How does my sister get her suicidal roommate's family to get involved instead of leaving it all on her?
May 22, 2007 10:31 PM   Subscribe

My sister is in med school. Her roommate, "Jane," is unwell in many, many ways. My sister doesn't have time to keep on being the hospital and police liaison and chief ambulance driver for her roommate. How do we get "Jane's" family to step up and take some responsibility?

In the nine months since my sister started medical school, her roommate has made at least three suicide attempts; the first landed her in the hospital for a week, the second was stopped, only to have her turn around and take a bottle of Tylenol the next day, which got her another multiple-day stay in the hospital. Jane also cuts herself. She has had some therapy/psych eval, but it seems that, at this point, she needs a bit more. Ok, a lot more.

Jane's a grad student, mid twenties, obviously depressed, and is still having health problems related to the most recent suicide attempt, which happened a couple weeks ago.

Her family lives nearby, and yet has refused to visit her or take any part in picking her up from the hospital on any of these occasions, instead leaving that responsibility to my sister. They do not return my sister's calls, do not visit their daughter in the hospital, and do not appear to care what is going on in their daughter's life when my sister does manage to get them to answer the phone.

"Jane's" latest suicide took a huge toll on my sister's schedule: her days are spent driving back and forth to the hospital, trying to get "Jane's" family to return her calls, trying to reschedule the exams that she's missing due to all of this. My sister is overwhelmed. Completely overwhelmed.

Wait, it gets worse.

Yesterday, "Jane" was raped a half block from their house. Once again, my sister has taken care of everything, and Jane's family has not bothered to return a call to see how their daughter is doing.

Legally, they are not "Jane's" guardians. She's an adult. But my sister needs to be out of this situation, and it's really hard for her to move out when she's worried about her roommate on so many fronts. What to do? What to do?

My sister has already been planning on moving out at the end of June, but she is now wanting to leave ASAP. She's not the appropriate person to help "Jane," but she seems to be the only one who will do anything for her. That makes it pretty hard for her to decide to do what she needs to stay healthy herself: get out of this situation that has gone from bad to worse post haste.

So, tell me, hive mind. What advice can you give to her? What should she tell the girl's family, if anything? Most importantly, what might she say that will actually help them get more involved and maybe get Jane what she needs?
posted by bloggerwench to Human Relations (40 answers total) 2 users marked this as a favorite
If "your daughter was raped yesterday" doesn't get Jane's family to step up, I think they're pretty much a lost cause.

I'm just baffled. Have they given any reason why they won't help Jane? Has your sister been able to engage them in any sort of conversation on the matter?
posted by granted at 10:58 PM on May 22, 2007

Can your sister get the college involved? Maybe if they made the phone calls they'd be responded to.
posted by Soliloquy at 11:11 PM on May 22, 2007

Here's a question, what is Jane doing to help Jane?

I understand quite well the kind of problems that depression can cause. I've had very similar situations occur within my own family and friends, none of which had happy endings. I have come to believe that there is a point at which you can no longer help someone unless they are willing to make an effort to help themselves. You said yourself that Jane is a grad student, so that tells me that she is at least of competent mind to reach a goal that many people never do. Why then can she not seek help for herself? Normally there are resources for students in positions like this. You never really mention what kind of relationship your sister and Jane have (are they friends or just roommates?). If Jane cares about your sister like your sister seems to care about Jane, then there should be some reciprocity involved. Bottom line... If she isn't willing to recognize that she needs help, your sister sure as hell isn't going to convince her.
posted by ISeemToBeAVerb at 11:13 PM on May 22, 2007

the family is obviously a lost cause.

at this point, it sounds like "jane" needs a mental health half-way house of some sort. people who's JOB it is to be there and provide supervision.

i realise your sister probably feels too guilty to leave jane, but if she's missing exams, etc. she needs to take a step back and start protecting her own interests and mental health. it's got to be incredibly distressing to live with someone who's actively trying to harm themselves. she needs to get out.

further, if there's no one else in the picture (i.e. providing supervision and support at home in place of family members) i would think health professionals will be less likely to just discharge jane to go home alone. it may help her get some more support, which she's clearly in need of, or may force her family to take her in.

