Expert: Peter L. - 11/5/2009

Question
My name is April, I am 30, married, and have 5 year old twins.  Last year we took in my husbands nephew who is now 18.  He grew up with a mother who did drugs, had him buy her drugs, and he has been in and out of Juvienile Hall and now Jail.  While he was with us we did family counselling.  During one of his private sessions he told his therapist he was having thoughs of killing us while we were sleeping.  This led to him being diagnosed as Bipolar and being removed from our home and being placed with grandparents.  Since he has now been in and out of jail for stealing, meth, etc.  He seems to have no desire to be clean, has a horrible attitude about "society", continues to use.  Just a couple of days ago he took 40 benadryl trying to get high.

Here is the problem, we need some advice as the grandparents/family members on how to deal with this.  He is 18, obviously had a very rough life and was never really a "kid" so to speak.  He has no home, goes from house to house to house.  Yesterday someone made him go to a place called "The Port of Hope" which provides rehab type services.  He has his initial consult with them in 4 days.  Do we as family members allow him to stay with us until (or if) he goes into rehab (none of us really think he wants to).  Or do we drop him off a shelter, or have him wander the streets and make him do it all on his own?  This is extemely hard for us to do, especially for the grandparents.  But what is the BEST thing for him and not for us emotionally?  Your help is greatly appreciated.  

Ps.  he is also not taking his medication for the Bipolar right now either.

Answer
Hi April,

Age 18 is considered adulthood (in some respects) but in terms of human development it is still very young.  The exposure to drugs, drug use, and the obvious questionable manner of parenting a young person receives in the home environment with his mother you describe is very threatening to mental health.  This young man has obviously not been nurtured and has trouble finding value and meaning in life.  Now that can be the case with young people who are exploring who they are, developing an identity, and sometimes results in behavior problems, e.g., depression, anxiety, etc.  We hear all the time about the struggles of adolescents growing up in today's world.  Here, we have a situation where this young man seems to not have had an opportunity to experience these adolescent struggles in an environment where he can learn emotional tolerance, balance, a strong sense of self, and resiliency.  

I would continue to try to help him unless he is clearly a continuing danger to the well-being of your family, steals, or uses substances in your home.  I would discuss these terms with him in a quiet conversation spelling out what you'd like.  If he doesn't respect these terms, it is my view that you need to protect yourselves and have him leave.  I do not feel the failure to respect even basic rules should necessitate even more tolerance of bad behavior, with an expectation that it will change - eventually.  Eventually may not come, and if he is headed for an even worse crisis, it will occur in your home.  You won't be able to stop it, but will be in the center of the storm somehow.

Winding up on the street is not a happy prospect, of course, but sometimes it's the only thing that brings about some awareness and behavioral limits.  He may become ensnared in the legal system, but like many of my clients may end up saying one day, "Boy, it was good I got arrested and put in jail.  I was out of control and a danger to myself!"

He needs long term rehab care, needs to take the medicine he's prescribed, and finally needs an environment where he can find some pursuit that interests him and gives him reason to stop using substances.  In my area, Job Corp works with kids just like your nephew, moving them into skills development in a safe, secure environment.

I hope this helps.

Regards,
Peter