What to do with mentally ill homeless people who refuse help?
One of my friends was mentally ill.  I had known him for years, but never knew about the illness.  It wasn&#x27;t until a cataclysmic event which resulted his suicide that I gained first hand experience with ... the tragedy of these broken minds.<p>He was an incredibly intelligent and accomplished person, but, like all of us, had his demon.  For him, it was robo-tripping; taking large doses of cough syrup to get a high.  It had been going on for years, maybe even decades.  The years of abuse manifested as a hidden mental illness; he had concocted an imaginary friend who he could visit whenever he was tripping.  The two of them grew very close together.  The relationship was complex, as was this imaginary person.  For all intents and purposes it was another &quot;intelligence&quot; living inside him.<p>Eventually he tried to cut his &quot;addiction&quot;.  But when he tried to stop cold turkey, he realized not taking the drug anymore would mean never seeing his friend again.  By this point, he had grown too attached.  So he continued his now ritualistic highs.<p>One day he was taken to the hospital for attempted suicide.  Amidst all of this was an underlying chronic depression.  The depression predated the abuse, likely your classic case of the depressed genius.  He was released very quickly, I think within 24 hours or so.  But now more of his close friends, including myself, knew something was up.  I had no idea any of the aforementioned abuse was going on, nor the extent of his depression (I knew he suffered, but didn&#x27;t know it was bad).<p>After that event, he sat down with me and told me everything.  It was a long, shocking conversation.  The evening after was one of those cold nights you don&#x27;t think you&#x27;ll ever escape from.  Like being lost at sea.  At one point he showed me a bag.  It was filled with pills; gel capsule cough syrup pills.  Probably about two fists&#x27; worth of the stuff.  He said that was his dose for later; the kind of dose he always takes.<p>I didn&#x27;t say much.  What could I say?  He talked about everything; the drug, his friend, the hospitalization.  When it was all over all I could do was hug him and tell him I was always there for him if he needed.  He wasn&#x27;t the kind of friend I hugged; we were more intellectual buddies.  In fact, that may have been the only time I&#x27;ve hugged him.  But, I think, despite my mind whirling from everything I had just heard, somewhere deep inside I knew ... this might be the end.<p>The next few days were tense.  Our mutual friends talked over what to do; we began seeking advice on how we could get him help.  Could we &quot;commit&quot; him to get mental help?  By this point, he didn&#x27;t want help.<p>During the long conversation with him, he talked about the hospitalization.  How violated he felt by the event; being forcefully taken, poked, prodded, drugged, and held against his will.  In many ways I had looked up to his man; he was older and smarter than me.  So when I racked my brain thinking about whether we should force him to get treatment ... I just didn&#x27;t know what was right.<p>When he wasn&#x27;t under the influence, he was more or less normal.  And if he did get treatment, he would lose his imaginary friend.  I know that sounds weird.  I could never describe this &quot;imaginary&quot; person the way my friend told it to me.  But, you know how someone will be telling you about a person they&#x27;ve been hanging out with, and just by the way they talk and the look in their eyes you know they&#x27;re in love (but don&#x27;t realize it)?  It was kinda like that.<p>So I could see his position.  If he felt that strongly about this &quot;illusion&quot;, how could I forcefully take it away from him?<p>It was only a few days before everything was over.  He committed suicide.  We didn&#x27;t get him help in time.<p>I&#x27;m still not sure how I feel.  Should we have more aggressively sought to force help upon him?  Should I have said something during that long confession of his; protest his actions, tell him to get help ... or ... something?<p>And in general, what should you do when anyone is in a position like this?  Clearly mentally ill, but so delusional that they don&#x27;t want help ... what is the right move?  Should we force help on them, like this article discusses?  My friend&#x27;s case would have been a little easier; he was a danger to himself.  But I don&#x27;t think the situation is any more clear cut.<p>I just wanted to share my story.  I don&#x27;t know if many people have had to face this kind of stuff first hand; had to make these kinds of choices.  Or, at least, I hope most haven&#x27;t had to.  It&#x27;s been many years since it all happened.  I still cry sometimes when I think about it.  I don&#x27;t envy the workers who go out in the streets and try to help the lost and the homeless.