unfortunately, you can't stop someone who's really intent on killling themselves, and it's not fair to have your sister be on 24 hour suicide watch.
posted by wayward vagabond at 11:37 PM on May 22, 2007

I think your sister is absolutely correct that she needs to get out. She also needs to steel herself to phone calls from Jane that say "I'm going to kill myself today". The one case I knew that was at all similar to this was someone who was very far gone in Borderline Personality Disorder, incapable of helping herself, and destroying anyone who tried to help her by basically requiring their 24 hour presence at her side (or she would kill herself, you see). There is only one way to detach from that, and it's absolutely brutal on a person who has a conscience (as your sister obviously does).
The best solution is to get a third party psychiatric professional involved somehow.

- Would Jane be willing to voluntarily sign herself into some kind of psychiatric care facility?
- If no, can your sister get one of the doctors from the recent suicide attempt to sign off on an involuntary commitment? Or can she leave that with the family to arrange?
posted by LobsterMitten at 11:44 PM on May 22, 2007

if your sister ever wants to finish med school and become a doctor, she has to cut loose from this black hole of attention before she gets sucked in past the event horizon. remember paul simon's "50 ways to leave your lover"? just change one word.
posted by bruce at 11:51 PM on May 22, 2007

It seems likely that your sister has plenty of justifications for threatening the school with legal action for putting her in this situation, including potential danger to your sister (which the school may be more cautious about post-Virginia Tech). If she can make a credible threat, the school may be willing to ask Jane to withdraw. That might force Jane to seek family support; it might encourage more suicide attempts. If your sister tries to do this, she or the school should make sure that some family or local resources are waiting for her.
posted by gsteff at 12:00 AM on May 23, 2007

If your sister tries to do this, she or the school should make sure that some family or local resources are waiting for her.
posted by biffa at 2:06 AM on May 23, 2007

My sympathies... I've known a few people in situations like this, and the answer is, sadly: Run away, do not look back. Take only what you need.

Your sister isn't responsible for Jane. If your sister wants to move forward with her life, she has to get the hell away from Jane. Now. Do whatever it takes. If it's only 5 weeks, see if there's a friend/family member near the university that your sister can stay with. Get in touch with school housing and say she needs emergency relocation. Staying the local hostel or SRO. Or anything. Get the hell out. You can't fix Jane or save her or even help her.

Two aside notes based on my experience with people not too different from Jane:

I sympathise with the family. You know why they won't come? They've been putting up with this for a lot longer than your sister has. Even being a family has its limits, and Jane has pushed hers past them. Poor folks. They've likley done everything they know how and it hasn't helped, now they're waiting for the call from the coroner.

And this ... I hate to even mention it because there might be some outrage... But a woman I know who did everything that Jane did (cutting, multiple suicide attempts) was also a huge liar, and told many verifiably false tales about being raped and abused. I don't know if Jane was raped or not, but my gut says the odds are low and she wants attention.
posted by Ookseer at 2:19 AM on May 23, 2007

as much as your sister doesn't want to be the one taking "jane" to the hospital, she *definitely* doesn't want to be the one to discover "jane" if she's successful in her attempts. even more reason to get out now.
posted by wayward vagabond at 2:31 AM on May 23, 2007

If this were me, I'd be in a terrible state. Staying is doing your sister's head in, going could be worse. Perhaps the best case of action is to try to get her referred to a psychiatric institution where they can care for her properly? I wouldn't leave until something else is in place - the guilt if it does go wrong would be too much for me to bear.

On a practical note your sister should document all of the help she has been giving this poor woman, and all of the time she has spent, and everything that has gone wrong, and go talk to her personal tutor or the director of undergraduate studies at her institution. I work at a uni and believe me people go off of the rails all the time and we try to deal with it as best we can - there are student services to help, there are extensions we can give for assessed work, we can take things into account during the exam marking and moderation period. But we can't do any of this if we don't know it's going on. This advice applies to both Jane and your sister. I'm assuming, as she's such a train wreck, that Jane is already with the student counselling service, but if not then that is the place to start, even if your sister has to drag her there.

