Key takeaways:
When a person refuses mental health treatment, it’s important to listen, express your concerns, and ask them how you can help.
If a person shows signs of a mental health emergency, then you should take action right away by contacting your local crisis response team, 988, or 911.
There are some cases where a person may be mandated to get mental health treatment. But most of the time, you can’t force someone to get help when they don’t want it.
Mental health conditions are common. More than half of people around the world will be diagnosed with a mental health condition at some point in their lifetimes.
Many people with mental health concerns are motivated to get help. But, some people with mental health conditions may refuse treatment for a variety of reasons, such as:
Being afraid of stigma
Not being aware there’s a problem (anosognosia)
Not realizing how serious their symptoms really are
Believing they can address the issue on their own
Not understanding how to navigate the healthcare system
Not knowing what mental health care is and how it can help
Lacking the financial resources or support structure to afford care
Not being able to find the right specialty or culturally appropriate care
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When someone you care about has a mental health condition and refuses to get help, it can be very challenging to navigate. Read on to learn more about what to say and do when a person refuses mental help, signs that a person needs emergency help, and available resources.
How to talk to someone who refuses mental help
When talking with a person with a mental health condition who doesn’t want professional mental health care, it’s important to treat the person with kindness and respect. Remember that they’re dealing with a mental health condition and may have valid concerns about getting treatment. Avoid blaming or shaming them. Instead, keep the following tips in mind.
Explain
Share your concerns with your loved one by explaining why you’re worried about them. Keep the focus on their present behavior and avoid labeling or diagnosing. For example, you might say, “I’m worried because I’ve noticed that you seem sad and withdrawn these past few weeks.”
Listen and build trust
Ask questions and listen to how your loved one feels about treatment. If you ask them why they don’t want help, let them share their answers without jumping to conclusions.
Often people who are struggling don’t want advice or feedback, but rather they just want someone to listen. Try to be present with your loved one and hear what they’re saying without interrupting. This helps to build trust and shows them that you are there to support them.
Be understanding
Try to understand where your loved one is coming from, even if you don’t agree. Consider reflecting back a summary of what they have said for clarification. Here’s an example of how you might respond: “You’re worried that going to therapy might make you feel worse, am I getting that right?”
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You might also validate their concerns while gently introducing the possibility that treatment might be helpful. For example, you could say: “Sometimes, therapy does make you feel worse initially. But most people find over time that the benefits far outweigh the drawbacks.”
Educate yourself
It’s hard to understand what your loved one is going through if you haven’t been through it before. Educating yourself on mental health and treatment can help you better understand what they’re experiencing and how to help. The National Institute of Mental Health (NIMH), National Alliance on Mental Illness (NAMI), and Mental Health America all offer valuable education.
Ask how you can help
When talking to your loved one, ask them how you can be most helpful. They may be more open to asking for help with household chores than treatment. Take any requests for help seriously. They may start with small requests at first and gradually work their way up to asking for other forms of help.
Give options
You can offer suggestions on ways that you can help them. For example, you could offer to help them find a therapist, psychiatrist, or support group. This can be especially helpful if your loved one has trouble navigating the complexities of the healthcare system or finding an appropriate health professional.
You could also help with childcare and housework like cooking or cleaning. Helping with these tasks may remove barriers to your loved one getting treatment. And while this may not be feasible for everyone, offering practical support such as financial resources to pay for treatment can remove other barriers to getting care.
At the same time, keep in mind your limits. Avoid giving support or help that’s not your responsibility — such as trying to do the work of improving your loved one’s symptoms for them.
Start small
Encouraging a loved one with a mental health condition to get help may not happen overnight. It’s best to start small and practice patience. For someone having a hard time with a mental health condition, even getting out of bed or going to the store can be an accomplishment. Notice your loved one’s efforts and progress, no matter how small.
Remain open
When someone refuses to get help, it’s normal to want to stop offering assistance. But you can continue to maintain an open dialogue with your loved one to help keep the door to future treatment open. Respect their boundaries, but let them know that you’ll remain a support to them.
988 vs. 911: These are go-to phone numbers to get help for emergencies. Learn about when to use one over the other.
Caring for someone with schizophrenia: A mother shares her experience caregiving for a child with schizophrenia.
Helping someone in crisis: Learn more about what to do when someone experiences a mental health crisis.
What counts as a mental health crisis?
A mental health crisis is a situation where a person is at risk of hurting themselves, someone else, or is unable to care for themselves.
A mental health crisis may involve:
A manic episode
Psychosis, or a loss of touch with reality
Homicidal thoughts, urges, or plans
Suicidal thoughts, urges, or plans
During a mental health crisis, a person’s safety and well-being are at risk. A mental health crisis requires immediate action to get the person the appropriate help they need to remain safe.
