More threads by ladydilv


Hello all,

My 46 yr. old brother has been experiencing paranoia and delusions. He refuses to acknowledge there is a problem and also refuses to go to a doctor. I believe he has suffered from mental illness since he was a child, but he has never been diagnosed by a doctor. Does any one have advice on how we can gently get him to realize he needs to see a doctor?

Thank you.



That's not an easy thing to do when someone is resistent, hon. To whom does he feel the closest? Perhaps that person might be able to talk to him.


I don't think my brother feels close to anyone. He lives with my sister and her 13 year old son. He is so irritable, it's hard for anyone to talk to him. My sister is about to give him an ultimatum - go to a doctor or find a new place to live. She doesn't want to throw him out because she knows he needs help. Perhaps tough love is the only thing that will work. Thanks for your response.

David Baxter PhD

Late Founder
A close friend recently went through this with her bipolar brother and bipolar father.

The father (in his late 70s) was also drinking heavily and was basically convinced to accept hosiptalization when he developed some alcohol-related problems. Once there, they treated the other issue as well.

The brother (early to mid-30s) refused adamantly and, when given the ultimatum of see a doctor or leave his parents' house, chose the latter. By then, the police were also looking for him and eventually I think did locate him in another city. A minor misdemeanor, unfortunately, at least so far, and when last headr from he was drifiting from friend to friend until each in turn got tired of his anger and paranoia.

Eventually, my guess is that he'll get into another fight with a store clerk or someone similar and wind up in custody, where perhaps the police or an astute Crown Attorney will get a court order for a 30-day assessment.

Sometimes, especially with disorders like bipolar disorder, schizophrenia, or paranoid disorder, where typically there is really no insight at all for the patient, it really is the only hope.


Welcome, Diana

I have a son with schizophrenia who does not believe he is ill and unfortunately, he has had to be treated against his will. People with psychotic symptoms can have the most difficulty seeing that their brain is not functioning as well as it could be.

When your leg has an injury, your brain tells you that it's injured and to go get it mended. When the brain has an injury, there is nothing to tell it that it is injured and needs to be mended. Sometimes, people will listen to family members when they appeal for them to get help but if your family has attempted many times already and he is refusing, then you really have no alternative then to use stronger measures. There is no point in repeating what has not worked, it's just a waste of time and energy. If your sister's household is suffering as a result of your brothers untreated illness then use whatever measures you can to get him treatment.

If you have to tell him that he either goes to the doctor and follows the recommended treatment of the doctor or has to leave the home then that is what must be done. It is important that your sister does what she says she will do and not just use this as a threat without following through. If he becomes destructive or abusive then don't hesitate to call the police. Tell them he has a mental illness and needs to be taken to hospital for an assessment.

It's also important to have all of his symptoms documented. Sleeping, eating, moods, unusual behaviour and how he interacts with people. It is too hard to rely on memory over time and can be most helpful for his future treatment.

Sometimes, as Dr. Baxter has described, the person has to hit rock bottom.

Remember that whatever you do to get your brother help, it is out of love and concern. You are not doing it to him but for him.

Hope it will be a smooth journey for your family.


I agree with Dr. Baxter and HeartArt. If nobody is able to talk to your brother, then your sister has no choice but to give him an ultimatum: Shape up or ship out. She has a responsibility to her young son, as well as to herself. People who are paranoid and delusional are not capable of rational decision making. If he goes over the edge, someone could get hurt.

It's hard to see something like this happening to someone you love, I know. Yet, better to take a hard stand now and hope for the best than to risk physical damage to your sister and her son if, and when, things spiral out of control for your brother.

I do hope things work out and that he will agree to get help for himself rather than become homeless. Please keep us informed.

Hugs to you, hon.


Maybe he just needs a change of scenery. Let him take a vacation to your place and experience a different environment.
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