You don't say where you are but in the UK I think the thing to do would be to get her sectioned under the mental health act, which will require contacting an approved social worker or psychiatrist (overview on the link above). This poor woman is clearly (I mean, clearly) a danger to herself and others and it isn't right to leave her on her own.
posted by handee at 2:43 AM on May 23, 2007

Most universities have resources to deal with this. Call whoever is easiest to get hold of in administration - I'd start with the registrar just because their number is easy to find - and just ask who the appropriate staff is. Then leave it in their hands. They are trained and available.
posted by joannemerriam at 3:37 AM on May 23, 2007

This is definitely the school's responsibility.
posted by Faint of Butt at 3:43 AM on May 23, 2007

I nth the suggestion to get the school involved. Also when your sister does get out, make sure Jane has NO forwarding information -- no address, no phone number, not even an email address or block her address. She's learned that your sister will always respond so I wouldn't put it past her to keep bothering her even after she's moved out.
posted by boomchicka at 4:23 AM on May 23, 2007

I second what Ookseer says. Don't be too hard on the family. It sounds shocking, but I have a family member who suffers from depression and anxiety disorders, but who also takes no responsibility for herself.

After 20 years of doing for that family member exactly what your sister is doing for Jane, I too did what Jane's family is doing--I stopped. Each time I thought, "Oh, I'll just help her a little bit" I learned that the first sign of "helping just a little bit" meant that she thought it was going back to the "helping her non-stop" that it had been. Now I've stopped completely.

It seems cold-hearted, but I found that what happened in my case is exactly what's happening in your sister's case: my family member found other people to use--still taking no responsibility for herself.

As ISeemToBeAVerb says--what is Jane doing to help Jane?

I agree with Ookseer on another matter--my family member was known to invent stories to get more attention. I'm not saying that Jane's lying about being raped, but I'd consider the possibility that she is.

Your sister needs to get out fast. She has to look after her own health (mental and physical) and her own studies.

If she's waiting to get out until the family pays attention to her (so that Jane can be looked after), she'll never get out. They know, they know. They're just refusing to get sucked in again themselves.

She can report this situation (in writing) to the school and to the family and to any other appropriate authorities. She can tell them and Jane that she will no longer be responding no matter how horrific the situation is. Then she can in good conscience put it out of her mind and move because she's done her best.

On no account should she give Jane her new phone number or address.
posted by purplesludge at 4:28 AM on May 23, 2007

Assuming your sister is in the US, and assuming that Jane is in a fairly typical hospital, my experience (including dealing with a close friend's suicide attempt while she was staying with me) lead me to think that the hospital will have licensed and trained professionals that should be involved in taking care of Jane's needs both pre- and post-discharge.

Specifically, Jane should already have been assigned a social worker, and I think mental health professionals are normally involved at some stage in unsuccessful suicide attempts. Perhaps your sister can verify if this has been done and try to get these people to formulate a realistic discharge plan for Jane that includes her family.

This obviously involves some continued effort on your sister's part, and I sympathize -- it's a tough spot to be in.
posted by lassie at 4:28 AM on May 23, 2007

Was she actually raped? The family pretty clearly thinks she wasn't, that it's just a call for attention. (I don't mean to belittle Jane; she clearly has major mental health issues and is incapable of acting rationally.)

Do this. Send a letter, certified mail, copied to several people at the university: Dean of students, the head of any medical facilities that exist, and the university president. Describe the situation. I assure you that, in the spirit of cover-your-ass, Something Will Happen. What may well happen is that Jane is immediately expelled from the university, but whatever, Something Will Happen.
posted by jellicle at 5:34 AM on May 23, 2007

if jane is as much a threat to herself as it sounds, i believe she can be involuntarily committed to a mental health institution. it may depend on what state you're in, but look into that.

your sister needs to move out. she can't let jane hold her hostage. this will actually be good training for her as a doctor--there will always be some patients who simply don't comply with their care, and who will die from it. i'm sorry your sister has to learn this lesson in such a personal way.

it might be a good idea for your sister to get into counseling as well. this must be horrible for her.
posted by thinkingwoman at 5:36 AM on May 23, 2007

Response by poster: Thanks for all the comments so far. ISeemToBeAVerb asked about Jane's and my sister's relationship: my sister moved in to the place without any previous friendship with Jane.