When should you intervene for someone who may need mental health help?
You should intervene if your loved one shows any signs of a mental health emergency. Signs that a person is experiencing a mental health emergency include:
Inability to maintain adequate hygiene
Severe changes in mood where a person goes from being happy, agitated, or extremely energetic to depressed, lethargic, and withdrawn
Threatening to harm others, engaging in violent behavior, or destroying property
Loss of touch with reality, such as seeing or hearing things that aren’t really there
Paranoia
Specific suicide plans or attempts
Can you force someone to get mental health care?
Yes, sometimes a person with a serious mental illness may be mandated to get mental health treatment. This can happen when a person is involuntarily hospitalized or mandated to attend outpatient treatment by a court. But in most cases, you can’t force someone into treatment.
If a loved one shows signs of a mental health condition and refuses help, but is not a danger to themselves or others or showing any signs of a mental health emergency, then you can’t force them to get treatment. You can encourage them to get help, but if they refuse, you must accept their decisions.
In the U.S., each state decides the laws on mandated mental health care. Generally, a person must be a serious risk to themselves or others in order to qualify for any form of mandated treatment. Involuntary hospitalization occurs when a person is committed to a psychiatric hospital without their consent.
A psychiatric team will determine if a person is a danger to themselves, others, or is seriously disabled due to their mental illness. The expert team may request an involuntary hold (or civil commitment) at a psychiatric facility. If the person’s symptoms are not stabilized within that time frame, then the psychiatric team can file for an extension, which a judge needs to approve.
In some states, a person may be ordered by the court to attend outpatient treatment. This mandates a person with a serious mental health condition or substance use disorder to attend therapy and take medication for a specified period of time. This is typically reserved for people who have a serious mental illness and who are unlikely to follow a treatment plan on their own.
If a court determines that a person with a serious mental illness is unable to make their own decisions regarding their healthcare and finances, then they may be appointed a conservator. When a person enters a conservatorship, they lose the right to make decisions about their finances, treatment, and housing.
How do you help someone with schizophrenia who refuses treatment?
Schizophrenia is a serious mental health condition that involves a loss of touch with reality. People with schizophrenia may experience:
Hallucinations (for example, seeing or hearing things that aren’t actually there)
Delusions (for example, false beliefs that the person is convinced are true)
Disorganized thoughts, speech, and behavior
Treatment is an important part of managing schizophrenia. People with schizophrenia benefit from medications, therapy, and other psychosocial supports. Untreated schizophrenia can affect a person’s ability to function and increase the risk for substance misuse and self-harm.
Here are some things to keep in mind when a person with schizophrenia refuses to get help:
Remember that the person has a serious mental illness and that their symptoms are not their fault.
Educate yourself about the condition and keep a list of resources in the event that you need them.
Remain calm, especially when the person is symptomatic. Use a calm and soothing voice and avoid confrontation.
Prioritize your own self-care. Supporting a person with schizophrenia can be challenging, so make sure you’re taking care of yourself and coping with your own emotions.
Who to contact for a loved one having a mental health crisis
If your loved one already sees a mental health professional, you can let them know about the situation. Keep in mind that they can’t share any information without your loved one’s permission. But they can listen and may intervene if the emergency is serious enough to warrant breaking confidentiality.
You may not be able to reach your loved one’s mental health professional, or they may not have one. In that case, take your loved one to the hospital, contact the Suicide & Crisis Lifeline at 988, or call 911.
Depending on where you live, you may be able to contact a mobile crisis team for help. These teams have training in how to intervene in a mental health emergency. To locate your local crisis response team, contact your state or county’s department of health. You can also check the Black Emotional and Mental Health Collective’s list of local resources.
Calling 911 should be your last option for help when possible. If you must call 911, let the emergency operator know your loved one is having a mental health crisis. Describe their behavior, your relationship to the person, and whether they have access to weapons.
You can also request that a Crisis Intervention Training (CIT) officer be dispatched. A CIT officer has specialized training in how to de-escalate situations involving a person with mental illness.
Once a CIT officer, police officer, or crisis responder arrives at the scene, they may ask you questions. Be sure to tell the responder that the person has a mental health condition. And give any information that you can about the person’s:
Diagnosis
Medications
Hospitalizations
History of violence or suicide
If the person doesn’t have a history of violence, make sure to note this as well.
You can request that your loved one be taken to the hospital. But once responders arrive, you no longer have control over the situation. The responder will determine the best course of action for the person.
When should you walk away from someone with mental illness?
Helping a loved one should never compromise your own safety. If a situation becomes dangerous, you should walk away. If you’re experiencing violence or abuse of any kind, then reach out for help by contacting the National Domestic Violence Hotline. To reach the hotline, you can call 1-800-799-SAFE (7233) or text “start” to 88788.
