Schizophrenia

How to Help Someone With Schizophrenia Who Refuses Treatment: Tips for Caregivers

Denise Mann
By
Angela D. Harper, MD
by
Updated on January 13, 2025
adult mother daughter sitting in chairs and speaking with therapist
To encourage a person with schizophrenia to see a doctor, offer to accompany them to their appointment.
Getty Images (Stock photo posed by models)
One of the best ways to help a person who has schizophrenia is to encourage them to seek treatment — but that’s easier said than done. It’s not uncommon for people with schizophrenia to avoid visiting a mental health professional or taking medications.

 In fact, non-adherence ranges between 63 and 74 percent in patients with schizophrenia.

If this scenario sounds familiar, it’s important not to give up. Friends and family play an important role in making sure their loved one has access to the right doctors and medication.

Support of family and friends is essential for individuals with schizophrenia. The practical, social, advocacy, and emotional support of loved ones can help individuals live fulfilling lives despite the challenges of the illness.

How to Find Treatment for Schizophrenia: The First Steps

It can be difficult to convince people who have schizophrenia that they need to take medication for their condition. But don’t assume that they’re in denial: Many aren’t able to think clearly when it comes to their condition. According to the National Alliance on Mental Illness (NAMI), about 30 percent of people living with schizophrenia experience severe anosognosia, or a lack of awareness of their serious psychiatric illness.

Other times, they may not think they need treatment because they believe their delusions or hallucinations are real.

 It’s important to approach the person in a supportive manner. Start by asking about their goals, which can pave the way to a productive conversation about next steps and aid in the development of a practicable plan.

“You want to help make their lives better in terms that are important to them,” says Ronald J. Diamond, MD, a psychiatrist and emeritus faculty member at the University of Wisconsin School of Medicine and Public Health in Madison. “Start by asking them how their life is going,” he says.

Dr. Diamond recommends you avoid talking about medication and diagnosis at the beginning, unless the person brings it up or is curious. Instead, focus on what they want out of life (e.g., to get a job or find someone to have a relationship with). Then you might suggest that trying medication or other treatment like therapy could help them achieve their goals. “You are helping the person move closer to what they want to accomplish,” he says.

Another way to gently encourage a person with schizophrenia to see a doctor is to offer to accompany them to their appointments.

Some people who have mental illness, including schizophrenia, fear that they’ll be stigmatized if they seek medical help. But this doesn’t mean you have to pretend that your loved one is okay. If you tell them, without being judgmental, that a doctor can help them cope with a specific symptom, they may feel encouraged to seek help.

“Think of recovery as a process, not a place,” says Diamond. Since schizophrenia is a chronic illness, it’s not something that doctors can cure. But, he says, “We can help you live as long and as functional and as enjoyable a life as possible.”

If you're feeling overwhelmed or want to learn more about taking care of your loved one, sign up for the NAMI Family-to-Family course at a location near you. It’s a free eight-session program for caregivers of people living with mental illness.

When a Loved One Who Has Schizophrenia Refuses Treatment

If your loved one doesn't want to take medications or see a psychiatrist due to negative experiences with this in the past, it's important to hear their concerns and help advocate for them to try something new if a medication they are on doesn't make them feel good.

If your loved one refuses treatment for schizophrenia and their symptoms are escalating, it may be time to get additional help. It can be both emotionally and legally difficult to force a person with a mental disorder to get treated, but if a loved one becomes dangerous, friends and family members may need to call the police to take the person to the hospital, according to NAMI.

Assisted outpatient treatment (also known as outpatient commitment) is available in most states. It mandates that people take part in their treatment and gives the state authority to bring them to a treatment center if they won't go on their own. Local NAMI chapters can sometimes put you in touch with a family member in your community who has sought guardianship for their loved one and might be willing to share their experience.

For more help and information, see these Mental Health Resources and Helplines.

Ways to Support a Loved One During Schizophrenia Treatment

Once a person starts treatment for schizophrenia, family and friends should be on the lookout for signs of relapse — new hallucinations, delusions, social withdrawal, disorganized thinking, difficulty communicating — which often suggest that the person has stopped taking medication.