Also, I was not very clear on their housing--they are off-campus, not in student housing.
posted by bloggerwench at 6:39 AM on May 23, 2007

Thinkingwoman has a great point. Your sister needs to try to handle the situation as she would if this were a patient of hers. You do what you can, but refer what you can't through the appropriate channels. I would talk to somebody at the hospital and ask what they could do (if anything) from a medical standpoint since she is so unwell. I'm sure this isn't the first time they've come across a situation like this. If that doesn't yield anything, then I'd contact the school. But this seems to be a medical issue first. It's nice that your sister has gone so out of her way to help, but unfortunately, some people just can't be helped. So you do the best you can, and that's all you can do.
Best of luck to your sister - her caring attitude and willingness to go out of the way to help another person is definitely an admirable trait, and I'd like her to be sane herself long enough for lots of people to enjoy it!

As soon as I got to the "Jane was raped" part of the question, I admit I rolled my eyes and said "Sure she was." If I knew Jane and heard the story from her I might have a different reaction, but it did send up a flag. It's possible that with all her problems she does look like an easy target for a rapist, but it's just as likely that it is a way to manipulate people for attention. Awful to think like that, but not everyone's intentions are pure.
posted by Iamtherealme at 7:11 AM on May 23, 2007

Call the school. Most universities don't like it when their students die. There should be health services department at most/all universities.
posted by chunking express at 7:12 AM on May 23, 2007

(sorry - the klklalksjdflajsdf at the bottom was to make sure I did indeed close the small tag and it didn't screw up the "My Comments" page, but as I always do, I hit Post instead of Preview. Though kljaklsjdlfa does pretty well sum up the situation)
posted by Iamtherealme at 7:12 AM on May 23, 2007

Response by poster: Regarding the credibility of the rape story, I have my doubts too. It just seems like too much; I in fact did say a few things like "Right! Sure she was. No, seriously?" when my sister told me. Apparently, there is a police report, etc. I still am on the fence--and if it's made up, I'm even more upset, since my sister seems to believe the story and is now scared about a rapist being loose in the neighborhood, to add to her not-insignificant other concerns.
posted by bloggerwench at 7:16 AM on May 23, 2007

Your sister needs to call her school's counseling services, not about Jane, but about herself. She needs support in extricating herself from a harmful and potentially dangerous situation. The counseling people might also have some insight into what is appropriate to do for Jane. But your sister is in over her head here, and there are resources on campus to help her.
posted by craichead at 7:50 AM on May 23, 2007 [1 favorite]

Yes, definitely check with the school. Start with the counseling center, or if the school has something like this, call them.
posted by MsMolly at 7:59 AM on May 23, 2007

Most med school deans I've heard of are supremely protective of their students and will bend over backwards to help them. It sounds like Jane is going to need some serious counsellings and attention. Your sister needs to contact the deans, and get out of the situation ASAP.

Fortunately, she's just finishing up first year which (at my med school at least) is a little more "laid back" than the rest of it. She's most likely got only more one more round of exams, so she can probably power through that. Tell her to take the summer off, relax, change her cell phone number, and be ready to hit second year running.

She should work with the school and Jane so that it does not affect her next year as she is going through Pathology hell and preparing for board exams.
posted by ruwan at 8:18 AM on May 23, 2007

Please don't tell your sis to report Jane to the school officials -- yikes! Medical students who are known to have MH problems have incredible problems getting residencies, getting licensed, even when very well qualified. I know because they call me to help with their discrimination problems.

This is also happening at undergraduate schools -- kids have been kicked out of school for being suicidal. Go to the Bazelon center's web site for details re several cases they have brought. Here's the story about one.

Instead reach out to confidential counselors, NOT the school officials. If Jane won't work to get better, well, that's her choice.
posted by ClaudiaCenter at 8:58 AM on May 23, 2007

Send a letter, certified mail, copied to several people at the university: Dean of students, the head of any medical facilities that exist, and the university president. Describe the situation. SNIP What may well happen is that Jane is immediately expelled from the university, but whatever, Something Will Happen.

