk to themselves or others, they may be detained for up to 72 hours for further evaluation. Throughout this period, hospital staff work to devise a treatment plan and ascertain if the individual requires extended care. If additional treatment is deemed necessary, the hospital can request the court to issue an order for the individual to be committed to a mental health facility. The court hearing offers the individual an opportunity to challenge the commitment and present their case. 

• Philadelphia: In Philadelphia's Mental Health Courts, individuals facing involuntary commitment undergo a rigorous evaluation process focused on determining if they pose a danger to themselves or others due to mental illness. Dangerousness criteria include recent actions such as threats or attempts of serious bodily harm or self-harm, assessed within the preceding 30 days. Involuntary commitment may involve family, crisis professionals, and law enforcement, with a petitioner required to have firsthand knowledge of the dangerous behavior and willing to testify at a hearing if necessary. Following authorization of a 302, individuals are transported to an emergency room for evaluation, where a physician determines if involuntary psychiatric admission is warranted for up to 120 hours, pending a potential 303 petition for extended treatment. The court proceedings ensure due process, evaluating whether continued hospitalization is justified based on the presented evidence and ensuring the patient's legal rights are upheld throughout the process. 

Denying Mental Health Problems: Why Does This Happen? 

Whenever we go through any physical or mental changes, we adjust to accommodate them. For instance, when we get sunburned, we adjust the mental image of our physical appearance, expecting to look different in the mirror. This process is much more complex than it seems. 

It occurs in the frontal lobe of the brain, where new information is organized and revised as a new narrative of who we are to update our self-image. Unfortunately, this area of the brain is often damaged in people who have disorders like schizophrenia, bipolar disorder, and even dementia. As a result, their brains may struggle to update any new information about themselves, including a mental health diagnosis. 

Without this very important update, the person may stick to the self-image they had before their illness. These perceptions may feel accurate enough that the person may believe their loved ones are mistaken or lying to them. 

If family, friends, and spouses insist they’re right, the person may feel angry, frustrated, and defensive. As you can imagine, mental health denial can make it difficult for someone to receive the mental health treatment they need. 

What to Do When Someone Refuses Mental Health Treatment 

While you may want to help your loved one overcome their battle with mental illness, you can’t force anyone to do anything unless they pose a threat to themselves or others. It’s also normal to struggle with recovery, and it’s important to place yourself in the person’s shoes. 

Maybe you hit a point in life when you wanted to make a change – it could be losing weight or eating better. The more someone asks about your food habits or workouts, the more irritated you’d get. When we do this to others, we increase their resistance to making good choices. 

Fortunately, there are several ways of getting mental help for someone who doesn't want it without forcing or cornering them. 

Listen and Validate Their Feelings 

Especially if your relationship with this person is iffy, it doesn’t hurt to just listen. Ask them what’s going on and sit quietly and patiently as they vent to you. Make eye contact and face them with your body to show you’re engaged and listening. 

Validate their feelings by responding with, “Yeah, that sounds hard” or “That seems very difficult for you." When people don’t feel like they’ll be heard, their feelings will be invalidated, and they’re less likely to reach out for help. By acknowledging their struggles, you’re opening the door to more conversations and eventually to actively searching for a treatment center for mental health. 

Ask Questions 

In our flurry to get this person help, we often neglect to simply ask the person what they want! Just like we’d ask a child who’s crying what’s wrong, it’s important to ask your loved one why they’re feeling the way they are. 

Not only will this open the floor for honest conversation, but it also keeps them in the loop. As we mentioned previously, you can’t force someone to do something they don’t want to do, so it’s important to find out what they want and find ways to support their goals in ways you can both agree on. 

If they’re willing, you can also ask them to consider doing what you want them to do. Medication is a common example. Many people with severe mental health disorders will stop taking their medication because of anosognosia or side effects, so it’s understandable why they’d be hesitant to keep taking them. 

Resist the Urge to Fix or Give Advice 

There is a time and place for advice, and that’s when the person asks for it. If they haven’t asked you to fix the situation or for your opinion, just show your support. It’s easy to make things about yourself when your immediate reaction is to fix something or give advice. Instead, be more open to listening to them unless they ask for your opinion. 

There may be times when you might even agree with them. Once you give people the space to feel heard, their walls go down, and they’re more open to a conversation about getting help. 

Explore Options Together 

Another major mistake people make when navigating how to get someone psychiatric help when they refuse is to explore treatment options without them. While you might be around to witness their symptoms and behavior, you can’t read the person’s mind, so how would you know what they need? 

Additionally, if the person says, “I don’t want to do this,” you might make it more difficult for yourself and them by demanding it. It’s okay to ask, “What do you want to do?” or “What treatment option sounds good to you?” 

You can even start small and avoid talking about the illness itself until they become more comfortable with the idea of getting treatment. For instance, you might start with work, relationships, life, stress, sleep, and then bring up the possibility of treatment. In this way, you show them how their life is being affected by their mental health disorder and the importance of getting professional support. 

Find Support for Yourself 

We can’t help others if we don’t help ourselves, and often people who try to help loved ones with mental health disorders neglect their own well-being. But it’s difficult to be patient and understanding when we’re tired and worn out. 

If you’ve been helping a loved one with their mental illness, reach out to other caregivers for support and advice. It’s important to have someone to talk to who understands what you’re going through and can keep you grounded. 

Our mental health rehab offers family therapy to help the family members, spouses, and close friends who have helped a loved one with mental illness. We incorporate both individual and group counseling sessions to offer clients the privacy, motivation, and support they need to recover from their own stress and exhaustion and stick around for their loved ones.