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Question:

My brother has all of the symptoms of Paranoid Personality Disorder. We are desperately trying to get him to be evaluated/treated. He does not want to be enrolled in Philadelphia, where we live. So we were considering your health system. Any input?

Answered by: Michael Grunebaum

Good psychiatric evaluation and treatment can be obtained in both Philadelphia and New York, not to mention most other large cities in the U.S. It may be that the paranoid symptoms are causing your brother to be excessively fearful of getting help from others. An approach that can sometimes help this is to find out what his goals and priorities are for the near future, such as feeling less anxious, sleeping better, or other things. You might be able to persuade him that the fastest way to accomplish his goals would be to get treatment nearby, so that he can easily consult his doctor if questions or need for adjustment comes up during treatment. You could call this a "patient-centered" approach i.e. you are starting with a focus on trying to meet what he feels his needs are, while at the same time trying to do what you believe is the best thing for him.