Five years ago my sister had a nervous breakdown. None of my family saw it coming. She was married with two children, ages three and nine.

Her husband, always unreliable and untrustworthy, offered no help to her during her hospitalization and ran away, leaving their kids with my elderly parents.

The doctors diagnosed my sister with paranoid schizophrenia and prescribed medication.

She started taking it regularly and seemed to improve. Later, she refused to take her medicine, insisting that nothing’s wrong with her.

Over the next five years, she became bitter and hateful towards my family. She was convinced that her husband was still in love with her and the kids.

He visited once a year for a few days, but provided no financial or emotional support for his family.

My sister refuses to divorce him. My parents continue to raise her kids and help my sister whatever way they can.

Her mental health has continued to decline and has affected her children.

She refuses to let me see the kids since she suspects that I called Children’s’ Aid to try to get help for the kids.

They did visit but she managed to convince them nothing was wrong. Strange, since she’s obviously a hoarder and doesn't clean their home.

Her son is now a teenager, acting out by running away for days and using alcohol and drugs. Their relationship has become physically abusive and he constantly harasses her for money. She lost her job several years ago.

She refuses to call the police and press charges, to avoid his having a criminal record.

My heart is breaking for the children. Is there anything I can do to force my sister to take her meds and get real help for herself and her children?

Please Advise

Your sister’s diagnosis and mental health decline is a tragic story for everyone involved.

Though her decisions and behaviour upset you, she’s not a wilful monster, but rather a disturbed patient of a disorder whose symptoms can include hallucinations, delusions, and fears that others are plotting against her.

She’s needed further help from a specialist’s care, support from everyone possible. But her husband fled, and her parents were understandably preoccupied with her children.

You’ve also cared deeply about the kids, but summoning child welfare authorities triggered her symptomatic reactions of fear and distrust.

The relationships that could benefit in the current situation are the ones you and the grandparents have with your sister’s angry, hurt and desperate son.

He’s punishing his mother for her illness through going missing, alcohol and drug use, physically abusing her. He could easily come to the attention of police.

Tell him so. Insist on his getting counselling. Explain that he and his sibling should’ve had it years ago, given the household dynamics. (There was also love and caring, too, but the absent father and erratic mother overshadowed all).

You’ve asked for ways to “force” your sister towards help.

I urge you instead to go, yourself, to a centre for mental health disorders (there’s one in your general area, which I haven’t named for anonymity’s sake).

There, ask to speak to a counsellor who can direct you to appropriate resources: e.g. for current approaches to this disorder, whether new medications have proven helpful to others, and how best to help her children deal with the situation.

It may lead you to getting your sister the professional help she’s long needed.

FEEDBACK Regarding the pregnant woman whose mother is concerned that she’s unprepared to care for a newborn and has had previous abortions (July 8):

Reader – “My heart goes out to this woman who’s excited about having a baby despite her mother’s concerns. From my personal perspective (my husband and I have two adult children who were adopted as babies) and from observing many other adopted children, birth parents and adoptive parents, I’d highly recommend adoption as a very satisfying relationship opportunity.

“In an open adoption, the birthmother could choose to arrange visits with the child and the adoptive family.

“Our children have both been enriched by contacts with their birthmothers and we’re deeply thankful to God for our children and their birthmothers!

“Possibly, this letter can be an encouragement for other people to enjoy the warm, loving relationships we all have with each other.”

Ellie - I’ve since learned she’s keeping her baby.