Again, I think this is a terrible idea. Sister needs to get out of the situation (and get her own MH care, perhaps). Jane will get help, or not, will survive med school, or not. Taking affirmative steps to get a person forever kicked out of medical school based on their MH status is really bad karma. (Note: A person kicked out of medical school is often disqualified from other medical schools. I know, again, from medical students calling me about getting discriminated against based on having MH problems while in school one, and being unable to gain admittance to school two.)

Actual qualifications -- passing classes, being able to give appropriate care -- can and will be assessed by the medical school and licensing system. If Jane doesn't get help she likely will not become a doctor -- but based on merit not based on Yikes! Scary! letters to the dean.
posted by ClaudiaCenter at 9:10 AM on May 23, 2007

Claudia, I believe it is the sister that is in medical school, not Jane.
posted by kitty teeth at 9:37 AM on May 23, 2007

Response by poster: Correct, Kitty Teeth. The roommate is in grad school.
posted by bloggerwench at 10:10 AM on May 23, 2007

Geez Claudia - if the girl is about to kill herself, surely getting kicked out of medical school is the lesser of two evils?
posted by handee at 10:31 AM on May 23, 2007

Well, up until ClaudiaCenter's information about the possible backlash/discrimination against anyone with a mental health "history" in med school, I was ready to suggest that your sister make an appointment for herself with the school counselors, just so that she'd be sure to have somebody's complete-and-undivided attention for an hour or so, and lay it all out to them, and get some advice on getting herself disentangeled.

Given that she probably doesn't want anyone in the MH office starting a folder with her name on it, maybe that's not such a hot idea.

So I'd suggest going to the deans. If "Jane" gets thrown out of grad school, that's unfortunate, but really I think it's clear that she needs to be in an inpatient psychiatric facility, at least for a while. At the very least, the school will want to make her go away (they don't want to be in the path of the lawsuits when "Jane" finally either succeeds in killing herself, or hurts someone else), and hopefully they'll be compassionate enough to help her get the care she needs. Either way, your sister can wash her hands of it, knowing she went way beyond the call of duty or roommateship there.
posted by Kadin2048 at 11:28 AM on May 23, 2007

There are a lot of answers here already, and I'm going to say right up front that I haven't read any of them.

I've been there. I've had a partner do the suicide attempt thing nearly successfully twice, along with sundry other disasters. I won't go into details, but it was bad, very bad.

I'll probably get slammed for this observation, but there is one thing to think about here: maybe her family has realized something your sister has not -- if someone's always there to pick up the pieces, then there's no incentive for Jane to break the cycle. (I speak as someone with a lifetime history of depression and "accidents" who's gotten better.)

No one has made your sister pick up the pieces for Jane. One of the hardest things I ever did was not doing a damned thing for my partner the second time around, and that includes not seeing her in the hospital, while she was in for observation.

Yes, Jane is sick, but your sister is helping her stay that way. She should stop. And yeah, it's probably too stressful to be a roommate and not help out.
posted by MarcieAlana at 12:09 PM on May 23, 2007 [1 favorite]

Response by poster: Some older questions:

Has my sister been able to engage the family in conversation? Not really; they have talked a few times, but they always blow off their daughter's problem and minimize it. How do you spell "denial" again?

Can my sister get the college involved? From what I understand, the roommie is on a leave of absence. She also goes to a different school, and they, as I mentioned before, do not live in campus housing.

Can she get a doctor (or the family) to sign off on an involuntary commitment? I don't know. It sounds like a good idea, and I'm sure she'll read it and think about it. Key problem: these all result in her having to stay involved and take responsibility.

