25-year-old man with mental health problems - where does he fit?

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Gravity

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Hi all,
I know I don't post here very often. I read a lot, but I almost always feel that everyone else here is much better placed to respond helpfully than I am, so I lurk. I could just really use the point of view of some other people on this issue.

It's about my brother. He is 25 and lives with me, our mother and mother's second husband. He has mental health problems as a result of drug use (and predisposition and upbringing I'm sure). However, when he was persuaded to see a doctor they rather failed him. He was put on prozac, because that's what GPs can do and he wasn't seriously ill enough to be referred to psychiatry. So our parents paid for him to see a psychiatrist privately but the psych didn't take on board the symptoms that were described to him and just doubled the prozac. Which I'm sure was not indicated for my brother's case because many of his symptoms resembled mania, though he was obviously also depressed. The attitude was "if we haven't seen it we can't take it into account" - well, he's able to stop talking and laughing to himself with effort for short periods of time, so he can appear quite normal, if antisocial, in short bursts.
(He stopped taking the prozac and it doesn't seem to have made a difference, except he's not angry about being medicated anymore.)

He can't work. He got fired from his first and only job because of his erratic and aggressive behaviour. He got another job but immediately lost it because he didn't turn up. He did some casual work for a builder my father knows, but required a lot of supervision and in the end that wasn't sustainable for the builder. (He was spending more time looking after my brother than actually working.) He also did some self-employed work landscape gardening, under another chap. He was motivated to do this and seemed to enjoy it, it was good for him, but he lost that too because of his aggressive behaviour when challenged and because the customers were uncomfortable with him. (I would be uncomfortable around him too, especially if he was wielding a sharp object.)

Right now he does two mornings a week in a charity shop, again thanks to a contact of my father's. The lady who runs the shop is good with him, won't take any rubbish, but he's kept out of the way of customers.

He's unemployable. And he isn't signed on, partly because he lacks the discipline, partly because he's simply not fit for work, partly because he wouldn't do the things he needed to do to get JSA and partly because the whole signing on process makes him worse. (Angrier and unhappier, which leads to him not trying as hard to control his outward symptoms, being more aggressive, taking less care of himself, etc.)

Our major worries are thus:
1) He's not in the system. He's not getting any NI stamps or anything. One day he'll need to draw a pension or something and basically right now he doesn't exist.
2) He can't stay living with mother and stepfather forever. It's a huge cause of tension, it's bad for all of us, and sooner or later they are going to sell this house and either downsize or move 150 miles away. This is a large house and they can't afford to stay in it for more than a few years longer.

Sorry for the long post. We've been going round and round in circles with this issue for the last two years. Every so often my parents will meet up and my mother will come home and cry - and I have to deal with that, because if she talks to her husband they end up arguing about my father and everything's worse. And then I'll see my father, and have to deal with the opposite side. And my grandmother, and my dad's partner, and everyone else passing judgment on everyone else. And it just feels eternal. Selfishly, I need this to stop so that I can stop this mediating business that I've been doing my entire life and is frankly destroying me. This issue was a contributing factor to my taking a leave of absence from university.
So please, if anyone has any insight, I would so gratefully receive it.

I hope you're all as well as you can be.

devine63

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Hello Gravity

I am very sorry to hear that you and your family are caught up in this very difficult situation.  I hope you will remember to do whatever you need to look after yourself and to prepare for getting back to University.

In very practical terms, it sounds as if your brother ought to be claiming Employment Support Allowance
[https://www.gov.uk/employment-support-allowance/overview ] - it's for people who are not currently well enough to work.  They should be able to get him some help from an advocate who can assist him to claim, if necessary.
He would probably be asked to attend ATOS so they can undertake a Work Capacity Assessment and then I would guess he'll be allocated to the Work Related Activity Group (WRAG).  He would also be entitled to help from the Disability Employment Advisor at the local Job Centre - they should help him to make sure that the voluntary work he is already doing would satisfy the requirements of the ESA rules. 

The second thing that would be worth doing (even though it is a very long term thing and not a quick fix) is getting your brother to apply to his local council for housing for himself -  they may refer him on to a partner organisation, but he should sign up with whoever there is available in your area.  Generally young single men don't get many points in a housing application, but being disabled (by his mental health condition) can make a difference and in some places that can mean they get housed.

