What to do about significant other's unstable brother?
December 2, 2013 8:11 AM   Subscribe

My partner's brother, after a lifetime of instability, seems to be getting worse and has recently made threats against my partner and one of the parents. My partner and the parent don't seem that worried; I take this very seriously. What can I do?

My partner's brother, "Mike," 21, lives with one of their parents, "Chris." The facts I know are these:

*Mike has been diagnosed and treated for various physical, mental, and emotional issues and hasn't ever held a real job. Mike has been involuntarily hospitalized before.
*Chris has been "trying to get services" such as public assistance for Mike "for years," but without much luck, for reasons I'm not clear about.
*Mike has alienated most people in his life, and is angry at both my partner and Chris, for reasons that seem mostly due to poor mental health, and in the past has shut off all communication with my partner for months at a time.
*Mike has made some verbal threats toward himself, Chris, and my partner.
*Recently, Mike went into a rage and broke something in Chris's house; Chris called the police and Mike was put on a psychiatric hold, then released back to Chris's house.
*My partner has mentioned a few times about feeling "scared of" Mike. At other times my partner has said Mike "has never been violent" and "wouldn't hurt anyone."
*My partner has repeatedly expressed how complicated the situation is, and how hard it is for Chris to not keep giving Mike second chances.

I take all of this extremely seriously. I obviously don't know Mike as well as my partner does, but based on what I do know, I feel that my partner and Chris are in denial. I totally understand that no one wants to admit their family member could be a threat. But I am concerned for the safety of my partner and Chris; if someone makes a threat, it seems obtuse to pretend it's not there. I alternate between feeling like I might be overreacting to feeling like everyone else is under-reacting, with potentially very negative consequences.

Any practical suggestions would be very appreciated. I'd like to have a heart-to-heart with my partner. What should I say/suggest/request? What can my partner do? (FWIW I live a few hours away; everyone involved is in California.)
posted by anonymous to Human Relations (13 answers total) 3 users marked this as a favorite
I appreciate the fact that you are concerned about this, but may not be much you can do in this situation. Your partner's brother is an adult and lives far from you.

Because he is an adult, Mike can't be forced to take medication or be hospitalized unless he presents a clear and present danger to himself or others. A lot of people make idle threats at one point or another, which doesn't necessarily mean that they are going to follow through on hurting themselves or others. Psychiatrists have the very tricky job of evaluating whether a danger is present, and on his most recent evaluation, they apparently found that the danger was not significant, because he was released. Psychiatrists typically make an effort to get collateral information on a patient's situation and state of mind from family members and friends. If your partner has material information that Mike might pose a current threat, the best option is really the one that Chris already took - having him evaluated for hospitalization via calling the police.

Obviously there are options like restraining orders and kicking Mike out of the house that exist in this situation, but considering you're talking to Mike's sibling and parent, I really don't think that you suggesting that Mike needs to move out, etc. would go over well at all. This is their family's business and you need to just be supportive of the stress they must be going through.
posted by treehorn+bunny at 8:36 AM on December 2, 2013 [2 favorites]

I don't know from your question how much experience you have with siblings with disabilities. My sister has a similar mix of mental health and ID challenges, and I have several close friends with brothers with a similar background.

I would caution you from reading the situation as either Chris or your partner being "in denial." The fact of the matter is, especially when there are some extreme behavioral issues on the table, families have to become very adept at reading and managing a range of crises. What may seem dismissive or unrealistic conceptions of behavior to you, and quite understandably, comes from extended experience weathering complex emotional situations. Sometimes things like psychiatric hospitalizations, calling the cops, and other interactions with the law can be helpful, as when Chris was forced to call the police. But other times, those institutions can actually be damaging for an individual like Mike who is ultimately trying to sort himself out, learn to understand and reuglate his emotions, and make his way in the world. It's tricky stuff, and there are a lot of unsatisfying answers -- like choosing not to engage threats as serious because you've been there many times before and your ultimate goal is to reinforce a more positive behavior and response to distressing experiences.

I would start from a perspective of acknowledging that Chris or your partner may not be super-fluent in the "best practices" of supporting a family member with disabilities, but they are probably trying very hard. Similarly, keep in mind that 21 is a super-chaotic age for many people, and especially for somebody dealing with complex emotional/intellectual/mental health challenges. Mike's big challenge right now will be to eventually transform these crises into a workable, healthy relationship with extreme emotions. It's very challenging, and it's not guaranteed to work, but that's the reality.

