Help - My sister's boyfriend is suicidal and she is at wits end and I don't know how to help her

[Mlle. Zabzie]

My sister has been with her boyfriend (let's call him Bob) for about 5 years.  They have a 7 month old baby.  Bob has always had issues with depression.  (He also has been completely unable to hold down a job - right now he is staying home with the baby; my sister makes good enough money for now though there isn't a lot extra).  He has been having medical issues (knee and back trouble) and won't go to a doctor.  They had some kind of fight last night.  My sister sent me a series of texts culminating with "I need to get out - think I should talk to a lawyer."  We spoke briefly at the time and she said "let's talk tomorrow."  I called her this morning and she was in tears.  He is talking about how he wants to die, how everyone would be better if he died, etc.  This is not the first time this has happened, but she says he seems much more serious about it this time.  He's talking about trying to find a gun (we are in NYC, so this fortunately won't be easy; also, he has no money and no credit card and my sister won't give him any).  She thinks she has talked him down "for now" but is still afraid to leave him alone.  She needs to work (see prior comment).  She has thought about calling his psychiatrist (he does have one), but is afraid he'll be institutionalized (but maybe that's for the best?)  So here's what I'm hoping the Board, which has much wisdom, can help me with (I've never dealt with anything like this):

 

1.  In the immediate term, are there any reputable resources that I can point my sister to that can help her deal with the situation?

 

2.  In the short term, should I be concerned about her safety and the safety of my niece?  Bob has in my presence never seemed violent, but since I think some of this was brought on by a conversation about splitting up, and he's been talking about guns, well, I've watched too many Lifetime Movies.  My priorities are pretty clear her - my sister and niece's safety comes first in my mind, but I don't want to blow things out of proportion.

 

3.  In the short term, should she urge him to get intensive mental health and maybe commit himself, if nothing else for the sake of their daughter?

 

4.  In the medium term, she's been wanting out of the relationship for a while (in July we had a long heart to heart about it).  Bob's not a bad guy per se, but my sister is under too much strain taking care of him (which can be a full time job), working, and taking care of the baby (when he has a depressive spell, he won't get out of bed, and she has to figure out childcare too).  Any thoughts on how to help her navigate that?

 

5.  Finally, and this is just a nasty confession on my part, I'm just really ANGRY at Bob.  I feel like he is manipulating my sister.  I don't know how serious his suicide threats/semi-attempts are, but to the extent that it's manipulation to keep her in the relationship, I'm furious (recognizing it could be that plus other things).  It's not fair because I know that depression is real (and I'm not minimizing it), but I want him to adult up and deal with the situation so that he doesn't hurt (mentally or otherwise) my sister and my niece. 

 

Anyhow, all thoughts and support welcome.

[Michael Seswatha Jordan]

I'm no expert by any means, and you probably don't care what I have to say, but, I'd point you to #4. If she's been wanting out of this for awhile.....just get it over with. I would have concerns for her and their child, because, you just never know what one will do when in a bad place. He's not contributing in any way, shape or form to the betterment of their lives, so get out of there. Then it will be Bob's responsibility to get his act together if he wants to be a part of his child's life. It might just be the wake up call Bob needs. Just my 2¢.

[Tears of Lys]

I agree with Seswatha up there. ^^

I know **I** wouldn't want to trust him around those that I held near and dear when he's so resistant to help.

ETA: Is he on depression meds? If so, apparently they aren't working so well. I'd call his psychiatrist/psychologist ASAP and tell them what's going on.

Someone who's depressive and suicidal AND talking about getting a gun makes my blood pressure rise to unsafe levels. Your sister should tread lightly but get the heck out of Dodge. Leaving your niece alone with him is worrisome to me too, at least while he's going through this... low point?

[Inigima]

My first thought, the immediate situation, is the national suicide prevention hotline, 1-800-273-8255. They can probably make some recommendations. The recommendation might be to have him institutionalized, I don't know. If that's the recommendation, she might consider taking it.

The longer term: Getting out of the relationship might be the best thing. I agree that this might be manipulation; either way she doesn't have to subject herself to this, and if he's receiving intensive mental healthcare/suicide watch, it might be the best opportunity.

Sucks with the kid and all. But you gotta look out for yourself, and for the kid.

[Lummel]

My sister has been with her boyfriend (let's call him Bob) for about 5 years...

 

Anyhow, all thoughts and support welcome.

 

 

With regard to (ii) if we assume that Bob only has violent intentions towards himself, how comfortable are you with not preventing a suicide, how happy are you with his suicide providing an out for your sister from her relationship, and for such a death to be in the background for your niece's life?  Not nice questions. 

 

Reading the story you tell I'd say that institutionalisation of Bob was certainly the least worst option in an emergency.  Maybe his talk is a cry for help, but it could well be that he needs help that is beyond the current strength or ability of your sister to provide.  Reaching out to professionals would seem to be a good precaution when the situation seems volatile.

