Extremely unwell family member - we don’t know what to do

Hi everyone,

I found this page looking for forums for supporting a loved one with mental illness.

Im honestly feeling quite overwhelmed, so I hope it’s okay to share our situation and ask for guidance from anyone who has walked a similar path.

My sister is 30 and has lived with severe contamination OCD for many years. As a family we’ve largely managed things privately over time, but over the past year her mental health has deteriorated significantly and she has been experiencing clear psychotic symptoms (hearing voices, hallucinations, disorganised behaviour, wandering for long periods and inability to care for herself).

She’s unable to work, eats very little due to contamination fears, and relies heavily on family for daily living. She has presented to hospital and acute mental health services multiple times and was prescribed antipsychotic medication, but due to her illness she cannot take it consistently or sustain engagement with treatment.

We feel very stuck with the hospital system. Even though she has mentioned suicidal thoughts from time to time and ongoing voices, imaginary friends and psychically looks unwell, because she wasn’t expressing active intent in the moment, she has been discharged each time and we’re told she doesn’t meet admission criteria. It’s a horrible experience, the last time we were in emergency we where there for 9 hours.. It feels like she has to reach crisis point before help is possible, which is terrifying to watch as a family. We feel like she IS at crisis point, the only thing left is for her to harm herself or someone else.

We have tried to access private psychiatric care. She sadly missed two psychiatrist appointments because she wandered and was uncontactable beforehand, and both psychiatrists then declined further engagement. The one time we did see one of them, the advice was essentially to keep taking medication and improve her diet, which hasn’t been achievable given her level of illness.

Recently there have been multiple episodes where she has been screaming at the voices in her head while alone at home, to the point neighbours became concerned and contacted the landlord, who then called my mother. Another incident occurred the other day where my mother was at her place trying to help with her care and try have her eat some food, she picked up a kitchen tool (was abstained from saying the word) and started screaming at the voices in her head. We are absolutely terrified. Lost. And feel like we’re in this alone.

These incidents really reflect how unwell she is outside of appointments and how unsafe things feel day-to-day.

She is currently living with my brother but that arrangement is becoming unstable because HE is becoming her full time carer and also struggles with mental health concerns, my mum is on minimum wage and my step father will absolutely not have her at the house.

I suppose I’m just hoping to hear from anyone who has supported a loved one with severe mental illness and poor insight like this…

I feel heartbroken watching her slip further away and feeling powerless to help her. My mum and brother are absolutely struggling and our family is on the brink of collapse.

Thank you so much for reading.