09-12-2017 12:51 PM
tennisstar here, one of the SANE forum moderators. Welcome to the forum, and thank-you for sharing your experiences. I'm really sorry to hear what you and your family are going through at the moment, as well as the recent passing of your mother, it must be so tough. From what you have expressed, my understanding is that your sister has been enduring a lot of distress associated with alcohool, anxiety, depression, and OCD (particularly around sleep), has considered and attempted suicide as a solution to her concerns, and isn't very receptive to interventions that do not involve medication to overcome her issues around OCD/sleep. It also sounds like you have tried a lot of strategies to help your sister get access to the right support and services, but she is not willing to get help unless it involves medication. I'm sensing that this is really tiring for you, as you are wanting to help your sister as best as you can and have exhausted a lot of options, but she is not willing to accept any new suggestions or ideas, which I imagine is very challenging and frustrating for you. Provided that you're still in a grieving process, this must all be so painful for you. Given that this is a difficult situation, I'm wondering what your support networks are like?
In response to your question as to what a case manager does, typically this professional (such as a psychiatric nurse, psychologist, or other mental health professional) undertakes assessment, monitoring, planning, and advocacy for the person, and help connect the individual with rehabilitation/support services. It's aim is to manage the illness or concerns the person is experiencing, in addition to relapse management. From my understanding, a lot of benefits are associated with ongoing case management, as it provides continuing care for the peson and helps the individual achieve their goals of recovery. Moreover, case management is important for people who have been repeatedly hospitalised or institutionalised as a result of mental health conditions. You can look up more information on the role of case managers here.
With regards to psychotropic medication too, evidence indicates that non-medical interventions such as psychological therapy are just as/more efficacious than medical interventions towards treating mental health conditions, with longer-term positive health outcomes. Typically, psychological therapy aims to get to the core of the problem and the underlying issues, and focuses on shedding light on some helpful approaches that may be applicable to the presenting problem and are tailored to the individual's presentation. Though it sounds like your sister may be resistant and that you have tried really hard, I'm wondering if perhaps exploring this avenue in more depth with your sister may be helpful for you?
I hope you've found this helpful