When we see someone in our life who is struggling with their mental health, our instinct is to help in any way we can. But it’s not always easy for someone to admit when they’re having a hard time. They may not want to seem “weird” or like they need to depend on others for assistance. However, when they seem to be out of touch with reality, getting them the help they need is essential.

Psychosis is a mental state characterized by a disconnection from reality, often manifesting in hallucinations, delusions, and impaired cognition. If you suspect that a loved one is experiencing psychosis or may be at increased risk of a full-blown psychotic episode, it’s important to seek professional help and provide support as soon as possible. If they don’t want professional help, we’re here to guide you on the next steps to help them start their journey toward recovery.

How to help someone with psychosis who doesn’t want help

Psychosis is characterized by hallucinations (seeing and hearing things that aren’t there) and delusions (beliefs without a basis of reality). It can interfere with every aspect of a person’s life, from their productivity to their safety. They occur as episodes, or periods of time where a person experiences a disconnect to their reality. Episodes can last anywhere from a few days to several weeks. 

It can be upsetting when you’re worried about a loved one but they don’t want to seek treatment from a professional health care provider for their psychosis. Your priority should be to have an open conversation where you convey empathy and compassion without making them feel inferior. With the right conversations, they can feel more inclined to explore treatment options.

If you have a loved one who is experiencing psychosis but doesn’t want any help, here are some steps that you can take:

• Show empathy — Empathy is the key component to a productive conversation with a loved one with any mental health disorder, including those that lead to psychosis. You want to make them feel heard and show empathy for what they are experiencing, even if those experiences are distorted from reality. 
• Make them feel safe — A person with psychosis may set boundaries that are outside of their norm due to feeling unsettled by their hallucinations and delusions. It’s important that you respect how they’re thinking and feeling to reduce the risk of making them feel threatened or anxious. For example, they may not want to be touched or hold eye contact. You should also let them set the tone to feel in control of the conversation. 
• Don’t lecture them — You want to be there for a loved one to provide them with support as opposed to lectures. They’re a person who needs help to improve, not something that needs to be “fixed.” Lecturing them can make them feel ashamed rather than help them find motivation and courage to seek treatment. Avoid making them feel bad about the consequences that may have come from the psychosis, such as a poor performance review at work.
• Educate yourself on de-escalation — If someone with psychosis is resistant to treatment, learning how to de-escalate dangerous situations that stem from their symptoms can help in the meantime. Learn de-escalation tactics to reduce the risk of violence, such as talking in concise sentences and not challenging their delusions and hallucinations. Try to stay calm and avoid making them feel threatened. When de-escalation doesn’t work, know your exits and when emergency services should be called.

Many people can experience psychosis for more than a year before receiving treatment, and lack of treatment for psychosis can increase the risk of violence and suicide. If your loved one’s psychosis behaviors put themselves or others at risk, call emergency services so that they can receive inpatient care. You can also call or text the 988 Suicide & Crisis Lifeline by dialing 988.

How to know when a loved one with psychosis needs help

In order to know when your loved one needs help with psychosis, you have to understand the signs and symptoms to look out for. Before a psychotic episode, there are emotions, thoughts and behaviors that can be warning signs that one may be developing, including:

• Paranoid ideas
• Uneasiness or nervousness around other people
• Social withdrawal or isolation
• Out-of-character ideas
• Lack of personal hygiene or self-care
• Trouble communicating clearly and logically
• Drop in school or job performance
• Anxiety
• Inappropriate or lack of emotions
• Altered sense of self
• Unusual perception of people, surroundings or senses

Though it’s not always the case, psychosis often stems from a diagnosable mental health disorder, including:

• Major depressive disorder
• Bipolar disorder
• Schizophrenia

Lightfully Behavioral Health can help your loved one get the help they need for psychosis

You can’t force someone to get the help they need for their psychosis. But with the right steps, you can reduce their resistance and guide them toward treatment. Treating psychosis usually includes antipsychotic medication, but a provider can help determine the safest and most effective options based on the severity of the psychosis and the mental health disorders that lead to it.

At Lightfully, our levels of care provide treatment that can address your loved one’s psychosis and help them develop the tools they need to manage it in the future. We make sure they feel supported and cared for every step of the way. If inpatient care is required following a mental health crisis stemming from psychosis, our Residential Treatment Center and Partial Hospitalization Program can be the next steps after discharge. 

Everything we do consists of evidence-based, clearly defined, data-driven and whole-person-centered care to guide your loved one along their mental health journey.

Change is possible. When your loved one is ready to take the first step, reach out to our Admissions Concierge Team. We’ll take the next steps together, toward the fullest, brightest version of them.