How To Help Someone With Schizophrenia Who Refuses Treatment

Supporting a loved one with schizophrenia — especially when they refuse treatment — can feel incredibly challenging. You may feel worried, powerless, or heartbroken if your loved one doesn’t want to accept treatment, particularly when they truly believe they aren’t experiencing symptoms.

Fortunately, there are ways to offer support that are practical and caring — while also respecting your loved one’s independence. This article explains why someone with schizophrenia might not accept treatment and shares strategies for supporting their health while maintaining your connection.

Why Do People With Schizophrenia Refuse Treatment?

If your loved one is refusing treatment, you may feel like they’re intentionally being difficult or resisting help. However, there are many reasons why someone with schizophrenia may not want treatment. Learning what those reasons might be can help you understand their perspective and respond with empathy.

They May Not Realize They Have a Mental Health Condition

It’s important to remember that no one chooses to experience the symptoms of schizophrenia. A common part of the condition is not recognizing that anything is amiss. This is called anosognosia (lack of insight).

Health experts estimate that between 50 percent and 98 percent of people with schizophrenia experience anosognosia. When someone doesn’t believe they have a health issue, it can be very difficult to convince them to stick to their treatment plan or take their medication.

They May Worry About Stigma

Your loved one might worry that being diagnosed with schizophrenia will lead to judgment, discrimination, or isolation. The drive to avoid stigma can be powerful — and sometimes enough to make someone avoid getting help, even when they’re struggling.

They May Have Had Difficult Experiences With the Health System

If your loved one has had difficult or unpleasant experiences with mental health care in the past — such as feeling ignored, judged, or unsafe — they may be hesitant to try again. They might even worry about losing their freedom or being hospitalized against their will.

They May Want To Avoid Side Effects

Antipsychotic medications (often part of a schizophrenia treatment plan) can cause unwanted side effects, like dry mouth, weight gain, or restlessness. If your loved one had a hard time with these effects before, it’s understandable that they’d be nervous about trying the same or similar medications again.

They May Experience Disorganization

The symptoms of schizophrenia can make it hard to stay organized, plan ahead, or remember daily tasks — all of which can interfere with getting treatment.

“Someone with schizophrenia may be too disorganized to know that they have an appointment at the clinic at 2 o’clock on Tuesday, or they may not know what day of the week it is,” said Dr. Robert Channon, a board-certified psychiatrist and a Distinguished Life Fellow of the American Psychiatric Association, with more than 40 years treating people with severe mental illness in Chicago. “So in other words, even the mental disorder will affect their being able to problem-solve or organize their life.”

Dr. Channon also described everyday barriers that may seem minor to others but are major hurdles for someone with schizophrenia, like:

• Remembering appointment times and locations
• Keeping a phone charged
• Having enough bus fare
• Bringing insurance cards or ID

“So, all of these things in terms of just organizing their life in order to get to the doctor's appointment — and then, of course, all of those things would pertain to going to the pharmacy to get the prescription filled,” Dr. Channon said.

How Can You Help When Your Loved One Refuses Schizophrenia Treatment?

Even if your loved one isn’t ready to accept help, there are still some meaningful ways you can support them. The strategies below can help you stay connected, promote safety, and take care of your own well-being.

Learn About Schizophrenia

Learning more about schizophrenia can help you respond with more patience and empathy. Understanding how symptoms affect thinking, emotions, and behavior can also help you avoid taking things personally.

Coordinated specialty care (CSC) is a team-based approach for people who’ve experienced psychosis. Many CSC programs include education and support for family members, covering symptoms, treatment options, and ways to support recovery.

Support Without Controlling

Your encouragement matters — but it’s also important to respect and accept your loved one’s choices. Instead of pressuring them to accept treatment or arguing about their condition, try asking how they’d like to be supported.

For caregivers whose loved ones are open to talking, Dr. Channon suggests approaching the conversation as a negotiation: “They could say, ‘I really want you to be taking the medicine, but I know you’re an adult, so I want to honor and respect that. How would you like me to be of help to you?’”

Let your loved one know treatment is always an option, even if they’re not ready at this time.

Listen Without Judgment

Listening with compassion can be one of the most powerful ways to support someone with schizophrenia. When a person is experiencing symptoms, they might say things that seem strange or upsetting. Try to focus on the emotions behind the words, which may be worry, frustration, or confusion.

Your goal isn’t to argue or to correct them. Instead, remain calm and open, even if what they’re saying doesn’t make sense to you. Avoid interrupting or giving advice unless they ask for it. You can respond with empathy by saying things like:

• “That sounds really upsetting.”
• “I can see why you feel that way.”

Listening without judgment helps build trust and keep communication open.

Sometimes, your loved one may not want to talk at all — and that’s OK. Give them space, but let them know you’re available when they’re ready. Spending time together in ways that don’t focus on their illness — like watching a movie or going out for a meal — can show you care and help maintain your bond.

Help With Daily Tasks

If you’re unsure of how you can help, ask your loved one what they would find most useful. Offering support with small tasks can ease their stress and make it easier for them to stick to routines.

Some tasks you could offer to help with include:

• Driving them to doctor appointments or therapy sessions
• Setting up medication reminders
• Cooking meals
• Doing laundry
• Helping with bills or paperwork

Even when someone isn’t ready for treatment, these everyday actions can build trust and reduce the chaos that often comes with untreated symptoms.

Set Boundaries To Protect Your Well-Being

Caring for a loved one with a serious mental illness can be emotionally and physically demanding. It’s no surprise that around 60 percent of family caregivers experience burnout — a state of exhaustion that affects your body and mind.

It’s important to remember to make time for your own self-care. Here are a few strategies you can try to support your own well-being while caring for a loved one with schizophrenia:

• Get regular exercise.
• Eat a balanced diet.
• Focus on getting enough sleep.
• Continue to do activities you enjoy.
• Join a support group.

Learn more about the resources that are available to schizophrenia caregivers.

Planning Ahead To Protect Your Loved One

Schizophrenia can cause symptoms that make it hard for someone to care for themselves. If your loved one’s condition is currently stable, it’s a good time to plan ahead, before a serious situation arises.

One proactive step is to work with them to create a psychiatric advance directive. This legal document lets your loved one outline their treatment preferences in case they’re unable to make medical decisions in the future. It can help doctors and caregivers understand what they want while giving your loved one more control over future care.

When Immediate Help Is Needed

If your loved one is ever at immediate risk of harming themselves or others, more urgent steps may be needed to keep them, and others, safe.

In some situations, this could include involuntary commitment to a psychiatric hospital. Involuntary commitment means a person is admitted for treatment even if they don’t agree to it — usually because they can’t meet their basic needs or are in danger. It often involves mental health professionals, social workers, or first responders working together to assess the situation and provide care.

Another option, if your loved one consistently refuses treatment and cannot safely manage their own affairs, is a conservatorship. This legal arrangement gives someone the authority to make decisions — like medical or financial choices — on behalf of your loved one.

Ask for Expert Help When You Need It

Choosing whether to pursue involuntary treatment or conservatorship can be difficult. You don’t have to figure it out alone. Talking with a mental health professional or legal expert can help you understand your options and get the support you need.

Find Your Team

On MySchizophreniaTeam, the site for those living with schizophrenia and their loved ones, people come together to ask questions, give advice, and share their stories with others who understand life with schizophrenia.

Do you have a loved one living with schizophrenia? Do you have tips for how to help a loved one who refuses treatment? Share your experience in the comments below.