Is my sister getting help for herself? She's trying. My opinion of her school is very low, given that the counseling services told her last time she called to say "Help! Life is really bad right now!" not only did they not make any referral, but they told her the line was only for "crises" and not to call again. I hope they don't see a single cent of alumni giving from her.
posted by bloggerwench at 12:33 PM on May 23, 2007

If, at any point, Jane's response to say "I'm going to commit suicide." your sister should simply pick up the phone and call 911. That will get Jane a trip to the hospital and a psychiatric evaluation. If the doctor believes she is a danger to herself, he or she can do an involuntary commitment (Locallly the law says 72 hours with possible extension.) That takes it out of your sister's hands to evaluate if the threat is serious or not.
posted by metahawk at 1:23 PM on May 23, 2007

Response by poster: She's not evaluating whether the threat is serious; she's dealing with actual attempts. I don't know if she has ever announced her intentions before going for it.
posted by bloggerwench at 1:31 PM on May 23, 2007

Response by poster: My sister weighs in with the following clarifications:

1. I am not an imbecile. Should Jane say to me, "I want to kill myself right now" I would OBVIOUSLY call 911.

2. In the past two weeks, Jane has already been held on a 5150 (aka involuntary psychiatric commitment) once. The hold was, as the law provides, for 72 hours, but it was then determined that they needed to extend it for a couple more days. Upon returning home, 5 days after commitment, it was right back to the same old same old.

3. Both psychiatric help AND therapists have been summoned, but they have taken a very back-seat approach to the situation (as evidenced by them scheduling an appointment for a session 4 days after the rape).

4. YES SHE WAS RAPED! There is forensic evidence proving this (rape kit from the hospital), and I have been centrally involved in the police investigation of the incident. I realize that this whole situation may seem to be rather over-the-top and that it appears that she is seeking attention. However, I do not buy into the theory that women just go around looking for somebody to rape them so that they can get attention. (on a side note, I also don't buy into the theory that women bring rape upon themselves by dressing provocatively or anything of the sort.)

5. Any tips on studying pharmacology for my final exam that's coming up in a couple days? Thanks!

Also, she says thanks for the occasionally fun reading!
posted by bloggerwench at 5:48 PM on May 23, 2007

Re: the 911 thing, I think the person who suggested this was just pointing out that even if Jane didn't seem serious about her suicidal ideation, to call 911 anyway so as to get the involuntary committment ball rolling (as it often takes nothing short of a 911 call for someone to get committed). Since your sis has since weighed in and said that Jane's already been committed and released, it looks like that's a moot point.

To bloggerwench's sister:

Look, at this point? Just leave. Move out, or find someone to crash with until finals are over and then move out. Tell Jane that you are leaving, that you cannot take care of her anymore, and that while you really hope she commits herself so she can get the help she needs, you are moving out regardless and will not be leaving any forwarding information (also, make sure the landlord has instructions not to give that info to her). You don't have to say it as bluntly, but be clear. And act on it. Even if you lose a deposit for breaking your lease, if you can swing it at all, it will be some of the best money you've ever spent. She is demanding more than anyone can reasonably be asked to give -- in fact, I wonder if she doesn't have some borderline personality disorder issues in addition to her depression/suicidal tendencies. But that's just me musing, and it's irrelevant; you've done what you can, and now you need to take care of yourself.

Any tips on studying pharmacology for my final exam that's coming up in a couple days?

Yes: study at the library.

Good luck.
posted by AV at 8:05 PM on May 23, 2007 [1 favorite]

bw's sis: I think people were suggeting that she might have been lying (or hallucinating?) about the rape, not that she "brought it on herself". You've cleared that up, though.

I'll just run through a few more possibilities, although I think we can all see that you're in an awful spot and there are probably no "best" moves right now...

Have you talked to her about the possibility of committing herself voluntarily?

Did the doctors at her last attempt have anything useful to offer about longer-term plans or care facilities?

Is it a possibility to literally drop her off with her family? Get her in the car, drop her off at their place?

Can you call a therapist in your area, not affiliated with your school, to get an emergency appointment for yourself? Many offer sliding-scale payment plans for students.

Again, I'm so sorry. Good luck.
posted by LobsterMitten at 8:44 PM on May 23, 2007

Just to semi-clarify -- the student mental health services, although offered by the school, are (supposed to be) confidential. So, I'm not suggesting that students should not use those services, especially as most students can't afford to go outside of that system.

I was talking about providing reports to school officials -- e.g. deans, presidents, etc. That's a completely different place for information to go. And particularly for medical school (though now I understand that Jane is not in medical school).
posted by ClaudiaCenter at 9:15 AM on May 24, 2007

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