The person is delusional and there is no way to break through the delusions, especially if he (or she) won't take the needed meds.

once psych drugs have worn off. It used to be recognized that seriously ill people didn't have the capacity to make rational decisions about their health care and they'd be involuntarily committed until they were stabilized on drugs.

The problem is that there are a lot of very good reasons for a rational decision to go off psych meds. The side effects are often horrific, worse than being so afraid they won't accept a sandwich from an outreach group but will pick it out of a trash can later if there's a bite taken out of it. Most of our drugs just aren't very good, especially for psychosis.

Unfortunately, civil liberties lawyers have stuck us with a very narrow definition of "danger to oneself or others." Unless you can persuade this person to give it a trial for a couple of weeks, your hands are legally tied unless there is a credible threat of violence, either to you or the person him/herself. And then it's very risky to call the cops for assistance and even if you only call an ambulance, they'll show up too. ERs won't be terribly helpful, either, since they've got the same restriction you do. Our jails are the mental hospital of last resort and no one gets treatment in them.

Those aren't cracks the mentally ill are falling through, they're chasms.

It's only for those who might harm selves or someone else.
I have been involved with system for a number of years.

The most serious problem with someone who is off meds AND acting a bit out of control, is when the police are called. That has an often fatal result.

the cops here are pretty well trained for that stuff, and very patient.
left w a script they wont take, and referrals they wont call.

See if you can get the person to call. Their therapist may be able to encourage them to take their meds or suggest alternative medication. There are so many different ones and they all have different side effects. Sadly, there really isn't a lot you can do.

Psych meds are primitive in relation to other therapies for medical conditions. In addressing anti-psychotics and mood stabilizers, the impact of the drug is to address the "positive" symptoms (the psychosis and mania that are obvious and disturbing to others), but have little or no impact on the "negative" symptoms (cognitive impairment, lack of motivation, poverty of thought). The relief granted by the meds often leaves the person desperate for help with those symptoms that are not even touched by psychotropics.

Complicating the problem is a serious symptom called anasognosia. This is a physical brain deficit that blinds a person to their own illness. They are not in denial. They are unable to recognize their own peril, or the impact that the disease has on others. Functional MRIs of non-compliant schizophrenic patients compared to Alzheimer's patients with lack of situational awareness show similar features as certain regions of the brain don't "light up".

You may need to assess what YOU are willing to tolerate. Your loved-one can not get better if your life becomes subsumed in their chaos and drama. It is critical to your loved-one that YOU be honest with them. DO NOT BECOME AN ENABLER! Set boundaries and stick to them. Explain to your loved-one that their refusal to stay on meds is creating consequences. Ask them how they plan on maintaining relationships or take care of their needs if they are constantly in chaos. Be direct and honest with them about your willingness to be part of their drama. If you are not getting some professional help, I strongly urge you to consider it.

I speak from experience with an adult son who was non-compliant for five years. Those years were hell. Addiction, arrests, jail, restraining orders...... After we finally stopped our co-dependent relationship, he was forced to make a choice for recovery. He has been sober, in counseling, and now has started working at a part-time.

Resources:

National Alliance for Mental Illness. (NAMI) Find your local chapter and take the 12 week "Family to Family" course. It is free, and you will learn much from others walking in your shoes. Most chapters also offer peer-led family support groups.

Book:
"I'm Not Sick, I Don't Need Any Help" by Torrey Fuller of the Treatment Advocacy Center. This is an organization dedicated to helping individuals (and families) seek legislation that would re-define incapacity, and allow for compelled treatment in a crisis BEFORE someone is a "threat to themselves or others"

Good luck on this difficult journey. Remember; It is NOT selfish to take care of you own needs. Your loved-one needs you to be healthy and honest in order for BOTH of you to be safe.

I know at my very worst my ability to judge my own mental state is the very first thing that flies out the window.

Physical damage or impairment, I don't know. Could be I simply walked down the wrong path at some important stage of my mental development. I've had doctors and therapists suggesting it's some kind of PTSD stuff, but I don't think so. All I can say for certain is that things got strange in my later adolescence. When I was twelve years old I knew everything, I was certain I understood the world. At nineteen I was a hot mess hurting everyone who cared for me.

My current meds seem to be working, but I don't like them. All I really know is that I end up in the hospital if I quit taking them, or their effectiveness fades. I landed in a locked psych ward just last year, danger to self, thankfully not to others... physically at least. I can say things that are incredibly hurtful to those who care about me, and in times of despair I wonder how I'm worthy of any sort of human relationship. (My crazy grandma had a similar capacity for saying mean hurtful things, but she could also be a danger to others, which is why she had to be removed from the home she owned, not because she was a danger to herself, nobody cared at that point because she'd burnt all her bridges, but because she was a physical danger to others. She was cussing up a storm and trying to bite the paramedics after they'd strapped her to the gurney.)

I've got more than forty years experience striving for some no-meds nirvana of "normal" people, but so far, no success.

for all that people might love and care for someone off the rails, to have to stand by, w the answer literally in your hand, a simple pill, and to have that person not only reject your advice, but to say and do incredibly hurtful things is just a special hell.

you have people who love the you that you want to be, feel you are, and can be. that you are not always that person is something they understand.
maybe this is something that comes w practice of going through the cycles enough times that they can find a comfortable distance from the hurtful things, and you can hang on to that trust, by memory, even when it is hard to feel it.

i look forward to the day that a shrinks job is to separate people's real emotions from the lies their brains tell them. so often the person who could be that lifeline is demonized as the cause of the illness/turmoil. of course you obsess about the most important person in your life! and none of us are perfect, so it is always possible to pick someone apart, and lay their failings on the table.
but it is the lies that are the source of the hurt, and the focus of the hurt isnt necessarily the cause of the injury. they could be your best ally, but shrinks too often reinforce those fears and hurts, and cut so many lifelines.

sigh.
you are one of the lucky ones my friend. and i have zero doubt that you deserve it.

My friend is so wise , and so correct in this instance.

Fifty-to-sixty years ago, meds, especially psychotropic drugs, were in their infancy.
Up until then, from the dawn of history, people, and their families, just suffered when they had a medical imbalance.

Now, treatment is available, perhaps not for all disorders, perhaps not permanent fixes, but what a relief it is to be rid of the suffering so relatively easily, at least compared to the days before meds were available.

when he was a teen he wanted to try life off the meds .. he ended up in the hospital both times .. He decided
Hospitals are worse then taking his meds daily .. I hope this helps

It's your personal decision, but meds have helped me. I'd be happy to tell them more.

This conspiracy BS stuff, I won't engage with.