What would you like to accomplish by speaking to your partner? It's very hard to affect family dynamics from the outside, and without a nuanced knowledge for how to encourage wellness and stability in folks with dual diagnoses, it's going to be near impossible. What my sister-in-law does when interacting with my sister is respect her wishes -- if she's reaching out to my SIL to hang out, my SIL makes an effort to reciprocate. There have been a few occasions where other family members have started conversations about my sister and she'll offer a though or two when asked. But the vast majority of the time, she just supports my brother by just being in his life, helping him be relaxed and, probably, being a sounding board when he asks for it.

So for you, I might advise a similar role -- just be there for your partner, listen to their concerns and talk it out. If you find yourself in a conversation with Chris, be thoughtful but respectful. And maybe spend a little time learning about the transition to independence.

If your partner asks you for advice with resources, perhaps you can introduce them to this network, which I have found helpful: http://www.siblingsupport.org/ (they have a great and affirming facebook group) You could check out one of the books they advertise, like Thicker than Water, and read it with your partner, if they're interested. But I would be careful to make sure this is what your partner desires. As a sibling, I try very hard to do my best by my sister and appreciate loving support, the knowledge that I can express my worries about my sister without judgment and with non-overwhelming back-and-forth, and those everyday little supports for de-stressing the most.

Good luck and I'm glad you're putting thoughtfulness and compassion into this :)
posted by elephantsvanish at 8:48 AM on December 2, 2013 [14 favorites]

Chris is demonstrably willing to call the police when and if Mike is physically violent. That doesn't sound like denial in any way; it sounds Chris has done a solid risk assessment, has boundaries, and is willing to enforce them with Mike.

As treehorn + bunny explained, if Mike was on a psychiatric hold and then released, that means, more or less, that psychiatrists agree that Mike is not an immediate threat to himself or others.

If you want to help get Mike stabilized, it might be worthwhile researching what options are available in his area/county/city for community mental health care, which might facilitate things like public assistance, Medicaid, etc., and which might be able to hook him up with a case manager.
posted by jaguar at 8:58 AM on December 2, 2013 [3 favorites]

I would like to provide a counter to the psychiatric-release-equals-safe idea - this is true in many countries, but is not always the case in the US, in which many places have an "imminent danger" standard. Ie, maybe Mike would profit from a month-long hospitalization, but psych-hold often will only assess if he's likely to kill himself or someone else essentially as he is presenting on the day they release him.

That said, you're the outsider: confronting your partner about this may lead to more friction for you.
posted by corb at 9:26 AM on December 2, 2013 [3 favorites]

I think your heart-to-heart might be most effective if you can approach it as an information gathering session, asking questions like:

- what do you worry about most when it comes to Mike?
- what don't you worry about as much?
- what do you think about when you decide whether to take a threat seriously?
- how did you handle this growing up? what were the best and worst times like?
- are there signs you look for to understand his behavior or mood?
- what do you do when you don't agree with what Chris or another family member decides?

And most importantly:
- what can I do to support you and your family?

I think you can definitely express your concerns and fears, but do it in a way that acknowledges that they are yours to deal with, and not your partner's. Hopefully your partner will understand that this is new and often frightening for you. You should be comfortable and informed, but I have to agree that it's family business and there is only so much you will be able to control.
posted by juliplease at 9:37 AM on December 2, 2013 [5 favorites]

Maybe time to read The Gift of Fear? If you're experiencing fear, you should maybe pay attention to that fear.
posted by musofire at 9:45 AM on December 2, 2013 [1 favorite]

Chris probably understands any risks quite well - sounds like Chris is doing a terrific job. Pay attention to how Chris does it, and emulate it. Gift of Fear - read it. Also read Stop Walking on Eggshells; which helps you define boundaries. If someone is seriously mentally ill, they are most dangerous to themselves, but since Mike inspires fear, develop good instincts and habits. Always have your mobile phone on you. If Mike is scary, leave, or in your home, ask Mike to change any hostile behavior or leave. Learn about Mike's condition, and know any warning signs. If Mike is tired, sick or using illegal drugs/alcohol, don't be around him. I wouldn't leave Mike alone in a home with a gun because of the risk of suicide.

Spend time with Mike at restaurants, parks, other places where socialization may help him deal with his behavior. Encourage Mike to follow his treatment plan, whatever it is.

Be as compassionate as you can about Mike. If he's schizophrenic, it's a tragedy, and he suffers the most.
Sapolsky - 24. Schizophrenia http://www.youtube.com/watch?v=nEnklxGAmak
posted by theora55 at 10:45 AM on December 2, 2013 [1 favorite]

I've been in your partner's shoes. I understand your concern and desire to help, but if my boyfriend at the time had criticized my family's approach to a loved one's mental illness or suggested we were "in denial," I would have flipped my shit. There are so, so many things you don't know about this situation and the years that preceded it.

That being said, you need to take care of yourself. If you are fearful or uncomfortable, express that to your partner and do what you think is necessary for you. Chris and your partner will do what they think is right for them.