The third thing is to start a conversation with your brother (and the rest of the family) about what he wants for himself in the future.   Would he like to live independently?  If so, the best setting for him, initially at least, might be to find lodgings - a room in someone's home, with weekly rent and a contribution to the bills to pay - this  can be a big help to someone who has a spare room and would like some company around the house [they even get a tax break for it - see   
https://www.gov.uk/rent-room-in-your-home]  as long as he and they can cope with his anti-social behaviours.  If the landlord is not a relative, your brother may be able to claim Housing Benefit to help with the rent.  Once you know what he wants, then the family can start working on helping your brother to develop the skills he will need to live independently ...

Finally it would be worth talking to your GP about your brother - ideally with him involved in the conversation, but you could talk it over with the doc first.   If his illness is sufficient to stop him working, then he probably should be seeing a doc regularly and may need some kind of treatment.

I hope these suggestions are useful, regards, Deb





Yvette

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Is it possible for you to video your brother (ask for his permission beforehand), when he is manic, so you can show the evidence to the Psychiatrist?

seegee

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Would any of the people he has worked for/ with be willing to write a short statement about the way his illness affects his behaviour (and therefore his unreliability as a worker)? 
That could be useful evidence both for mental health services and an ESA claim.

Hope you (the family as a whole) manage to find some way of improving things and that you (personally) are getting some time when you can do something that you enjoy, as you need to ensure your own well-being as best you can if you hope to help other family members. >bighugs<

ditchdwellers

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It must be a difficult situation for you all.   >hugs<

Minniehaha

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I was once in a very similar situation to yours, Gravity, so you have my sympathy.  >hugs<

Selfishly, I need this to stop so that I can stop this mediating business that I've been doing my entire life and is frankly destroying me. This issue was a contributing factor to my taking a leave of absence from university.

Yes, it needs to stop but you're not being selfish for wanting that. You're a young person, you have your own life to get on with and, quite frankly, you shouldn't be expected to mediate in this awful situation when there are trained professionals whose job it is to do just that.

So, it's time to let the professionals take over to provide the specialised guidance your brother so desperately needs and for the sake of your own health.  He ought to be assigned to a mental health social worker or a 'MIND' advocate (phone them on 0300 123 3393 for advice) and, hopefully, he'll get the help he needs with things like ESA & PIP claims and future housing needs.

Good luck. Xx

Yvette

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I agree with Minnie.

You have been very caring and done everything you can. 

But you need to be able to live your own life.  >hugs<

Gravity

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Thank you all, you have been very kind and helpful.

Bizarrely, in something of a reverse-jinx, yesterday my brother was like a completely different person.
He had arranged to go to the Job Centre of his own accord, spoke very nicely to the person who phoned him from the JCP about his work history, didn't get upset or aggressive when we couldn't help him find his paperwork, but contacted his father to help him sort it out, then went off to the meeting. Then came home, ate dinner with us and my sister's children, spent some time with us and was in control of himself - no talking and laughing to himself, not acting agitated*. He was restless, but polite. He didn't even get aggressive when my mother asked him about the JCP and he stayed in the room after the conversation was finished.
*I'm sure he was exhibiting these behaviours when alone, but the fact that he controlled them when around people was amazing - he hasn't done that, or been able to do that, for a long time.

I don't know what happened.

This is positive, I suppose, though I don't imagine it will last. (Nothing is fixed that quickly or easily.)

What worries me is that he is able to appear so reasonable and together for short periods of time, around people he is not so familiar with, so I can see him not getting the help he needs from the JCP. Of course, it is positive that he can appear 'normal', as we all thought he had lost that ability more or less.

I'm not really sure where I'm going with this - such a big change has me thrown. I suppose I'll let my mother enjoy it while it lasts.

You're right about ESA, Deb. I think he should apply, though doubtless my parents have other strange ideas and that's up to them. The problem is him cooperating, admitting to his problems, and coming across so normal sometimes. And getting him to see medical professionals. Or basically do anything he doesn't want to.

The point about getting him on the council's list for accommodation is a good one - we may as well do it now. Also about asking the people he has worked with for statements is a really good idea too, thank you for that. I think the builder he worked for would be willing, perhaps some other people too.

I will pass on your thoughts.

