How Can You Convince Someone to Seek Help for Paranoia?

Reader’s Question

A friend of mine shows the symptoms of paranoid schizophrenia. He believes people are drugging him, hacking into his computer, etc. He has a history of drug use (I think mainly cocaine). He has lost 2 jobs because of this already and has threatened to commit suicide. However, he doesn’t
believe he needs help and thinks everyone is just out to get him and refuses to see a psychologist. How can one convince him to go?

Our Clinical Psychologist’s Reply

His paranoid thoughts can be related to paranoid schizophrenia or his drug use. The use of cocaine, meth, amphetamines, etc. can produce symptoms of severe paranoia and hallucinations. A major problem with paranoia is the externalization of blame, that is, the individual believes everyone around them is creating the problem — not them. As you describe, they may lose several jobs due to their paranoid behavior and accusations, yet feel the job was the problem. Treatment is often difficult as they begin to believe that treatment professionals are involved in the conspiracy to harm them.

To encourage assessment and treatment, it’s often helpful to emphasize their symptoms rather than a disorder. If he feels he has been drugged, suggest a psychiatric consultation to discuss that issue. When he becomes suicidal, often associated with a “crash” from amphetamine, encourage him to seek help for suicidal thoughts. You can also use the approach of listing recent problems such as job loss, the feeling of being drugged, suicide thoughts, etc. — then encouraging a psychological or psychiatric consultation to help understand what’s wrong.

While his symptoms may increase and decrease, as a friend you’ll need to consistently encourage him to avoid drug use. Drug use will greatly increase his pananoid thoughts and behaviors. Paranoia eventually becomes so strong that he will be brought to the attention of law enforcement or mental health authorities, often through the emergency room or through disruptive behavior in the community. Remind him that you are willing to help and be supportive, but he is required to cooperate in efforts to make his life better.

When encouraging mental health consultation, do your homework. Learn about community mental health resources — the psychiatrists, psychologists, clinics, hospitals, etc. In this way, if he decides to seek help, you’ll have information about your community readily available.