In the meantime, feel free to open up a dialogue about mike with your partner. I'm sure he is stressed and could use someone to talk to. Make suggestions if solicited, but do not take this opportunity to tell him he and his parent are doing it all wrong. Really, it is complicated.
posted by snarfles at 10:56 AM on December 2, 2013 [5 favorites]

It sounds like this may be your first close encounter with serious mental illness. To people who've never seen it before, it seems like there should be resources to handle these types of situations. Unfortunately, what Chris is doing IS what "handling it" looks like.

Of course you should open up to your partner about your own fears about the situation, but please be aware that they aren't "in denial", they're probably handling the situation the best they know how. If you are able and willing, you could offer to provide practical support, such as researching available social services, car rides, or financial assistance, but I would really think hard about this assumption you seem to have, that there is a silver-bullet solution that they are not addressing.

That being said, make sure your own boundaries for safety are being observed. If you are worried about your partner, you might suggest specific strategies like never being alone, and always knowing the right emergency numbers to dial. That's really the angle I would take on this conversation, besides general listening/support like juliplease suggests.
posted by tinymegalo at 12:48 PM on December 2, 2013 [4 favorites]

First, read comfort in, dump out. You, my dear must comfort Mike, Chris and your partner, and find someone external to dump out to (preferably a professional, because from what you have written you do not have experience with mental illness and ill-informed friends will just ratchet up the drama).

As you are several hours away there is very little you CAN do, practically. You can listen non-judgementally to your partner. Brene Brown gave a great talk on empathy vs sympathy. Your partner needs your empathy because your sympathy is a burden to them.

There is no magic "service" that is will solve Mike's problems. If you intend you be with your partner for a long time your life will also include Mike as he is now. Can you accept that? It would be better to walk away now then create problems with judgement and demands that "something" be done.
posted by saucysault at 1:48 PM on December 2, 2013 [2 favorites]

Mod note: From the OP:
Thanks, all, for the input and advice. I have, FWIW, experience with serious mental health concerns before, and am not concerned about the brother's mental health per se.

I am concerned about the *threats of violence* he has made. I think I may have underplayed this: Mike has said things to Chris like, "If I go down I'm taking you with me" and has made violent threats directed at my partner as well. Isn't there some protocol to follow when someone (mentally ill or not) makes violent threats and is possibly a danger to himself and/or others?

Also relevant: when Mike was set to be released, a panel asked Chris whether Chris wanted to take Mike back. Chris expressed it was impossible to reject Mike in front of a panel of people. I understand this is complicated; I also wonder if family devotion might be getting in the way of reason.
posted by restless_nomad (staff) at 4:41 PM on December 2, 2013

Isn't there some protocol to follow when someone (mentally ill or not) makes violent threats and is possibly a danger to himself and/or others?

Yes, but in California generally the client can't be put on a psychiatric hold for more than 72 hours against his will unless he is making a threat against a specific person ("I'm going to kill Chris") that is a serious threat of physical violence ("I'm going to kill Chris with a gun") and, usually, that is a credible threat ("I'm going to kill Chris with the gun that is currently in my nightstand, and I have a confirmed history of shooting other people").

It's hard to do much if someone's making vague or non-credible threats, especially if the people he's threatening aren't interested in pressing charges -- because pressing charges is the other protocol.

If he's so disabled that he can't take care of himself on a fundamental level -- as in, he needs to be in long-term locked psychiatric inpatient care because he's having trouble meeting basic needs like clothing, housing, and feeding himself due to his mental illness -- then the parent could look into getting Mike conserved and forcing him into a facility.

I really think the best action here would be for you, partner, and/or Chris to google "community mental health" and the name of the county where he's residing, and ask them for help and guidance.
posted by jaguar at 4:58 PM on December 2, 2013 [3 favorites]

"Isn't there some protocol to follow when someone (mentally ill or not) makes violent threats and is possibly a danger to himself and/or others?

(IANYL TINLA) In NY, Chris or your partner could likely seek an Order of Protection against Mike that would bar him from being within a certain perimeter of them on penalty of arrest. If they felt seriously in danger they could consult with a domestic violence organization and take steps to move, hide their address, change their phone numbers, etc.

The thing it it doesn't sound like any of the people being threatened feel like those steps would be helpful in any way. In some cases, threatening could be a criminal act and anyone who witnesses could make a police report. It doesn't sound like Chris or your partner would want to and I don't know what the ramifications would be relationship-wise for you if you did.

I think a good resource for you would be a domestic violence organization in the jurisdiction where Mike lives. They could give you an idea of local laws, resources, and safety planning tips as well as perhaps a realistic idea of possible outcomes.
posted by Salamandrous at 11:45 AM on December 3, 2013

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