I really appreciate all of your responses. And thank you for confirming that I'm not selfish to want to live in a less stressful environment - my place within my family is very odd and I would have fled a long time ago except that my own health problems rather prevent me making any progress.
Deb, thank you for the good wishes re: university. In fact, I took the leave of absence over two years ago, and have now finished my course. I will graduate in January. It's a great relief and a huge achievement considering how unwell I have been at times.

Thank you all again.  >bighugs<

auntieCtheM

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Congratulations on finishing your course despite all the problems you have encountered along the way.   >hugs<

devine63

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Well done, Gravity, I'm delighted to hear you are graduating.  If your brother is currently a bit more well, it's  probably a good time to have some of those difficult conversations about what he would like - especially as the family would then know what he wants when he's no longer able to express it.

I had a further thought - your brother might be ill enough to qualify for Disability Living Allowance - or rather for PIP!
regards, Deb

seegee

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Well done for completing your course under difficult circumstances, Gravity.  >thumbsup< >bubbly<

Yvette

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Sunshine Meadows

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Quote
I know I don't post here very often. I read a lot, but I almost always feel that everyone else here is much better placed to respond helpfully than I am, so I lurk. I could just really use the point of view of some other people on this issue.

 >hugs< good to see you posting now and that the answers are helping.

Mr Sunshine has Biploar II

http://en.wikipedia.org/wiki/Bipolar_II_disorder

Quote
Bipolar II is difficult to diagnose. Patients usually seek help when they are in a depressed state. Because the symptoms of hypomania are often mistaken for high functioning behavior or simply attributed to personality, patients are typically not aware of their hypomanic symptoms. As a result, they are unable to provide their doctor with all the information needed for an accurate assessment; these individuals are often misdiagnosed with unipolar depression

In my experience there needs to be a crisis before GPs and mental health services take an active approach for things. After his motorcycle accident I could see that Mr Sunshine was becoming progressively more mentally unwell, I went and talked to a GP about him and was given a helpline number. I rang the helpline and was told to give Mr Sunshine his credit cards back and that he did not sound ill so much as he was doing what he wanted to. By the end of the week he was in a mental health unit in because of hypomania and being a risk to himself. Talking to his family their description of Mr Sunshine does sound similar to your brother albeit Mr Sunshine is not generally described as aggressive so much as big headed and Walter Mitty like.

Hopefully this 'new attitude' will last but if it doesn't it might be that the family as a whole have to face the decision of letting your brother sink low enough for his situation to be properly assessed. In my opinion without a proper diagnosis of mental illness he is unlikely to get Employment and Support Allowance because it is easy for the decision maker to just take it that your brother's personality traits are the issue.

People in a manic phase of Bipolar can seem like they are just presenting a Narcissistic type A personality. It can be difficult to see what is the illness and what is the personality, but in my situation with Mr Sunshine his kind, generous, nature does surface often enough for me to see who he is - if that makes sense.

That said even if your brother does get a diagnosis of being mentally ill it does not mean anyone in your family has to put up with aggression and disturbing behaviour that is detrimental their own health and quality of life. This is especially the case when it comes to brother's and sister's because in all likelihood the parents will eventually be gone leaving the sibling to carry on something they might well have not agreed to.

Now I have written a long posts too, sometimes it just takes more words  >hugs<

Gravity

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Thank you all so much again for your kind words and help.
I'm sorry for disappearing for so long. You know how life can be.

I agree with you, SunshineMeadows, the idea seems to be that you will be okay as long as you're not so unwell you're causing a lot of trouble.

My sympathies to you for this difficult situation with Mr. Sunshine. I hope he is less unwell now and life is a little easier for you both.  >hugs<

One of my parents' particular worries about all this is that they won't always be here to prop him up, and they don't want that responsibility to fall on us, though it inevitably will, they want it to be as settled and sorted out as possible long before that happens.


So, here's for my bizarre unexpected news. I feel as if I have wandered into a parallel dimension.
The brother has got a job! He had a trial shift in a kitchen on Saturday and they offered him the job. Time will tell whether this is good for him (when he was originally becoming unwell, he was working in a kitchen and the late night shifts and all the rest of it were not marvelous), but it's damn impressive that he managed to persuade some people, over a period of hours, that he is capable of working in a kitchen.

A bit of positive news!

Thank you so much again, kind lovely internet people  >bighugs<

devine63

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Hi Gravity

how nice to have some positive news!   I hope your brother's new job works out for him [and if it does not, maybe that will provide an opportunity instead, to reconsider how best he can be supported].
regards, Deb