 

 

As to (v) I don't blame you at all, I might venture to suggest that he's manipulative out of a lack of alternatives in his mental cabinet but maybe I'm just trying to be generous here.  I do find your openness about your anger praiseworthy, well it seems like a virtue to me anyhow ;)

 

(iv) What can you do to help her?  Give her a bed for a few nights?  Find her a lawyer?  Help with childcare?  Help with difficult conversations - with parents or with Bob?  Help with money?  Help with finding alternative accommodation?  It sounds as though your sister feels safe to turn to you in these circumstances, sit with her at a table with a pad of paper and ask her what you can do to help - you can have some headings like housing, money, childcare, moving, written down on a sheet beforehand to organise things a bit and perhaps arising from that there might be a few things you can sort out for her (either personally or through delegation) that would be a help?

 

 

Hope all goes well for you all

[TerraPrime]

If they didn't have a child, I would maybe give a different counsel (probably not) but with a young child? Get. Out. Kick him out, or move out, or do something. This situation is untenable. 

 

Love is not the cure for depression. Saying to someone who is clinically depressed that "I am no longer capable of helping you and giving you what you need" is not the same as saying "I don't love you." Although in this case, sounds like love is waning and fading away, in part due to the strain that his mental illness is putting on her. But that's life. 

 

I'd say for the immediate term, get your niece to your house at least. I'd present it as "let me take care of her so you two can adult through this without a distraction." If he ends up getting the help that works, then great. If not, that's one less thing for your sister to worry about while she's at work. 

 

Lastly, I understand your anger. But I will also point out that real depression and associated mental health issues actually prevent people from acting like adults. They don't perceive reality the same way we do and they don't have the same approach to analyze life events when they're in the grips of a reality-distorting mind melt. So if we accept that Bob has genuine mental illness issues, and by all the signs, he does, then blaming him for not doing the whole adult thing is a bit misguided. 

[.H.]

Well, easy to say from the armchair but:

1: You already gave the answer, speak to his psychiatrist. This person is a professional, therefor should be able to advise on what is probably the best way to go forward (if it gets him committed, then it does, you can't make threats and pretend there are no consequences).

2: It is doubtful he is a threat to anyone but himself and possibly not even himself (this could easily be a 'cry for help') but it's nothing to be taken lightly, so see point 1.

3: Probably, yes (if he is resisting help so much, it is probably a sign of you suspicions in point 5).

4: If she wants out, get out. If she's told you she wants out, no doubt Bob knows this too (even if he doesn't realize he knows) and it could well be a main driver in his current behavior. Get him squared away with professional help, then go see a lawyer.

5: You are probably right, but again, it's nothing to be taken lightly. The relationship is doing neither of them favors it seems. See point 1 and 4 though.

Just my worthless opinion. Hope she finds a path trough.

[Mlle. Zabzie]

Thanks.  This is my gut as well.  He is on meds.  She says he is taking them but they aren't working.  I think she should call his doctor but she has been resistant so far.  Right now she is feeling responsible for him (UNFAIR but can't help it).  She doesn't want to leave him alone.

[TerraPrime]

Thanks.  This is my gut as well.  He is on meds.  She says he is taking them but they aren't working.  I think she should call his doctor but she has been resistant so far.  Right now she is feeling responsible for him (UNFAIR but can't help it).  She doesn't want to leave him alone.

 

There are laws for civil commitment for a reason. When people are mentally unwell, they are incapable of making decisions that will help themselves, and your sister, being his wife, is given the option of initiating a chain of event that may actually get him the help he needs. 

[Seventh Pup]

If you are able to, I think in the short term I would help her find, and perhaps help her pay for different childcare. Having a suicidal person watching a young baby is a recipe for disaster. I would also see about helping your sister to find a place she feels safe staying outside of the shared home with Bob.  Most suicidal people will only hurt themselves, but as Terra said their reality is different then ours, and mental illness can bubble up in both self harm and harm to others. 

 

Second after making these offers of help, I would step back from the situation. If you offer real concrete help, then it is up to your sister to take it, or leave it. She unfortunately can't be responsible for Bob. But she can make decisions for her own life.  I think involving his doctor is prudent, as it sounds like he''s made specific threats of self harm.

 

I am very sorry for this situation, which is unfortunately way to common. :grouphug:

[.H.]

Thanks.  This is my gut as well.  He is on meds.  She says he is taking them but they aren't working.  I think she should call his doctor but she has been resistant so far.  Right now she is feeling responsible for him (UNFAIR but can't help it).  She doesn't want to leave him alone.

Meds can only do so much (I went into psychology because I really don't believe in the medications as answers, but that is a wholly different topic for a different day).

The relationship isn't healthy for either of them, let alone for the child. I would actually say she's right, she shouldn't leave him alone. She should leave him in the hands of professional help.

Again, easy for me to say though.

[Iskaral Pust]

Sister and niece should come stay with you for a few days while Bob packs and leaves. Absolutely call his psychiatrist and set up an emergency meeting -- stated inclination to suicide is the classic signal. Whether Bob is sincere or just manipulative is now the shrink's concern, as is any decision on committing him.