“If family or friends see that the person is spending a lot of time alone or doesn’t want to do the things they once found pleasurable, it's time to call the doctor,” says Tatiana Alexandra Falcone, MD, a psychiatrist at the Cleveland Clinic in Ohio. “It’s very important to recognize changes in behavior early on during a psychotic break with reality,” which can result in deadly consequences.

Estimates vary, but one study found that people who have schizophrenia have a lifetime risk of suicide of approximately 4.9 percent, and the suicide rate for adults with schizophrenia is about 4.5 times higher than for the general population.

Once your loved one begins to recover, try to find a happy medium between doing too much on their behalf and doing too little to help. The goal is to help them build the independence or interdependence and confidence they need to help take care of themselves.

“Think about what you can do to help make their life better," Diamond says. “Can you go to the gym together, help them get a volunteer or part-time job, meet for lunch, or go to church?” This kind of support is invaluable to people who have schizophrenia.

It’s important to remember not to impose your own goals on the person or to try to convince someone that they have schizophrenia if they believe they do not, but rather to focus on what you can do to help them improve the quality of their life and achieve goals they set for themselves. You should share what you know about their condition, but that doesn’t mean getting into fights about it, says Diamond. “You don’t need to be right,” he says. “You just need to be useful.”

Crisis Support

If you or a loved one is experiencing significant distress or having thoughts about suicide and needs support, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24/7. If you need immediate help, call 911.

For more help and information, see these Mental Health Resources and Helplines.

The Takeaway

  • Sometimes people with schizophrenia don’t know that they need help.
  • Through various supportive measures, loved ones and caregivers can help individuals who resist treatment.
  • With help from caregivers, individuals with schizophrenia can enjoy fulfilling lives despite the challenges of the illness.

Resources We Trust

Additional reporting by Barbara Kean.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

  1. Schizophrenia. Mayo Clinic. October 16, 2024.
  2. What Is Schizophrenia? American Psychiatric Association. March 2024.
  3. Loots E et al. Interventions to Improve Medication Adherence in Patients with Schizophrenia or Bipolar Disorders: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. September 28, 2021.
  4. Why Is Family Support So Important for Schizophrenia? National Alliance on Mental Illness Montana. September 11, 2023.
  5. Anosognosia. National Alliance on Mental Illness.
  6. Supporting Recovery. National Alliance on Mental Illness.
  7. Stigma, Prejudice and Discrimination Against People with Mental Illness. American Psychiatric Association. March 2024.
  8. Getting Treatment During a Crisis. National Alliance on Mental Illness.
  9. What Are My Options for Caring for a Loved One Who Won’t Get Treatment? Can I Have Them Involuntarily Committed? National Alliance on Mental Illness. October 21, 2024.
  10. Relapse of Schizophrenia. U.S. Department of Veterans Affairs.
  11. Understanding Psychosis. National Institute of Mental Health.
  12. Bareis N et al. Means of Suicide Among Adults With Schizophrenia Across the Life Span. Schizophrenia Research. January 2023.
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Angela-Harper-bio

Angela D. Harper, MD

Medical Reviewer

Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.  

A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.

Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.

Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.

She and her husband are avid travelers and have been to over 55 countries and territories.

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Denise Mann

Author

Denise Mann is an award-winning health journalist in New York. Her articles regularly appear in Healthday, Wall Street Journal, Health.com, Newsday, American Profile, and other consumer health portals. She is the chief editor of Plastic Surgery Practice and a feature writer for WebMD. She writes about women's health, cancer, diabetes, heart disease, diet and fitness.

Her first foray into health reporting was with the Medical Tribune News Service where her articles appeared regularly in such newspapers as the Detroit Free Press, Chicago Sun-Times, Dallas Morning News, and the Los Angeles Daily News. She received the Journalistic Achievement Award from the American Society for Aesthetic Plastic Surgery in 2004 and 2011.

She lives with her husband, their miniature schnauzer, and their two sons. An avid indoor cycler, Mann is always up for a Soul Cycle class. In her spare time, Mann is working on a fiction novel loosely based on her extended family.

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