The importance of getting a mentally ill person to safety and returning to decent mental health needs to trump any inhibition from embarrassment or fear of alienating the troubled person. It is common for patients to completely change their attitude toward their families when they are unwell. That hostility is often a by-product of the illness that distorts thinking, supercharges emotions, and leads to a lack of insight into being sick. All of this can be expected to improve with treatment.

Someone’s eventual apology, forgiveness, and validation from their family is, of course, the best possible outcome. I have seen scenes where someone’s post-psychotic appreciation of family has been generous and emphatic. The lesson here is to use the opportunity to engage a system that has power over your troubled loved one, to steer him to the treatment he has been avoiding or refusing.

Think of how often people take advice from their doctors that they have repeatedly rejected from their loved ones. There is something about the neutrality and authority of one’s personal physician that can mobilize change and healthy behaviors. You may be met with resistance, suspicion, or an attempt to shut the door by minimizing your questions or responding to them in a superficial or sarcastic response. In this case, you may need to press (but gently).

ALI ZAIB JATOI,

Karachi.