Your sister can decide later with the benefit of space, no threat of danger and, hopefully, proper treatment for Bob, whether she wants to continue the relationship.

Good luck Zabzie.

My sister's husband recently went through a nervous breakdown. She asked him to live outside the family home for a while until things improved. I gather things are getting better for him now, although he has not yet moved back in.

[Which Tyler]

For what its worth, I'd echo Terra and 7th.

As someone who's been severely depressed, and even suicidal before, I also echo that depressive thoughts and thought processes are not those of rational adults. Anger at such thoughts is understandable, but really not helpful.

I would absolutely agree with ensuring niece's safety, and offering all help possible to sister. Consult with sister, strongly advise alerting the oyah, and leave in the hands of the professionals, that or let the suicidal thoughts take there course (whilst ensuring no harm to others)

[Mlle. Zabzie]

Weird double post.  Sorry.

[Dr. Pepper]

If Bob is already under the care of a psychiatrist then it would be a great idea for he or your sister to contact his doctor.  His doctor will be able to determine if he requires inpatient care (not all people expressing suicidal ideation need this).  I can understand why Bob or your sister might be concerned about inpatient care but if that's what he needs, then that's what he needs. If possible, I would also encourage your sister to contact others in his support network - family, friends, etc.  Hopefully some of them can help.  

 

Finally, there is never a perfect time to get out of a relationship.  If she wants out, she will have to take those steps.  As her sister, aside from financial, board, or childcare assistance, you can support her emotionally by reminding her that she has nothing to feel guilty about.  She did the best she could but she's not required to stay in a relationship that is unhealthy for her, her child and also Bob.  

[Aemon Stark]

Is there a mobile crisis line you can access? Otherwise I would certainly suggest that your sister call his psychiatrist, but I'm not sure what they'll be able to do if only contacted by a third party. 

 

Do not worry about getting him "institutionalized". This will NOT result in his becoming an indefinite involuntary psychiatric inpatient. I am not familiar with the legislation in NY, but involuntary admission can generally only occur in the context of a mental disorder AND [b]imminent[/b] harm to oneself or others, and it can only last 24-72 hours outside of a very formal and rigid process. In any case, admission for inpatient psychiatric care is not uncommon, and I would discourage use of language like "commitment" or "institutions". If that's the kind of help he needs, then better he gets it. It doesn't mean he's getting "committed" 

 

If you're concerned about safety, whether about Bob, your sister, or your niece, then most certainly call for help. There may be a crisis/suicide hotline. It may be better to speak to Bob directly before doing any of this, but I would certainly suggest it for your sister. 

 

I don't have many other specific suggestions, but I would say that your feelings toward Bob are certainly legitimate, even if - I would also say - you should not act directly on them. I don't know what his actual diagnosis is, but there may be some missing pieces that are important that you are unaware of. 

[Mlle. Zabzie]

Thanks all.  She has convinced him to talk to his doctor, who has increased his medication, which is good (it may or may not be the answer - I don't know).  She has gotten the next couple of days off work, and knows that my door and sleeper sofa are open to her and her daughter any time.  I strongly urged her next week to drop her daughter off at my apartment on the way to work if nothing else.   She is now trying to figure out whether to encourage him to go home and stay with his parents for a little bit.  On the one hand, it might be good for him to be back around that support network.  On the other, his parents live out in the country and though they do not have firearms, firearms are easily accessible there.

[DireWolfSpirit]

Thanks.  This is my gut as well.  He is on meds.  She says he is taking them but they aren't working.  I think she should call his doctor but she has been resistant so far.  Right now she is feeling responsible for him (UNFAIR but can't help it).  She doesn't want to leave him alone.

That's outrageous. Perhaps it would lighten her self imposed burden if she sighned the guy up for disability?

[Guy Kilmore]

One thing that your sister can do, in conjunction with her ex-boyfriend and psychiatrist, is to come up with a risk or crisis plan where steps are outlined as to what to do when certain things happen.  I would also encourage her boyfriend/husband to be engaged in some kind of therapeutic intervention aside from just medication.  Your sister might also want to do the same thing as there will be considerable stress on her shoulders.

 

Part of the crisis planning should include information on who can be contacted, such as suicide hotlines and crisis resources (Aemon is correct, most metropolitan areas have a mobile crisis team.  They can come and do assessments and whatnot, recommending courses of treatment, providing resources and/or hospitalization.  They aren't the police, so their recommendations remain voluntary, but are a good step to use when someone is making suicidal threats, but not necessarily being readily dangerous.)

 

My field of work is mental health case management and I frequently address situations such as this, if you have a question, feel free to drop me a message.  I work out of the Minnesota, so I will not be familiar with the ins and outs of New York.

 

ETA:  DireWolf, if their income is considered one household, I imagine they would pass certain thresholds where he could qualify.

[Tears of Lys]

That's outrageous. Perhaps it would lighten her self imposed burden if she sighned the guy up for disability?

That's a great idea. I never even thought of that.
It was made for people with issues like this where they can't work due to illness.