In some cases supporting a loved one with mental illness can affect your own mental health. It’s important to prioritize your own self-care and set healthy boundaries. Many family and friends benefit from their own therapy to help them cope with the challenges of caring for a loved one. NAMI offers resources and support groups for family and friends of a loved one with mental illness.
Resources for assisting someone who refuses mental help
There are many resources available for people dealing with mental health conditions.
You might consider providing them with the resources below. If your loved one doesn’t want help, they may be reluctant to reach out to one of these organizations. Let them know that they can reach out if they wish, but don’t force or pressure them to do so.
Resources for people dealing with mental health conditions include:
The 988 Suicide & Crisis Lifeline: It offers 24/7 confidential support to people in crisis or thinking about suicide. Contact the Lifeline by calling or texting 988 or chatting online.
Crisis Text Line: The Crisis Text Line offers 24/7 crisis support via text. Text “home” to 741741 to speak with a live crisis counselor or you can message securely on WhatsApp.
Veterans Crisis Line: It’s available 24/7 to all veterans, even those who are not registered or enrolled in VA benefits. To contact the Veterans Crisis Line, call 988 and select 1, or text 838255. You can also access the Veterans Crisis Chat online.
Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA provides information on mental health and assistance finding local treatment. For referrals to treatment, call the National Helpline at 1-800-662-HELP (4357) or search the Behavioral Health Treatment Services Locator.
Getting referrals to mental health services
When a loved one refuses help, finding healthcare professionals and programs that offer treatment can be challenging. Along with the resources listed above, you may be able to get referrals for mental health services from your local crisis team.
Some communities offer assertive community treatment (ACT) for people with serious mental health conditions. ACT is an evidence-based approach that offers therapy and medication management. It also offers assistance with housing, job training, and finances.
The goal of ACT is to support people living with severe mental illness. It uses a team approach to help in many areas of people’s lives. ACT may be especially helpful if your loved one has not made progress using traditional treatment approaches.
To learn more about possible local ACT programs in your community, contact your state or county’s office of mental health. Your local office of mental health can also advise you of other options for mental health services.
Options that may be available in your community might include:
Respite services
In-home treatment services
Transportation to treatment
Housing for people with mental health conditions
If your loved one is already connected to a treatment program or mental health care professional, they can also provide assistance connecting with local community programs. Many programs help with mental health treatment, housing, and transportation.
The bottom line
People with mental health conditions may vary in their openness and motivation to get treatment.
If someone you know shows signs of a mental health emergency, take action right away. Contact 988, 911, or your local crisis response team and tell them your loved one is dealing with a mental health crisis. In most cases, you can’t force a person with a mental illness to get treatment. But if your loved one is a danger to themselves or others or is unable to care for themselves, they may be mandated to treatment until their symptoms have improved.
When it comes to talking with your loved one with a mental health condition, it’s important to listen, express your concerns, and ask them how you can be most helpful. As difficult as it can be, try to practice patience. Remember that a person who resists help is going through a difficult time and will benefit from your continued support.
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References
American Psychiatric Association. (1999). Mandatory outpatient treatment.
Benitez, B. R. (2012). Confidentiality and its exceptions including the US Patriot Act. California Association of Marriage and Family Therapists.
Bond, G. R., et al. (2015). The critical ingredients of assertive community treatment. World Psychiatry.
Conroy, J., et al. (2020). Why people aren't getting the care they need. American Psychological Association.
Fariba, K. A., et al. (2023). Involuntary commitment. StatPearls.
Franz, S., et al. (2010). Crisis intervention teams may prevent arrests of people with mental illness. Police Practice and Research.
Los Angeles County Department of Mental Health. (n.d.). About conservatorship.
McGrath, J. J., et al. (2023). Age of onset and cumulative risk of mental disorders: A cross-national analysis of population surveys from 29 countries. The Lancet Psychiatry.
Menjivar, J. (2022). Consider these steps before calling the police when someone is having a mental health emergency. IDONTMIND.
National Alliance on Mental Illness. (n.d.). Family members and caregivers.
National Alliance on Mental Illness. (n.d.). Getting treatment during a crisis.
National Alliance on Mental Illness. (n.d.). Navigating a mental health crisis.
National Institute of Mental Health. (2023). Mental illness.
National Institute of Mental Health. (2023). Schizophrenia.
Substance Abuse and Mental Health Services Administration. (2019). Civil commitment and the mental health care continuum: Historical trends and principles for law and practice.
Substance Abuse and Mental Health Services Administration. (2023). For friends and family members.
U.S. Department of Veterans. (n.d.). Tips for helping a loved one living with schizophrenia.
