My Schizophrenic Sister Refuses Treatment


My sister has been diagnosed with schizophrenia. She is in her mid 40’s and has three children. We convince her to seek medical attention about a year ago, but after four consultations she has decided that her doctor and everyone else for that matter “is in on it”. She doesn’t trust anyone and thinks people are “out to get her”. I am worried about alot of things for starters her children, how is this affecting them? How can they possibly cope with it living under the same roof as her when she constantly hears voices and sees people that are not there. Her youngest is seven years old, I don’t know what all this has possilby done to her because my sister swears all her children have been abused my these imagenary people she sees. We(my mother and I) tried speaking to her doctor to see if we could try to understand her and her conditon, but the doctor told us that he could not say anything to us because of patient /doctor privacy. My whole family feels helpless and frustrated that we can’t help her and her children becuase as long as she can provide for her family there’s nothing that we can do. We tried to get her medical attention even when she did’t want it, but no one was willing to help. They said being crazy is not a crime and until she’s willing or she can’t provide for her children anymore, then they would step in. Meanwhile we just have to watch her get worse. I’m also a mother myself and know that this mental condition is genetic and I’m terrified of the possibilites. What can family members do? When it’s so obvious everyone around her is worried sick for her and her family.

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You are not alone in your situation. Many many families have struggled with similar issues relating to a parents (or sibling’s) compentency to meet important responsibilities. It is heartbreaking, I know, but it is also complicated from a social and civil liberty standpoint. Your sister’s right as an adult to govern her own life does need to be preserved as well as it can be, becuase to make special exceptions for her would jepordize everyone’s civil liberties. The “authorities” should not be able to force medication or hospitialization on people without cause, for instance. The flip side of the equasion is that it takes a long while and some serious and sometimes dangerous accidents before authorities are able to document that something is deeply wrong, and then take appropriate action. Typically, it takes police reports or abuse reports before appropriate action gets taken. Even then, authorities generally do not rush to take away parental rights, but rather work to try to stabilize the (then) patients so that they can function independently to the best of their abilities. Conservatorship and extended mandated hospitalization do occur, but more rarely today than in the past.
It may seem “criminal” to let your sister’s “negligence” go unchecked, but try to see it from the other side of things. It would also be criminal if a judge took away your own children (or forced you to receive treatment) on a false or flimsy pretext.

Under the circumstance, you would appear to have several options. You could try to convince your sister to let you take care of her children, although this sounds like a hard sell. You could work on her to continue in treatment, and/or hospitalize herself, alhtough based on your prior experiences with her paranoia, this sounds like a non-starter. You could call child protective services and/or the police when you suspect abuse or neglect is occuring and help build up the public record necessary for involuntary treatment to be mandated. You could sit back, live and let live and practice your relaxation techniques to stay calm. Option #3 might be the most direct route to what you want, but not everyone would be comfortable with that sort of thing.


Schizoprenia is partially inherited genetically; it does run in families. This means that you may carry the genetic predispositions yourself (even if they are not expressed), and may have passed them on to your own children. Your sister’s children are also at heightened risk for developing the illness. Fortunately, not everyone who has some genetic risk for Schizophrenia will develop the disease. Though the risks are heightened, they are still relatively small. The typical onset for Schizohprenia occurs in young adulthood (e.g., middle to late teens, early twenties), so your children should be educated about the disease and its symptoms prior to that time.

At risk people can maybe do a few things to protect themselves, but nothing I say here is definitive. One thing would be to stay away from marijuana products and other hallucinogens. There is some suggestion that vulnerable people who use these drugs heighten their already heightened risk. Another would be to be educated and watchful for the signs of schizophrenia, and to consult with a psychiatrist at the earliest possible occurance to try to head off the possibility of a full psychotic episode. Of course, leading a healthy lifestyle is always a good idea (healthy exercise, food, sleep, etc.), but doing this well won’t necessarily lower your schizophrenia risk.

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- Mark Dombeck, Ph.D.

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